Nursing/Midwifery Intervention - Munny Kaew Case Study

Case Study 2:

Munny Kaew Munny is a 45-year-old Cambodian man who lives in Western Sydney with his wife, Ary, and their three children, a girl Chan aged 10, and twin sons, Prak and Rith, aged 6 years. He has presented at the community centre with his wife. Ary is very worried that Munny has not been his usual self since he was interviewed by his employer six weeks ago.
Munny has worked in a large bakery for the last five years that supplies bread for large supermarket chains. He finds this job stressful because he has to start work at 1 am but he says that he enjoys his work once he gets there. However, when his employer spoke to him, he was very surprised to learn that his employer was not satisfied with his work and that if it did not improve, Munny would lose his job. D
Since that incident, Munny has become less and less communicative at home. He is taking increasing amounts of sick leave and when he is not at work, he spends most of his time in bed. Now he rarely takes notice of his children, who were previously the centre of his attention, and no longer does anything around the house. Ary is also worried because Munny is not showing any interest in food and believes he has lost a significant amount of weight. Ary says that she has tried to talk to Munny, but he only speaks in one word answers and says that he is fine and to leave him alone.
Ary tells you that Munny’s family were forced to move from their home into the countryside during the Khmer Rouge period in Cambodia in 1975. His father was shot by the Khmer Rouge. After that, Munny and his mother escaped but had to live in a refugee camp in Thailand until they received a visa to Australia in 1985. After finishing school in Australia, Munny started a degree in law but soon dropped out and started an apprenticeship as a baker. He was always very proud that he could support his family, including his mother.
Munny was always very close to his mother, but she died after a long battle with cancer 6 months ago. Although Munny visited his mother every day during her illness, Ary worries that he did not take time off work after she died. She says that Munny just wanted to keep going so he did not have to think about losing his mother.
When Munny comes to the centre, he was well dressed but his clothes are loose fitting. He is slumped in his chair and staring at the floor. When he is greeted by the nurse, he does not make eye contact and only gives monosyllabic answers to any questions saying ’fine’ or ’no problems’. However, when the nurse asks if Munny has ever thought about whether life was worth living, he shook his head. When asked how his family might feel if anything happened to him, Munny simply shrugs his shoulders. Munny then asks the nurse to leave him alone because he doesn’t want to talk about anything anymore.

Questions 1a) Using the same case study you used in the first part of this assessment, the Analysis of a Case Study, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and support your risk assessment with evidence from the current literature.

Questions 1b) Identify one nursing / midwifery intervention you would immediately undertake with your client to address the risk area noted in question 1a and include a rationale for the intervention.

Ensure the intervention includes who would actually carry out the intervention and when the intervention should occur. Your rationale should state how and why this intervention is carried out. Ensure literature is included.

Questions 2a) Using the same case study you used in the first part of this assessment, the Analysis of a Case Study, identify a mental health concern and use current evidence from literature to support your answer.

Questions 2b) Identify one nursing / midwifery intervention you would undertake with your client to address the mental health concern noted in question 2a and include a rationale for the intervention.

Ensure the interventions include how and when you would carry out the intervention. Your rationale should state why you would carry out the particular intervention. Ensure literature is included when you discuss the rationale.

Questions 3) Using the same case study you used in the first part of this assessment, the Analysis of a Case Study, use current literature, identify and discuss (2) two legal, ethical or professional issues a nurse /midwife may need to consider when working with the client in the case study.

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