Question 2839

Question Answered step-by-step Family background This is a story of the Brar family, an immigrant… Family backgroundThis is a story of the Brar family, an immigrant from India. The Brar family is a traditionalnuclear family composed of a married couple and their three children. They do not have thesupport of any extended family to assist them with daily necessities that they have nowneglected. Rajiv is a 42-year-old who works in a factory. His wife, Nirmala, is 39-years-old whorecently had to resign from her part time job at the local grocery. Their only daughter Poonam is12 years old and was recently diagnosed with Crohn’s disease. Research conducted found thatthe risk of Crohn’s disease is higher in females after the age of 14 (Shah, et al., 2018). They alsohave two sons Rajeesh and Arjun who are 15 and 10 years old, respectively. All three childrenattend school at a local public school.The Brar family was born in Punjab and belong to the Punjabi culture. The Brar’s practiceSikhism. Their religion requires special considerations around dietary needs, prayer routine, andnecessary religious accommodations. They were a close-knit family until their situation recentlychanged. They were always very supportive of each other, especially when they migrated toCanada in 2015 from India. The Crohn’s and Colitis Canada Organization (n.d.) found thatCanadian immigrants from South Asian countries have higher rates for Inflammatory BowelDisease.Upon their arrival to Canada, they rented a 3-bedroom apartment in Scarborough, Ontario.Unfortunately, Poonam’s diagnosis of Crohn’s disease significantly increased the family’sexpenses. Although healthcare is free in Canada, higher income and social status are linked tobetter health care (World Health Organization, 2017). For example, access to hospital’s privaterooms. The family depends on Rajiv’s income; he makes minimum wage of $15 per hour andworks more than 60 hours per week. Following Poonam’s diagnosis of Crohn’s disease, Nirmalawas not able return to work to help Rajiv with the expenses. The family could no longer affordtheir 3-bedroom apartment. They had to apply for government subsidized housing. The Brarfamily lives in Ionview, a small neighbourhood in the district of Scarborough. Their place isadjacent to the community centre, plaza, and public school.As recent immigrants to Canada, this family has communication challenges and often requires atranslator. Rajiv’s co-worker, Harbir, is a close family friend. His knowledge has becomeessential in helping this family navigate the healthcare system and find social support. Harbir haslived in Canada for more than 25 years. He has strong ties with the community. He speaksEnglish and Punjabi fluently. Harbir will assist them in accessing resources that they need.Besides Poonam, all members of the family are in good health. Unfortunately, their currentsituation negatively affects the well-being of all the family members. Nirmala often becomesanxious, stressed, and is easily get angered. She has become overweight. She does not exerciseand she neglects her diet. Rajiv feels exhausted, frustrated, burnout, and stressed. The couple isdeveloping animosity towards one another; they do not have time for each other. Their eldestson, Rajeesh, feels neglected and isolated as his parents do not give him much attention. Rajeesh(15), often experiences peer pressure and he is doing things to please his friends, seeking theirapproval. He was caught smoking cigarettes and skipping class. The couple’s other son, Arjun,also feels neglected, isolated, and jealous. Due to the lack of emotional support from his parents,he feels unmotivated with school and sports activities. Nirmala’s and Rajiv’s only daughter,Poonam, feels guilty. She considers herself a burden to the family. She suffers from depression,helplessness, and frustration. Her condition has caused her to become moody, emotional, lonely,and socially isolated.Development of the health problemAt the age of 8, Poonam developed abdominal pain, bloody diarrhea, and unexplained weightloss. It was November 2015, the Brar family had been in Canada for less than a year. They hadlimited resources and knowledge on how to consult a doctor. Fortunately, Rajiv’s co-worker,Harbir, advised them to go to a walk-in clinic to consult a doctor regarding their daughter’scondition. The physician then referred Poonam to Sick Kids Hospital in Toronto to see aPediatric Gastroenterologist. The specialist diagnosed Poonam with Crohn’s disease. Nirmalaand Rajiv felt overwhelmed, worried, scared, lost, and confused with the situation. The Brarfamily have been greatly impacted by the chronic health problem of their daughter. The children,being relatively young, do not understand the disease process and its effect on their family. Theirlifestyle, social lives, and daily normal routine has dramatically changed.According to Brazier (2021), “Crohn’s disease is a chronic, or long-term, condition that causesinflammation of the digestive tract. Crohn’s disease can be painful, debilitating, and sometimeslife threatening.” The diagnosis of Crohn’s disease involves a series of tests such as stool andblood