nur 320 Chapter 2: Family-Centered Care and Cultural Considerations

Answer: 2, 3, 4 Explanation: Interventions that will enhance family-centered care for this client and family include asking the adolescent to be an active member of care by making food choices, allowing the family to pray each day with the adolescent, and encouraging the adolescent's friends to visit during visiting hours. These interventions each promote the concepts of family-centered care. Making all decisions for the adolescent and family and leaving all questions for the healthcare provider do not promote the concepts of family-centered care.

1) The nurse is planning care for an adolescent client who will be hospitalized for several weeks following a traumatic brain injury. Which interventions will enhance family-centered care for this client and family? Select all that apply. 1. Making all ADL decisions for the adolescent and family 2. Asking the adolescent what foods to include during meal time 3. Allowing the family time to pray each day with the adolescent 4. Encouraging the adolescent's friends to visit during visiting hours 5. Leaving all questions for the healthcare provider

Answer: 1 Explanation: Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment. There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family-assessment tool is not indispensable to accuracy in the assessment. Focusing primarily upon the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members. Observing the family in the home setting is only recommended in some cases.

12) A nurse is working with a pediatric client. When obtaining an accurate family assessment, which initial step is the most appropriate? 1. Establish a trusting relationship with the family. 2. Select the most relevant family-assessment tool. 3. Focus primarily upon the mother, while learning her greatest concern. 4. Observe the family in the home setting, since this step always proves indispensable.

Answer: 4 Explanation: The benefit of employing the family-centered-care philosophy is that the priorities and needs as seen by the family are addressed as a partnership between a family and a nurse develops. In family-focused care, the healthcare worker assumes the role of professional expert while missing the multiple contributions the family brings to the healthcare meeting.

2) A new pediatric hospital will open soon. While planning nursing care, the hospital administration is considering two models of providing healthcare: family-focused care and family-centered care. Which action best demonstrates family-centered care? 1. Telling the family what must be done for the family's health 2. Assuming the role of an expert professional to direct the healthcare 3. Intervening for the child and family as a unit 4. Conferring with the family in deciding which healthcare option will be chosen

Answer: 2 Explanation: An extended family contains a parent or a couple who share the house with their children and another adult relative. A binuclear family includes the divorced parents who have joint custody of their biologic children, while the children alternate spending varying amounts of time in the home of each parent. A gay or lesbian family is comprised of two same-sex domestic partners; they may or may not have children. The traditional nuclear family consists of an employed provider parent, a homemaking parent, and the biologic children of this union.

3) A school-age client tells you that "Grandpa, Mommy, Daddy, and my brother live at my house." Which type of family will the nurse identify in the medical record based on this description? 1. Binuclear family 2. Extended family 3. Gay or lesbian family 4. Traditional nuclear family

Answer: 4 Explanation: The mother from the cohabitating informal stepfamily does not have a husband; the nurse should be asking about the "child's father." In the traditional nuclear family, the traditional extended family, and the two-income nuclear family, the child's father is the same person as the mother's husband.

4) The nurse is performing an assessment of a child's biologic family history. Which situation would necessitate the nurse's asking the mother for information should use the term "child's father" instead of "your husband"? 1. Traditional nuclear family 2. Traditional extended family 3. Two-income nuclear family 4. Cohabitating informal stepfamily

Answer: 1 Explanation: The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint-custody arrangements. The nonbiologic stepfather from the blended or reconstituted family, the divorced biologic father when the single-parent mother has custody, and the nonbiologic father from the heterosexual cohabitating family are without legal authority to seek emergency medical care for the child.

5) Several children arrived at the emergency department accompanied by their fathers. Which father may legally sign emergency medical consent for treatment? 1. The divorced one from the binuclear family 2. The stepfather from the blended or reconstituted family 3. The divorced one when the single-parent mother has custody 4. The nonbiologic one from the heterosexual cohabitating family

Answer: 3 Explanation: The single-parent family most typically lacks social, emotional, and financial resources. Nursing considerations for such families should include referrals to options that will enable the parent to fulfill work commitments while providing the child with access to resources that can support the child's growth and development. The binuclear family, the extended family, and the traditional nuclear family generally have at least two adults who can share in the care and the nurturing of its children.

