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LICEO DE CAGAYAN UNIVERSITY LICEO DE CAGAYAN UNIVERSITY Rodulfo N. Pelaez Blvd. Carmen, Cagayan de Oro City COLLEGE OF NURSING COLLEGE OF NURSING In Partial Fulfillment of the Requirements In NCM501205 Related Learning Experience FAMILY CASE STUDY Submitted to: Submitted by: GROUP A5 S.Y. 2010-2011 February ,2011 COMMUNITY HEALTH NURSING CASE PRESENTATION TABLE OF CONTENTS I. INTRODUCTION A.) Specific objectives B.) Scope and Limitation of the study II. SPOT MAP III. FAMILY PROFILE
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LICEO DE CAGAYAN UNIVERSITYLICEO DE CAGAYAN UNIVERSITYRodulfo N. Pelaez Blvd. Carmen, Cagayan de Oro City

COLLEGE OF NURSINGCOLLEGE OF NURSING

In Partial Fulfillment of the Requirements

In NCM501205 Related Learning Experience

FAMILY CASE STUDY

Submitted to:

Submitted by:

GROUP A5

S.Y. 2010-2011

February ,2011

COMMUNITY HEALTH NURSINGCASE PRESENTATION

TABLE OF CONTENTS

I. INTRODUCTION

A.) Specific objectives

B.) Scope and Limitation of the study

II. SPOT MAP

III. FAMILY PROFILE IV. FAMILY HEALTH HISTORY

VI. PRESENT HEALTH STATUS

VII. IMCI

VIII. HOME AND ENVIRONMENT

IX. FAMILY COPING INDEX

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X. SCHEMATIC PRESENTATION OF FAMILY HEALTH PROBLEM

XI. FAMILY HEALTH PLAN

XII. ACTUAL IMPLEMENTATION

XIII. RECOMMENDATION

XIV. EVALUATION

XIV. BIBLIOGRAPHY

XV. APPENDICES

I. INTRODUCTION

Families are the foundation of society. It is where we come into the world, are

nurtured and given the tools to go out into the world, capable and healthy or we

aren’t. While the families have the greatest potential for raising healthy individuals,

they can also wound their members in places that will never heal. When families

breakdown and fail to provide the healthy nurturing we need, the effects impact not

only our own lives, but also our communities.

The family is the basic unit of society that consists of those individuals, male or

female, youth or adult, legally or not legally related, genetically or not genetically

related, who are considered by others to represent their significant persons. As a

universal social institution, it may be defined as a group of persons united by ties of

marriage, blood, or adoption; constituting a single household unit; interacting and

communicating with each other in their respective social roles as husband and wife,

mother and father, son and daughter, and creating and maintaining a common

culture.

 Families were special person that would always be there for you throughout

life. “Blood is thicker than water as they say” its because no matter what happen

they would always be a bond that connects each one of you, and when there is

problem or trials in the family especially if it talks on health, hatred and hurt

feelings would taken for granted because all you wanted is to support each other.

Every of us need a family, we can’t make it alone, even if we are the richest person

in the world, you would ask yourself, what will you do with your money? Money

cannot buy happiness, and it can never buy true family

      Family is a part of society, a community in which individual has the same

interest, and a community with a goal; to help each one become a productive

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individual who in return could assist in development. There is a good chance for

success if communications between all the family members are open and honest.

Each person's needs must be recognized as being legitimate and important. Each

individual must, with mindfulness and intention, make a commitment to the survival

of the family.

      Community Health Nursing is a unique blend of nursing and public health

practice woven into human service that properly developed and applied has

tremendous impact on the human being. Its responsibilities extend to the care and

supervision of individuals and families in their homes, work place, schools and

clinics.

The primary focus of the community health nursing practice is on health

promotion. And the goal of the community health services is raise the level of the

health of the citizenry.

In this special field of nursing that combines the skills of nursing, public health

and some phases of social assistance and functions as part of the total public health

program for the promotion of health and the improvement of the conditions in the

social and physical environment, rehabilitation of illness and disability.

