WK3 Caring for Vulnerable Populations Child Abuse

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Questions

1. Identify which case you chose.

2.Discuss several risk factors that may impact health outcomes for the vulnerable population in your case study.

3.Identify one agency in your community that can assist this vulnerable group and assess this agency in terms of the 4 A's (see the lesson). Discuss each of the A's separately to assess accessibility, acceptability, affordability, and availability for this population.

Here are two agencies in NYC:

https://healthyfamiliesnewyork.org/default.htm

http://www.newyorkcenterforchildren.org/about/

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4 A’s

Acceptability

Does the client have confidence that the referral source will be able to help?

What were the past experiences, either positive or negative?

Does the referral fit with the client’s values?

Does it conflict with higher priorities? Consider Maslow’s hierarchy of needs.

Is there fear of the unfamiliar or of having to admit that help is needed?

What is the cost to the client other than money-time, loss of work, and so forth?

Accessibility

Consider things in the client’s situation that may limit access to the referral agency or hinder the client’s ability to follow through on the referral.

Examples

Transportation, language barriers, hours of operation, and conflicts with client’s work or school schedule.

Availability

Is there a referral source that meets the client’s need?

This goes back to community assessment and being aware of the resources that are available in the community. Part of the role of a CHN is to identify gaps between client needs and existing resources (assessment) and to work to fill in any identified gaps (assurance).

Affordability

What fees does the referral agency charge?

Is there a sliding fee scale?

Will the agency accept third-party payment?

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References

About NYCC. (2019). New York Center For Children. Retrieved from http://www.newyorkcenterforchildren.org/about/

Chamberlain College of Nursing. (2019). NR443 RN Community Health Nursing: Week 3 lesson. Downers Grove, IL: Online Publication.

HFNY. (2019). Healthy Families New York. Retrieved from https://healthyfamiliesnewyork.org/default.htm

Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.

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Chamberlain College of Nursing NR443/435/436: Week 3 Case Study Week 3 Case Study: Child Abuse This case study provides you with an opportunity to immerse yourself in the role of a community health nurse and examine primary, secondary, or tertiary prevention strategies related to a population health problem. As you work through the case, reflect on what you have learned from this course about community health nursing, and apply it to this scenario. Your Role You are working as a community health nurse in your local health department. One of your roles with the health department is to case manage pregnant women who are on Medicaid. You continue to work with an interdisciplinary team both within and outside the agency. Team Members • Anne, a fellow nurse with the health department, is on medical leave, so you have been assigned this case. • Christina is a social worker with the health department. • Tracey is a case worker from Child Protection Services. • Mark is a dietician with the local WIC (Women, Infants, and Children) office. The Case You are assigned to a new case. Marissa is 15 years old and is pregnant with her first child. Marissa lives with her mom and her five siblings in a two-bedroom apartment. You arrive to your first visit, and a young boy, Marissa’s brother, who is about 5 years old answers the door. He lets you in to find Marissa sleeping on the couch. There is also another couch where her 10-year-old sister is sleeping. Even though the apartment is dark and everyone seems to be sleeping, you decide to continue with the visit as Marissa wakes up and is willing to participate. As you are getting to know her, more of the family wakes up, and you can now hear whom you assume is her mother yelling at one of her siblings. You continue talking to Marissa, but her mother is getting louder and all of a sudden you hear three smacking or hitting noises. They are in a back bedroom, so you do not see anything, but you hear a child crying and her mother telling the child to “shut up” or he will get “more.” Marissa tells you her siblings range from 3 to 12 years old. As you leave the visit, you know that Marissa, as well as her mother, need additional support and education regarding parenting and proper forms of discipline. As a nurse, you know you are a mandated reporter, so you go back to your office and research child abuse and Child Protective Services (CPS). You decide to talk with your team about what just happened, too. Your team agrees that Tracey, from CPS, needs to be notified. Next, please go into the Week 3 Discussion, and answer the prompts. NR 443/435/436 Week 3 Case 1/2018 MM LS 1
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Attached.

Running head: CARING FOR VULNERABLE POPULATIONS: CHILD ABUSE

Caring for Vulnerable Populations: Child Abuse
Student’s Name
Institutional Affiliations

1

CARING FOR VULNERABLE POPULATIONS: CHILD ABUSE

2

Case Study: Child Abuse
The Case
Marissa, a 15-year-old is pregnant with her first child. Marissa lives with her mother and
five siblings in a two-bedroom apartment. The siblings range from 3 to 12 years old. The house
occupied by the family is not adequate to accommodate the family members as well as it has
lighting ergonomics. When the community health nurse arrived at the home, Marissa was
sleeping on the couch as well as her 10-year-old sister was sleeping on another coach. The role
of a community health nurse in the local health department is to case manage pregnant women
who are on Medicaid (Nies & McEwen, 2019). The community health nurse works in an
interdisciplinary team that includes Anne, a fellow nurse with health department but currently on
medical leave, Christina, a social worker in the health department, Tracey, a caseworker from the
Child Protection Service, and Mark, a dietician with the local WIC.
Risk Factors
Vulnerable populations depend upon the community for almost every aspect of
wellbeing. Marissa needs effective resources during her pregnancy that is essential to both her
and the baby. Various risk factors that may impact health outcomes of Marissa include her age,
existing health conditions, and health issues that may occur during pregnancy (Nies & McEwen,
2019). Marisa is a teen who is likely to develop anemia and pregnancy-related high blood
pressure and go through early labor. Since she is a teen, she is also not likely to know that she
has sexually transmitted infections. Because she is from a low-income household, she may be
less likely to receive prenatal care or observe the prenatal appointments (Nies & McEwen, 2019).
Existing health conditions may include obesity, high blood pressure, Zika infection, autoimmune
disease, and HIV/AIDS. Lifestyle factors that may impact Marissa’s health outcomes include
alcohol use, drug use, and tobacco use. Alcohol consumption during pregnancy increases the
baby’s risk to sudden infant syndrome, and fetal alcohol spectrum disorder (FASD) (Nies &
McEwen, 2019). The effect of FASDS on the fetus includes behavior problems, intellectual and
developmental disabilities, disorders of the heart, bones, and kidney, and abnormal facial
features. Drinking may also lead to Marissa having a miscarriage or st...


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