Introduction to Medical-Surgical Nursing, 6th ed.
7
Lesson Plans for
The Nurse and the Family
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 7.1:
2. Compare various family structures or lifestyles that characterize modern American families.
4. Describe roles and communication patterns within families.
6. Describe the role of the nurse in dealing with families experiencing various stressors.
7. Identify community resources that may help to meet the family’s needs.
CHAPTER TEACHING FOCUS
• In this chapter, the student will be introduced to topics related to the nurse and the family, including
types of families, family developmental theory, and family roles and communications.
2 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
CHAPTER PRETEST
Have the students answer these questions prior to covering this chapter to understand where they stand
in relation to the content.
1) A blended family is also referred to as a(n) __________.
a) nuclear family
b) step family c) communal family
d) open family
2) The number of single-parent families in the United States is approximately __________.
a) 1 in 2
b) 1 in 3 c) 1 in 4
d) 1 in 5
3) A newly married couple is referred to as a(n) __________.
a) beginning family
b) launching family c) newlywed family
d) initial family
4) A family with 8-year-old twins is referred to as a(n) __________.
a) multiple fertility family
b) young family c) launching family
d) introductory family
5) A retired couple with no children is referred to as a(n) __________.
a) infertile family
b) launching family c) aged family
d) later-life family
6) A family member with certain responsibilities and obligations is defined as fulfilling a(n) __________.
a) role
b) communication c) adaptation
d) defense mechanism
7) The clear transmission of a message is known as __________.
a) maladaptive communication
b) stress response c) functional communication
d) coping response
8) When a family maintains active linkages with the community at large, it is known as a(n)
__________.
a) external coping strategy
b) internal coping strategy c) functional communication
d) dysfunctional communication
9) Maintaining family cohesiveness and sharing feelings is known as a(n) __________.
a) external coping strategy
b) internal coping strategy c) transmission of values
d) teaching beliefs
10) The nurse may provide assistance to the family by __________.
a) telling them how to run their family
b) serving as a maternal role model
c) serving as a liaison to community resources
d) minding his/her own business
_________________________________________________________ Chapter 7 The Nurse and the Family 3
Introduction to Medical-Surgical Nursing, 6th ed.
Chapter Pretest Answers
CHAPTER BACKGROUND ASSESSMENT
Discuss these questions with your students prior to covering this chapter to understand where they stand
in relation to the content.
Question: A 58-year-old husband who is also a grandparent, retired early from a law firm where he
worked for the past 10 years. His 30-year-old second wife is pregnant with their first child. He is surprised
but elated and has accompanied his wife to her first prenatal visit. How should the nurse begin to address
the needs of this family?
Answer: Many individuals at the husband’s current age with established families are usually becoming
Question: A 62-year-old grandmother is caring for her late daughter’s two children, ages 13 and 15 years
old. The daughter was her only child, and the children’s father has been “out of the picture” for several
years. After enrolling the teens in school, the grandmother asks to see the school nurse because she is
concerned about the grieving and coping skills of her grandchildren. The grandmother quit her nursing
supervisor position to care for the children full time. Her husband, who is 64, has decided to delay
retirement to save for the teens’ college expenses. How should the school nurse respond to this
situation?
Answer: As the school nurse starts the assessment, she should keep in mind the typical stages of family
4 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Instructor Preparation
Textbook Objectives Covered
2. Compare various family structures or lifestyles that characterize modern American families.
4. Describe roles and communication patterns within families.
6. Describe the role of the nurse in dealing with families experiencing various stressors.
7. Identify community resources that may help to meet the family’s needs.
Lesson Preparation Checklist
• Prepare lecture from TEACH lecture slides available on Evolve.
