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