Ms. Jones is a 22-year-old mother of three small children who recently moved to an urban area. She brings her oldest child, age 6, to a local comprehensive primary care nursemanaged health clinic...

Ms. Jones is a 22-year-old mother of three small children who recently moved to an urban area. She brings her oldest child, age 6, to a local comprehensive primary care nursemanaged health clinic (NMHC) for school immunizations. During the course of the history and physical examination, the nurse practitioner becomes aware that this mother also has two younger children, aged two and three, at home. The family rents a small apartment in housing that was built in the mid-1950s. Ms. Jones reports that her mother (the children’s grandmother) also resides with them. The grandmother is the child care provider, while Ms. Jones works as a local hair salon. The grandmother mother smokes 1.5 to 2 packages of cigarettes daily; Ms. Jones reports that she is a nonsmoker. Upon further questioning, the nurse practitioner learns that the 3-year-old child has a chronic cough and occasional wheezing. Ms. Jones also confides to the nurse practitioner that she recently missed two menstrual periods and is sexually active.

1. What are some possible health care needs of Ms. Jones? Her mother?

2. What screenings should be performed on Ms. Jones? Her mother?

3. What screenings should be performed on Ms. Jones’ children?

4. What other interdisciplinary team members should be involved in this family’s health care?

5. What are some possible referrals that would benefit this family?