• Student performance evaluation of all entry-level skills required for student comprehension of
topics related to the nurse and the family, including:
• The concept of family
Materials and Supplies
Key Terms
• functional communication
Assignments 2 hours
1
READ – Textbook (pp. 83–88)
ANSWER – Text
• Review Questions for the NCLEX Examination: 1 (p. 89)
2
READ – Textbook (p. 83)
REVIEW
_________________________________________________________ Chapter 7 The Nurse and the Family 5
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
3
READ – Textbook (pp. 84–85)
ANSWER – Text
ANSWER – Study Guide
• Part IB: 1-5 (p. 31)
• Part IIC: 3 (p. 32)
• Part IIID: 1, 8 (pp. 32–33)
4
READ – Textbook (pp. 85–87)
ANSWER – Text
ANSWER – Study Guide
• Part IIC: 1 (p. 32)
• Part IIID: 2 (p. 32)
5
READ – Textbook (pp. 87–88)
ANSWER – Text
ANSWER – Study Guide
• Part IIC: 2, 4 (p. 32)
• Part IIID: 3, 4, 6, 7 (pp. 32-33)
6
READ – Textbook (pp. 88–89)
REVIEW
ANSWER – Study Guide
• Part IIID: 5 (p. 32)
7
READ – Textbook (pp. 88–89)
6 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Lecture Outline 20 minutes
1
&
2
Slide 1
Chapter 7
The Nurse and the Family
Slide 2
Types of Families
• Traditional nuclear family
• Made up of biologic or adoptive parents
• Mother and father and their children
• Extended family
TALKING POINTS:
• How do families differ?
Types of Families (cont.)
• Step-parent family or blended family
• Made up of step-parents and their children
• Single-parent family
Slide 4
Types of Families (cont.)
• Nontraditional family
• Open marriages
• Communal families
TALKING POINTS:
Slide 5
Family and Culture
• In the United States, many variations in cultural patterns among families
• Cultural patterns transmitted from parent to child
_________________________________________________________ Chapter 7 The Nurse and the Family 7
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Slide 6
Family and Culture (cont.)
• Diversity may occur within ethnic groups and classes
• The best way to assess specific cultural patterns of a family is to get the information
3
Slide 7
Beginning Families
• The first marriage of a couple marks the beginning of a new family in which the couple
moves from their families of origin to a new relationship
• Developmental tasks
TALKING POINTS:
• What are the five major stages of the family life cycle?
• The beginning families stage is also referred to as married couples or the stage of
marriage.
Slide 8
Families with Young Children
• During the stage when families have young children, the major activities are childbearing
and childrearing up to about age 12
• Developmental tasks
• Set up a young family as a stable unit
• Develop parental roles to meet the changing needs of the children
Slide 9
Families with Adolescents
• The stage when families have teenagers is often the most challenging and difficult
• As an adolescent moves from being dependent on and controlled by parents to
independence and assumption of adult roles, conflicts often emerge
• Developmental tasks
Slide 10
Launching Children and Moving On
• Begins when the first child leaves the parental home and ends with the “empty nest,”
when the last child has left home
• Can be short or long
• Parents are generally middle-aged and may feel “sandwiched” between the demands of
children and the needs of their own elderly family members
8 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Slide 11
Launching Children and Moving On (cont.)
• Parents become grandparents, which requires a change in their roles and self-image
• Major family goal is the reorganization of the family into a continuing unit while releasing
mature young people into lives of their own
• Developmental tasks
TALKING POINTS:
• What are common reasons more grandparents have grandchildren living with them?
Slide 12
Families in Later Life
• Begins with retirement of one or both spouses and ends with the death of the second
spouse
• Role modification necessary
• Income, self-esteem, status, and health decline
• Developmental tasks
• Maintain a satisfying living arrangement
TALKING POINTS:
• When the family is made up of a married couple, what developmental task is identified at
each stage?
4
Family Role Structure
• Each member of the family has a role
TALKING POINTS:
• What are traditional roles in families?
• How do these sometimes need to be redefined?
• Healthy family: there is opportunity to shift roles easily from time to time
Family Role Structure (cont.)
• Family roles may be performance-oriented or emotional
_________________________________________________________ Chapter 7 The Nurse and the Family 9
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Slide 15
roles.
Family Role Structure (cont.)
• Formal roles
• Limited number of positions in the family that are explicitly defined
• Wife-mother, husband-father, son-brother, daughter-sister
• Informal roles
• Not as apparent; usually meet the emotional needs of individuals or maintain the
TALKING POINTS:
• What happens if a family member is unable to fill a role or roles?
Slide 16
Family Interaction
• A unique form of social interaction
• Based on intimate and continuing relationships
• Family functions are carried out through interaction
• Important influence on family interaction is the self-esteem of each member
• If adult members have adequate self-esteem, they can provide the love and
TALKING POINTS:
• Family interaction is the sum total of all of the family roles being actualized within a family
at a given time.
