Nursing Family Assessment

Introduction to the family

The K family consists of the husband EK a 43-year-old gym owner, the wife VK a 36-year-old banker, and their teenage daughter TK aged 13 years. VK is the stepmother to TK who is from a previous EK relationship. TK’s biological mother died a few years ago from a fatal car accident. Currently, the family lives in a suburb East of Miami where EK also owns a gym facility. VK works in a bank that is located five miles from the family’s residence and she commutes every morning. In addition, VK is currently pregnant and she is in her second trimester. This paper is a health assessment of VK’s family and it will be accompanied by a nursing diagnosis.

Family assessment

Both VK and EK are Caucasian with German, Russian, and Danish heritages while their daughter is Asian-American. EK is an ex-army officer who served in both Afghanistan and Iraq before retiring to open up a gym. His wife works as a credit officer in a local bank and the couple shares financial responsibilities. Their daughter joined high school recently, and she is becoming a distinguished scholar. The couple has collectively had TK for only seven years after her mother died and EK became her primary guardian. EK and VK have been in a relationship for approximately nine years although they have been married for six.

The couples’ family affairs are very much in order and there are rarely any disagreements in this family. The couple can sort out their problems and obtain viable solutions for any possible scenario. Once VK delivers the baby, she is planning to take three-month maternity leave while EK is planning on minimizing his working hours so that he can assist with the baby-duties. The couple has already made all the necessary provisional arrangements concerning the baby’s arrival especially the financial ones. The couple also plans to enlist the services of a home daycare once VK’s maternity leave elapses.

Although the couple has made all the necessary plans, they are still anxious because none of them has had firsthand experience as a new parent. EK’s daughter was born when he was on an eight-month tour of service. The couple’s daughter is quite active and she dutifully accomplishes various tasks around the house each day after school. She is also excited at the prospect of having a sibling and she hopes the new baby will be a boy.

The family is quite comfortable in their current living arrangements because their house is fully paid for. In addition, the family has a good positive image of themselves and they are comfortable with their current sense of worth. Both parents are satisfied with their career prospects and they both earn enough money to put them in the middle class. The baby comes as surprise to the two because they have been trying for the last 5 years. Furthermore, they have sought in-vitro fertilization before without any success. Their house is located in a serene middle-class neighborhood. In addition, the house’s interior is spacious and it is tastefully decorated.

VK has always struggled with the fact that she might get old without having a biological child. Nevertheless, VK has always treated TK as her child and the two have formed a strong bond between them. On the other hand, EK is anxious about being a trainer when he is past 50 years of age. At 43, EK is a motivation to most of the middle-aged clients who frequent his establishment. EK’s main goal in life has always been to make positive changes in society and he believes his business is currently doing so. VK’s impending motherhood will most likely relieve significant stress that has been piling up in the family for the last few years.

The fact that TK is progressing deeper into adolescence is also a source of concern for the family (Rosenthal, Gurney, & Moore, 2013). Lately, VK has been concerned with the fact that TK is starting to experiment with a questionable fashion sense.

Developmentally, VK’s family is at two different stages. First, the family is at the ‘stage of adolescent children’. On another front, EK and VK are at the infant-introduction stage of development. The family developmental theory that has been put forward by Erickson would also indicate that the infant introduction stage is subject to issues of ‘trust versus mistrust’. During this stage of development, most family members express a need for “maximum comfort with minimal uncertainty to trust himself/herself, others, and the environment” (Combrinck‐Graham, 2015). TK is currently participating in full-time schooling while she confronts the adolescent stage of development.

In this stage, TK is expected to confront matters of her own identity and also face inescapable confusion. Family development theorists indicate that during the adolescent stage “the individual tries integrating many roles (child, sibling, student, athlete, and worker) into a self-image under role model and peer pressure” (Combrinck‐Graham, 2015). When the baby is born, the couple will enter into the ‘young adult stage’ of development. In this stage, both EK and VK will experience ‘intimacy versus isolation’. For example, VK will be the mother of an infant and she will have to learn to center her decisions around her new role as a mother whilst respecting her previous roles as a stepmother and wife (Dinkmeyer, 2011).

