Three types of family health problems
In the first-level assessment of the family nursing care plan, problems are classified by nature into health threats, health deficits, and foreseeable crises (stress points). A health threat is a condition that favors disease, injury, or failure to reach health potential, such as hazards in the home. A health deficit is an instance of failure in health maintenance already present, such as illness or disability. A foreseeable crisis is an anticipated period of unusual demand on the family, for which it must adjust its resources. The wife's cataract surgery next month will take the main caregiver away for a time, so it is a foreseeable crisis.
Why the surgery fits
The wife is the grandfather's caregiver. While she is in surgery and recovering, she will be unable to supervise his diabetes management, watch over him for falls, or manage his medicines. The family must plan in advance: who will care for the grandfather, how his meals and medicines will be handled, and how she herself will be supported after surgery. Other typical foreseeable crises include pregnancy, a birth, school entry, marriage, retirement, a planned move, and death of a member.
| Condition in this family | Type of problem |
|---|
| Loose rugs and dim stairway | Health threat (accident hazard) |
| Persistently high blood sugar | Health deficit (illness present) |
| Early dementia | Health deficit (illness present) |
| Wife's cataract surgery next month | Foreseeable crisis (stress point) |
Why the other options are not foreseeable crises
Loose rugs and a dimly lit stairway are health threats: they favor accidents, and the grandfather has already fallen once. The persistently high blood sugar and the recently diagnosed dementia are health deficits, conditions already present. Watch out! The word "recently" in the dementia option may suggest an emerging crisis, but a diagnosed illness is a deficit. A foreseeable crisis is an event yet to come that will strain the family.
Exam takeaway
Ask whether the condition favors future harm (threat), is already present (deficit), or is an anticipated event that will strain the family (foreseeable crisis). For this family, the nurse plans with them before the surgery: identifying another caregiver such as the son, arranging diabetes monitoring and fall prevention, and preparing the wife for her own recovery. Anticipatory planning lessens the crisis when it comes.