Friedman Family Assessment and Nursing Diagnosis Essay

Friedman Family Assessment and Nursing Diagnosis Essay


A comprehensive family assessment is key to the process of family health promotion (Carpenito, 2010). The Friedman Family Assessment Model will be used for identifying family strengths and weaknesses as well as developmental stages and risk factors. The structure and function of a family will be assessed with the help of an interview in order to identify three nursing diagnoses and develop a plan of nursing intervention.

Structural Assessment

Barner family is a traditional family in a nuclear setup and is composed of two parents and two girls aged 14 and 12. The kids’ names are Tn and Sh. Ax is the father and is a 38-year-old Caucasian male. He is a truck driver; therefore, most of the week he is absent from a family home. Ts is also Caucasian and is the mother of the family. She is 36 years old and pursuing her nursing degree. She also works one day per week in a hospital. Ax and Ts have been married for 15 years. This is the first marriage for both of them.Friedman Family Assessment and Nursing Diagnosis Essay

Home and Community Environment

Barners live in a single-family house near a community park. Both kids have their own rooms. The family is of Russian descent and is highly religious: it attends the Eastern Orthodox Church every Sunday. The father plays a traditional role of family leader and provider while the mother takes care of the family matters. He makes all decisions in the family, and it seems that the wife supports his role as head of the household.

Therefore, it could be argued that there is no evidence of role conflict in the family. However, the mother complained that she often feels exhausted because of the necessity to perform multiple roles simultaneously. She said that because of the absence of the father in the home due to the nature of his profession, she experiences increasing pressure from time demands stemming from her inability to keep a balance between her classes, work, and home. Therefore, it could be said that she has role overload exacerbated by excessive psychological demands (Potter, Perry, Hall, & Stockert, 2010).Friedman Family Assessment and Nursing Diagnosis Essay

Both parents received an equivalent of a high school diploma in Russia. Ax and Ts moved to the United States ten years ago and lived in California for nine years before moving to Miami. They are employed at steady jobs with the potential for promotion and upward mobility. The family even dreams about buying a bigger house. Taking into consideration the fact that both parents are currently occupying salary-paying positions it could be said that they are a part of an economic middle class. In the framework of the Freidman Family Assessment Model, Barners are in the fifth developmental stage of a family with adolescent/young children (Potter et al., 2010).Friedman Family Assessment and Nursing Diagnosis Essay

 Family Functions

Developmental stage 3 was disrupted when Tn was diagnosed with asthma. Moreover, the parents struggled to cope with diminishing privacy at home after the birth of the second child. However, Barners said that the family did not experience any stress-related to individual family member’s developmental states at the moment of the interview. Tn is the oldest kid, and she immensely enjoys being a good role model for her little sister. She loves helping in the house and often does dishes. She is an extremely shy kid and has problems with overeating. She reports not being able to stop herself from consuming large portions of sugary beverages and sweets on a regular basis.

An imperative mode of communication is typical for the family. All parent-child interactions are associated with parents playing the role of coaches and advisors. It could be argued that protective authority is a favorable mode of communication for children because it makes them feel safe and supported; however, communication norms dictated by imperative mode restrict their self-expression (Galvin, 2015). There is no evidence of violence in the family. Barners reported not having an emergency plan.Friedman Family Assessment and Nursing Diagnosis Essay

Health Care Functions

Ax and Ts reported having been practicing safe sex with one partner. The parents also said that in addition to birth control pills they use latex condoms because they are not planning on having another child. They also confessed to not having a history of STDs and never changing sex partners. Barner’s family described their current health status as “relatively healthy.” Even though they value health and would like to improve their condition, the family regularly engages in the risky health behavior of smoking.