The couple reckons that they were not immediately ready for their role as new parents as the pregnancy was neither planned nor expected. VK became pregnant even after she had abandoned in-vitro treatments. All family members have gone through all the necessary immunizations. Nevertheless, the couple has not gone through the medical and educational aspects of this pregnancy together. Their busy and conflicting schedules have also meant that the couple has not gone through any practical prenatal training. VK has been filling this gap by listening to various audiobooks on childbirth during her commute. VK has also been relying on the experiences of both her mother and her sister when it comes to best practices during pregnancy (Rosenthal, Gurney, & Moore, 2013).

The family is very health-conscious, and they all believe in a good diet and exercise. Furthermore, their income levels allow them to achieve their goal of a healthy lifestyle. The family’s collective-activities include going shopping and visiting the local park. Furthermore, the family is also very future-oriented and they all have above-average health insurance coverage. Currently, the only active stressor in the family is the impending arrival of the new baby. Every family member is ready to adapt when the newborn comes. The family believes in a Central Deity but they do not go to church. The family’s overall belief is in hard work and family virtues. The family has engaged in a statewide disaster preparedness program and they have made all the necessary adjustments.

Nursing Diagnosis

The first thing about this family that makes it relevant to community health nursing is the fact that it fits into the ‘family systems theory’. According to the family systems theory, “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” (Loudermilk & Perry, 2007). Even though only VK will be giving birth, all family members are preparing for the event as well.

This is a great indicator of a functional family. Consequently, the developments that are accompanied by the arrival of the new baby will not create a shock in the family. For instance, once the baby starts attending daycare, this will have a definite effect on family finances. However, because the family is working as a unit the family will not experience any significant financial shocks.

The other important observation about this family concerns their choice of nutrition and exercises (Carpenito, 2010). From this assessment, it is clear that even before the pregnancy the whole family was already health-conscious. Furthermore, VK has already begun to consult on the appropriate diet choices from books and her other relatives. All these trends signify that the family is working from a point of information.

Although the family believes in regular exercise routines, they do not engage in this activity as a family. The father owns a gym where all family members can access the facilities at their convenience. However, only TK and EK can find the time and will to engage in regular physical exercises. VK leaves for work quite early to avoid rush-hour traffic and by the time she comes home, her schedule is too tight to accommodate physical exercises. This trend leaves the mother vulnerable to health risks.

The other relevant diagnosis in respect to this family assessment is that VK might end up running into some inconveniences during delivery. This diagnosis is informed by the fact that although VK has relevant-knowledge concerning delivery and labor, she lacks any practical experience. The knowledge from books and other experienced people cannot match the preparedness that is derived from childbirth classes. Overall, ignoring this aspect of preparedness could lead VK to have less than the recommended knowledge-levels during childbirth.

Short Plan of Care/Interventions

First, the nurse should continue to monitor and verify the nutritional portions that are consumed by the family. Furthermore, the nurse should insist on obtaining the current levels of Body Mass Index (BMI) for all the family members. The nurse should also provide the family with resources that can enhance their cohesion as they await the arrival of another family member (Schwebel & Fine, 2002). These resources might include public-health literature or referrals.

The nurse can also provide therapeutic intervention by training VK and/or her husband on how she can use pillows and other tools to improve comfort during her third trimester (Lowdermilk & Perry, 2007). At this point, the nurse should also offer educational intervention by educating VK on how to go about the labor and delivery process. This educational process can be accomplished using instructional videos and pamphlets.

References

Carpenito, L. (2010) Nursing diagnosis: Application to clinical practice. Philadelphia, PA: Lippincott, Williams & Wilkins.

Combrinck‐Graham, E. (2015). A developmental model for family systems. Family Process, 24(2), 139-150.

Dinkmeyer, D. (2011). Adlerian family therapy. American Journal of Family Therapy9(1), 45-52.

Lowdermilk, D., & Perry, E. (2007). Maternity and women’s health care. Philadelphia: Mosby.

Rosenthal, A., Gurney, M., & Moore, M. (2013). From trust on intimacy: A new inventory for examining Erikson’s stages of psychosocial development. Journal of Youth and Adolescence, 10(6), 525-537.

Schwebel, I., & Fine, A. (2002). Cognitive-behavioral family therapy. Journal of Family Psychotherapy, 3(1), 73-91.