Case Study – Health Risk Determination

Case Study – Health Risk Determination

Should Glenna consider herself disabled or at risk? Why? And should the nurse consider Glenna’s family at risk? Why?

Glenna should consider herself disabled and at risk. Firstly, Glenna uses a wheelchair after losing leg mobility at a younger age. This means that she may be incapable of carrying out all the necessary activities to care for her three children. Secondly, Glenna is at risk due to the abusive nature of her partner (CDC, 2020). When the nurse walked in, she found her crying while holding her cheek. The man ran out, holding a t-shirt, suggesting marital violence. According to the Centers for Disease Control and Prevention (CDC), a conflict between romantic partners is a relationship factor that suggests risk (CDC, 2020). The nurse should consider Glenna’s family at risk due to the children’s exposure to violence among intimate partners. In addition, Glenna is a smoker, which could be a sign of stress in specific circumstances. Furthermore, Glenna seems to lack comprehension of Jonathan’s special needs and rejects the nurse’s desire to review his development. The individual and family risk factors qualify the family for special attention.

What history questions will reveal predisposing, social or enabling risk factors?

The following history questions will reveal predisposing, social, or enabling risk factors:

1. Are all three children from the same father?
2. How long has Glenna been widowed?
3. How did the children relate to their late father?
4. What kind of relationship does Glenna have with her children?
5. What changes has Glenna noticed in the children following the death of their father?
6. What level of education has Glenna achieved?
7. How do the children relate to Glenna’s current partner?
8. Has Glenna experienced/witnessed any form of violence in the past? If so, who was the aggressor?
9. What are Glenna’s support systems?
10. Do the children play with the neighbors’ children?
11. Has Glenna been treated for depression or any mental issues in the past?

What risk clusters can be identified?

Two main clusters of risk present in Glenna’s family include victimization and perpetration (CDC, 2020). Jonathan, who is 18 months old, is predisposed to age and special needs risk factors, making him vulnerable. Individual risks such as Glenna’s inability to understand Jonathan’s needs increase the chances of perpetuation. Family stress resulting from marital violence and possible depression increases the family’s risk as well. The two risk clusters signify a need for special attention toward Glenna and her family.

What community health nursing techniques could empower Glenna and her family?

First, it is important to build trust or alliance to encourage full participation from the patient (Rimondini, Busch, Mazzi, & Donisi, 2019). In this case, Glenna already distrusts the health workers and believes they are unable or unwilling to assist. It is important to prove to her that the health workers will actually help Jonathan. Second, providing the necessary information is critical in enabling Glenna to understand Jonathan’s needs. Third, promoting familial collaboration is important to address any underlying issues that Glenna may not notice in the other two children and probably her partner. These three nursing techniques should improve the situation as Glenna opens up and allows Jonathan to receive assistance.

How can the nurse avoid insulting the mother?

The nurse should adopt the DESC script communication strategy. This approach enables the health worker to provide information objectively without being judgmental (Grissinger, 2017). It is important to highlight the negative and positive impacts of each aspect of the treatment plan. The nurse should also be empathetic towards Glenna to avoid uttering words that may be hurtful. The nurse’s character will play a big role in maintaining respect towards Glenna and her family.

References

CDC. (2020). Risk and Protective Factors for Perpetration. Retrieved from Violence Prevention: https://www.cdc.gov/violenceprevention/intimatepartnerviolence/riskprotectivefactors.html

CDC. (2020). Violence Prevention. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/violenceprevention/childabuseandneglect/riskprotectivefactors.html

Grissinger, M. (2017). Disrespectful Behavior in Health Care. Pharmacy and Therapeutics, 42(2), 74-75,77.

Rimondini, M., Busch, I. M., Mazzi, M. A., & Donisi, V. (2019). Patient empowerment in risk management: a mixed-method study to explore mental health professionals’ perspective. BMC Health Services Research, 19(382).

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Health Risk Determination

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 has managed 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 passed 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.

Health Risk Determination

“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 risk clusters can be identified?
4. What community health nursing techniques could empower Glenna and her family?
5. How can the nurse avoid insulting the mother?

Use 2 peer-reviewed articles, not Wiki, or Google. Use Google Scholar or credited sources