As part of the requirement of NCM501205, students were asked to have a family

Care Study for them to understand more deeply the community health nursing. This

aimed for student to study each family, their functions and their ways of living and

if this family passed the standards of considered as the health ways of living.

I had chosen Family for this care study and I visited the family for 4 times. All of

us were given enough time to visit our families for us to fully appreciate the

changes that we had brought to our individual families.

This study is intended to better understand the common diseases as well as the

health problems that are commonly encountered by the family in the community.

This was purposely done to enhance my knowledge and to help the family in the

process.

A.)OBJECTIVES OF THE STUDY

At the end of 5 days Community Health Nursing Exposure, we will be able to:

Establish trust and rapport to chosen family

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Assess the health needs, plan, implement and evaluate the impact of health

care to the family members

Provide a quality nursing care to the family members

Reinforce health teachings to family members

This case study will serve as a basis or reference to evaluate the nursing

managements and health teachings implemented and imparted to the family

members

B.) SCOPE AND LIMITATION

The study was conducted within the parameters of Zone 4-B Carmen,

Cagayan de Oro City to the Divina Family. The study focuses on:

1. obtaining the family profile, health history and present health

condition,

2. assessing, recording, and gathering of pertinent data about the

family, estimating the nursing needs and coping capacity of the

family

3. identify the primary health problems of the family members and the

applicable interventions to solve the priority problems.

4. evaluation, recommendation and referrals for the Family.

This study is conducted with a minimal time frame of 3 home visitations from

February 8, 14, 15, 2011. With the time given, we grasped the opportunity to take a

closer look at the environment, nutrition, activities or routines of the family that

might threaten their health. However, not all the time all the family members were

available due to their occupational activities so the physical assessment of each

member was not consistent as to the home visitations correspondingly.

II. SPOT MAP

From the point of reference (Liceo de Cagayan), it is approximately 1.5

kilometers from Zone 4B barangay Carmen.

From Liceo de Cagayan University, the PUJ travels along the Vamenta BLVD

up to the Golden heritage polytechnic College. The house of the Divina Family is two

houses away in front of the said school.

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III. FAMILY PROFILE

FATHER

Name : Emmanuel Enloran

Position in the Family : Head of the Family

Sex : Male

Birth Date : December 25, 1964

Age : 46 years old

Civil Status : Married

Nationality : Filipino

Address : Zone 4-B, Carmen, Cagayan de Oro City

Religion : Roman Catholic

Educ. Attainment : High School Level

Occupation : Unemployed

Monthly Income : None

Allergies : No known Food and Drug Allergies

MOTHER

Name : Gina Mae Divina

Position in the Family : Mother / Bread Winner of the Family

Sex : Female

Birth Date : March 10, 1979

Age : 32 yrs. old

Civil Status : Single ( Live-in )

Nationality : Filipino

Address : zone 4-B, Carmen, Cagayan de Oro City

Religion : Roman Catholic

Educ. Attainment : High school Level

Occupation : Store Owner

Monthly Income : 7,000/month (estimated)

Allergies : No Known Food and Drug Allergies

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ELDEST

Name : Sherela Enloran

Position in the Family : Eldest

Sex : Female

Birth Date : November 13, 2007

Age :3 yrs. old

Civil Status : Child

Nationality : Filipino

Address : Zone 4-B, Carmen, Cagayan de Oro City

Religion : Roman Catholic

Educ. Attainment : None

Occupation : N/A

Allergies : No Known Food and Drug Allergies

IV. FAMILY HEALTH HISTORY

A. FATHER

Mr. Emmannuel Enloran, head of the family was born through normal

spontaneous vaginal delivery. He is the second among the five siblings. Mr.

Emmanuel was not able to remember if he had any immunizations during his

childhood years. He verbalized that his family has a history of hypertension and

diabetes. He does not have any food allergies. He drinks occasionally and don’t

smoke.

B. MOTHER

Mrs. Gina Mae Divina, a 32 years old, gravida 1, parity 1, abortion 0, was born

through normal spontaneous vaginal delivery. Mrs. Divina was not able to recall if

she had any immunizations during her childhood years. She gave birth to her child

at home through normal vaginal delivery assisted by the midwife in their barangay.

