Health promot case stud

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 Read the following case study and answer the reflective questions.  Please provide evidence-based rationales for your answers.  

APA 7th edition

references within 5 years

MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 2

Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.

Due: Saturday by 23:59 pm

CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan

Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,
her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income
neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and
worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring
of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to
the United States as a registered nurse and met her husband, a drug company representative. The
older couple moved to the United States when their daughter became a U.S. citizen and petitioned
them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come
to the United States.

The Arahans found life in the United States different from that in their home country, but their
adjustment was not as difficult because both were healthy and spoke English fluently. Most of their
time was spent taking care of their two grandchildren and the house. As the grandchildren grew older,
the older couple found that they had more spare time. The daughter and her husband advanced in
their careers and spent a great deal more time at their jobs. There were few family dinners during
the week. On weekends, the daughter, her husband, and their children socialized with their own
friends. The couple began to feel isolated and longed for a more active life.

Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where
they still had relatives and friends. However, political and economic issues would have made it
difficult for them to live there. Besides, they had become accustomed to the way of life in the United
States with all the modern conveniences and abundance of goods that were difficult to obtain in their
country. However, they also became concerned that they might not be able to tolerate the winter
months and that minor health problems might worsen as they aged. They wondered who would take
care of them if they became very frail and where they would live, knowing that their daughter had
only saved money for their grandchildren’s college education. They expressed their sentiments to
their daughter, who became very concerned about how her parents were feeling.

This older couple had been attending church on a regular basis, but had never been active in other
church-related activities. The church bulletin announced the establishment of parish nursing with
two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.
Here, they met one of the registered nurses, who had a short discussion with them about the services
offered. The registered nurse had spent a great deal of her working years as a community health

nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related

Reflective Questions

1. What strategies could be suggested for this older adult couple to enhance their quality of life?
2. What community resources can they utilize?
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
4. What health promotion activities can ensure a healthy lifestyle for them?

  • CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan
  • Reflective Questions

Prevention of Disease Case Study

Question One

The nurse would collect information about the child’s physical health to assess Ricky. According to Martin et al. (2019), the nurse would obtain a history of the child’s eating habits and be aware of any changes in appetite or refusal to eat. The nurse would inquire about any recent illnesses or injuries that might have affected his appetite or ability to swallow food. The nurse would also collect information about the child’s emotional health. Ricky’s physical health can be assessed by noting signs of dehydration, fever, and changes in blood pressure. Ricky’s emotional health can be evaluated by recording anxiety symptoms, such as restlessness and irritability when preparing or eating food. In addition, Shatkin (2019) supports that the nurse would collect information about the family’s socioeconomic status and diet.

Question Two

The nurse would first want to ascertain whether or not Ricky’s refusal to eat is due to any underlying medical condition. She would next like to determine whether or not Ricky is experiencing any pain or discomfort with eating, as this could be a symptom of an underlying medical condition (Lumba et al., 2018: Martin et al., 2019). The nurse should also ask Ricky’s mother about his recent behavior at school, including whether there were any new friends or activities that he joined or participated in recently. If there were any changes, the nurse should inquire about them so she can further explore the issue of Ricky. The question to the mother should follow the following criteria. Nurses would ask the following questions: what are the child’s eating and dietary pattern? How has this changed over time, and why? What are his preferences, likes, dislikes, and favorite foods? Is he eating enough at meals? Does he have a problem with food? If so, what is it?

Question Three

The extended family residing far away influences the family’s approach to health promotion. The extended family can also help by being available for play dates or visits when needed since the parents have a tight schedule as full-time workers (McNeil, Campbell & Crews, 2018). They can also support other activities essential to the child’s development, such as school events or celebrations like holidays with Ricky. As such, Ricky feels it is necessary to have a close relationship with his family, so he may be stressed about not being able to visit them often. Dallacker, Hertwig, and Mata (2018) argue that their child is not getting to see them as much as he would like. It also means that he will not be able to spend as much time with extended family as he would like.

Question Four

There are several factors to consider when determining whether malnourishment is a factor in a family of Ricky’s. If the family is experiencing any other issues, it might contribute to Ricky’s refusal to eat. If so, you may consider those factors in evaluating their situation. For example, if the family has recently experienced a divorce proposal or other significant life change, Lumba et al. (2018) support that it may be difficult for them to focus on nutrition concerns when trying to cope with their own emotional needs. Or if another child in the household shows signs of malnutrition, such as not gaining weight or being underweight. Another factor is if the family is currently experiencing a period of economic hardship. This entails whether the household income is significantly lower than previously and whether the family’s food budget has been cut (Panda, 2019). This could mean they must make difficult choices about what they eat and how much they spend on groceries.


Dallacker, M., Hertwig, R., & Mata, J. (2018). The Frequency of Family Meals and Nutritional Health in Children: A Meta‐Analysis. Obesity Reviews, 19(5), 638-653.

Lumba-Brown, A., Yeates, K. O., Sarmiento, K., Breiding, M. J., Haegerich, T. M., Gioia, G. A., … & Timmons, S. D. (2018). Centers for Disease Control and Prevention Guideline on The Diagnosis and Management of Mild Traumatic Brain Injury Among Children. JAMA Pediatrics, 172(11), e182853-e182853.

Martin, M. A., Perry-Bell, K., Minier, M., Glassgow, A. E., & Van Voorhees, B. W. (2019). A Real-World Community Health Worker Care Coordination Model for High-Risk Children. Health Promotion Practice, 20(3), 409-418.

McNeil, J. C., Campbell, J. R., & Crews, J. D. (Eds.). (2018). Healthcare-Associated Infections in Children: A Guide to Prevention and Management. Springer.

Panda, P. K. (2019). Metabolic Syndrome in Children: Definition, Risk Factors, Prevention and Management—A Brief Overview. Pediatr Oncall J, 16, 67-72.

Shatkin, J. P. (2019). Mental Health Promotion and Disease Prevention: it’s About time.

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