Child and Family Nursing Practice: Eating and Body Image Issues

This report focuses on child and family nursing practice, specifically addressing the case of a 15-year-old female named Tina. The report begins with a family assessment, including a genogram and identification of family strengths using the Australian Family Strengths Nursing Assessment Guide (AFSNAG). The assessment reveals issues related to Tina's eating behavior and body image. The report then outlines nursing care plans for each issue, including descriptions, nursing goals, implementation strategies, and evaluation methods. The eating behavior issue is characterized by irregular eating habits and a lack of a balanced diet, while the body image issue stems from concerns about weight gain. The nursing interventions involve patient and wellness teaching, dietary management plans, and encouragement of physical exercises. The report emphasizes the importance of a balanced diet, regular meal patterns, and the integration of physical activities to improve Tina's overall health and well-being. The evaluation of the interventions includes monitoring BMI, lifestyle changes, and the absence of symptoms related to poor nutrition.

Child and Family
Nursing Practice

Table of Contents
PART 1. Nursing Care of the Family: Assessment.........................................................................1
PART 2. Nursing Care of the Family: Planning, Implementing and Evaluating............................3
1. Eating behaviour issue in Tina: ..............................................................................................3
2. Body image issues in Tina:.....................................................................................................4
REFERENCES................................................................................................................................7

Illustration Index
Illustration 1: Genogram of family structure...................................................................................1
Illustration 2: Genogram of family structure...................................................................................1

PART 1. Nursing Care of the Family: Assessment
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Illustration 1: Genogram of family structure
Illustration 2: Genogram of family
structure

