2810NRS Child and Family Nursing Practice: Case Study Report

This report presents a case study analysis of the Zhang family, utilizing the nursing process to address various challenges. The assessment identifies issues such as parental stress, child behavioral regressions (thumb sucking, toilet training), and the impact of long working hours on family dynamics. The planning phase involves setting short-term and long-term goals, including improving parental health and managing the child's behavioral issues. Implementation focuses on psychosocial interventions, such as cognitive-behavioral therapy and behavioral therapy. Specific techniques like activity scheduling, coping statements, relaxation exercises, and sleep pattern alterations are implemented. Furthermore, the report evaluates these interventions by noting progress and gathering feedback from the family. The report also analyzes the impact of current social and health policies, particularly regarding vaccinations, presenting both pros and cons and addressing parental concerns. The analysis incorporates research-based evidence to support recommendations and policy discussions, offering a comprehensive overview of family-centered nursing care.

Running Head: Child and Family Nursing Practice 1
Child and Family Nursing Practice
Student’s Name
Institutional Affiliation

Running Head: Child and Family Nursing Practice 2
Child and Family Nursing Practice
Problem/Issue Identification: Recognition of challenges/issues faced by the family
It was assessed that there are many social, health, and development of family challenges/
problems that are faced by the Zhang family. Jin has to work on long hours, he left home early
and came back late that may be effected not only to his health but also effected on his daughters’
development as they are unable to get time from their father. It can be seen that due to his hectic
routine Jin might be exhausted; that’s why he is frustrated on his daughters as well as his wife by
beating them. Daiyu, being a working mother also unable to give quality time to her daughters
and it could be effected to her health as well because she mentioned she is unable to get proper
sleep after her return to the job. The inattention of the parents leads the Lucy in thumb sucking,
regressing to toilet training and tantrums like activities
Planning: Development of a nursing goal for the family
Short term goals included, Jin and Daiyu should take care of their health and get proper
sleep as according to the Maslow theory, health care under the basic need of a person’s life
(Highland, 2016).To attain the level of self-esteem and self-actualization, it is necessary to take
care of their basic needs (Henrikson et al., 2017). Jin should relax after coming home by going
some relaxation exercises and some coping statements for his frustration. It is a part of the
mental health that came under the basic need of a person (Kotteeswari, & Sharief, 2014). Long
term goals included the behavioral management of Lucy’s regression. Children mostly show
regression due to distress situations and experiencing it on a daily basis.
Implementation of Nursing Care Interventions
Psychosocial intervention plans could be applied to managing the issue of the Zhang
family. These intervention plans address psychosocial or relationship problems. Psychosocial

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interventions in which person show primary symptoms of mental health problems (Youde,
2013). Cognitive-behavioral therapy and behavioral therapy like therapies or models will be
included in these interventions (Edens, 2013). Jin and Daiyu both have to go for their work for
long hours that leads to a stressful situation. Studies indicated that a person’s physical and mental
health is badly affected by the stress in the job (Henrikson et al., 2017).
This stress created impact not only on the work environment but also at their homes and
the individual have to live in continuous state anxiety, and tension. This anxiety and tension
affected the relationship of the person with his workers as well as in the home environment
(Youde, 2013). In the case of Jin, he has to work hard and usually, and he has to leave home
early and came back late. This situation stays him on the environment of continuous tension and
anxiety (Edens, 2013). To cope with this situation, Jin provided by the activity scheduling
technique and coping statements for lowering down his stress (Moreira et al., 2013). Relaxation
exercise, like deep breathing, will also be taught to him so that he could able to relax whenever
he frustrates (Kotteeswari, & Sharief, 2014).
Daiyu has the same stress situation as she joined the clinic after six months. Same
techniques will be provided to Daiyu to cope with the job stress situation. She has sleep
problems because of the breastfeeding routine of her six-month-old daughter. Daiyu’s sleep
problem is related to her daughter’s sleep. In this case, behavioral treatment will be provided to
alter the sleep pattern of her daughter. Time will be scheduled for waking up and bedtime by
giving the child positive reinforcement (Horne et al. 2015). Studies indicated that besides
positive reinforcement, systematic ignoring the child’s call at night would also be effected to
manage the sleep pattern of a child (Costa, & Ceolim, 2013). By ignoring the child’s call reduces
the child call that leads to the set pattern of the sleep (Kotteeswari, & Sharief, 2014).

