Family/community health care plan

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Excellent work.

Here is what I see and what would concern me as a nurse. I see a lonely depressed and overwhelmed young woman who is about to break from the strain of it all. I see that the entire household's safety is in jeopardy due to the mothers depression and urges to hurt others and probably herself. I think the mother's fatigue is base in her deep depression as evidenced by her flat affect and inability to care for herself and the children.

I see that she is not properly grieving for her mother and that her mother was always the parent leaving her without the skills/tool to care for the children. I see the out of control/acting out 15 year old as side effect of this broken family and is having difficulty being the "adult" breadwinner when the Mother/Mother passed away (if the bong/drugs are really the 15 year old) or the 15 year old who is working (most pot smoking teens don't' have jobs) is the scapegoat for hiding the mothers drugs that are on display in the kitchen. (if you were 15 would you be leaving your bong in the kitchen?) so the mother is self medicating with the drugs.

I am concerned that the 3y/o is only eating vegemite sandwiches (nutrition) and the mother wants the child to use a knife. I am concerned that the mother is annoyed at the normal questioning from a 3 y/o will cause the mother to resort to violence in an effort to silence the child.

I am concerned that the infant is not getting enough nutrition but is that the infants issue or the mothers overwhelming depression that the mother doesn't allow the infant to feed and is "fussy" because it is hungry. I see this baby getting hurt/killed by this mother as she has openly admitted to feeling violent towards the infant.

I see safety is paramount here. I see malnutrition here is key for the 3 y/o and infant. I see the mothers depression placing everyone safety in jeopardy. I see a family about to self destruct from grieving and depression. I see a mother is desperate need for intervention and education.

risk for violence - other directed; caregiver role strain;

breastfeeding - ineffective; deficient knowledge - r/t breastfeeding, and also development of 3yo;

coping - ineffective; coping - compromised family;

attachment - risk for impaired;

parenting - risk ? for impaired(no risk here has already shown to be impaired);

fatigue; sleep pattern - disturbed;

body image - disturbed; resilience- risk for compromised;

self esteem - risk for situational low;

feeding pattern - ineffective infant;

neglect- self; infant/3y/o

home maintenance - impaired;

family processes - interrupted; loneliness - risk? or; again....risk? there is enough evidence to prove otherwise.

role performance - ineffective; social isolation; anxiety.

Have I missed anything? I was thinking fatigue; breastfeeding - ineffective; deficient knowledge; and risk for violence would be my top 4 diagnoses. Although I don't usually put "risk of" as top priority this one I would as the consequences are very real and seem imminent. Personally when a care giver verbalizes violence I consider that and act of violence itself..

Does this help?

Anytime!