Child and Family Nursing Practice

Write a 1500-word case study report in which you use the nursing
process. Part 1: The case provides you with the assessment data you need to: identify
challenges then to plan, implement and evaluate a nursing care plan for the Zhang family.
Part 2: Asks you to analyse the impact that current social and health policy has on children
and families.
Family Assessment Case Study – The Zhang family
You are a community health nurse who has been visiting the Zhang family (refer to your
Genogram from Assessment 1). Wei’s stoma has broken down and he requires daily
intravenous antibiotics via a peripherally inserted central catheter (PICC). You are also
providing stoma education for Wei and the family. You use the phone interpreter to speak to
the Grandparents during a family meeting with Wei, Ling, Jin and Daiyu to undertake a
family assessment.
Your family assessment is as follows:
 Jin Zhang is a thirty-seven (37) year old man. He has been married to Daiyu Zhang, a
thirty-one (31) year old woman, for ten (10) years. It is the first marriage for both of
 Jin and Daiyu were both born in China and immigrated to Australia 4 years ago.
 They have two daughters:
o Lucy (3 years old) and Olivia (6-month-old).
 Daiyu is a G5P2; she has had 3 miscarriages at 8 weeks, 17 weeks and 14 weeks
 Jin works long hours as an accountant in a large firm, and he is working towards a
promotion. He leaves early and gets home late, often after the children have been
bathed and put to bed.
 Daiyu is a full-time dental nurse and works Monday – Friday, but has to do a
Saturday shift 0900-1500 every second weekend. She has just returned to full time
work after 6 months maternity leave.
 They rent a 2 story, 3-bedroom town house in Sunnybank Hills with a small backyard.
 They do not have a car and neither of them drive. The house is located about 1
kilometre from the nearest bus stop, and the shopping centre is 2 kilometres away.
Extended Family
 Jin is an only child and his parents immigrated to Australia at the same time as Jin and
Daiyu. They live with Jin and Daiyu. Jin’s father, Wei, is aged 74, and his mother,
Ling is aged 67. Jin financially supports both his parents. They have no other family
in Australia.
 Wei and Ling speak Mandarin and do not speak, read or write English. .
 Daiyu’s parents are still in China. They visited Australia when Lucy was born, but
they have not been able to afford to come back since. Ling has 2 brothers, who still
live in China.
Current situation:
 Ling is the primary carer for Lucy and Olivia whilst Jin and Daiyu are at work.
 Wei has recently been diagnosed with stage four (4) bowel cancer and had a bowel
resection and colostomy six weeks ago. Because he was not eligible for Medicare,
there was a big gap payment that Jin had to pay, so Daiyu was forced to return to full
time work earlier than planned.
 Ling is also caring for Wei. His stoma has broken down and he is struggling to cope
with his wound and the diagnosis of stage 4 bowel cancer. He does not help much
with the children or housework and spends most of his time in bed or in the garden.
 Ling also does all the cooking and housework.
 Olivia is still being breast fed at night and Daiyu wakes 2-3 times a night to feed her.
Olivia has formula and expressed breast milk during the day and has just commenced
solid food. Diayu has not had much sleep since returning to work.
 Daiyu is also worried about Lucy. Since Daiyu returned to work, Lucy has started
sucking her thumb and has regressed in her toilet training. She now needs nappies
both day and night. Lucy has also started to throw tantrums at night and in the
morning when Jin and Diayu are leaving for work or coming home. Her tantrums are
annoying Jin; Wei and Ling do not know how to cope with this.
 Ling is becoming withdrawn and is constantly snapping at the children and Daiyu.
 Daiyu is missing her parents very much as she is feeling isolated from her family.
Daiyu skypes her parents regularly but often becomes upset as her parents ask her
constantly when they will have a grandson. She has told Jin she would like another
baby, but Jin has said no.

Sample Solution