She admitted that she use pills as contraception. Her family has a history of

hypertension on both paternal and maternal side. Mrs. Divina has no known allergy

in food and drugs.

C. Eldest daughter

Sherela Enloran is the first and only child in the family. She was born trough

normal spontaneous vaginal delivery assisted by the midwife in their barangay.

Sherela grew up on the care of her mother at Zone 4 b Cagayan de Oro because her

father has other family living in patag Cagayan de Oro. Her mother was able to

brought her on the barangay health center and was able to complete the

immunization. Last year, she experienced Dengue Fever and was treated through

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Paractamol for fever and drinking of “Tawa-tawa”. Sherela does not have any food

and drug allergies and have not received blood or any blood products at the past.

V. PRESENT FAMILY HEALTH STATUS

First level of assessment has been performed on the 3 members of the family

during the 3 home visitations which covered the period starting February 8, 14 and

15. We only met the wife because the husband is on his other family at patag

Cagayan de oro city. Mrs. Divina said that her husband visits on their house 2 times

a week

During the first level of assessment, data has been gathered through interviews

conducted through the wife. Her husband does not smoke and drinks occasionally.

Her child completed the immunization .

With regards to family planning, the couple decide to use pills as their

contraception.

All members of the family have no known drug and food allergies. With regards

to the kind of food they eat, they seldom eat meat, their viand, if there’s any, was

mostly canned goods, noodles and vegetables.

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NURSING SYSTEM REVIEW CHART

Name: Gina Mae Divina(Mother)

Temp.: 37.1 0CPulse Rate: 82 bpm Resp. Rate: 20cpm BP: 110/70 mmhg_ Temp.: 36.9 0CPulse Rate: 66 bpm Resp. Rate: 18cpm BP: 110/70 mmhg_ Temp.: 36.8 0C Pulse Rate: 70 bpm Resp. Rate: 17cpm BP: 110/80 mmhg_

INSTRUCTIONS: Place an [X] in the area of abnormality. Comment at the space provided. Indicate the location of the problem in the figure using [X].EENT:[ ] impaired vision [ ] blind [ ] pain[ ] reddened [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning[ ] edema [ ] lesion [] teethAssess eyes, ears, nose throat for abnormalities.[x ] no problemRESPIRATORY:[ ] asymmetric [ ] tachypnea [ ] apnea [ ] rales [ ] cough [ ] barrel chest[ ] bradypnea [ ] shallow [ ] rhonchi[ ] sputum [ ] diminished [ ] dyspnea[ ] orthopnea [ ] labored [ ] wheezing[ ] pain [ ] cyanoticAssess resp. rate, rhythm, pulse blood breath sounds, comfort [x] no problemCARDIOVASCULAR:[ ] arrhythmia [ ] tachypnea [ ] numbness

[ ] diminished pulses [ ] edema [ ] fatigue[ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain

Assess heart sound, rate, rhythm, pulse, blood pressure.

Circulation, fluid retention, comfort[ ] no problemGASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass[ ] dysphagia [ ] rigidity [ ] painAssess abdomen, bowel habits, swallowing bowel sounds, comfort.

[x] no problemGENITO-URINARY AND GYNE:[ ] pain [ ] urine color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nocturiaAssess urine frequency, control, color, odor,Comfort, gyne bleeding, discharge[ ] no problemNEURO:[ ] paralysis [ ] stuporous [ ] unsteady

[ ] seizures [ ] lethargic [ ] comatose [ ] vertigo [ ] tremors [ ] confused

Untrimmed nails (X)

Dry skin

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[ ] vision [ ] gripAssess motor, function, sensation, LOC, strength

Grip, gait, coordination, speech[x] no problemMUSCULOSKELETAL AND SKIN: [ ] appliance [ ] stiffness [ x] itching [ ] petechiae [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin color

[ ] flushed [ ] atrophy [ ] pain[ ] ecchymosis [ ] diaphoretic [ ] moist

Assess mobility, motion, gait, alignment, joint function skin color, texture, turgor, integrity [x] no problemLegend:First assessment: February 8, 2011Second assessment: February 14, 2011Third Assessment: February 15, 2011

