Reference no: EM133444090

CASE STUDY

Health Assessment: John DeBruno

John DeBruno, a 29-year-old man separated from his wife, walked into the health maintenance organization stating he had a severe sore throat, could not eat, had not worked for a day, and was feeling "awful." He wanted to see the physician and get a prescription for an antibiotic. The medical record revealed two episodes within the last 9 months of reports of a sore throat, culture of organism, and antibiotic treatment. The separation from his wife occurred 1 year ago. He had not had a physical examination in 2 years. During the assessment interview, the nurse gathered the following information: John DeBruno appeared tired; he presented his problem in short, terse statements; he was irritable about the clinic's slow service; and he expressed a need to get back to work. Within the last 3 weeks he had been required to work overtime because he faced deadline penalties, and his boss said that Mr. DeBruno's promotion, due in 2 months, depended on his performance now. The company is struggling, and layoffs may be pending. Mr. DeMarco said that, in general, things were fine. His wife was apparently happy without him, and he was too busy to care or to think about that relationship. He made one remark about his boss: "What do you do with a nervous boss?" He described his diet as fast food "taken on the run." He said he gets about 6 h of sleep per night and awakens one to two times near morning. He has infrequent contact with family members, who live in the area. In accordance with the clinical protocol for the health center, the nurse collects a throat culture.

Questions

1. As Mr. DeBruno's nurse, how would you comprehensively assess his health?

2. What are several different diagnoses and possible individual, family, and etiological factors to consider?

3. What work-related health issues may be a concern?

4. What other issues may impact the community where Mr. DeBruno is employed?