A family is referred to the home care psychiatric nurse because of repeated arrests of their teenage son for dealing drugs. The family consists of the parents and their children: Joe, age 15, and Maryann, age 10

Question

During the nurse's first home visit, the family reported many concerns stemming from family members' impulsive spending habits. During the visit, there were several arguments between the parents. Joe (the 15-year-old son) left the meeting abruptly. Maryann (the 10-year-old daughter) constantly interrupted when other members of the family were speaking. There was little concern or discussion about the teenage son's potential jail term. The nurse assessed that the family has which of the following levels of differentiation? a. low
b. medium
c. moderate
d. high

Answer 1

A
The nursing assessment would reveal that the family is at the low level of differentiation. Families at this level display emotion, act impulsively, have difficulty delaying gratification, cannot step back and analyze a situation before reacting, and cannot maintain intimate interpersonal relationships. The family referred to in the question tells the nurse that the family spends impulsively, Emotional outbursts consisted of the arguments between the parents and Joe leaving the session. Joe's behavior and Maryann's constantly interruption demonstrated their inability to delay gratification. The family's inability to recognize the severity of their son's potential jail term demonstrated the family's inability to understand the magnitude of their problems.