Community case study

8/7/2019 Community case study

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SAINT MICHAELS COLLEGE OF

LAGUNAPlatero, Bian, Laguna

SCHOOL OF NURSING


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Objectives

To assess family conditions and problems related to health through theestablishment of baseline data.

To be able to acquire knowledge about the disease. To educate well the people around the community in which they canmaintain proper cleanliness in their compound.

To improve health status of the families in the community. To reduce mortality rate in the community.


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INTRODUCTION

Upper respiratory tract infections (URI or URTI) are the illnesses caused

by an acuteinfection which involves the upper respiratory

tract: nose, sinuses, pharynx or larynx. This commonly includes:

tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold.

Signs and symptoms

Acute upper respiratory tract infections

include rhinitis, pharyngitis/tonsillitis and laryngitis often referred to as

a common cold, and their complications: sinusitis, ear infection and

sometimes bronchitis (though bronchi are generally classified as part of the

lower respiratory tract.) Symptoms of URI's commonly include cough, sore

throat, runny nose, nasal congestion, headache, low grade fever, facialpressure andsneezing. Onset of the symptoms usually begins 13 days after

the exposure to a microbial pathogen. The illness usually lasts 710 days.

Group A beta hemolytic streptococcal pharyngitis/tonsillitis(strep throat)

typically presents with a sudden onset of sore throat, pain with swallowing

and fever. Strep throat does not usually cause runny nose, voice changes or

cough.

Pain and pressure of the ear caused by a middle ear infection (Otitis media)

and the reddening of the eye caused by viral Conjunctivitis are often
http://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Respiratory_tracthttp://en.wikipedia.org/wiki/Respiratory_tracthttp://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Paranasal_sinushttp://en.wikipedia.org/wiki/Pharynxhttp://en.wikipedia.org/wiki/Larynxhttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Laryngitishttp://en.wikipedia.org/wiki/Sinusitishttp://en.wikipedia.org/wiki/Otitis_mediahttp://en.wikipedia.org/wiki/Common_coldhttp://en.wikipedia.org/wiki/Rhinitishttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Tonsillitishttp://en.wikipedia.org/wiki/Laryngitishttp://en.wikipedia.org/wiki/Common_coldhttp://en.wikipedia.org/wiki/Sinusitishttp://en.wikipedia.org/wiki/Ear_infectionhttp://en.wikipedia.org/wiki/Bronchitishttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Sore_throathttp://en.wikipedia.org/wiki/Sore_throathttp://en.wikipedia.org/wiki/Runny_nosehttp://en.wikipedia.org/wiki/Nasal_congestionhttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Feverhttp://en.wikipedia.org/wiki/Sneezinghttp://en.wikipedia.org/wiki/Otitis_mediahttp://en.wikipedia.org/wiki/Conjunctivitishttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Respiratory_tracthttp://en.wikipedia.org/wiki/Respiratory_tracthttp://en.wikipedia.org/wiki/Nosehttp://en.wikipedia.org/wiki/Paranasal_sinushttp://en.wikipedia.org/wiki/Pharynxhttp://en.wikipedia.org/wiki/Larynxhttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Laryngitishttp://en.wikipedia.org/wiki/Sinusitishttp://en.wikipedia.org/wiki/Otitis_mediahttp://en.wikipedia.org/wiki/Common_coldhttp://en.wikipedia.org/wiki/Rhinitishttp://en.wikipedia.org/wiki/Pharyngitishttp://en.wikipedia.org/wiki/Tonsillitishttp://en.wikipedia.org/wiki/Laryngitishttp://en.wikipedia.org/wiki/Common_coldhttp://en.wikipedia.org/wiki/Sinusitishttp://en.wikipedia.org/wiki/Ear_infectionhttp://en.wikipedia.org/wiki/Bronchitishttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Sore_throathttp://en.wikipedia.org/wiki/Sore_throathttp://en.wikipedia.org/wiki/Runny_nosehttp://en.wikipedia.org/wiki/Nasal_congestionhttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Feverhttp://en.wikipedia.org/wiki/Sneezinghttp://en.wikipedia.org/wiki/Otitis_mediahttp://en.wikipedia.org/wiki/Conjunctivitis


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thecoronavirus, parainfluenza virus, adenovirus, enterovirus, and respiratory

syncytial virus.

Up to 15% of acute pharyngitis cases may be caused by bacteria,

commonly Group A streptococcus in Streptococcal pharyngitis ("Strep

Throat").

Influenza (the flu) is a more severe systemic illness which typically involves

the upper respiratory tract. Influenza is a relatively uncommon cause

ofinfluenza-like illness.

Treatment

Treatment depends on the underlying cause. There are currently no

medications or herbal remedies which have been conclusively demonstrated

to shorten the duration of illness. Treatment comprises symptomatic support

usually via analgesics for headache, sore throat and muscle aches.

