Case Study, Chapter 25, Working   with Vulnerable People Glenna, age 38, lost leg function during a motor vehicle accident at   age 16. She plays basketball at the community center and teaches aerobic   classes for wheelchair-bound people three times a week. She manages a medical   equipment rental business since her husband died. Business is not profitable.   A physician’s referral was made to the public health department for a   developmental assessment. A nurse heard angry shouting as she   stepped toward the porch of the tiny house with peeling paint. The nurse   stepped over a broken tread and knocked on the weather-stained door at the   end of a ramp. Suddenly a large man burst through the doorway tugging on a   T-shirt and muttering. The nurse glanced passed the fleeing man. Three   children, ages 18 months, 4 years, and 6 years old, knelt on linoleum worn   through to the wood. The TV blared a cartoon. No one heard her knock as the   children stared at their mother who was crying and holding her cheek. The   nurse knocked a second time on the open door and introduced herself. The   woman wheeled around to face the other way. “We are busy. Please come back later,”   the woman spoke over her shoulder. “Pick up the blocks, Chica. Make sure the   back door is locked, Stephano and please make a peanut butter and jelly   sandwich for your brother and sister. Not now, Jon. She tells the youngest   child, who is banging a block on her wheel.” The nurse replies, “I can make another   appointment, but it will only take a few minutes to assess Jonathan now that   I am here. Your physician said you are concerned about his development. If   you could answer a few questions I feel sure we can help you. I can help make   the sandwiches while we talk.” The nurse’s scan of the living room located a   stained spoon and knife near a broken mirror on the coffee table along with a   towel, toys, and a magazine. Chica’s hair was uncombed. The boys’ hair hung   to his shoulders and looked unwashed. The mother pulled her robe together over   her chest and folded her arms. “You can’t help. Jon is normal but different.   You will ask a 100 questions, insult me, and then say there is nothing you   can do, just like the doctor did. He made us wait 45 minutes and then says he   is going to call someone else. We don’t need that kind of help. Jon is a   smart boy with attention problems. I need to clean up. We don’t have time to   talk right now.” She raised her voice. “Chica, pass me the cigarettes, will   ya? Gracias.” Jon continued banging his mother’s chair   and vocalizing. The children stared at the nurse. Chica looked afraid.   Stephano looked hopeful. His dirty pajamas ended well about the ankle (Learning   Objective: 3). 1-Should Glenna consider herself   disabled or at risk? Why? And should the nurse consider Glenna’s family at   risk? Why? 2-What history questions will   reveal predisposing, social or enabling risk factors? 3-What risk clusters can be   identified? 4-What community health nursing   techniques could empower Glenna and her family? 5-How can the nurse avoid   insulting the mother? Textbook Chapter 25, Working with Vulnerable People Community and Public Health Nursing Author(s): Rector, C. (2019). Publisher, Edition: Edition:  9th ed. ISBN: 13: 978-1-4963-7625-1 Blais K., & Hayes, J. (2016). Professional nursing practice: Concepts and perspectives (7th ed.). Upper Saddle River, NJ: Pearson. ISBN 9780133801316