Family Assessment Assignment Essay

A family nursing assessment was done on the Lois G. family during collar nursing visits over a period of one month. The family costs at 1234 primary(prenominal) St. and their home phone number is 314-987-6543. This is a scurvyer- middle course of instruction (Friedman, Bowden & Jones E.G., 2003), African American, Baptist, single-p arnt, c arr, part family that is barbarian-oriented and non geographic in solelyy mobile. Lois is 45 and has 3 children, Carmen, a 16 year old girl, Emille and Camille, twin 9 year old girls. The pay back is the sole custodial parent of the oldest child. Carmen has minimal contact with her paternity, Wayne, whom her convey divorced when she was 2 years old. The fit father, Sherman, has vocalize custody and covers full parental responsibilities for their accusation. Lois does not require a kindred with either Wayne or Sherman. The t everyy live with their father 3 to 4 days a calendar week and then spend equal time with their scram. The family is in Duvalls fifth life cycle stage. The potential task and transitions for this family are changes in roles and condition career changes loss of parent in family of origin and changes in physiological health (Friedman, et al., 2003). In addition to these developmental tasks, the family is menstruati simply facing the tasks of balance freedom with responsibility and problems with parent-teenager communication. The family nursing diagnosis for this family is Parental Role dispute and Deficient Health Care K forthwithledge which is think to the familys sure health care c one timerns.Lois has a masters in training and mathematic. She is a high schooldays math t individuallyer and values breeding and good grades. Carmen is social, active, solely quite. Carmen does assisted with the care and supervision of the twins, exactly now is involved in more(prenominal) school and social activities that take up most of her free time. She has a mild interest in establishin g a relationship with her father and states he is attending sports activities and making same efforts to be a part of her life. She is an A student and participates in high school sports and church activities.Camille and Emille are both real outgoing and enjoy being somewhat their older sis and being the center of attention. Camille and Emille exchangeable livelihood with both of their parents, but say it would be nice if they could right stop at one home and still hold both parents in that location. Emille does really well in school, and although Camille is wagering at grade level, she has been struggling in some subjects. The family is genuinely active in their church and attends services all Sunday and bible study on Wednesdays with her sister and her family. In Lois family of origin, in that location are five children and she is the middle child. She has an older sister, an older brother and devil younger brothers.Her grandparents on both side of her family are from Mississippi, but later moved to St. Louis to piece their families in better living and accomplishmenting conditions. Her parents are from St. Louis. Lois mother, Catherine, died of colon cancer when Lois was 28. Lois father, JC, is in the late stages of Alzheimers disease but is up to(p) to stay in his home because his second wife, Ms. Verdell, provides him 24 minute of arc care. This illness has been very difficult for the family but they get a plenteousness of faith in God and this has assisted them in dealing with his deadening decline. Lois states she is very thankful that her father has the support of his wife, because she doesnt feel she and her sister would be able to provide him the type of care he receives from her. Lois states she has a very good relationship with all of her immediate and extended family members. She is very close to her sister and sees her and her sisters family at least on a every week basis, if not more often.Her three brothers, who are un married, live out of t receiveship but come to St. Louis to visit frequently. She is excessively close to her extended family on both her mother and fathers side of the family and will travel to Mississippi some(prenominal) generation a year to visit them. Lois states that she is not aware of any health issue with her siblings although she thinks her oldest brother may have high fall pres certainly. She had aunts on both sides to die from cancer (unknown type) and two uncles to die from core disease. The nuclear family has no special needs, is not experiencing any major illnesses, nor is in that observe an immediate family member with disabilities. Lois is experiencing a lot of stress contemplating a hysterectomy this pass due to uterine fibroids and menorrhagia. Carmen has been experiencing irregular menses, but now is on stock control pills (BCP) to regulate her cycle. She however, doesnt want to take the BCPs. Thetwins have mild to moderate eczema, which is being treate d with a prescription local steroid, but this is inconsistent because when the twins are with their father he doesnt always gain the daily ointment as ordered. in that location is no history of surgeries, chronic or prolonged illnesses, asthma or allergies in the family. Lois states she needs more information on interference options for her fibroids treatment options for Carmens irregular menses and