NUR4636 \u2013 Community Health Nursing
\nCase Study
\nChapter 28
\nWorking with the Homeless
\nSally Anne, aged 19, brought two children into the emergency room. The 6-month-old boy\u2019s
\ncomplaints are a cold with mild fever, fatigue, vomiting with dry coughing spells, decreased intake
\nof cola (2 ounces every 3 hours\u2014her version of clear liquids), one scraped diaper per 12 hours\u2014
\nthe diaper is not soaked so Mom recycles it after scrapping off the solids. The child\u2019s cry is weak,
\nred eyes, sneezing moves thick mucus, prolonged cough, high-pitched noise during intake. The
\nchild\u2019s condition did not improve over the last 24 hours.
\nThe family of three lives in the family sedan parked behind a service station due to Mom\u2019s
\nfear of lack of shelter safety. Turk, the 3-year-old, sports bruises on arms and legs, and a knot on
\nhis forehead. He appears semiconscious (responds to light pain), coughs when disturbed, refuses
\nfluids and food, and pulls away from touch. Mother states that he has been sick for more than a
\nweek, but she is concerned that he has not been as fussy the last 24 hours. His skin tents when
\npinched. Sally Anne believes he lost weight but has not used a scale. Turk does not look adults in
\nthe eye or follow a finger point. He moans but has not communicated with words. He appears to
\nfantasize, and finger plays violently. His fingers seem to attack each other. He does not seem to
\nlisten nor does he respond to questions. Both children are wearing dirty clothing. Mom is
\nexhausted and asks for help with formula and diapers.
\nTreatment: Both children kept overnight for assessment in a room with a bathroom and
\ncouch. Mother permitted to bath and wash children\u2019s clothing after their baths. Cooling mist tent
\nordered. Children placed next to each other for convenience and for precautions. Social worker
\ninvolved for discharge planning. The boys are placed on IVs for hydration and given clear fluids for
\ndrinking. Antibiotics are placed in the IV.
\n1. What information is needed for a complete assessment?
\n2. Will this family be worse off when released from the hospital? What community resources
\nfor homeless families could be activated in the small town? What prevents the family from
\nfalling through economic cracks that will prevent developmental assessments and
\ntreatments?<\/p>\n","protected":false},"excerpt":{"rendered":"
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