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Child and Family Nursing Practice

Table of Contents

Introduction.

Description of Challenges of Cooper’s Family.

Renee may lack understanding regarding asthma condition.

Planning Nursing Care.

Implementing Nursing Care.

Evaluating Nursing Care.

The Issue regarding Medication and Administration.

Planning Nursing Care.

Implementing Nursing Care.

Evaluating Nursing Care.

Conclusion.

References.

Introduction to Child and Family Nursing Practice 

Patient- and family-centered care is a nursing approach to providing healthcare that benefits patients, families, and healthcare providers. PFCC is one of the best nursing approaches with the potential to address inequalities in accessing and getting quality healthcare services for people with asthma. It accommodates and responds to the patient's needs and their families. Asthma is a complicated disease, and its management is further complicated by its heterogeneity and difficulty in achieving optimal control. This paper discusses the challenges faced by asthma patients and their family members to the case study provided. It identifies the relevant nursing goal and appropriate interventions to achieve the goal. Finally, it evaluates the chosen nursing intervention's effectiveness and whether it met the planned goal of care (Al-Motlaq & Shields, 2017).

Description of Challenges of Cooper’s Family

Renee May Lack Understanding Regarding Asthma Condition

Asthma is a disease of the respiratory airways in which there is breathlessness due to obstruction to the flow of air in the lungs. It is typical for members of the patient’s family not to have an understanding of the disease affecting their patient, the stages it goes through, and how to help the patient overcome its adverse effects. For instance, Renee does not know the dangers of giving an overdose or under-dose to an asthma patient. That is why she is administering medication without a spacer. In the patient-and family care approach, nurse practitioners need to teach both patients and their families about the disease (Brown, Looman & Garwick, 2019).

Planning Nursing Care

In Cooper's case, the nursing goal should be to verbalize the understanding of causes and therapeutic management regimen for asthma. Patient and family education is vital for reducing disparities in access to quality medical care. It is also essential for making the family understand the disease's dynamics, ways of helping the patient manage symptoms, and how to cope with the resultant emotional and financial strain (Deatrick, 2017).

Implementing Nursing Care

Nursing intervention for Cooper and his family should be to assess the pharmacological therapy, give the patient his drugs according to prescriptions, monitor his response to medications, and help the family understand the disease and ways to cope with it. Grant et al. (2019), wrote that a person with asthma often feels frustrated with the illness and may get involved in fights, be stubborn, depressed, and withdrawn, which can affect their family members' peace at home. This behavior is observed in Cooper. He is loud, defiant, and ‘plays rough’ with his mother (Renee); this frustrates her. Author Foster and Shields (2020), further explains that family members may feel guilty, thinking that somehow they contributed to the illness. Such is Renee's case; she is reluctant to leave Cooper’s side, which shows she is battling with feelings of guilt. Besides, siblings may become jealous or angry due to the extra attention given to the sick child. This behavior is seen in Ella, Cooper's 3-year-old sister, who, upon visiting Cooper in the hospital, feels shy and reluctant to go to her mother but instead cuddles with her grandmother.

Furthermore, the family may suffer financial stain because treating asthma is expensive. Cooper’s family seems financially strained by his health condition. His grandparents cannot visit the hospital often because they cannot afford the cost of parking. Cooper has had three hospital admissions for the last six months, and this must have strained the family financially with paying hospital bills and buying his drugs (Grant, 2019).

The nurse should focus on helping Cooper to be optimistic about his condition and encourage his family to give the necessary social support to accomplish this. While assisting Cooper to think positively, the nurse must teach the family how dangerous asthma is, how susceptible the patient is to have an attack, and the benefits of having a positive attitude. There is a need to care for the patient's family (including parents, siblings, grandparents, and other caregivers) who may be feeling overwhelmed by their family member's condition. Moreover, a solid education plan is required for the patient's family to know how to help him achieve the best outcome. The nursing intervention must aim to increase the patient's and family's confidence in analyzing and responding to symptoms, administering medications, and shifting the environment to reduce triggers (Grant & Guerin, 2018).

Evaluating Nursing Care

Author Looman (2020), suggest the following ways by which the nurse can evaluate the effectiveness of the intervention: first is to assess how the patient responds to treatment-is he improving or getting worse, is he thinking positively, is he happy, and is he optimistic about healing? Second is to evaluate the family's response, including how much they understood about asthma, if they can identify the symptoms, if they have accepted the condition of the patient, and whether they can take care of him?

The Issue Regarding Medication and Administration

Managing of asthma is considered to be highly complicated. It is instrumental in creating a tough situation both for the patient as well as for the family. It is taking something more on the part of the caregivers and the doctors than that of prescribing the right kind of medication to guarantee the patients of asthma. It has to be meant for their wellbeing both in as well as out of the hospital. In support of the same issue Cooper according to the case review, has been re-admitted to the hospital multiple times (three) in the last six months (Looman, 2020).

Planning Nursing Care

In context to Cooper's care, the nursing goal will be to demonstrate behaviors that will help Cooper improve or maintain a clear airway and avoid frequent asthma attacks. This goal is relevant to Cooper’s case because his mother (Renee) does not understand the dangers of administering asthma medication without a spacer. She is not sure of the dosage she is giving Cooper, thus risking an over-dose or under-dose. Therefore, Cooper must be helped to improve his health and avoid unnecessary complications. Additionally, Cooper may be exposed to allergens, which may be triggering his asthma attacks, thus the need to assess his environment inside and outside the hospital (Lorenz, Sabino & Corrêa Filho, 2018).

