Option 2: Consider the following scenario:

You are caring for Mr. Jones, who was admitted to the hospital 4 days ago for treatment of injuries sustained in a motor vehicle accident. His diagnoses are fractured right femur, right shoulder dislocation, and closed head injury. Mr. Jones also has chronic hypertension, which has been worsened by his failure to take his medication for several days before the accident and by the stress of the accident. Mr. Jones is 48 years old, married, and has three children aged 15, 10, and 4 years. He is the owner of a small, home-based plumbing company. Two other plumbers work for him. His wife does not work outside the home but does some of the office work for his company. The family lives in a small house in a relatively rural area, about 25 miles from the nearest city. Mrs. Jones is a quiet, shy person who does not drive very much outside of her immediate area. Mr. Jones is the dominant figure, making all major decisions in both the business and the family. The family’s financial situation could be described as “just surviving month to month.” The family belongs to a small Baptist church in their community but are not active because Mr. Jones usually considers himself “on call” every weekend. Mr. Jones is a Native American and has no family in the area. Mrs. Jones is from the area and has one sister and an elderly mother living nearby. On the basis of the above information, and the information from your text, describe what you think would be the impact of this illness on Mr. Jones and his family with respect to the questions that follow.

1. What stage of illness do you think Mr. Jones is demonstrating? Give a rationale for your answer.
2. On the basis of references to Mr. Jones’ cultural background and previous behavior, how do you think Mr. Jones would behave as a patient while in the hospital? Would he be cooperative? Would he tell you if he had pain? Would he refuse treatment? What internal and external influences might be factors?
3. What internal, external, and interpersonal stressors might be operative for Mr. Jones? List as many as possible.
4. What stressors might be factors for this family? List as many as possible.
5. What is the potential impact of Mr. Jones’ illness on the family system?
6. As a nurse, what could you incorporate in your plan of care to assist Mr. Jones and his family with their family disruption? 

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