NURS 4341 Case Study 2 Homeless

NURS 4341 Case Study 2 Homeless

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Title: The Role of the School Nurse in Health Promotion among the Homeless

Scenario

Today, Mr. James got a call from the school nurse alerting him to the fact that after his 11-year-old, Stevie, told his teacher “My ear really hurts,” he was seen by the school nurse. An assessment found the child had a low-grade fever and swelling and redness in the left outer ear canal. When the nurse told Stevie he needed to be seen by a medical healthcare provider, the child began to cry saying, “We can’t afford a doctor, daddy is out of work and we may have to live in our car.” The nurse engages in a conversation with Mr. James who confirms that he is raising his 11-year-old son Stevie as a single parent since the death of his wife 6 months ago. He lost his job as a cook at a local restaurant making it difficult to keep up with rent and utilities for their apartment. He has looked for work, but the Covid pandemic has made restaurant work difficult to secure and the added childcare responsibilities have placed even more restrictions on the type of work he can apply for. The situation is made even more critical now that his unemployment benefits are about to run out and the family is being threatened with eviction.

What are the findings that require immediate follow-up by the nurse?

Scenario, continued

Mr. James takes his son to a neighborhood clinic where an assessment interview is conducted with both Stevie and Mr. James. After discussing the current challenges facing the family, Mr. James volunteered that his situation has “really taken a toll on us; I’m getting so overwhelmed. Stevie’s a good kid but losing his mother has changed him; he doesn’t say it but I know he misses her terribly. I’m afraid he’ll get behind in school and I know he worries about me way too much.”

2. Item Type: Matrix/Grid

Use an X to indicate which potential assessment finding is associated with each of the listed health foci. All assessment findings should be used and can apply to both foci.

Scenario, continued

Stevie is seen by the pediatrician and his ear inflammation is treated with medication. The clinic’s nurse is now turning attention to the psychosocial issues challenging this family.

3. Item Type: Cloze (Drop Down)

Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided.

Based on the assessment finding, the family’s priority need will be to address ______________1____________. In addition, there will be a need for interventions to promptly address ____________2____________ and ______________2_______________.

Scenario, continued

The clinic nurse is now addressing actions needed to achieve psychosocial goals for this family.

4. Item Type: Extended Drag and Drop

Use an X (or drag and drop) to indicate which actions listed in the left column would be included in the immediate plan of care for this family.

Scenario, continued

Mr. James has agreed to comply with the proposed plan of care for himself and Stevie. The nurse is now planning and implementing appropriate interventions for immediate implementation.

5. Item Type: Extended Multiple Response (Highlight)

What nursing actions are appropriate for this family at this time? Select all that apply.

1. Arrange grief counseling for both Stevie and Mr. James.
2. Facilitate meeting with local social services representative.
3. Assess Mr. James in constructing a workable financial budget.
4. Identify local support groups for parents without partners.
5. Assist family in developing an at-home study schedule for Stevie.
6. Identify employable skills Mr. James has unrelated to restaurant work.
7. Arrange for Stevie to attend a support group for children who have lost a parent.
8. Facilitate arrangements for weekly family counseling session at local outpatient mental health clinic.

Scenario, continued

Five weeks have passed since Mr. James’ initial contact with the school nurse. Stevie’s ear is no longer inflamed, and the pain has totally subsided. A local employment agency has helped Mr. James to secure part-time work with a local food delivery service, and he has qualified for bimonthly food supplements from a local food bank. Stevie will be receiving free lunches at school and dinner twice a week at his grief support group sessions. Mr. James hopes to attend grief counseling as well as a support group for single parents held at a local church.

6. Item Type: Enhanced Hot Spot/Highlighting

Highlight the findings that indicate this family is progressing as expected.

Five weeks have passed since Mr. James’ initial contact with the school nurse. Stevie’s ear is no longer inflamed, and the pain has totally subsided. A local employment agency has helped Mr. James to secure part-time work with a local food delivery service, and he has qualified for bimonthly food supplements from a local food bank. Stevie will be receiving free lunches at school and dinner twice a week at his grief support group sessions. Mr. James hopes to attend grief counseling as well as a support group for single parents held at a local church.

• Visit http://www.hhs.gov/homeless to learn more about the homeless population in the United States. Provide an overview of the causes and consequences of the homeless problem in the United States.

• Discuss what social determinants of health relate to this case and why. How can we work to solve this problem?

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