1. Mr. and Mrs. Le bring their 6-year-old daughter, Thuy, back to…

1. Mr. and Mrs. Le bring their 6-year-old daughter, Thuy, back to the Emergency Department (ED) because she is not responding to the medication that she was given 3 days earlier for a lung infection. She had received an injection of an antibiotic and was given a prescription for oral medication. When the doctor is examining her and listening to her lungs, he sees several “strips” on her back that look like burns. When he questions the parents about these marks, they say that the mother did this to “let the bad wind out” so Thuy could breathe more easily. The nurse asked if they had gotten her antibiotic prescription filled and if she was taking the pills. The parents, not looking directly at the nurse, replied “yes”, “ya, ya,” but then asked if the nurse would give Thuy another injection.

What do you think caused the “strips” on Thuy’s back? Should the Dr. do anything about them?

Should Children’s Protective Service be notified?

Should Mrs. Le be asked if she could apply any other substance to the rubbed areas if the skin has been broken, or Thuy indicates that she has pain in those areas?

Do you think that Mr. and Mrs. Le did understand about getting the prescription filled and making sure their daughter took the medication? Why do you think that they asked about another injection?

 

2. Mrs. Vo is a Vietnamese woman who gave birth to a daughter 12 hours ago. Her neighbor comes to visit – she is very excited about the new baby. When she walks into the room, Mrs. Vo is lying in bed with the infant in the bassinet beside her and there is a full bottle of milk in the crib. Mrs. Vo has not had a shower and most of her breakfast remains on her tray; she has eaten only the tea and toast. When the neighbor exclaims how pretty the infant is, she turns her head away and does not comment. Her mother is sitting in a chair beside the bed, and when the baby begins to cry, she reaches in, picks her up, and begins feeding her the bottle of formula. The neighbor says, “I thought you were going to breastfeed?” Grandmother replies, “She will when real milk is there.” The neighbor explains the benefits of colostrum (clear and very nutritious – comes before the milk) to the mother, but the grandmother and mother continue to answer that the baby will receive breast milk when the “good milk” is there. What is an appropriate comment or question by the neighbor about Mrs. Vo’s food intake?

What is your opinion of Mrs. Vo’s food intake?

How would you expect this mother to behave toward her baby in terms of compliments or care taking?

Who would you most likely expect to find at her bedside and caring for the infant?

What do Mrs. Vo and her mother mean by “real milk” and “good milk?”

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