Ricky, age 4 years, arrives in the clinic with his mother. Rickylives with his mother and father, who both work full-time, and hisinfant sister. Their extended family lives in a different statemore than 100 miles away. Both parents are of average height and ingood health. Ricky’s mother mentions that Ricky often expressesfrustration, particularly in regard to food. Conflict over foodoccurs every day. Mealtime is a battle to get him to eat, unlesshis mother feeds him. Ricky’s baby sister seems to tolerate allbaby foods but requires her mother to spoon-feed. Ricky’s mother isquite frustrated and concerned that he will becomemalnourished.  

  1. What additional assessment information would you collect?

  2. What questions would you ask, and how would you further explorethis issue with the mother?  

  3. In what ways does the distance of the extended family influencethis family’s approach to health promotion?  

  4. What factors would you consider to determine whethermalnourishment is a factor in this family?

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