The family chosen for this assignment is composed of a grandmother 55 years of age and her grandson age thirteen and granddaughter age fifteen. The family resides in a rural setting in Arizona. The grandmother has had guardianship of her grandchildren for twelve years. Health perception and management focuses on the individuals perceived health and well-being, and on health maintenance practices. (Koshar, n. d. ) The family perceives their overall health to be good. The grandmother reports no chronic health conditions and considers herself to be in good health for her age.
The children are healthy and have not experienced any serious illness or injuries thus far. All family members are current on immunizations, receive annual age appropriate health screens and dental exams and cleanings. The grandmother drinks alcohol socially on occasion but not to excess. She has been tobacco free for two years. The grandchildren both state they have not experimented with drugs, alcohol or cigarettes. They state they are aware of the dangers and health hazards of drug, alcohol and tobacco abuse. The grandmother and children take an age appropriate vitamin supplement daily.
Over the counter remedies for minor illness such as colds and flu are used when needed. Nutrition and Metabolism focuses on how the family consumes food and fluid in relation to metabolic need. (Koshar, n. d. ) The grandmother tries to encourage healthy eating habits. Whole grains, fresh fruits and vegetables, low fat dairy products and lean meats are served on a regular basis. Milk, water, juices and herbal iced tea are beverages drank in the home. Soda is bought on occasion as a special treat. Most evening meals are eaten in the home. The family usually eats out once a week.
The children are both at a healthy weight and are considered to be of average height and weight for their age. The grandmother is slightly overweight. All family members appear well nourished and hydrated. Elimination focuses on excretory patterns to include bowel, bladder and skin. (Koshar, n. d. )The children report no problems with elimination. The grandmother states she occasionally has trouble with constipation and will drink prune juice to help relieve constipation. She states she does not have problems with incontinence or bladder retention.
Activity and exercise focuses on the activities of daily living including exercise and leisure activities. (Koshar, n. d. )The family enjoys a wide variety of physical activities. Physical activity is tolerated well. The family rides their horses several times weekly. The grandmother and granddaughter barrel race on a competitive level two to three times monthly. The children are active in 4-H and FFA. The grandson plays football during the school year. The grandmother would like to join a health club to exercise on a more regular basis but does not feel she has the time to do so.
Cognition and Perception focuses on ones ability to comprehend and utilize information and on the sensory functions. (Koshar, n. d. ) Both children do well in school. They do not have any learning disabilities. Hearing and vision are fine. The grandmother uses glasses for reading only and does not have any other sensory deficits. Sleep and rest focuses on an individuals sleep, rest and relaxation patterns. The children average eight to nine hours sleep nightly. Both children state they feel well rested and are not tired during the day.
The grandmother sleeps five to six hours a night during the work week. She states she has trouble occasionally falling asleep at night. The grandmother at times feels fatigued during the day. To relax the grandmother likes to read and spend time outdoors. The children read and watch TV to relax. Self-perception and self-concept focuses on how an individual perceives their identity, body image and self-worth. (Koshar, n. d. ) The children both expressed that they saw themselves as normal teenagers. They stated they are happy living with their grandmother and feel loved and cared for.
The granddaughter sees herself as an attractive person and is happy with the way she looks. She sees herself as popular at school and states she has many friends. She believes she could do better in school, if she tried harder but states she is too busy with her horses and friends. The grandson sees himself as average. He states he would like to work out more , to build more muscle. He said he gets along well at school, but sometimes feels shy around people he does not know. He is very proud that he made high honor roll all four quarters this past year at school.
The grandmother sees herself as a good caring person. She is happy with her life and feels blessed that she is able to take care of her grandchildren. She is self conscious about being overweight but otherwise considers herself to be an attractive person. Roles and Relationships focuses on the individuals role in the world and how one relates with others. (Koshar, n. d. ) The grandmother as the primary caregiver fulfills the role of parent in the family. The childrens natural parents live out of state. The children visit them in the summer months and holidays are usually spent together at the grandmothers home.
Although there has been role reversal between the grandparent and parents the family interacts well together and has a close supportive loving relationship. Sexuality and reproduction focuses on the individuals satisfaction or dissatisfaction with sexuality and reproduction functions(Koshar, n. d. ) The grandmother is post-menopausal. She is not sexually active at the present time. The children are not sexually active. They are aware of safe sex practices to prevent pregnancy and stds. The grandson states he is not really interested in girls yet.
He is just beginning to go through the developmental changes of puberty. The granddaughter is well developed for her age and began menstruating at twelve years of age. Coping and stress tolerance focuses on the individuals view of stress and coping strategies. The main stressful issue in the home is trying to balance work, school and social activities in a single parent home. The grandmother in addition to working full time as a RN is now attending school online full time. She feels over whelmed at times trying to find the time and recourses to get the children to their various social activities.
She has started to rely more on friends to help with transportation needs. The children have been supportive and have started helping out more with household chores. The family relies on one another, friends and extended family members for support. Values and belief. The grandmother has a strong work ethic and believes in the value of a good education. She believes it is important to be a productive member of society . She encourages her grandchildren to think for themselves and be respectful and kind to others.
The family does not attend church on a regular basis, however they do consider themselves Christian. The first wellness nursing diagnosis selected for the family is Readiness for enhanced activity-exercise pattern(Weber, 2005) due to the grandmother and grandson both expressing an interest in increasing their physical activity and desiring to me more physical fit. The second diagnosis selected is Caregiver role strain(Weber) related to the grandmother experiencing stress trying to balance work, school, and raising grandchildren in a single parent role.