Assignment task:
Using a Gordon's Functional Status data organization framework, categorize data from the case study scenario below. Using the data, identify three health concerns regarding the particular case study. The health concerns should be discussed according to the current literature (prevalence in this age group, factors leading to the health concerns etc.). Using one of the health concerns, develop one NANDA nursing diagnosis.
Case Study Scenario:
As part of a health-promotion visit for Sarah Eustache-Daniel and Thomas, her 2-week-old infant, Jessica Wong, a registered nurse, planned to conduct an infant assessment, provide breastfeeding support, teach about normal infant development and care activities, and assess Mrs. Eustache-Daniel's adaptation to motherhood and her postpartum recovery status. Before the visit, Ms. Wong reviewed the clinical information she obtained during Mrs. Eustache-Daniel's hospitalization. Mrs. Eustache-Daniel is a 34-year-old Indigenous primiparous woman who delivered a 3.22 kg (7-pound, 10-ounce) healthy boy (Thomas) after a 12-hour labour. The labour had progressed well without complications. Mrs. Eustache-Daniel received epidural anaesthesia at 6-cm dilatation, and the baby was delivered vaginally. Her husband, Louis Daniel, provided labour support and was present for the delivery. After a 2-day hospital stay, Mrs. Eustache-Daniel was discharged. At discharge, the infant was breastfeeding, had normal newborn examination findings, and weighed 3.40 kg (7 pounds, 5 ounces). Ms. Wong had been impressed by both parents' preparation for the birth. They had attended childbirth classes and read several books about infant development and parenting. Ms. Eustache-Daniel planned to take a 12-month maternity leave from her position as a lawyer in a large practice and had arranged for a childcare provider to come to the family's home to take care of the infant beginning 2 weeks before the end of her maternity leave. Mr. Daniel had not planned to take time off from his job because he had recently been promoted to a high-level managerial position in his company that required increased travel and time at work. He was able to postpone a business trip to be present at the delivery and had sent a plane ticket to his mother-in-law so she could come and stay at their home during the first week after Mrs. Eustache-Daniel and Thomas were discharged from the hospital.
During the visit, Ms. Wong first assessed the infant. She incorporated teaching concerning normal infant development and concluded that Thomas was a healthy 2-week-old infant who was feeding well. Thomas's circumcision was healing without complications and he had regained his birth weight.
When Ms. Wong asked how Mrs. Eustache-Daniel was doing, Mrs. Eustache-Daniel hesitated and then responded, "I'm not sure. I'm very glad that Thomas is doing well... but I worry sometimes that I'm not going to be able to do everything right for him. It's funny, but I've spent so many years getting an education and establishing my law career. It was hard work, but I managed to do well. Now a little infant overwhelms me. I don't know how I'll manage this." When Ms. Wong asked Mrs. Eustache-Daniel to talk more about her concerns, Mrs. Eustache-Daniel described how incompetent she felt while her mother was staying with her. "My mother could do everything so easily. I fumbled with every diaper. It felt like she criticized how I did things. When she told me about what she did when she had children, I felt pushed to do things 'her way' and not the way that I had planned. She even wanted to give him a bottle when I was trying so hard to get breastfeeding going. At least the doctor said Thomas had gained enough weight. Thomas's weight gain made me feel like I wasn't a total failure. I couldn't wait for her to go, but I fell apart after she left. I was alone. Louis is out of town until the weekend, and I couldn't get Thomas to stop crying yesterday. I thought I would scream, so I put him down in his crib and I just sat there crying. What's wrong with me? I've never felt so out of control before. I want to be a good mother, but I feel like I can't give any more right now."
In response to Ms. Wong's follow-up questions about mental status, Mrs. Eustache-Daniel described frequently feeling irritated and sad, crying a few times over the previous several days, having difficulty sleeping even when the baby was asleep, feeling fatigued, and being worried about how she would be able juggle everything when she goes back to work. Ms. Wong also inquired about the family's cultural, ethnic, and religious backgrounds. Mrs. Eustache-Daniel responded, "Interesting that you should ask. That's actually another issue right now. I am from Manitoba and my family is Métis and Catholic, but I am not a practicing Catholic now.
I added my maiden name to Daniel when I got married, to honour my family. Louis is Protestant, but not really religious. His family comes from Saskatoon. They are very nice and were supportive when we got married. We were lucky that our families accepted us together. I have to admit, though, that we didn't really figure out what can be done about raising the baby. Louis thinks that we'd be hypocrites to have a Catholic christening. Plus, my mother told me that I'd be selfish to go back to work so soon. Can you help me? I feel like I'm going out of my mind, and I don't know what to do."