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Problem
Alex Nguyen is a 9-year-old Vietnamese-American boy living in a crowded urban neighborhood with his parents and two younger siblings. His medical history includes moderate persistent asthma and ADHD. His recent asthma exacerbation, caused by indoor air pollution and use of strong cleaning chemicals, resulted in a 3-day hospital admission. Post-discharge, the family received an asthma action plan, but follow-up revealed significant confusion about medication instructions and symptom management. Alex's parents are recent immigrants with limited English proficiency. His mother stays home with the children and relies on older siblings to translate. His father works two labor-intensive jobs and is often unavailable. Despite good intentions, the family struggles with health literacy and understanding complex instructions. At school, Alex has difficulty focusing, shows impulsive behavior, and has been referred to the counselor for classroom outbursts. His teacher notes frequent absences on days when air quality is poor. The school nurse schedules a meeting involving the asthma educator, pediatrician, school counselor, and family. Alex's mother is quiet, avoids eye contact, and offers short responses. Alex is withdrawn but brightens when asked about soccer. The nurse facilitates the meeting with simplified language, visual aids, and interpreters, identifying several health system and cultural barriers. Get the instant assignment help. How can the nurse assess and address health literacy needs in this family?
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