NURSING SYSTEM REVIEW CHART

Name: Sherela Enloran (daughter)

Temp.: 37 0CPulse Rate: 90 bpm Resp. Rate: 18cpm BP: N/ATemp.: 36.6 0CPulse Rate: 87 bpm Resp. Rate: 19cpm BP: N/A Temp.: 36.8 0C Pulse Rate: 89 bpm Resp. Rate: 18cpm BP: N/AINSTRUCTIONS: Place an [X] in the area of abnormality. Comment at the space provided. Indicate the location of the problem in the figure using [X].EENT:[ ] impaired vision [ ] blind [ ] pain[ ] reddened [ ] drainage[ ] gums [ ] Hard of hearing [ ] deaf [ ] burning[ ] edema [ ] lesion [ ] teethAssess eyes, ears, nose throat for abnormalities.[x ] no problemRESPIRATORY:[ ] asymmetric [ ] tachypnea [ ] apnea [ ] rales [ ] cough [ ] barrel chest[ ] bradypnea [ ] shallow [ ] rhonchi[ ] sputum [ ] diminished [ ] dyspnea[ ] orthopnea [ ] labored [ ] wheezing[ ] pain [ ] cyanoticAssess resp. rate, rhythm, pulse blood breath sounds, comfort [x] No problemCARDIOVASCULAR:[ ] arrhythmia [ ] tachypnea [ ] numbness

[ ] diminished pulses [ ] edema [ ] fatigue[ ] irregular [ ] bradycardia [ ] murmur

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[ ] tingling [ ] absent pulses [ ] pain

Assess heart sound, rate, rhythm, pulse, blood pressure.

Circulation, fluid retention, comfort[ ] no problemGASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass[ ] dysphagia [ ] rigidity [ ] painAssess abdomen, bowel habits, swallowing bowel sounds, comfort.

[x xxx] no problemGENITO-URINARY AND GYNE:[ ] pain [ ] urine color [ ] vaginal bleeding

[ ] hematuria [ ] discharge [ ] nocturiaAssess urine frequency, control, color, odor,Comfort, gyne bleeding, discharge[x] no problemNEURO:[ ] paralysis [ ] stuporous [ ] unsteady

[ ] seizures [ ] lethargic [ ] comatose [ ] vertigo [ ] tremors [ ] confused [ ] vision [ ] gripAssess motor, function, sensation, LOC, strength

Grip, gait, coordination, speech[x xxx] no problemMUSCULOSKELETAL AND SKIN: [ ] appliance [ ] stiffness [ ] itching [ ] petechiae [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin color

[ ] flushed [ ] atrophy [ ] pain[ ] ecchymosis [ ] diaphoretic [ ] moist

Assess mobility, motion, gait, alignment, joint function skin color, texture, turgor, integrity [x ] no problemLegend:First assessment: February 8, 2011Second assessment: February 14, 2011Third Assessment: February 15, 2011

Immunization

Immunization Schedule Sherela Enloran

BCG √

Untidy appearance

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DPT1 √

DPT2 √

DPT3 √

OPV1 √

OPV2 √

OPV3 √

HEP B1 √

HEP B2 √

HEP B3 √

MEASLES √

VI. INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS

Date: February 8, 2011

Child’s Name: Sherela Enloran Age: 3 years old Ht: 80 cm Wt: 11kg. Temp: 36.8 C

ASK: What are the child’s problems? None Initial visit: √ Follow-up visit:__

ASSESS (circle all signs present)

CHECK FOR GENERAL DANGER SIGNS

NOT ABLE TO DRINK OR BREASTFEED

VOMITS EVERYTHING

CONVULSIONS

ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN

YES___NO_√_

DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES ___NO_√_

For how long? Count the breaths in one minute. 18 breaths per minute. Fast breathing?

Look for chest indrawing. Look and listen for stridor.

DOES THE CHILD HAVE DIARRHEA? YES_NO_√__

For how long? __days

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Look at the young infant’s general condition. Is the infant: Abnormally sleepy or difficult to awaken

Restless or irritable?