Slide 17
problem-solving, and having and resolving misunderstandings.
Functional Communication
• Clear message enabling receiver to understand the intent or meaning of sender
• In healthy families, a dynamic, two-way process; sender and receiver are active
participants
TALKING POINTS:
• What is the difference between functional and dysfunctional communications?
10 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Emotional Communication
• Expression of emotions or feelings
• Anger, hurt, sadness, happiness, affection, and tenderness
TALKING POINTS:
• Is emotional communication healthy communication?
Affective Communication
• Involves verbal messages of caring and physical gestures of touching, caressing, holding,
and looking
TALKING POINTS:
Slide 20
Dysfunctional Communication
• The opposite of functional communication
• Unclear transmission of information prohibits receiver from understanding the intent or
meaning
TALKING POINTS:
• Dysfunctional patterns of communication may be subtle, and the intent of the
communication is not clear.
5
Family Coping
• A positive response that families use to resolve problems or reduce stress
_________________________________________________________ Chapter 7 The Nurse and the Family 11
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Slide 22
Stress and Adaptation
• Stress
• The response produced by a stressor (or event causing the stress)
• Adaptation
• The process of adjustment to change
• How a family adapts to stress and change affects family health and functioning
TALKING POINTS:
• What does coping involve?
Strategies for Adapting to Stress
• Defense mechanisms
• Ways of responding to stress
• Mastery
• Result of using effective coping strategies
TALKING POINTS:
Slide 24
Coping Strategies
• Actions that families use to respond to stressors
Types of Coping Responses
• Deal with the situation causing the problem
• Geared toward altering or eliminating the stressor
TALKING POINTS:
• What are examples of these three types of coping responses?
12 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Slide 26
Coping Strategies
• Internal coping strategies
• The ability of the family to pull together and respond to problems as a cohesive unit
• Positive communication is crucial for successful internal coping
TALKING POINTS:
• What other coping strategies can you teach families to assist with coping?
6
Slide 27
Family Nursing Care
• General concepts when assessing families and their coping strategies
• Stressors experienced by the family
• Kinds of coping mechanisms used
dysfunctional
TALKING POINTS:
• What family members should be involved when assisting families to cope?
Role of the Nurse
• Consider the needs of family members, especially in cases in which there is a serious
illness or threat of death
TALKING POINTS:
Role of the Nurse (cont.)
• Consider the family’s influence on individual members as you assess, diagnose, plan,
implement, and evaluate nursing care
TALKING POINTS:
• Why is it important to assess the relationships among the patient and other family
members?
_________________________________________________________ Chapter 7 The Nurse and the Family 13
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
7
Community Resources
• Help families cope with health care problems
• Informal resources
Community Resources (cont.)
• Books, magazines, and leaflets can help families learn about an illness or condition, learn
what to expect with the disease, know that they are not alone, and deal with the situation
TALKING POINTS:
• What are some formal resources in your area?
Slide 32
• Rationale: This is the correct statistic.
Question 1
• According to the 2000 census, which of the following statements are true?
A. Seventy percent of households were maintained by married couples.
B. In 5.5 million households, partners were living together but not married.
C. In unmarried partner households, about 1 in 7 of these had same-sex partners.
D. Children under the age of 18 resided in 60% of opposite-sex partner households.
TALKING POINTS:
Slide 33
Question 2
• Which of the following statements is true about family roles?
A. A role is how one is expected to behave in a situation or what is expected of a person
in a certain position.
B. Culture and social class do not influence family roles.
C. Members can only function in one role within the family.
D. Family members can each only function in either a formal or informal role.
14 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
Activities
Classroom Choose from below to make 30 minutes
Online
1
ASSESS BASELINE
• Have the class complete the Pretest. Collect
their work and use the results to guide how
you teach the class.
DISCUSS
• Discuss the concept and functions of the
family. What are the main types of families
and how might the differences influence
health care needs?
• Discuss cultural diversity in the family. What
is the best way to assess the specific
cultural patterns of a family?
•
• Define concept map for the class and then
have the students draw concept maps
illustrating how the family and society are
connected and how they influence each
other. Call on students to share their maps
and discuss their conclusions.