Judicious use of antibiotics can decrease unnecessary adverse effects of

antibiotics as well as out-of-pocket costs to the patient. But more importantly,

decreased antibiotic usage will prevent the rise ofdrug resistant bacteria,

which is now a growing problem in the world. Health authorities have been

strongly encouraging physicians to decrease the prescribing of antibiotics to

treat common upper respiratory tract infections because antibiotic usage does

not significantly reduce recovery time for these viral illnesses. Some have

advocated a delayed antibiotic approach to treating URIs which seeks to

reduce the consumption of antibiotics while attempting to maintain patient
http://en.wikipedia.org/wiki/Coronavirushttp://en.wikipedia.org/wiki/Parainfluenza_virushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Enterovirushttp://en.wikipedia.org/wiki/Respiratory_syncytial_virushttp://en.wikipedia.org/wiki/Respiratory_syncytial_virushttp://en.wikipedia.org/wiki/Group_A_streptococcushttp://en.wikipedia.org/wiki/Streptococcal_pharyngitishttp://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Influenza-like_illnesshttp://en.wikipedia.org/wiki/Drug_resistancehttp://en.wikipedia.org/wiki/Coronavirushttp://en.wikipedia.org/wiki/Parainfluenza_virushttp://en.wikipedia.org/wiki/Adenovirushttp://en.wikipedia.org/wiki/Enterovirushttp://en.wikipedia.org/wiki/Respiratory_syncytial_virushttp://en.wikipedia.org/wiki/Respiratory_syncytial_virushttp://en.wikipedia.org/wiki/Group_A_streptococcushttp://en.wikipedia.org/wiki/Streptococcal_pharyngitishttp://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Influenza-like_illnesshttp://en.wikipedia.org/wiki/Drug_resistance


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under 12 years of age with the common cold. Oral decongestants are, also,

contraindicated in patients with hypertension, coronary artery disease, and

history of bleeding strokes.

The use ofVitamin C in the inhibition and treatment of upper respiratory

infections has been suggested since the initial isolation of vitamin C in the

1930s. Some evidence exists to indicate that it could be justified in persons

exposed to brief periods of severe physical exercise and/or cold environments.

There is no evidence to support the age-old advice to rest when you are sick

with an upper respiratory illness. In fact, moderate exercise in sedentarysubjects with a URI has been shown to have no effect on the overall severity

and duration of the illness. Based on these findings, it was concluded that

previously sedentary people who have acquired a URI and who have initiated

an exercise program may continue to exercise.

Pathophysiology

Contributing Factor

bacteria

Predisposing factor

Age
http://en.wikipedia.org/wiki/Vitamin_Chttp://en.wikipedia.org/wiki/Vitamin_C


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multiplie

alveoli

Penetrate the sterile lowerrespiratory tract (lungs)

Release damaging

infection

inflammati

vasodilatio

colonizatio

coug

Increase

mucus

crackles

Irritation of airway

Increase goblet

Occluded

the airway

Exudates

come from

bacteria

erode the

lung

A B CA BC

C


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Scale of Ranking Health Conditions and Problems

According to Priorities

Criteria Weight1. Nature of the condition or problempresented.S l W ll t t

33

1

Lung

Decrease

Alveolar air

sacs become

hypoxi


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A condition or problem notneeding immediate attention

Not perceived as a problemor condition needing change

0

Typology of Nursing Problems in Family NursingPractice

FIRST-LEVEL ASSESSMENT

Presence of Health Deficits

-Presence of an actual problem occurring in the family. Instances of

failure in health maintenance.


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1. Inability to recognize the presence of the condition or problem due to poor

hygiene and poor environmental sanitation.

Cues/Data Community Nursing Problem

Mother is very busy earning a

living that she cannot take care

of the children

Poor environmental sanitation

and poor hygiene

Inability to make decision with

respect to taking appropriate

health actions due to lack of

knowledge.

Inability to provide a home

environment conducive tohealth maintenance and

personal development due to:

a. Ignorance of preventive

measures.

Priority Setting

Priority # 1 Presence of Health Deficit

A. Illnesses state, regardless of whether it is diagnosed orundiagnosed (cough and colds). Pneumonia


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Preventive

potential

3/3 X1 1 By performing properhygiene of the body andproper environmentalsanitation.

Salience 0/2 X1 0 It is not a felt problem

Total 3 2/3

Priority # 2 Presence of Health Threat

A. Poor environmental sanitation

Criteria Computation Actual

Score

Justification


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Total 3 2/3

Priority # 3 Presence of Health Threat

A. Inadequate living space

Criteria Computation Actual

Score

Justification


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performing housework andjoint recreational, leisure orplay activities.