Look for sunken eyes. Pinch the skin of the abdomen. Does it go back : Very slowly (longer than 2 seconds)?

Slowly?

DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37C YES__NO_√__

Decide malaria risk Does the child live in malaria area? Has the child visited/traveled or stayed overnight in a malaria

area in the past 4 weeks? If malaria risk, obtain a blood smear.

LOOK AND FEEL

Look or feel for stiff neck Look for runny nose

THEN ASK :

For how long has the child had a fever? days. If more than 7 days. Has fever been present almost

everyday? Has the child had measles within the last 3 months?

Look for signs of MEASLES

Generalized rash and

One of these, cough, runny nose, or red eyes.

------------------------------------------------------------------------------------

If the child has measles now or within the last 3 months:

Look for mouth ulcers If yes, are they deep and extensive?

Look for pus draining from the eye. Look for clouding of the cornea.

------------------------------------------------------------------------------------

ASSESS DENGUE HEMORRHAGIC FEVER

THEN ASK:

Has the child had any bleeding from the nose or gums or in the vomitus or stool?

Has the child had black vomitus or black stool? Has the child had persistent abdominal pain? Has the child had persistent vomiting?

LOOK AND FEEL:

Look for bleeding from nose or gums Look for skin petachiae Feel for cold and clammy extremities

---------------------

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Check for capillary refill.___ seconds. Perform tourniquet test if child is 6 months or older AND has

no other signs AND has fever for more than 3 days.

DOES THE CHILD HAVE AN EAR PROBLEM? YES__NO_√_

Is there ear pain? Is there ear discharge?

If yes, for how long ___days

Look for pus draining from the ear Feel for tender swelling behind the ear.

No ear infection

THEN CHECK FOR MALNUTRITION and ANEMIA

Look for visible severe wasting. Look for edema of both feet. Look for palmar pallor.

Severe palmar pallor ? some palmar pallor?

Determine weight for age. Very low?

No anemia and not very low

weight

CHECK THE CHILD’S IMMUNIZATION STATUS Circle immunizations needed today.

__√_ __√_ __√_ _√__

BCG DPT1 OPV1 HEP B1

__√_ __√_ _√__ __√__

DPT2 OPV2 HEP B2 MEASLES

__√_ _√__ _√__

DPT3 OPV3 HEP B3

Return for next immunization on:

Completed

(date)

CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or older.

Is the child six months of age or older? Yes_√_No___

Has the child received Vitamin A in the past six months? Yes_√_No___

Vitamin A needed today

Yes __No _√_

ASSESS CHILD’S FEEDING If child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years old.

Do you breastfeed your child? Yes__No___If Yes, how many times in 24 hours? ___ times. Do you breastfeed during the night? Yes__No__

Does the child take any other food or fluids? Yes__No__If Yes, what food or fluids? __rice, vegetables, fish and meat______________________________________________

How many times per day? _3__times. What do you use to feed the child? _____spoon________

If very low weight for age: How large are servings?

Feeding Problems:

Child has no feeding

problems

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______________________________

Does the child receive his/her own serving? ____Who feeds the child and how? _______

During the illness, has the child’s feeding change? Yes___No___

If Yes, how?

No anemia and not in very low

weigh

ASSESS CARE FOR DEVELOPMENT:

Ask question about how the mother cares for her child. Compare the mother’s answers to the Recommendations for Care and Development for child’s age.

How do you play with your child?

How do you communicate with your child?

Care and development

problems

ASSESS OTHER PROBLEMS None

VII. HOME AND ENVIRONMENT

a.)Housing

The living space of the house is really small and adequate just for them.

The house is divided into two rooms, one-fourth of the house is occupied

by the store, while three-fourths for the bedroom.

They used electricity for lighting.

The window of the house is the store itself.

It has no living room and a comfort room.

They cook outside the house, beside the comfort room.

They all sleep together in their bedroom.

Presence of breeding sites of vectors of diseases such as mosquitoes are

seen outside the house.

They store their foods by using food containers.

Used clothes just left dumped inside the room and lots of hang clothes are

seen.