a better way to make sure the twins are using their medication for their eczema when theyre at their fathers home.Lois has lived in the St. Louis playing area all of her life and now she and her family live in Hazelwood MO, a middle-class, culturally diverse suburban area in St. Louis County, MO. Her home is considerably assessable to highways, schools, hospitals, shopping and entertainment. She is able to easily get to her sisters and fathers homes and to church. She doesnt have a lot of interaction with her neighbors her confederacy is centered more on where her family and churc h are located and not necessarily on where she lives. Lois lives in a nicely decorated, well maintained, three sleeping room ranch home, with a fenced yard on a low traffic street. Lois and Carmen have their own jockeyrooms and the twins share a bedroom with twin beds. She has a finished basement that the children utilize for their inexpert activities. There are several TVs and computers in the home and for to each one one person has access to these for both leisure and school work. The family room is tho off the kitchen and this is the center of family interaction. The familys communication is didactic and normally occurs around the kitchen table at meal times.The twins review their day at school and Carmen relates what her upcoming activities are. Lois reviews their show up in school, or addresses issues specific to each child. She does have one-on-one with each child, although not every day, it is several times a week. Lois states communication with Carmen has become more difficulty over the hold out 6 months. Lois and Carmen have always been very close, but as the twins have required more of Lois attention and Carmen has gained more independence, she feels this is changing. Although Lois states that she has always been able to talk with Carmen, she now feels on that point are more dis cartels and some lose of communication. Lois feels Carmen doesnt show her the expected amount of respect when she is told to do something or reminded to do chores and her tone is not acceptable to Lois. Carmen talks freely with her motherto negotiate her wants and needs or to express her feelings, but gets angry when she feels her mother is unreasonable in her expectations. She states she wishes her mother would listen more and not raise her voice and then get angry at her when she does the same. Lois states there are areas that she makes the sole decision, like home rules and behavior expectations some areas that are negotiable, like social activities and the use of BCPs for irregular menses and then there are areas that Carmen makes her own decisions, like clothes and hair styles.I explained to Lois this is a normal pattern for adolescent development and that some research has shown that when the child is young they are more likely to have value agreement with the parent, but it seems relatively uncharacteristic of families with middle and late adolescents (Edgar-Smith, 2010). Currently Carmen does not want to take BCPs because she said it makes her feel funny. She isnt able to give a broader description of the feeling and hasnt diffused any specific physical complaint or symptom, but just states she wants to stop taking the BCPs. Lois and Carmen had a discussion around this issue and concord that Carmen would take the BCPs for 6 months and then follow up with her desexualise to see if continuing or stopping the BPCs would be the surmount option for her. Lois is able to communicate openly with both Camille and Emille and they are antip honal to the rules and expectations that Lois has laid out for the household and individually. Carmen will talk to the twins, but its usually to give correction or instruction, not to inquire. Lois states the twins share their own style of communication which is verbal and non-verbal when interacting with each other.With others, Camille will usually start the communication and then Emille will join in. Lois prepares all the meals and is very aware of the importance of a balanced meal plan. She makes breakfast and lunches for everyone in the morning and then cooks dinner every night. She usually cooks the meals while the girls are doing homework, watching TV or playing games. She said she needs more help at meal times. I asked her if she could assign task for each child to do so everyone would have a part in meal preparation and she said she would start a routine that involves all the children in this. Carmen is capable of independent meal preparation (but does not arise this), so s he will be the one to set up the intellectual nourishment preparation and organize items for the twins. Lois will give specific instructions on what she wants everyone to do, so she wont havethe entire responsibility of meal preparation for every meal every day. Lois, as the mother and only parent in the home, is the sole power source for decision making in the family and has reward and coercive power over the children, although she will bring with the twins father due to the legal agreement of joint custody. Carmen, as the oldest child, has inferred power over the twins. The twins, as the two youngest children, are on an equal power base. When asked about the closeness in the family structure, Lois feels she is adpressed to Carmen and Camille.Carmen is closest to her mother and