Case Study: School Health Clinic.

NUR322: School Health Clinic- Nursing Case Study Assignment


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It is 2pm, and you are working at the local secondary school. It is mid-way through term three. Lachlan is 14 years old, in grade 9, his first year at this Secondary School. He has transferred to his new school at the beginning of the school year. You are aware that he has Juvenile Onset Diabetes Mellitus (Type 1), because his mother informed you at the beginning of the year. Lachlan presents to you stating he ‘feels funny.’ This is his first presentation to the School Health Clinic.
You take a blood glucose measurement which is low (3 mmol/L), and you give him a glass of orange juice and a sandwich, while asking him some questions about his day. He proceeds to tell you that he skipped lunch because he was keen to play basketball with his friends. He didn’t want to miss out as he was just starting to fit in with the group. You ask him to start eating his lunch now as you continue collecting a history from him.

Client history 
Lachlan lives at home with both parents and two siblings, Chelsea (16) and Trent (7). His parents both work in the family business with his grandparents. He likes to play sport and rides his bike to school most days (about 3km from home). He was diagnosed with diabetes when he was 9 years old. Since his diagnosis his diabetes has been managed well following a regime of BD insulin. For the past two years he has been administering his own insulin, using pens. Previously his father administered the insulin as his mother has an aversion to needles. She can administer Lachlan’s
insulin but prefers not to do so. According to Lachlan, both his parents have a good knowledge of the disease, its manifestations and care required. He keeps a blood glucose diary; although when you examine it you notice there are many lunchtime readings not entered. After a brief discussion with Lachlan you identify that he is being managed solely by his General Practitioner and does not receive any other community support.

Case Study Questions to be addressed 
From the case study, identify the key issues of concern you have for Lachlan and his family. Explain how/why you identified these issues/concerns.
Develop and discuss the care you would implement/introduce to support Lachlan to manage his chronic condition.
Discuss the developmental issues and challenges which Lachlan and his family face, e.g peer pressure, changing dependency relationships, seeking independence, risk taking behaviours.
Considering Lachlan’s developmental age, what communication strategies and specific practice models might you use when interacting with Lachlan and his family? Remember to consider his rights and the family’s rights, family and child centred care.

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