• Divide the class into small groups, and
assign one of the following nontraditional
families to each group:
• Open marriage
ASSESS BASELINE
• Post the Pretest and the Background
Assessment online and have your class
complete them. Use the results to guide how
you teach the class.
2
DISCUSS
• Ask the students to identify and list on the
board the components of modern society
POST AND COMMENT
• Post the following discussion topic online
and have students comment. List at least
3
DISCUSS
• Lead a class discussion on the stages of the
family life cycle. What are some of the main
POST AND COMMENT
• Post the following discussion topic online
and have students comment. List the stages
_________________________________________________________ Chapter 7 The Nurse and the Family 15
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
4
DISCUSS
• Discuss the role structure of the family. What
are some of the common formal and
informal roles? How might these roles
influence the way a family functions and
communicates?
• Divide the class into small groups and have
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Compare and
contrast functional and dysfunctional
communication within families. How might a
family’s communication style become an
issue in health care and patient education?
5
DISCUSS
• Lead a class discussion on the role of
patient education in encouraging and
supporting useful coping strategies. Then
create a two-column table on the board, with
POST AND COMMENT
• Describe adaptive mechanisms the nurse
can teach families to use to cope with
stressors.
6
DISCUSS
• Divide the class into three groups and
assign each group one of the following
scenarios:
• Siblings arguing about whether to place
their father in a nursing home
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Describe the
importance of assessing both the patient
and the family as a unit in providing nursing
care. How might the family influence
16 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 7.1
7
DISCUSS
• Discuss the role of informal and formal
community resources for a family coping
with health care problems.
• Obtain a list of agencies in your area that
provide community services. Before class,
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Complete an
online search. What are some family
resources in your area that you feel would
be advantageous for families?
Critical Thinking Question
A nurse is caring for an 18-month-old child with a fractured femur. The injury is currently
under investigation because it is alleged to have occurred when the baby fell down several
stairs. The infant’s young parents, both 20 years old, live together and have one other child,
a 3-year-old. While the nurse is caring for the infant, the parents are arguing loudly and
abusively about who should babysit the other child and who should stay at the hospital.
Both work two jobs and are trying to balance work and child care. Should the nurse get
involved when the parents begin arguing? Why or why not?
Discussion Guidelines: The nurse needs to intervene and request that the discussion continue
elsewhere because the behavior is inappropriate for the 18-month-old and anyone else in the
Instructor Notes/Student Feedback
_________________________________________________________ Chapter 7 The Nurse and the Family 17
Introduction to Medical-Surgical Nursing, 6th ed.
7
Assessments for
The Nurse and the Family
CHAPTER OBJECTIVES
Lesson 7.1:
2. Compare various family structures or lifestyles that characterize modern American families.
4. Describe roles and communication patterns within families.
6. Describe the role of the nurse in dealing with families experiencing various stressors.
7. Identify community resources that may help to meet the family’s needs.
Assessments by Lesson & Objective
Lesson 7.1
1
Evolve Instructor Resources
• Test Bank: 1, 24
Evolve Student Resources
• NCLEX Review: 1
2
Study Guide
• Part IA: 1-5 (p. 31)
Evolve Instructor Resources
• Test Bank: 2-5, 8
Evolve Student Resources
3
Study Guide
• Part IB: 1-5 (p. 31)
• Part IIC: 3 (p. 32)
• Part IIID: 1, 8 (pp. 32-33)
Evolve Instructor Resources
• Test Bank: 6, 7
Evolve Student Resources
4
Evolve Student Resources
Study Guide
• Part IIC: 1 (p. 32)
• Part IIID: 2 (p. 32)
Evolve Instructor Resources
• Test Bank: 9-16, 25, 26
18 Chapter 7 The Nurse and the Family _________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
Assessments by Lesson & Objective
5
Study Guide
• Part IIC: 2, 4 (p. 32)
• Part IIID: 3, 4, 6, 7 (pp. 32-33)
Evolve Instructor Resources
6
Study Guide
• Part IIID: 5 (p. 32)
Evolve Instructor Resources
• Test Bank: 19, 20
Evolve Student Resources
• Prioritization: 2
Evolve Instructor Resources
Instructor’s Notes/Student Feedback