Introduction
Date of patient care ‑ Dec.12.2009. Care and all the contacts were arranged either in family apartment, or in the family nursing hospital department. Length of time spent in direct contact with family – 5 sets, 1-2 hours each (8 hours in total).
Client
J.C. Age 28. TPAL index 1-0-1-1. Abortion took place when J was 17. In accordance with medical records, development term was foue weeks.
The delivery was assisted with Ventouse (Dec.11.2009)
Procedures done and why
Ventouse was required for preparing a patient for kidney transplantation. Gravidity stimulated the aggravation of chronic kidney decease. Dialysis was held regularly starting from the 15th weak of pregnancy.
Significant problems for mother and/or newborn
Nephrologist warned the patient from pregnancy, as high blood pressure, preeclampsia, renal insufficiency development, and violations of fetus development could appear with high credibility. However, blood pressure and renal failure were the only problems.
The only family member, who was present during care is the patient’s husband. After birth, one kidney was transplanted, while the other was removed.
The Fist Impression of the Family
They are quite friendly, and their wish to have kids is overwhelming. Regardless of the decease, they both stay positive, and never lose hope. Nephrologist’s warnings were clear enough, though, they risked to try, and they are not going to surrender. Both are ready to take care for each other if there is a necessity.
Analysis
Development Stage
Mom and dad of the child are married. They live in a single room apartment at the moment with their child. Neither she, nor he have children from previous marriages (This is the first marriage for her, and the second for him).
A family is attempting to terminate a “Couple” stage and enter expanding phase of parental years. This appeared to be hard enough at the beginning, especially considering the necessity to monitor (wife) J. ’s and kid’s health. However, they clearly realized that it was just a matter of time. Both are glad to take an active part in baby’s growing process, and regardless of the fact that (husband) J. often feels too exhausted after his working day, he never avoids helping (wife) J. with feeding, bathing, or tidying up.
Adequacy of Home Environment
As for the matters of adequacy of home environment for a growing family, it should be stated that their apartment is not too large, however, they are planning to move to a larger apartment in a year or two. Therefore, a kid will be close to mother for the nearest year, while after moving to another place, there will be an opportunity to offer larger space for the growing human.
However, this is the apartment in a comparatively old building, and there is no a smoke detector, safety alarm, or carbon monoxide detector. That is why it is not recommended to stay there for a long time, and move to a safer apartment as soon as possible.
The atmosphere within the family is quite friendly, as both parents experience love and respect to each other. Therefore, the child will not experience difficulties associated with parents – kid, or parent-parent communication. Grandparents do not have an opportunity to interfere the growing process, as (wife) J. ’s parents have died, while (husband) J. ’s parents live in Europe.
In fact, considering the researches by Langton (2004), it should be emphasized that the circumstances are quite suitable and adequate for the young family, as few young families are able to boast with a separate house and enough opportunities for refurbishing a house if a deadline is squeezed. As a rule, such families are friendly enough, as there is no opportunity to lock in separate rooms in the case of conflict. Moreover, the family has become exceptionally close to each other after the kidney transplantation, and after the difficulties caused with pregnancy.
Family Communication Patterns
They are friendly enough, and their communication patterns are based on the fact that (wife) J. does not remember her father, and appearing of a reliable man in her life became an important event. (husband) J. is 5 years older, and looking at their relations it seems that he cares (wife) J. like a sister. He is the oldest child in his family, as his brother Patrick is 7 years, and sister Judith 5 years younger. That is why, (husband) J. has a firm stereotype that younger should be cared about.
Her brother Jason was imprisoned in 1994, and died of tuberculosis in 2005. J. and her mother had a very difficult life, that is why she accepts (husband) J. ’s care, and replies with love and gratefulness.
As it is stated in Friedman (2003, p. 38):
Parental support and communication from parents does appear to play a role in adolescent behavior, and openness in communication may be considered a protective measure against possible use. Communication, family management, and monitoring are important predictors of adolescent problems, delinquency, and related problem behaviors, even after taking into account critical demographic and family factors, including socioeconomic indicators, age, gender, race of the youth, family structure, and family history of abuse.
On the light of this fact, it should be stated that communication patterns of the analyzed family may be regarded as quite suitable for the young family. They state that the first two years of their marriage was featured by some conflicts and difficulties caused with everyday necessities, however, the perspective of tragedy (when (wife) J. ’s and Fetus’ lives were endangered) made them closer to each other.
