Applied Nursing Model

According to Stanhope and Lancaster (2008) “Each family is an unexplained mystery, unique in the ways it meets the needs of its members and society” (p. 550). Family nursing is a special field that involves the nurse and family working together to achieve progress for the family and its members in adjusting to transitions and responding to health and illness. The Friedman Family Assessment Model serves as a guide in family nursing to identify the developmental stage of the family, environmental data, family structure, composition, and functions as well as how the family manages stress and their coping mechanisms. From this data, three nursing diagnoses with interventions are developed.

A family health assessment is a process by which a nurse evaluates and describes the health status of a given family. It is a framework that helps to identify areas of potential risk for illness, opportunities for health education and actions needed to address these (World Health Organization, 2001). Specifics covered in a nurse led family assessment will include family history, perceptions about health, reports, health records, and any clinic test results. The nurse conducts an interview, compiles data and performs an appropriate

Family health assessment is an integral part of the formula used in creating a customized plan of care for the families’ health care. Family health assessment is also a tool that can be used to identify and evaluate the family’s health concerns, their life style and also helping families make good decisions regarding their family’s health. Family’s perception towards health and health promotion could be very different and unique, which makes the Family health assessment even more challenging for the nurses and health care professionals. Nurse’s have a moral obligation towards the society to help them promote their families health. The

Whitlatch (2013) defines a family assessment as a process of gathering, systematizing and analyzing information to help the family take preventative or problem-solving measures. A family assessment presents an unbiased view of overall understanding of a family- not merely problems, but also its needs, strengths, values and goals. As these dynamic features keep changing over time, a family assessment is an ongoing exercise (Whitlatch, 2013). When an assessment is undertaken with a solution-focused approach to identify family 's strengths and potential to prevent or solve health issues, it is termed as a family strengths assessment. It helps understand health issues and the needs from the family’s perspective and plan a healthcare accordingly utilizing the family 's inherent strengths to yield a positive health outcome. (Peterson, Blackburn, Bazemore, OʼNeill, & Phillips, 2014)

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

Hypertension is sometimes referred to as the silent killer (Aycock, Kirkendoll, & Gordon, 2013). Today it is a public health problem. According to the American Heart Association 2013 Statistical Fact Sheet (2013), one out of every three adults has high blood pressure, which is estimated at 77.9 million people (AHA, 2013). High blood pressure is also referred to as hypertension. Hypertension is a prevalent medical condition that carries with it the risk factor for increased chances of heart disease and stroke (Gillespie & Hurvitz, 2013). Hypertension remains one of the top 10 causes of worldwide disability-adjusted life years (as cited in Drenjančević-Perić et al., 2011). For the estimated 348, 102 deaths in 2009, high blood pressure was listed as the primary or contributing cause of death (AHA, 2013). Despite the health risk associated with hypertension, the diagnoses of high blood pressure continue to rise. By 2030, hypertension is expected to increase by 7.2% from 2013 estimates (AHA, 2013).

Family health as a whole is an integral part of the development of healthy individuals. In order for the family to produce healthy individuals they need to function well holistically in all aspects of family life including health and wellness. If even one individual in the family is experiencing health issues which are not being addressed it can have a detrimental effect on the whole family. Therefore, it’s imperative that when performing an assessment on a family the nurse has as complete and thorough

R.O. is a 43-year-old female Latino patient who has been living at home alone since she got divorced three months ago. She does not have any living or available family in the United States. She is the oldest of three children. Her parents died of an accident when she was little. Two of her sisters live in Mexico. She has lost contact with her family in Mexico when she got married and move to the United States. She also has stopped communicating with her ex husband since they got divorced. Although she does not have any support from her family, she states that her church member has been very supportive. Moreover, R.O. states she was a homemaker until the divorce. Currently, she has been working as a dishwasher near her house.

A nursing assessment of a family is the basis of nursing interventions. Stanhope and Lancaster (2008) state, “By using a systematic process, family problem areas are identified and family strengths are emphasized as the building blocks for interventions and to facilitate family resiliency (p. 567). The following paragraphs will describe a typical family. The family consists of a mother, a father, a 10 year old daughter, and a six year old son. The family chosen was interviewed individually and as a family.

One nursing theory that has influenced my values and goals as a nurse is Jean Watsons Theory of human caring: Transpersonal Caring as the Fulcrum. Watson believed every person needs an interconnection with others and caring promotes this need. Through caring, a nurse can help the patient have balance and harmony of mind, body, and soul (Cherry & Jacob, 2014).

In the given scenario, I am a family nurse practitioner in a busy emergency room. Early in the evening hours, I am presented with a concerned mother who is seeking medical attention for Paige, her six-year-old daughter. The mother reports the patient has been displaying cold symptoms for a few days with a cough that continues to worsen. The issue that the patient faces is limited access to healthcare providers in the area who accept Medicaid, which is Paige’s health insurance provider. After discovering Paige’s physician’s office does not have any appointments available for three days, the concerned mother decides to seek care for her daughter at the emergency department. Considering the patient’s condition is considered non-urgent, and our

Kaakinen et a. (2015) states every family has a story about how the potential or actual health event influences its individual members, family functioning, and management of the health event. Nurses are charged with gathering, sifting, organizing, and analyzing the data to craft a clear view of the family’s story. Family assessment begins from the first moment that the family is referred to the nurse. It is important for nurses to filter data gathered in the story through different views or approaches, which affects how we think about the family as a whole and each individual family member.

My family health assessment was conducted using the 11 Gordon functional health pattern. Marjorie Gordon’s functional health pattern is a guide for establishing a comprehensive nursing date base, using the 11 categories enable nurses determines the following aspects of health and human function (Gordon 1987). The Gordon 11 functional health patterns are health perception/health management, nutrition, elimination, activity/exercise, cognitive, sleep/rest, self perception/self concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, values and belief. This paper will summarize the findings of each health pattern as well as the family based nursing

A family health assessment is a significant instrument in conveying a health care plan for a family. This paper will discuss the nurse’s role in family assessment and how this task is performed. By the use of family focused open ended questions, 11 functional health patterns were covered. The health patterns were values and health perception, nutrition, sleep and rest, elimination, activities and exercise, cognitive, sensory-perception, self-perception, role relationship, sexuality, and coping. This principle is known as the Gordon’s functional health patterns. Family health assessment defines the assessment of actual and potential problems of individuals (Gordon, 1994). This assessment tool included 11 systematic principles for data collection of the family, and assists the nurses to develop a nursing diagnosis and appropriate interventions. Using Gordon’s functional health patterns, this paper will summarize the findings of each health pattern as well as the family based nursing diagnosis of each assessment. This paper will also discuss different health promotion strategies along with web-based resources, also including a system based theory guide in family assessment.

The two major types of hypertension are primary and secondary. Primary hypertension accounts for more than 90% of all cases and has no known cause, although it is hypothesized that genetic factors, hormonal changes, and the altercations in sympathetic tone all may play a role in its development. Secondary hypertension develops as a consequence of an underlying disease or condition. The prevention and treatment of hypertension is a major public health issue. When blood pressure is controlled, cardiovascular, renal disease, and stroke may be prevented. The JCN, reported more than 122 million individuals in American are overweight or obese, consume large amounts of dietary sodium and alcohol, and do not eat adequate amounts of fruits and vegetables; less than 20% exercise regularly. Both modifiable and non-modifiable factors play a role in the development of hypertension