Tina Kaufman is 15 year old female studying in the 10th year of her high school. She has
habits of recreational activities which includes playing softball and basket ball along with this
she is also interest in attending the youth oriented programmes at church which includes youth
camps and studies related to bible. She also likes singing, dancing and acting the school plays
and achieve good grade in her academics in high school. Her mother name is Barbara, a 48 year
old women which is a home-maker. Tina lost her relationship with her biological father named
Mark when he got separated from Barbara in 2006. Now Tina has a stepfather named Stephen
who is 45 years old and own as construction business, her mother married him in the year 2008.
Tina's biological father also remarries with a woman named Simone and she is only 33 years old.
Tina also have a brother named George and he is 23 years old. He lived in the interstate with his
partner Jeremy and Tina is not having any contact with him, also her parents do not speak to him.
The family of Tina is of German descends and like to continue the same religion. They
attend full gospel at church on regular basis. Her parents do not meet anyone on the personal
basis and are not having any close friends. Tina's mother Barbara parents are also still alive her
father name is Birgit (age 72 years) and her mother name is Reinhard (age 76 years) and they are
living independently. Barbara tries to visit her parent in every two weeks but her this activity is
putting her relation with Stephen in strain as he does not get well along with her parents.
Stephens mother is also still alive and she is suffering from dementia and residing in the nursing
home. Stephen's father named Christopher died 2 years ago when he was 70 years old due to
lung cancer. He does not like to visit her mother, her name is Robyn and she is 68 years old
because she is not able to recognise him due to her dementia problem.
In accordance to the family the two strength that are selected using the Australian Family
Strengths Nursing Assessment Guide (AFSNAG) are: sharing activities and support (Family
strengths and the Australian Family Strengths Nursing Assessment Guide, 2017). Aspects of
sharing activities includes the activities that family do together and the time they spend together.
In terms of sharing activities the family of Tina visits church together on daily basis and are
interested regrading the Tina's athletic activities such as baseball and many church related
activities which includes youth centred camps and Sunday services. They get themselves
involved in her activities thus fulfil the concept of sharing activities. The concept of support
involves how family members observe each and know about what help they want and look for
many ways to look and care for each other (Schaffer, Sandau and Diedrick, 2013). This also
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includes the encouragement to one for doing things they want to do (Uhl and et.al. 2013). In the
Tina's family her mother is quite concerned regarding her eating habits and also planned a visit to
school nurse before her physical examination. Her family also interested in her recreational
activities and are involved with her in that and encourages her.
PART 2. Nursing Care of the Family: Planning, Implementing and Evaluating
The two issues that were identified during the family assessment are: body images issues
and eating behaviour issues in Tina.
1. Eating behaviour issue in Tina:
a) Description of issue:
On the basis of the family assessment it was found that Tina is not concerned regarding
her food habits. She had not developed the proper routine of taking balanced diet and whenever
she is hungry. As per the views of Hockenberry and Wilson (2014), there is need of certain
amount of nutrients in our body to perform functions of day to day life. Lack of these nutrient
can effect the functioning of various organs and weakened the immune system (Stuart, 2014).
Tina prefers grabbing the snack from the school vending machine or from the convenience store
on her way back to home. And she gets concerned only in case if her weight increase than she
reduces her intake of meat and sweets and take salads, yogurt, fruits and vegetable to maintain it.
According to Ackley, Ladwig and Makic (2016), irregular meal pattern can increase the risk
related to the high blood pressure, type 2 diabetes and obesity.
As it is mentioned that Tina is involved in many athletics activities, the irregularity can
lead to serious problems in her development of the body. Lack of proper nutrient not only
reduces her energy count but also lower down the functioning of her brain. As per the views of
Tabloski (2013), lack of proper balance in nutrients and important minerals also lead to bone
weakness and result in bone injuries in athletes if there consumption of important macro
nutrients and micro nutrients is low. In case of Tina her inappropriate consumption of nutrient
and high intake of snacks not only causes serious bone injuries but also leads to obesity. Thus, in
severe conditions it may leads to physical limitations, reduction in gastric juice formation, lack
of interest in eating and poor digestion problem.
b) Making a Nursing care plan:
Appropriate nursing goals can be identified by taking concern regarding the issue. The
major nursing goal for the problems is to make Tina and her mother aware regarding the
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importance of proper diet in maintaining the general health of the body and healing process of
body. Being involved in the physical and athlete activities she might get an injury so it is
necessary to make her acknowledge regarding the importance of diet and the effective healing
procedure. Thus, it is important to acknowledge the both of them regarding the importance of
eating behaviour. By making Barbara aware can make her more conscious regarding the health
aspects of her daughter and can further encourage her to achieve the proper eating habit. Nurse
also recommended the Barbara and Tina to go through the online encyclopedia related to proper
food habits and eating behaviour (http://www.encyclopedia.com/food/news-wires-white-papers-
and-books/eating-habits).
c) Implementation of the care plan:
To achieve the goal mentioned above following nursing interventions can be applied to
support family in achieving their goal. First and the foremost thing is to making Tina aware
regrading the proper diet nurses can plan nurses can help family by patient teaching and wellness
teaching approaches. It includes acknowledging the Tina and her family regarding important
macro nutrients and micro nutrients that are required in daily life to complete all activities.
Patients teaching includes educating the Tina regarding the diet that she should consume at
proper interval time. Wellness teaching is given to parents and patients both to make them aware
regarding various meals and the importance of presence of different nutrients in the different
meals (Carman and et.al., 2013). Thus, through this Barbara the mother of Tina can able to
