Case Studies

Chapter 31: Health Supervision

1. Mikheil and Sophia have brought in their first-born child, Michelle, for her newborn wellness examination. Michelle is 3 days old. She was delivered vaginally at 38 weeks’ gestation. Sophia’s pregnancy and delivery were unremarkable. Mikheil and Sophia are from Jordan but have been in the United States for 8 years. They plan to travel back to Jordan as soon as Michelle is ready to travel. The nurse explains the process of health supervision to the parents, and explains that this includes developmental surveillance and screening; injury and disease prevention; and health promotion. Mikheil and Sophia state that they are not aware of these principles and request further explanation. (Learning Objectives 1, 3, and 4) a. What are the principles of health supervision? b. What is developmental surveillance and screening, and what are some of the factors that may place Michelle at risk for developmental problems? c. What are some of the various types of screening the nurse may perform on Michelle?

2. Jakea, age 12 months, is being seen in the county health department for her 1-year wellness examination. Kayela states that Jakea has been a healthy child and she breastfed her for 6 months but had to stop after that because of her employment. Jakea has two older siblings at home, one in preschool and the other in kindergarten. At the conclusion of the physical examination, Jakea’s mother, Kayela, states that she has been hearing some news reports about the link between autism and the MMR vaccine. She asks the nurse if that is one of the vaccines Jakea will receive today. Kayela then asks about the number of vaccines Jakea will receive on this visit and how many injections she will receive. (Learning Objectives 5 and 6) a. What is the purpose of immunizations and what are the immunizations Jakea would be expected to receive at this visit? b. What is the difference between active and passive immunity? c. What are some barriers to receiving immunizations and what can the nurse do to overcome these barriers?