test, biopsy, sigmoidoscopy, colonoscopy, endoscopy, and CT scan (Brazier, 2021).Poonam’s diagnosis started with an x-ray and ultrasound of the abdomen which showedinflammation and scarring in her intestines. She had an endoscopy and colonoscopy utilizinga scope to explore parts of her gastrointestinal tract. To examine her lower intestine or colon thescope was inserted through her anus (colonoscopy). To examine her esophagus, stomach and partof her small intestine, the scope was inserted in her mouth. She was sedated and biopsies weretaken. Results showed severe inflammation and scarring in the large intestine and moderateinflammation in the stomach and esophagus.Patients with Crohn’s disease may have different symptoms that include stomach pain, vomiting,loss of appetite, fever, bloody and watery stool, unexplained weight loss, poor growth, mouthulcers, rashes, joint pain, and eye redness, and inflamed anus (SickKids, 2013). The typical signsand symptoms Poonam was experiencing were severe abdominal pain, fatigue, loss of appetite,and rectal bleeding. During her most recent flair up she was malnourished and requiredhospitalization and tube feeding. Her condition negatively impacted her quality of life includingphysical, psychological, and social well-being. Due to fatigability, she has had difficultyengaging in school, sports, and other extracurricular activities. She has missed all of grade 6 andmost of grade 7. Her relationship with her friends has deteriorated. She cannot go out with themor invite them over due to her impaired immune system, pain, and exhaustion. Her increasedsusceptibility to infections has made the family very nervous and they stay home most of thetime. Poonam is always in her bedroom causing her to feel socially isolated. In addition, she hasalso become dependent on her parents and siblings for assistance with activities of daily livingincluding toileting, eating, and bathing.While there is no known cure for Crohn’s disease, Poonam started her treatment to alleviate hersymptoms. She took steroids to assist her in lowering the activity of her immune system anddecrease inflammation. Poonam suffered side effects from the corticosteroids. Acne, weightgain, and mood swings made her recovery difficult (National Institute of Diabetes and Digestiveand Kidney Disease, 2017). These changes made her experience disturbed body image, self-pity,and depression.Long-term disorders that Brar family worried about include loss of bone mineral density,osteoporosis, and diabetes mellitus caused by this medication. However, corticosteroids workwell inducing remission in Crohn’s patients. Fortunately, Poonam quickly responded to thesteroids. Once remission started, Poonam’s doctor recommended biotherapies which help toneutralize the proteins decreasing inflammation in the intestines (National Institute of Diabetesand Digestive and Kidney Disease, 2017). She was prescribed Remicade via intravenous infusionevery 6 weeks. then….Impact of the health problem in the family(https://academic.oup.com/jcag/article/2/Supplement_1/S1/5107699)quality of life. How does the illness influence their routine? The mother resigned from her workand became a full-time caregiver, dad has to work two jobs, and does not sleep well. The twoboys had to reduce their extracurricular activities due to parent’s financial and time constraints.A Private caregiver had to be hired to help manage the daily responsibilities of the family.challenges – Include prolonged symptoms due to late or inappropriate diagnosis, social stigma ofhaving a chronic disease that affects toileting habits, difficulty with excursions due to limited oruncertain access to bathroom facilities, affordability of medications, diminished employmentprospects, limited community-based supports, and inequitable access to health care services andspecialistsf. How does the illness influence their ability to carry out their responsibilities…their job,education, social activities, relationships, family responsibilities, and communityresponsibilities? They have no time to go out with other people, family tension, no time to beinvolved in religious and spiritual practices. The 15 year old had to quit his membership in SikhSports Club.? economic costRemicade? Every dose was 2800 dollars. Government covered the cost as mother wasunemployed and father had no extended coverage.g. How does illness influence their sense of meaning in life? unmotivated, restricted,enumerate problemsCare PlanThe focus of care in Brar’s family story will be Poonam. She needs to stay in remission and getback to her daily routines. The community health nurse needs to consider all members of theBrar family as recipients of care. The care plan will focus on the management and copingstrategies of this family that has been impacted by a chronic disease. Question:Could you please make a family care plan, Identifies tools, priorities, interventions, and rationales. Presents detailed, realistic assessments, supported by the information presented and concepts from the readings Health Science Science Nursing NURS 1077 Share QuestionEmailCopy link Comments (0)

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now