Here are the instructions for my Discussion Question for this week. This is a case study and at the end there are 3 questions to answer.
Week 8: Discussion Part one
Initial Visit: Meet the Family
Background: Field Family: Mother: Michelle age 25, Father: Mike age 27, Daughter: Jennifer age 5, Son: Rey age 18 months. Maternal Grandmother: Mary age 48, Paternal Grandfather: Tom age 52.
Office: Rural, NP owned, Family Practice Clinic
Today is a busy day in your rural family practice clinic. You are reviewing the chart of your next appointment and realize that there is very little information and that you are scheduled to do well-child exams on a male age 18 months and female age 5 years, who appear from last names to be siblings. Your office schedules 20 minutes each for well-child exams. Upon entering the room, you note a Caucasian woman who appears in her early 30s who sits focused on paperwork, a male toddler climbing on the exam table to reach up and take the otoscope off of the wall, while a preschool-aged appearing female is sitting at your computer pretending to type on the keyboard.
As you introduce yourself, the mother stands abruptly and grabs the toddler off of the exam table, smacking his hand and causing him to cry, while simultaneously yelling “I told you to stop it!” She states, “I am so sorry. They usually behave. I am Michelle, and this is Rey and Jennifer.” You then inquire as to the reason for their visit, as you always do. The mother reports they recently moved to the area to live with her parents due to a recent separation from her husband, and she is there to have a physical exam before they lose her husband’s health insurance benefits. She reports that the children are currently healthy and have a regular pediatrician back at home.
HPI: The mother denies any recent illnesses in either child and reports they are here for their check-up. She does report that since moving in with her parents recently, it has been difficult to get the children to go to bed at night and stay in bed and expresses extreme frustration with this. She reports that they are eating three meals per day and two snacks, one at bedtime and one in the afternoon between lunch and dinner. They do brush their teeth twice a day, ride in car seats in the car, and play vigorously both indoors and outdoors at home. She also verbalizes extreme concern of their impending loss of health insurance.
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