Salience 2/2 X1 1 It is not a felt problem

Total 2 2/3

Family Assessment Guide

Family Name: Cesista family

Address: Sitio Pitong gatang

I D hi D t


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III. FAMILY MEMBERS CHART

Name Ag

e

Se

x

Civil

Status

Family

Position

Relations

hip tothe

family

head

Educationa

lattainment

Occupati

on

Mabel 32 F Married Mother 1st year

High school

Noel 33 M Married Father Husband Grade 2 Constructi

on worker

Manuel 7 M Single 1st child Son Grade 2

Raymo

nd

6 M Single 2nd child Son

Maan

Shane

5 F Single 3rd

child

Daughter

Arrol

Jae

2 M Single 4th child Son


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Interaction patterns

among members

(+)

VI. Family Dietary HabitsBreakfast

Coffee, rice

Lunch

Rice, Viand(monggo)

Dinner

(Food that are left over in lunch time)

VII. Household and Environment

A. Type of House B. Is the living space adequate?

Wood

Mixed

Concrete

Makeshift

Yes

No

C. What are the appliances owned by the family?

Cabinet

D. Garbage Disposal E. Type of Waste Disposal

Collected Burning Flush


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J. Food Storage/ Cooking K. Common Household pests

Covered Cabinet

Uncovered Pots/ pans

Stove Refrigerator

Cockroach Lizards

Ants others, pls.Specify:

Rodents

L. Are breeding site for these pests

present at home?

M. Common Household pets

Yes

No

None

N. Are there accident hazard present at home? No Yes

VIII. Health and Health Practices

A. Common illness encountered for the last six months and thetreatment done.

Cough, colds, Fever Biogesic

B. Whom do you consult for health related problems?

Manghihilot Albularyo Health Worker Brgy. Health Workers

Midwife Nurse Doctor Health Center


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2. Exercise Yes No

3. RelaxationActivities?

Yes No

4. StressManagement

Yes No

IX. Community Awareness Organization

1. Are you aware of an existingorganization in yourcommunity?

Yes No

2. Name all organization you are in. New Hope

3. Are you aware of its activities and projects? Yes No

4. How are you involved in its activities?Attend meetings Evaluation

Planning Give Donations

Implementation Not involved


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In the morning, we went to Sitio Pitong gating to have our written

survey. We were able to finish surveying 48 families by noon. After having

lunch, we went to San Antonio RHU for our preparation for Lolas Program.

November 18, 2010

In the morning, we prepared all the things for the lolas program. We

also had our practice for the intermission number. At 1:30pm, we went to

Malaban, and held the program. We were able to finish at 3pm.

Second Week

November 22, 2010

We went in Sitio Pitong gatang in the morning to look for potential

leaders that will come and accompany us in endorsing our proposed projects

to different organizations to ask for help. after that, we went to the Barangay

Health center of Mamplasan, we had our lunch there. And after that, we were

divided into groups for the dissemination of works for the


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proposed projects: renovation of their CR, Planting, and solar panel for them

to have electricity. In the afternoon, we talked about the inventory of all the

expenses for the renovation of the CR.

November 24, 2010

We are divided again into groups: one group will give the letter to

Doctor Asio, the other one will go with sir Joemil and Sir Jhay in the Municipal

hall for the seeds, and othe other one will go to the Sitio to take some pictures

for our documentation. At the end of the day, we all accomplished our

assigned works.

November 25, 2010

It was supposed to be our last day in the community, but because we

have our wellness program in school, we are only required to attend to that.But we meet the next group to endorse the ongoing activity in the community.


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FAMILY CARE PLAN

HEALTH

PROBLEM

FAMILY

NURSING

PROBLEM

GOAL OF CARE OBJECTIVE OF CARE NURSING

INTERVENTION

METHODS OF

NURSE-

FAMILYCONTACT

Unsafe

environment

as a health

threat

-Inadequate

living space

-Sick children

are being

close to those

who are not

Inability to

make decisions

with respect to

taking

appropriate

health action

due to:

a. Lack of

knowledg

e/ insight

as to

alternativ

e courses

of action

open tothem

b. Lack of

living

space for

the whole

family

After nursing

interventions

the family will

be able to

know the

different

method andalternative to

keep

themselves

from being

infected such

as not to join

themselves

with the ones

who havecolds and

cough

especially their

children.

After nursing

interventions the

family will:

a. Practice safe

disposal of

secretions

b. Have their

sick family

members

consult to

health care

providers

(health

center)

c. Have their

family

members kept

distance to

those who

have cough

a. Established

rapport

b. Discuss the ways

on how to prevent

or control

themselves from

having cough and

colds

c. Encouraged on

proper secretions

and waste

disposal

d. Emphasized

proper hygiene

Home Visit


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and colds

Community case study

Documents

Transcript of Community case study