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For the purpose of behavioral management of Lucy, behavioral therapy would be used to
manage her problematic behavior. Thumb sucking, regression to toilet training, and showing
tantrums will be managed by positive and negative reinforcement, modeling, and role-playing
with her (Edens, 2013). First of all, role play will be conducted in front of her so that she could
able to understand the reinforcement strategies (Moreira et al., 2013). After that, by reducing the
problematic behaviors, positive reinforcement will be provided to her. Lucy’s parents and grand-
parent will be psycho-educated for this behavioral management of Lucy’s problem, about
regression and the causes of regression. By psychoeducation, they can get understand her
problem and then actively participated in the behavioral management techniques (Moxon, &
Snape, 2013). Intervention plans for all these psychosocial problems will be applied by taking
the Antecedents (A), behavior (B), and consequences (Damnjanović et al., 2018). By altering the
antecedents, consequences will also be altered. In Lucy behavioral management, this behavioral
technique will be applied so that her consequences of thumb sucking, tantrum, and toilet training
will be managed (Costa, & Ceolim, 2013).
Evaluation of Nursing Care Interventions
Evaluation of the intervention plan will be done by taking notes on each problematic
behavior. Notes on activity scheduling and the coping statements will be given to Jin so that it
can be checked at the end of the intervention plan. Pre and post ratings of the problematic
behaviors will be taken from the Zhang family to evaluate the effectiveness of the intervention
plan.
The impact that current social and health policy has on children and families
Daiyu has not vaccinated Lucy or Olivia because she is worried about the impact that the
vaccinations may have on her children. On the concern of Daiyu, the nurse will be responded to

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her by telling her the pros and cons of the vaccinations. There is Research-based evidence can
tell her the accurate pros and cons of the vaccination to the children. On the light of proses of
vaccination, Studies indicated that vaccination has its direct effect on the health benefits of the
children (Healthcare Access and Quality Collaborators, 2017). It can also be concluded in many
studies that health benefits of the vaccination lead to the economic productivity of the nation by
decreasing the fertility, improvising educational benefits and reinforcing the macroeconomic
stability of the nation (Edens, 2013).
Nearly from a century, it can be seen that vaccination of smallpox has its great positive
influence rate on the children (Goldenberg, 2016). Approximately 90% cases of measles,
diphtheria, Haemophilus influenza, mums, etc. reported that using universal immunization and
after vaccination, its effectiveness studied that resulted in nearly 99% (Healthcare Access and
Quality Collaborators, 2017). Vaccination can save money and the time of the families as the
vaccinated diseases are the life-long diseases (Henrikson et al., 2017).
If someone caught any kind of disease, it could lead to life-long disability and financial
problems due to loss of work’s time as well as medical bills. It can be seen that nearly one or two
generations ago, some diseases are prevalence on a large scale like smallpox, German measles,
etc. these diseases affected a large number of a newborn that leads towards the high mortality
rate (Highland, 2016). Now with the help of vaccination, these diseases could be controlled. At
that time, parents give trust to the vaccination; that’s why now there will be no harm to such
disease (Moxon, & Snape, 2013).
Other the other hand there are some studies conducted on the cons of the vaccination on
children. There are many studies conducted on the hesitancy of the parents towards vaccination
of the children (Parasidis, & Opel, 2017). For parents, uncertainty towards vaccination of the

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children means that children show discomfort in front of their parents, whereas there is no
evidence found against this hesitancy (Roeder, Mariner, & Kock, 2013). Oher the other hand,
studies show that when children will not vaccinate against a certain disease, later in life, this
decision lead towards occurring of that disease (Henrikson et al., 2017). Some studies indicated
that some parents refused to vaccinate their children due to the highly economical rate of the
vaccinations, not due to any impact of the vaccination. There are some studies indicated that
some parents rely on their parenting style and they believe that they can live a healthy lifestyle to
their children that why their children have no need to get any kind vaccination (Youde, 2013).

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