Assignment task: Juanita is a 16-year-old female who has a history of moderate, persistent asthma. She lives with her mother and brother in an urban setting in an apartment building that was built 60 years ago. The apartment has forced hot air heat that does not always work well and is plagued by rodent infestation. Although there is no smoking in her apartment, there are multiple cigarette smokers on her floor in the building. The road in front of her apartment is used frequently by trucks, often idling for hours while they await unloading at a distribution center located on her block.
It has been a challenging year in school for Juanita, having missed about 45 days due to two hospital admissions for asthma in the last five months. She has also missed school on days when she stayed home because she felt that her breathing would not allow her to make it through the school day. The school is concerned that Juanita may not be able to pass to the next grade at the end of the current academic year. This has Juanita and her family quite sad.
Juanita has a primary care provider in her community, but she needs to take three different buses to get there. She has seen a pulmonologist in the past, but that was during an inpatient stay. These providers have prescribed a regimen of three different medications that she is supposed to take every day.
Her insurance coverage has been problematic, since her family's eligibility for coverage lapses every year. She is eventually able to be reinstated for insurance coverage, but it does lead to her having gaps in obtaining the necessary maintenance and "rescue" medication to keep her asthma check" (Lamb, 2013, p. 177).