Camille. Emille is closest to Camille and her father. Camille is closest to her mother and Emille. Lois doesnt feel there is a lack of bonding with any of the children. The family exhibits the traditional middle class African-American values of strong family bonds support from kin and friendships flexibility in family roles and strong religious commitment and participation. She has the middle class values of honesty, catchy work, progress, achievement and respectability (Friedman, et al., 2003). Individualism and equality are valued, but she stresses respect for God, family and elders good grades and academic achievement above all else. Health care for the children is important to her. She utilizes her health care insurance to makes sure they have all the infallible physicals, immunizations, eye and dental care recommended by their pediatrician. She has delayed her own routine health and dental care and screenings to meet work or family commitments. I explained to Lois that in a recent study a questionnaire was addicted at both men and women to evaluate family burdens domestic responsibilities the appraisal of work and family and values involved in work-family balance.The results of this study show that, in the turn over economic and cultural context, assuming family burdens and domestic responsibilities increases the positive appraisal of work and family (Cantera, Cubells, Martinez & Blanch, 2009). Lois sees her family as very healthy since there are no illnesses or major health crises but also sees how delaying her health care could straight affect the health status of the family. The children are active in sports, but Lois feels she has been neglecting herself by not getting the exercise she has been used to even though her weight remains consistent and within normal limits. The familys forage consists of all food groups and is appropriate for each childs addition needs. All the children are within their normal body mean index (BMI). Mealtimes are structured and usually occur at home, although she will have one or two nights a month afterwards church where the family eats out. I educated Lois regarding several studies that have investigated the eff ects of diet on the growth of fibroids. According to the subject area establish of Health (NIH), recent findings from a study of more than 22,000 African American women showed that women who consumed milk, cheese, ice cream, or other dairy products at least once a day were less(prenominal) likely to develop fibroids than were women who consumed dairy less frequently (National Institute of Health, 2013).Lois states one thing she makes sure she does is get plentiful rest she sleeps about 7 hours each night. If she feels she needs more rest, she goes to bed earlier. She doesnt drink alcohol, smoke tobacco, use illicit or recreational drugs, nor do any of the children engage in any of these practices. The main stressor the family is experiencing is the parent-adolescent relationship which Lois is aware is a normal developmental task that the family will progress through. Another area of stress Lois expressed is lack of knowledge related to treatments for uterine fibroids. She was giv en educational material from the NIH website factsheet on uterine fibroids and current studies and treatment options. Also Lois wanted information on current treatment options for teenagers with irregular menses.Lois was given information from the PebMed website on a study to root the effectiveness and acceptability of progestogens alone or in combination with oestrogens in the regulation of irregular menstrual bleeding. The study results state there is no consensus about which regimens are most effective and further research is needed (Hickey, M., Higham J.M., Fraser I. 2012). I encouraged her to follow up with Carmens doctor after the 6 month course of BCPs and then discuss her options. Lois was also given information on treatment options for eczema (Weston, 2011). I encouraged her to have the twins father apply the medication to them daily and if he wasnt able to adhere to the treatment schedule, she could have the twins apply their own ointment. The family handles stressors wel l overall family adaptation is appropriate and the family is meeting all the expected developmental task of this stage. See attachment for genogram.ReferencesCantera, L., Cubells, M., Martnez, L., & Blanch, J. (2009). Work,family, and gender Elements for a theory of work-family balance. The Spanish Journal Of Psychology, 12(2), 641-647. Edgar-Smith, S. E. (2010). Family relational values in the parent-adolescent relationship. Counseling & Values, 54(2), 187-200 Friedman, M. M., Bowden, V.R., & Jones, E. G. (2003). Family nursing Research, theory, and practice. (5th ed.). Upper Saddle River, NJ Prentice Hall. Hickey, M., Higham J.M., Fraser I. (2012). Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. nary(prenominal) CD001895. DOI 10.1002/14651858.CD001895.pub3. National Institute of Health. U.S. Department of Health and Human Services, National Institutes of Health. (2013). Uterine fibroids. Retrieved from United States Government website http//report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=50&key=UWeston, W.L., (2011). Epidemiology, clinical manifestations, and diagnosis of atopic dermatitis (eczema). http//www.uptodate.com/home/index.html.