They cook their food at a dirty kitchen outside their house, in front of the

laundry area and comfort room, by using firewood.

Fire hazards are noted, such as house made of wood and they use

firewood in cooking in the house.

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b.)Water Supply

For the water supply, they use faucet and they are sharing it with the

other households near them.

c.) The Kitchen

They cook through a firewood, their kitchen is outside their house near the

laundry are and the toilet.

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d.)Toilet

The toilet is shared with the other households near them, since they are

only renting the place.

e.)Garbage disposal

The place their garbage in sac beside the house, and when the Garbage

track arrives they throw it away.

f.) Sanitation Condition

The area and the house itself have a really poor sanitation. It is very

exposed to fire hazards and vector sites that may cause danger to the

people living there.

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g.)Drainage Sytem

The drainage system is exposed to the individuals living there, especially

to our chosen family since it is just beside their house, and the drainage

are clogged with garbage and leaves.

h.)Kinds of Neighbors

Low income settlers.

Their past time is playing cards, chatting with neighbors, and staying

outside their houses.

Only a few couples were married, and they seem to be very suspicious of

interviews.

They are lively neighbors and satisfied with their life.

i.) Social and Health facilities available

For their health facilities, they seek health care services at the health

center.

There are also stores around the area.

j.) Transportation

a. For their transportation, they ride jeepneys and motorcycles.

VIII. FAMILY COPING INDEX

AREAS

SCALE

JUSTIFICATION1 3 5

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1.)Physical independence

- Family providing partially the needs of the members with the support of the separated father of the children

Each member of the family does not have a physical problem that inhibits or affects their activities of daily living.

2.)Therapeutic independence

- they have their own traditional treatment whenever diseases occurs

The family is aware of the right procedure for treatment but the mother wasn’t able to grasp its importance, just like when her daughter got sick with symptoms of dengue, she still chose to treat it at home through drinking of “Tawa-tawa” than taking her to the hospital.

3.) Knowledge of the health condition

- the family does not used to go to heath center to seek consultation

They lack knowledge about any condition that might lead them into complications and severity of possible illnesses that they could acquire.

4.) Application of principles of general hygiene

- Family’s views on sanitation and proper personal hygiene and adequate rest and relaxation.

Garbage is not properly

disposed; they are not practicing the segregation of wastes. And they do not have a compost pit of their own

Lack of storage facilities

5.) Health attitude

- This category is concerned with the way the family feels about health care in general, including preventive services, care of illness and public health measures.

Accepts health care advice in some degree but with reservation.

The mother seldom consults at the health center.

The family gives little importance on their dental care.

Some of the water containers use in storing drinking water is uncovered.

6.) Emotional competence

- This category has to do with the maturity and integrity with which the members of the family are able to meet the

The family sees life as what it is and although they have a lot of problems in life the family accepts their situation and satisfied with it.

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usual stresses and problems of life, and to plan for happiness.

7.) Family living

- This category is concerned with the interpersonal or group aspects of family life.

She was the bread winner of the

family and supportive to each family member.

8.) Physical Environment

- Is concerned with family home and community, or work environment as it affects family health.

There are areas near and inside their house, which permits as a breeding sites of mosquitoes, flies, and rodents.

The drainage is exposed and garbage are visibly seen.

9.) Use of the community facility

- Is concerned with the degree to which the family members know about the wisdom with which they use available community resources for health education and welfare. Use of hospitals, clinic, welfare organization, churches, etc.

The mother haven’t visited the health center to seek for medical advice because she has important things to do and doesn’t have enough time.

Legend:

5-complete competence

3-moderate competence

1-incompetent

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IX. Schematic Presentation of Family Health Problem

SOCIAL BIOLOGICAL

CulturalPoliticalEconomic

Paternal and maternal sides have both history of hypertension

The mother believes that taking certain herbal plants and maintaining her diet treats her disease.

Mother: When she has headache she relieves it through taking Paracetamol

Father:

drinks occasion-ally.

He had an history of Stroke last year 2010.

Mother seldom attends the community meetings & gatherings

Father:

High school graduate

Mother: 2nd year high school

Unemploye

d

housewife.