Responsibilities with Family & Community
Their responsibilities are defined in accordance with the roles of both in their family. (husband) J. realizes that he has to work for both, as (wife) J. is experiencing difficulties with health, and has to take care of their child. The model of sharing responsibilities is quite traditional, as (wife) J. has to stay at home, and (husband) J. is in the role of “breadwinner”. Such a role division helps them to protect the common family values, and have a precise division of responsibilities. Hence, as it is stated by Langton (2004), traditional allocation of roles and responsibilities within a family is not a very effective way for creating a full fledged family. However, (wife) J. is planning to get back to work soon, and start a postal tuition. It is stated that families where both parents work, and where responsibilities are not shared strictly, kids do not have a prejudice that tidying up, cooking, dishwashing etc is solely women’s responsibilities, and vice versa. This in no way forms incorrect socialization patterns (as it may be argued in Langton, 2004) as these responsibilities do not feature social and gender roles.
Considering community responsibilities, it should be stated that (husband) J. and (wife) J. experience progressive views, and they do not have any racial, ethnic, or religious prejudices. They are absolutely tolerant, and are going to claim from their children to be tolerant and sympathetic towards the surrounding people.
Family values
Family values of the family involve taking care of each other, appreciate culture of other people, be honest with others, but also do not be naïve and too credulous. In fact, there is nothing to talk much about their values, as (husband) J. and (wife) J. seem to be a perfect couple, and their values are fully represented in their communication style as well as attitude towards each other.
As for raising children, their largest value is the necessity to grow them jointly, regardless of the social outdated norms and principles. Both consider that the largest value is to have friendly relations within a family, that is why all the other values are secondary for them. Considering the researches by Keleher (2007), it should be emphasized that the actual importance of family values is defined by their influence on the atmosphere within the family. If these values are not in conflict, or when one of the spouses has enough courage to change his or her values, the atmosphere is adequate for raising children.
The largest value for them is their child. Regardless of the restricted budget, their home is filled with development toys, literature, and healthy food for the kid, and for themselves.
Family’s Ability to Meet Affective Needs of Members
Meeting affective needs of the other members is not a problem in the family. Both realize that there is no place for affection now, as all the efforts should be directed at acquiring larger apartment, maintain (wife) J. ’s health, and take care of a kid. (husband) J. had to give up his aristocratic habit of smoking cigars, while (wife) J. stopped listening to music loudly. Moreover, she agreed to sell her vinyl disks to a collector, as they needed money to buy the most important clothes and items for their kid. Such an approach towards satisfying their own affective needs, according to Vlosky and Bruin (2001), creates the necessary basis for developing trustful relations within a family, and if a kid copies this behavior model, she will also study to be responsible and non-egoistic.
Family’s Ability to Meet Socialization Needs of Members
Socialization needs of this family involve the necessity o transform the pattern of needs and requirements, as well as adapt their own behavior to each others needs, as well as realities of their family. In accordance with Keleher (2007, p. 159):
Resocialization refers to the process of discarding former behavior patterns and reflexes accepting new ones as part of a transition in one’s life. This occurs throughout the human life cycle. An example might be the experience of a young man or woman leaving home to join the military, or a religious convert internalizing the beliefs and rituals of a new faith.
In the light of this statement, it should be emphasized that the actual importance of socialization needs is explained by the necessity to adapt towards the environment. Considering the fact that (husband) J. and (wife) J. agreed to sacrifice their affections and habits for improving the comfort of each other, and improve their family development, it should be stated that their ability to meet socialization needs is impressing. (husband) J. states that he did not manage to meet these needs during his previous marriage, and it is simple to sacrifice particular habits and meet socialization needs for (wife) J. , as they are tuned for each other.
Family’s Ability to Meet Health-Care Needs of Members
They both had to adapt. It has not been stated anything about (husband) J. ’s problems so far, though, he has some blood pressure problems. They both consider that their aim is to support each other, and make life of the other more comfortable. Hence, (wife) J. tries not to worry her husband with the health problems too much, and has created a relaxation program for him. They do yoga together in order to stay fit, and breath exercises for keeping pulse and blood pressure within the frames of normal indicators. J., in his turn, ordered a water filtration system for her. He clearly realizes that she is not able to enjoy some of her favorite beverages, so, he had to refuse from the also, in order not to seduce (wife) J. for violating the diet requirements.