Implementing Nursing Care

The nursing intervention should be to assess the medication that he is taking and ensuring it is administered as prescribed to prevent repeated Asthma attacks. Asthma medications are meant to avoid attacks; hence they must be taken daily and with the right dosage to prevent inflammation in airways and keep asthma under control. Therefore, the nurse must teach Renee how to administer medication in the right manner and the dangers of not adhering to the doctor's prescriptions (Rossiter et al., 2017).

Furthermore, the nurse should consider administering immunotherapy allergen shots to prevent allergy symptoms. The shots should be injected in small doses under the skin on a regular schedule. The body will then get used to the allergen and respond less when exposed. Vaccinating the patient is another important measure that the nurse should consider (Lorenz, Sabino & Corrêa Filho, 2018). Vaccination requires the patient to take flu shots annually to prevent them from contracting the flu virus, which may aggravate asthma symptoms for several days. Complications from the flu include pneumonia; hence Cooper should be given a pneumonia shot once every 5 to ten years.

Moreover, Cooper will need a Tdap vaccine to safeguard them against whooping cough, diphtheria, tetanus, and the zoster vaccine to prevent shingles. The nurse must help Cooper and his family to follow the asthma action plan. Even when the Cooper feels ok, Renee should ensure that he takes his medications while adhering to the doctor's instructions for each medicine he takes.

Finally, after ensuring Cooper is taking his medicine and adheres to the doctor’s prescription, the nurse should assess his respiratory and avoid any asthma triggers. He/she must identify asthma triggers that aggravate Cooper’s symptoms by setting his surrounding environment both in the hospital and home. Asthma triggers include allergies, air pollutants, fragrances, dust, and smoke. In this case, the nursing intervention will be to ensure that the Cooper stays away from the allergens such as smoke, dust, animal fur, and fragrances to prevent increasing inflammation of the airways that may trigger an asthma attack (Svavarsdottir et al., 2018).

Evaluating Nursing Care

To evaluate the nursing intervention's effectiveness, the nurse should determine how the patient responds to therapy and how adequate control is achieved by therapy. Randomized Controlled Trial (RCT) of interventions shall be used to determine Cooper's response to therapy. The nurse will look at the following: Cooper shows decreased symptoms, he has reduced the use of short-acting beta2-agonist (SABA), he behaves normally, has reduced exacerbations, fewer RD visits, and reduced side effects from medication (Rossiter et al., 2017).

Conclusion on 

Asthma is a complicated disease that overwhelms both the patient and their family. The stress associated with it reveals itself among family members in various ways. Through the PFCC initiative, nurses are responsible for ensuring the well-being of both the patient and the family. Moreover, the participation of the family in the care of the patient has significant benefits. However, family participation will depend on their understanding of the patient's condition. Therefore, nurses should educate the family adequately to enable them to provide the patient with the necessary psychological and emotional support.

References for Therapeutic Conversations with Children and Families

Al-Motlaq, M. A., & Shields, L. (2017). Family-Centered Care as a Western-Centric Model in Developing Countries. Holistic nursing practice31(5), 343-347. https://doi.org/10.1097/HNP.0000000000000228

Brown, C., Looman, W. S., & Garwick, A. E. (2019). School nurse perceptions of nurse–family relationships in the care of elementary students with chronic conditions. The Journal of School Nursing35(2), 96-106. https://doi.org/10.1177/1059840517741944

Deatrick, J. A. (2017). Where is “family” in the social determinants of health? Implications for family nursing practice, research, education, and policy. https://doi.org/10.1177/1074840717735287

Foster, M., & Shields, L. (2020). Bridging the child and family centered care gap: Therapeutic conversations with children and families. Comprehensive Child and Adolescent Nursing43(2), 151-158. https://doi.org/10.1080/24694193.2018.1559257

 Grant, A., Reupert, A., Maybery, D., & Goodyear, M. (2019). Predictors and enablers of mental health nurses’ family‐focused practice. International journal of mental health nursing28(1), 140-151. https://doi.org/10.1111/inm.12503

 Grant, J., & Guerin, P. B. (2018). Mixed and misunderstandings: An exploration of the meaning of racism with maternal, child, and family health nurses in South Australia. Journal of advanced nursing74(12), 2831-2839. https://doi.org/10.1111/jan.13789

Looman, W. S. (2020). Teaching Systems Thinking for Advanced Family Nursing Practice: A Theory-Based Tool. Journal of Family Nursing26(1), 5-14. https://doi.org/10.1177/1074840719891439

Lorenz, V. R., Sabino, M. O., & Corrêa Filho, H. R. (2018). Professional exhaustion, quality and intentions among family health nurses. Revista brasileira de enfermagem71, 2295-2301. http://dx.doi.org/10.1590/0034-7167-2016-0510

Rossiter, C., Schmied, V., Kemp, L., Fowler, C., Kruske, S., & Homer, C. S. (2017). Responding to families with complex needs: a national survey of child and family health nurses. Journal of advanced nursing73(2), 386-398. https://doi.org/10.1111/jan.13146

Svavarsdottir, E. K., Sigurdardottir, A. O., Konradsdottir, E., & Tryggvadottir, G. B. (2018). The impact of nursing education and job characteristics on nurse's perceptions of their family nursing practice skills. Scandinavian Journal of Caring Sciences32(4), 1297-1307. https://doi.org/10.1111/scs.12573

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