Define the three important attributes that characterize contemporary families.
a. Family durability
b. Family resiliency
c. Family diversity
a.
... [Show More] Family durability
Durability is a system of support and structure that extends beyond the walls of the household.
b. Family resiliency
Resiliency is the ability of the family to cope with expected and unexpected stressors.
c. Family diversity
Diversity is the uniqueness of each family unit; each person has specific needs, strengths, and important developmental considerations.
A family is defined as:
a set of relationships that a patient identifies as family or a network of individuals who influence one another/s lives, whether there are actual biological or legal ties.
Nuclear family:
A nuclear family consists of two adults (and perhaps one or more children).
Extended family:
An extended family includes relatives in addition to the nuclear family.
Single-parent family:
In a single-parent family, one parent leaves the nuclear family because of death, divorce, or desertion, or a single person decides to have or adopt a child.
Blended family:
In a blended family, parents bring unrelated children from prior or foster-parenting relationships into a new, joint living situation.
Alternative family:
Alternative families include multi-adult households, grand families, and communal groups with children, nonfamilies, and cohabitating partners.
Family caregivers:
Increase in people living with chronic illnesses and the older adult population have created a greater need for family caregiving. Older adult caregivers have special needs—risk factors for poor health and emotional distress.
Poverty:
female single-parent families and families with unrelated individuals are especially vulnerable
Homelessness:
severely affects the functioning, health, and well-being of the family and its members. Children of homeless families are often in fair or poor health and have higher rates of asthma, ear infections, stomach problems, and mental illness.
Domestic violence:
Emotional, physical, and sexual abuse occurs toward spouses, children, and older adults across all social classes. Factors are complex and may include stress, poverty, social isolation, psychopathology, and learned family behavior.
Structure:
each family has a unique structure and way of functioning; each of the relationships has different demands, roles and expectations
Function:
what family does, such as how a family interacts to socialize younger family members, cooperates to meet economic needs, and relates to the larger society.
Structure may enhance or detract from the family's ability to respond to stressors
a. Rigid structure:
b. Open or flexible structure:
Rigid structure:
An open or extremely flexible structure and consistent patterns of behavior that lead to automatic action do not exist, and enactment of roles is overly flexible.
Open or flexible structure:
An open or extremely flexible structure and consistent patterns of behavior that lead to automatic action do not exist, and enactment of roles is overly flexible.
Identify the three levels and focuses proposed for family nursing practice.
Family as context
Family as patient
Family as system
Family as context
As context—the primary focus is on the health and development of an individual member existing within a specific environment.
Family as patient
As patient—family needs, processes and relationships are the primary focus of nursing care.
Family as system
As system—you care for each family member (context), family unit (patient) using all resources available
Hardiness:
the internal strengths and durability of the family unit.
Resiliency:
the family's ability to return to a previous, healthy level of functioning after a disruptive or stressful event has occurred
a. Genetics:
may or may not result in actual development of a disease. Sometimes identification of genetic factors and counseling help family members decide whether to test for the presence of a disease and/or to have children.
Chronic illness and/or trauma:
influences an entire family economically, emotionally, socially, and functionally. It also affects a family's decision-making and coping resources.
End-of-life care:
the families need for information, support, assurance, and presence is great. Each family approaches and copes with end-of-life decisions differently.
Three factors underlie the family approach to the nursing process. Name them.
a. assess all individuals within their family context
b. assess the family as patient
c. assess the family as a system
Identify and define the areas to include in a family assessment.
a. family structure—determines members of the family, relationship among family members, and the context of the family
b. developmental assessment—determines how the families adapt during predictable and unpredictable changes and difficult times
c. family functioning—addresses how individuals behave in relation to one another; includes instrumental aspects that are routine activities
A comprehensive, culturally sensitive family assessment is critical in order to:
a. Understand the family life
b. Understand the current changes within it
c. Understand the family's overall goals
d. Understand the family's expectations
Give some examples of nursing diagnoses applicable to family care:
a. Conflicting caregiver attitude
b. Impaired family coping
c. Risk for caregiver stress
d. Impaired family process
e. Risk for parent child attachment
f. Family able to participate in care planning
e. Family knowledge of disease
When planning family-centered care, the goals and outcomes are:
need to be concrete and realistic, compatible with the family members developmental stages and acceptable to family members and their lifestyle.
Health promotion:
Interventions to improve or maintain the physical, social, emotional, and spiritual well-being of the family unit and its members
Acute care:
be aware of the implications of early discharge for patients and their families
Discharge planning:
be sure the family caregiver is prepared for discharge and knows where to obtain necessary supplies.
Communication:
help the family members to maintain open lines of communication with you and the interprofessional health care team to anticipate your patient's and family member's needs
Restorative and continuing care:
to maintain patients' functional abilities within the context of the family
A married couple has three children. The youngest child has graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. What developmental tasks does the nurse expect this family to experience at this point in time? (Select all that apply.)
1. Take on parenting roles
2. Making room for the wisdom of older adults
3. Refocusing on marital issues
4. Determining new focus on recreational activities
5. Developing intimate relations with others
Answer: 3, 4
Family structure can best be described as:
1. A complex set of relationships
2. A basic pattern of predictable stages
3. The pattern of relationships and ongoing membership
4. Flexible patterns that contribute to adequate functioning
Answer: 3.
Rationale: Ongoing membership of the family and the pattern of relationships, which are often numerous and complex
When planning care for a patient and using the concept of family as patient, the nurse:
1. Includes only the patient and his or her significant other
2. Considers the developmental stage of the patient and not the family
3. Understands that the patient's family will always be a help to the patient's health goals
4. Realizes that cultural background is an important variable when assessing the family
Answer: 4.
Rationale: Is critical in forming an understanding of family life, current changes in family life, overall goals and expectations, and planning family-centered care
Interventions used by the nurse when providing care to a rigidly structured family include:
1. Attempting to change the family structure
2. Providing solutions for problems as they arise
3. Exploring with the family the benefits of moving toward more flexible modes of action
4. Administering nursing care in a manner that provides minimal opportunity for change
Answer: 3.
Rationale: Very rigid structures impair functioning. [Show Less]