Mom attended prenatal care regularly, as her kidney problems had been a serious concern for nephrologist and gynecologist who monitored her pregnancy. At the moment, the child is regularly monitored by a pediatrician, and, luckily, no problems have been observed. The kid has been already subjected to all the necessary vaccinations. There are three teeth at the moment.
Family’s Ability to Cope with Stressors
Actually, this is one of the largest problems for the family. In fact, they have too much stressors, and sometimes they are close to nervous breakdowns. These moments are full of desperation, despair, and stress. They are not able to remove stressors, however, they have an opportunity to trust each other, and rely on each other in the case of extreme difficulty. It is impossible to remove stressors; however, they know how to make their family life brighter.
Their ability to cope with stressors may not be perfect, though, they believe that they are able to improve their skills, and make their life better. In fact, some stressors are more serious in comparison with raising a child. (Friedman, 2002) Nevertheless, their faith and trust to each other makes them believe that stressors may be overcome easily.
Synthesis
The overall impression of the family is based on the fact that the family is quite friendly, and the challenges which they had to face made them even closer to each other. Considering the fact that this is the second (husband) J. ’s marriage, he should have larger family communication experience in comparison with (wife) J. , nevertheless, they are equal to each other, and, regardless of the age difference, both feel that they are tuned to each other.
They may be regarded as a perfect family, as both have perfect manners, and are able to sacrifice their needs for the sake of the other’s comfort and health. This is one of the key aspects of a successful family, and, considering the fact that a child had cost them numerous challenges, they are going to make everything possible for raising a happiest and a well-brought-up person.
Their strengths is in their friendship, love, and respect to each other. Their weaknesses is in their health problems and restrictedness of a family budget. However, their resources to overcome the problems are impressing, as they have an opportunity to have a child, they have abilities and strengths for growing.
Diagnoses
There are essential health threats for (wife) J. , and it is not recommended for her to have another child. She was lucky enough for becoming pregnant regardless of the nephrologist’s warnings, though, her organism may not be endurable enough for the second time. She has a chronic kidney decease risk, and transplanted kidney is not 100% effective at the moment.
Potential diagnosis is the credibility of misbirth, and further aggravation of kidney decease. Considering the fact that (wife) J. is living with the only kidney, the problem is quite real. It is recommended to wait until the full organism restoration after transplantation and pregnancy, and have another kidney transplanted. Then, there will be an opportunity to plan another pregnancy.
As for wellness diagnosis, it should be stated that (wife) J. is emotionally ready for another pregnancy, she is quite willful with her health difficulties, and observes diet strictly. Therefore, the first requirement of wellness prognosis is observed. Status and function leave to wish better, as hr kidney is not 100% effective at the moment, and there are some renal problems observed. Therefore, she will have an opportunity to bear another child.
Family diagnosis is linked with the necessity to create more suitable atmosphere for having another child. Hence, two kids require more space for playing, studying and developing. Additionally, they have to make the apartment suitable for raising a child: remove all the traumatic items from the direct reach of a kid and cover power plugs.
They have to learn coping with stresses more effectively, as another child may cause more serious health difficulties, and larger expenses for medical services.
Conclusion
The family has all the opportunities to have suitable diagnosis for having another child, however, they should cope with the existing problems. Considering the fact that (wife) J. C had to experience kidney transplantation and Ventouse birth, it is not recommended to subject her heath to risk by becoming pregnant until the full restoration of the organism. In accordance with optimistic forecasts, she will have such an opportunity in 2-3 years. However, their will to recover, and their common efforts will make this forecast realistic. As it is stated by Langton (2004), families with health problems often have healthy kids, however, in order to minimize the risk, J and J will have to observe the medical prescriptions strictly.
Reference List
Friedman, M. (2002) “Family Nursing: Research, Theory, and Practice” Library of Congress Cataloging-in Publication Data. 5th ed.
Keleher, H. (2007). Community Nursing Practice: Theory, Skills and Issues. Crows Nest, N.S.W.: Allen & Unwin.
Langton, H. (Ed.). (2004). The Child with Cancer: Family-Centred Care in Practice. Edinburgh: Balliere Tindall.
Vlosky, D. A., Bruin, M. (2001). “Say-so” as a Predictor of Nursing Home Readiness. Journal of Family and Consumer Sciences, 93(1), 59