The family’s knowledge about some services provided by the government is limited

Financially unstable

Genetic Physical

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IX. FAMILY NURSING CARE PLAN

ENVIRONMENTAL

Toilet type: water-sealed

Drainage and stagnant water beside the house, kitchen, and laundry area

Presence of improper food storage

Flies seen over the area and possible for

rodents

Improper garbage disposal: segregation not practiced

Susceptibility to transmission of harmful microorganisms or vectors within family members

Health threat: Improper garbage disposal; Presence of breeding or resting sites of insects, rodents and other vectors; Poor personal hygiene; Accident hazards; Unsanitary food handling and preparation

Health deficits: HYPERTENSION

Presence of breeding sites of mosquitoes and rodents

Lots of clothes hanged around the bed room.

open store window

Drainage clogged with leaves and garbage

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Priority #1

CUES HEALTH PROBLE

M

FAMILY NURSING

PROBLEMS

GOAL OF CARE

OBJECTIVES OF CARE

INTERVENTION MEASURES

METHODS OF NURSE-FAMILY

CONTACT

EVALUATION

Subjective:

“ daghan lamok labi na pagkagabii”

as verbalized by the mother

Objective:

-stagnant water

Presence of breeding or resting sites of insects, rodents, and other vectors

Inability to provide a home/

Environment which is conducive to health maintenance and personal development due to

-inadequate knowledge of importance of hygiene and sanitation,

-lack of skill in carrying out measures to improve sanitary

After nursing intervention the family will be able to improve environmental condition to eliminate risk of vector-borne and carrier diseases.

After nursing intervention the family will

be able to:

a. identify possible breeding sites of insects, rodents and vectors.

a. take measures in maintaining sanitary surroundings.

b. identify and demonstrate ways of eliminating breeding sites of insects,

1. Discuss with the family the importance of maintaining clean surroundings.

2. Educate the family about possible breeding sites of insects, rodents and other vectors.

3. Provide sufficient information about diseases brought about by insects and other vectors.

4. Demonstrate methods in eliminating breeding sites.

Home Visit 1. The family was able to identify breeding sites of insects, rodents and vectors.

2. Identified ways of eliminating breeding sites of insects, rodents and other vectors.

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condition rodents, and other vectors.

Priority #2

CUESHEALTH

PROBLEMFAMILY

NURSING PROBLEM

GOALOBJECTIVES

OF CAREINTERVENTION

MEASURESMETHODS OF NURSE-

FAMILY CONTACT

EVALUATION

Subjective: “Diretso na ibutang sa basurahan” as verbalized by the mother.

Objective:

- Scattered garbage outside their house

- No garbage can

Improper garbage disposal as a health threat.

1. Inability to properly segregate and dispose due to lack of awareness on proper waste disposal.

2. Inability to appreciate the importance of garbage disposal.

After nursing intervention the family will be able to demonstrate correct ways of garbage disposal.

After nursing intervention the family will be able to:

a. Identify and classify types of waste as biodegradable and non-biodegradable.

b. Practice proper method of waste management.

1. Provide teachings about the correct ways in garbage segregation

2. Educate the family about the risks and effects of improper garbage disposal to promote better compliance.

Home visit

At the end of nursing intervention, the mother started to clean the home environment and sorroundings atleast once a day and place a sack for their garbage to be placed.

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3. Encourage the family to maintain environmental sanitation by utilizing proper garbage containers.

Priority #3

CUES/ DATA

HEALTH PROBLE

M

FAMILY NURSING PROBLEM

GOAL OF

CARE

OBJECTIVES OF CARE

INTERVENTION PLAN

NURSING INTERVENTI

ON

METHOD NURSE-FAMILY CONTACT

RESOURCES NEEDED / REQUIRED

Subjective:

“Sa makita ninyo ang kanal namo walay tabon

Poor Drainage System as a health

Inability to provide a home environment conducive to

At the end of 20 minutes, the client will be

At the end of 20 minutes, the family will be able to:

a. Identify the

Health teachings about the ff.:

a. Benefits of having

Home Visit -Expenses for transportation of the student nurses that will go to the family.