Despite the fact they have made numerous attempts to quit the unhealthy habit, they decided that smoking cessation would deprive them of “the quickest way to unwind.” Moreover, the head of the family consumes alcoholic beverages every week and does not want to change unhealthy behavior saying that “it is something I enjoy.” Barner family recognized the necessity of focusing more attention on nutrition. All family members reported consuming a significant amount of processed food due to the inability to prepare healthy meals because of busy lifestyles. Taking into consideration that Ax is a truck driver, he less frequently relies on frozen foods; however, his frequency of fast-food restaurant usage is the highest in the family.Friedman Family Assessment and Nursing Diagnosis Essay

As a result of unbalanced diets, all Barner’s report being overweight. All family members except Ax reports having a normal frequency of bowel movements. The father says that he sometimes experiences problems with constipation and has four bowel movements per week. He also reports having only five to six hours of sleep on a regular basis for the last eight years.

The children have a busy lifestyle because of extracurricular activities. Although they ideally would like to sleep more, they report playing computer games until late at night and, as a result, having only seven to eight hours of sleep. She says that she does not always “feel rested” because of the lack of sleep but still does not feel motivated to change her schedule. It could be said that the overall health of the immediate members of Barner family is good. The history of the extended family indicates the presence of diabetes and a few members with hypertension. Ts has lost her older brother due to a complication of diabetes. Nonetheless, she does not want to change her nutritional pattern.

The family immunization record was up to date. Mr. Barner was diagnosed with hypertension a year ago. Mrs. Barner reported having a tubal ligation. The family denied any medical history except for the case when Tn was diagnosed with asthma at the age of three. Ax reported taking prescription medications to normalize his bowel and bladder pattern as well as address a hypertension problem. The family on the paternal side was a source of significant support for Barners. However, in 2013 Mr. Barner’s mother passed away due to cancer. Ax reports that he feels a lack of external support since then.Friedman Family Assessment and Nursing Diagnosis Essay

 Diagnoses and Plans

Ineffective Health Maintenance

The family is not able to maintain their health (NANDA-I) (Carpenito, 2013). Barners demonstrated a lack of interest in improving their health patterns and behaviors. They also have a long “history of lack of health-seeking behaviors” (Carpenito, 2013, p. 302). The causes of ineffective health maintenance in the family: lack of motivation and poor nutrition.


The patients will voice their intent to develop health maintenance behaviors.


  • Determine the family’s knowledge of health education, health screening, and self-responsibility facilitation;
  • Determine the family’s patterns of health care;
  • Provide Barners with specific information related to health promotion;
  • Discuss the family’s food choices;
  • Advice the parents to quit smocking (Carpenito, 2010).Friedman Family Assessment and Nursing Diagnosis Essay

Imbalanced Nutrition: More Than Body Requirements

Intake of a number of nutrients that surpass metabolic needs (NANADA-I) (Carpenito, 2013). All family members are overweight and show sedentary activity patterns. The diagnosis is associated with a dysfunctional eating pattern (Carpenito, 2013).


All family members will be able to explain why they are at risk of significant weight gain.


  • Discuss nutritional intake and explain the rationale for engaging in modification techniques for managing caloric intake.
  • Provide referral to a weight loss program.
  • Instruct the family to change their activity pattern.Friedman Family Assessment and Nursing Diagnosis Essay

Disturbed Sleep Pattern

Three family members complained about “prolonged periods without sleep” (NANDA-I) (Carpenito, 2013, p. 412). Ax and children had difficulty falling asleep.


The family members having a persistent problem with falling asleep will report acquiring a balance between rest and activity.


  • All causative and contributing factors have to be identified.
  • Reduce environmental distractions.
  • Encourage a sleep routine.
  • Organize daytime activities.
  • Provide necessary health teaching.Friedman Family Assessment and Nursing Diagnosis Essay

Carpenito, L. J. (2010). Nursing diagnosis: application to clinical practice. Philadelphia, PA: Lippincott Williams & Wilkins.

Carpenito, L. J. (2013). Handbook of nursing diagnosis. Philadelphia, PA: Lippincott Williams & Wilkins Health.

Galvin, K. (2015). Family communication instructor’s review copy. New York, NY: Routledge.

Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2010). Fundamentals of nursing. St. Louis, MO: Mosby Elsevier. Friedman Family Assessment and Nursing Diagnosis Essay

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