6) The community health nurse is assessing several families for various strengths and needs in regard to after-school and backup childcare arrangements. Which family type will benefit the most from this assessment and subsequent interventions? 1. The binuclear family 2. The extended family 3. The single-parent family 4. The traditional nuclear family

widely spaced

In general, for children who are more _______________ in age, the parents have greater influence than do the siblings. However, the older sibling may be a strong role model for younger brothers and sisters.

closer

Siblings, especially those of the same gender, who are _____________ in age tend to have a closer relationship because they often share many common experiences through childhood and adolescence

extended family

a couple shares household and childrearing responsibilities with parents, siblings, or other relatives families may reside together to share housing expenses and child care however, in many cases, the child may be residing with the grandparent and one parent because of issues associated with unemployment, parental separation, parental death, or parental substance abuse grandparents may raise children due to the inability of parents to care for their own children

family-centered care

a partnership between nurses and families that involves respecting the family's role, strengths, and experiences with the healthcare system, nurses have an opportunity to develop an effective partnership with the child and family as they make healthcare decisions that promote the child's health

family-centered care

a philosophy of health care in which a mutually beneficial partnership develops between families and the nurse, and also other health professionals in this way the priorities and needs of the family are addressed when the family seeks health care for the child each party respects the knowledge, skills, experience, and cultural beliefs that the other brings to the healthcare encounter

Positive family relationships

are characterized by parent-child warmth and supportiveness warm parent-child relationships can buffer children from stress and promote positive cognitive and social outcomes parents who are warm and place high demands on their children for appropriate behavior have children who tend to be content, self-reliant, self-controlled, and open to learning in school

nuclear family

children live in a household with both biologic parents and no other relatives or persons one parent may stay home to rear the children while one parent works, but more commonly, both parents are employed by choice or necessity two-income families must address important issues such as childcare arrangements, household chores, and how to ensure quality family time dual-career/dual-earner families are now considered the norm in modern society

heterosexual cohabiting family

describes a heterosexual couple who may or may not have children and who live together outside of marriage This may include never-married individuals as well as divorced or widowed persons Some individuals choose this model for personal reasons; others do so for financial reasons or to seek companionship

Gay and lesbian families

include those in which two adults of the same gender live together as domestic partners with or without children, and those in which a gay or lesbian single parent rears a child Children in these families may be from a previous heterosexual union, or be born to or adopted by one or both member(s) of the same-sex couple A biologic child may be born to one of the partners through artificial insemination or through a surrogate mother Children who are adopted or born into lesbian and gay families are highly valued, as with heterosexual families Evidence suggests that children reared by same-sex couples are as well adjusted as those born into heterosexual families and have positive peer relationships

blended or reconstituted nuclear family

includes two parents with biologic children from a previous marriage or relationship who marry or cohabit This family structure has become increasingly common due to high rates of divorce and remarriage. Potential advantages to the children may include better financial support and a new supportive role model. Stresses can include lack of a clear role for the stepparent, lack of acceptance of the stepparent, financial stresses when two families must be supported by stepparents, and communication problems

The child-free family

is a growing trend in some cases, a family is child free by choice; in other cases, a family is child free because of issues related to infertility

binuclear family

is a postdivorce family in which the biologic children are members of two nuclear households, with coparenting by the father and the mother. The children alternate between the two homes, spending varying amounts of time with each parent in a situation called coparenting, usually involving joint custody. Joint custody is a legal situation in which both parents have equal responsibility and legal rights, regardless of where the children live. The binuclear family is a model for effective communication. It enables both biologic parents to be involved in a child's upbringing and provides additional support and role models in the form of extended family members.

extended kin network family

is a specific form of an extended family in which two nuclear families of primary or unmarried kin live in proximity to each other the family shares a social support network, chores, goods, and services.

single-parent family

is becoming increasingly common in some cases, the head of the household is widowed, divorced, abandoned, or separated in other cases, the head of the household, most often the mother, remains unmarried single-parent families often face difficulties because the sole parent may lack social and emotional support, need assistance with childrearing issues, and face financial strain

single-mother-by-choice family

represents a family composed of an unmarried woman who chooses to conceive or adopt without a life partner although these families are included in the single-parent family statistics, they differ significantly in that these women typically are older, college educated, and financially stable and have contemplated pregnancy significantly prior to conceiving