Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father, who
 both work full-time, and his infant sister. Their extended family lives in a different state more than
 100 miles away. Both parents are of average height and in good health. Ricky’s mother mentions
 that Ricky often expresses frustration, particularly in regard to food. Conflict over food occurs every
 day. Mealtime is a battle to get him to eat, unless his mother feeds him. Ricky’s baby sister seems to
 tolerate all baby foods but requires her mother to spoon-feed. Ricky’s mother is quite frustrated and
 concerned that he will become malnourished.
 Reflective Questions
1. What additional assessment information would you collect? 2.
3. 4.
  What questions would you ask, and how would you further explore this issue with the
 In what ways does the distance of the extended family influence this family’s approach to
 health promotion?
 What factors would you consider to determine whether malnourishment is a factor in this