PHN Pearl Palmer, RN Public Health Theresa Lee, South side, Home visit 09/12/2016

1. In this case the population served is a 15-month Hispanic male child, of single Caucasian
mother. She has one other child, 3 years of age. She is a single mother and is of low income.
2. One factor from the Healthy People 2020 (HP2020) Social Environment broad category of
Determinants of Health1 identified in the above community that impacts health, functioning, or
quality of life is the poor neighborhood with old houses where the child is living with his mother,
grandmother and older sibling. The mother of the child does not have access to healthy foods.
Also, the mother is living in an area of the town where there is concentrated poverty.
3. One factor from the HP2020 Health Services broad category of Determinants of Health1
identified in the child that impacts health, functioning, or quality of life is the lack of access of
health care. The child and his mother are part of Health Start Program that is targeted to women
with low income. In addition, the health literacy of the mother may impact the quality of life of
the child. The public health nurse has to assist the child through home visits to ensure that he is
receiving appropriate care and growing well.
4. a) One nursing action taken by the CHN is to assess through the home visit for any health
problems and home safety. After receiving the agreement that she can come for the home visits,
the nurse begins her assessment by gathering information from the patient and their family. The
questions will help to discover the patients health status and be able to identity health problem
and factors that can contribute or improve the patients health. The nurse then schedules a
referral or a follow up.
b) The activitys related Core Public Health Function1 is assurance that promote and protect
public interests through programs. The child is enrolled in a program which is taking care of a
pregnant mom and her child up to 2 years of age. Also, the nurse informs the childs mom of

necessary services to reach agreed goals. The home visits are done for this reason and require
agreement of the family before realization.
c) The related Essential Public Health Service1 is the essential service #7: link the child to
needed personal health services and assure the provision of care when otherwise unavailable.
The nurse monitors the childs health by asking if the child has a pediatrician and the last visit of
the child. The nurse also assesses the environment and the childs surroundings to look for any
health hazards, as well as how the toddler interacts or is stimulated.
d) The related intervention would be referrals or follow up that allow the nurse to assist the child
and the mother to identify and access necessary resources in order to prevent or resolve problems
or concerns. The home visit that the students nurse was able to assist in, was a follow up of the
child, where the nurse is making connection with the appropriate resources in the community.
5. Primary prevention is the level of prevention because the public health nurse is promoting
health and wants to prevent any disease that would occur to the child. The corresponding stage in
the natural history of the disease or health problem is the stage of susceptibility because no
diseases are presents at this point and the goal is to prevent this health problem. The nurse asked
about the childs well visits and immunizations status.
6. Risk for delayed development of the 15-month old child is related to unhealthy food provided,
environmental hazards as evidence based by inappropriate food for this age cooked by the
grandmother, sharp corners of the table and a large amount of furniture in the living room.
Rationale: at this age, the infants are under the direct care of the mom and most injuries at this
age group are resulted from the presence of household hazards, and enhanced mobility of older
infants as they develop. Home safety is important. In addition, at this age, the child needs an
appropriated food to ensure his proper growth.