provide her daughter with efficient diet by getting appropriate information of the presence of
different nutrients in various types of meals.
d) Evaluation of the nursing care interventions:
Many approaches can be taken in order to evaluate the effectiveness of the interventions
to meet the planned goal of care. The first and foremost approach is the physical examination of
the Tina which includes evaluation of the BMI (Body Mass Index). By getting the proper BMI
values it can be identified that her body is fit and free more various risk factors. Another
approach can includes the assessment of the change in the lifestyle and habit of taking
appropriate amount of food at proper interval of time. And finally looking for presence of the
sign and symptoms related to poor nutritional intake which includes pale and dry skin, red and
swollen tongue, raise in blood pressure and sign of fatigue. The absence of all these factors can
help in proper evaluation of the interventions taken.
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2. Body image issues in Tina:
a) Description of issue:
On the basis of the family assessment it was identified that the weight of the Tina is more
when compared to her age. Tina do not take the adequate amount of nutrients rich food and
prefers taking packed snack that can leads to her increased weight. She also used to skip her
lunch in school and go to library and study. Then on the way back to home she buys snacks from
the conventional store and consume the packed food. Thus, this consumption snack rich in fat
can ultimately increase the body weight of Tina. It was also found that her made comments on
her regarding that she has grown and filled out. Then after getting through this situation she gets
concerned regarding her body weight. Then she starts consuming less amount of food and
depends on yogurt, fruits and vegetables as the main meal and excludes meat products and
sweets from the normal diet. She also used to weighs herself on the regular basis and in case if
her weight gets more than 56.5 kg she gets more concerned. As per the view of Heyland and
et.al., (2013), through irregular eating habit and consumption of snacks rich in fat leads people to
overweight which in turn disturbs the normal body posture. People who gain extra weight looks
fatty and distorted in shape.
b) Making a Nursing care plan:
Important nursing goal in order to gain the proper body posture and size is to plan the
dietary management chart and involvement of body stretching exercises that helps in meeting the
Tina's long term goal of weight control by using the principle of balance diet. As it is found that
after gaining more weight she gets concerned regarding her body and start taking less amount of
food. This ultimately effects the proper functioning of the digestive system can leads to reduction
in the formation of gastric juices necessary for digestion (Dewar and Nolan, 2013). This also
effects her participation various athletic activities as increase weight and improper body posture
posses difficulties in running. This practice not only effects her proper body function but can also
pose hinders in her athlete activities. Thus, there is need of proper diet chart balance her food
intake. Nurse also recommended Tina and her mother to go through the blog of true weight in
which there are methods to maintain the healthy balanced diet (https://truweight.in/blog/food-
and-nutrition/balanced-diet-chart.html).
c) Implementation of the care plan:
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In order to achieve the above mentioned nursing goal following interventions can be used
by nurses to support the family in achieving their goal. Nurse can help Tina by verbalizing the
measures that are necessary for beginning the weight reduction. Secondly nurse can help Tina by
making her a diet chart which includes the amount of nutrients that are required at different
interval of time. They can combine the dietary procedure along with involvement of physical
exercises in her routine (Edelman, Mandle and Kudzma, 2013). There is much information
available on the types on body stretching activities that van help Tina to achieve the good body
posture without being concerned about the food intake. Along with that these practices not only
help her in achieving the good body posture but also aids in improving her performance in
various athletics activities. Thus, nurse can also involve her mother to take care of the proper
intake of diet by Tina encourage her to follow the diet chart prepared by her.
d) Evaluation of the nursing care interventions:
In order to evaluate the effectiveness of the interventions to meet the planned goal of care
many approaches can be used (Grol and et.al., 2013). The first and the foremost is the assessment
of Tina's psychological status in respect to her weight control. This includes the change in her
thoughts and emotions regarding the body image. Second approach is to know her knowledge
regarding the nutritious diet and needs of the supplements. Through this information nurse can
get an idea about whether Tina is following the diet plan or not. Along with that the
observational assessment can be used which includes a keen observation of the body posture of
the Tina to find the change after she was given with the nursing interventions.
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REFERENCES
Books and journals
Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing Diagnosis Handbook-E-Book:
An Evidence-Based Guide to Planning Care. Elsevier Health Sciences.
Carman, K. L., & et.al. (2013). Patient and family engagement: a framework for understanding
the elements and developing interventions and policies. Health Affairs. 32(2). 223-231.
Dewar, B., & Nolan, M. (2013). Caring about caring: developing a model to implement
compassionate relationship centred care in an older people care setting. International
Journal of Nursing Studies. 50(9). 1247-1258.
Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2013). Health Promotion Throughout the Life
Span-E-Book. Elsevier Health Sciences.
Grol, R., & et.al. (2013). Improving patient care: the implementation of change in health care.
John Wiley & Sons.
Heyland, D. K., & et.al. (2013). Failure to engage hospitalized elderly patients and their families
in advance care planning. JAMA internal medicine. 173(9). 778-787.
Hockenberry, M. J., & Wilson, D. (2014). Wong's Nursing Care of Infants and Children-E-
Book. Elsevier Health Sciences.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for
organizational change: overview and practical applications. Journal of Advanced
Nursing. 69(5). 1197-1209.
Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health
Sciences.
Tabloski, P. A. (2013). Gerontological nursing. Pearson Higher Ed.
Uhl, T., & et.al. (2013). Insights into Patient and Family‐Centered Care Through the Hospital
Experiences of Parents. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 42(1).
121-131.
Online
Family strengths and the Australian Family Strengths Nursing Assessment Guide. (2017).
[Online]. Available through <http://eprints.utas.edu.au/16893/>. [Accessed on 29th
September 2017].
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