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ug usahay ra malimpyohan as verbalized by Mrs.

Objective:

-Open Drainage made out of soil

-Presence of scattered barbecue sticks,cello- phanes

-Pungent odor

threat. health maintenance and personal development due to:

a.Inadequate knowledge about the importance of sanitation and preventive measures.

b.Lack of skills to improve home environment

able to acknowledge the importance of having a clean drainage effectively.

benefits of having a clean and close drainage system.

b. Enumerate the disadvantages of unclean drainage

c. Emphasize the importance of keeping the drainage clean.

a clean drainage system.

b. Disadvantages of unclean drainage.

c. Importance of keeping the drainage clean.

-Time and effort of the student nurse and family members.

-Broomstick,

Priority # 4

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XI. ACTUAL IMPLEMENTATION

FIRST VISIT

Date: February 8, 2011

Our first exposure in the area, we were tasked to assess six families in each pair. We were able to survey the area and assess and

interviewed six families, and we noticed that some families are not open to give data about their families. Our chosen family for the care study

should be under the required qualities.

Since day one was the first meeting with the family, we focused more on establishing trust and rapport with the family members. We

introduced ourselves and explained the purpose of our visit and succeeding visits. We were able to collect data needed stated in the

assessment sheet. We also observed the environment and identify specific applicable problems in their area. At first, the mother was not that

open to talk about her family, since she was another woman of her live-in partner, and for her it’s a private data. Since, only the mother and

child were available during that time, the father’s data are provided by the mother alone. A simple physical assessment was also done and we

were able to impart health teachings to them

SECOND VISIT

Date: February 14, 2011

In our second visit, we were not able to conduct a continued assessment and interview due to limited time, because we were busy

preparing for our micro-teaching on the next day.

In this day, We focused on distributing our invitation cards for our micro-teaching on the next day and buy the needed materials and foods.

We also gave invitation card to our FCP family and

THIRD VISIT

Date: February 15, 2011

During third visit, We continued assessing the family and identified heath threats and provided them with additional health teachings. We

also took pictures of the area and the family members, we were not able to meet the head of the family again.

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XII. RECOMMENDATION

The rest of the family is advised to go to the nearest health center for more consultations if they would acquire any illness. The health

center can also be helpful in the prevention of any diseases. I also told them to go to the Germans Doctor if they need check up because it is

free and the doctors there can help them.

XIII. EVALUATION

As part of our requirement as nursing students of Liceo de Cagayan University, we were exposed at Bulao, Iponan, Misamis Oriental.

I was able to render care to the Caler family for 5 home visits Bulao, Iponan, Misamis Oriental. During those visitations, the family was

being assessed and various problems were being identified which needed attention in order to improve the family living condition. In those

problems I had able to identified, I was able to give nursing care based on the knowledge that I learned from school.

After giving them the interventions, the family became knowledgeable of the importance of one’s health and the importance of having a

clean safe and disease free environment.

This experience made me realized the true essence of being a health care provider. I was able to experience rendering care not just to

this certain family but also to the community people and it’s not easy. But even if this is so, I felt challenged and I enjoyed the times when we

were walking under the scorching heat of the sun. Blending with the community people and mingling with them gave me a feeling of

satisfaction to be accepted as health care providers. I was able to touch and made even a difference to the lives of the family I cared for and

so with those people in the community.

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XIV. BIBLIOGRAPHY

Community Health Nursing Service Section, National League of Philippine Government Nurses, Inc.,Community Health Nursing Services

in the Philippines, 9th Ed.

Maglaya, Arceli, Nursing Practice in the Community, 4th Ed.Argonanta Corporation, Marikina City, Philippines, 2004.

Kozier et al, Fundamentals of Nursing, 5th Ed. Pearson Education Asia Ptc. Ltd., Singapore, 2002.

Lippincott et al, Manual of Nursing Practice, 7th Ed. Philippines Edition. Gopson Papers Ltd, Noida, India, 2001.

Integrated Management of Childhood Illness, Department of Health

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Sparks and Taylor. Nursing Diagnosis Reference Manual; 6th Edition. Copyright 2005 by Lippincott Williams and Wilkins

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