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INTRODUCTION

A family is a primary social group, a small community, in any


society, typically consisting of a man and a woman, or any two
individuals who wish to share their lives together in a long-term
committed relationship with one another, raising offspring and usually
resides in the same dwelling.
It is the main building block of a community; family structure
and upbringing determines the social character and personality of any
given society. it is also the place where we all learn: love, caring,
compassion, ethics, honesty, fairness, common sense, reason,
peaceful conflict resolution and respect for ourselves and others, which
are the vital fundamental skills, and family values, necessary to live an
honorable and prospers life in harmony, in the world community.
During our community exposure at Barangay Pala-o, Iligan City,
we had our home visitation where we chose to have the family with
most cases to assess with for our presentation. Among the families,
we chose the family with a unique case. Thus, we chose Salic Family,
in which one of their family members is suffering from a wretched
condition, a condition called hydrocephalus.
Hydrocephalus is a condition caused by an imbalanced in the
production and absorption of CSF in the ventricular system. When
production is greater than absorption, CSF accumulates within the
ventricular system, usually under increased pressure, producing
passive dilation of ventricles.
However, there are two classifications of hydrocephalus namely
communicating and non-community hydrocephalus.
Communicating hydrocephalus is also known as non-obstructive
hydrocephalus. It is caused by impaired cerebrospinal fluid
reabsorption in the absence of any CSF-flow obstruction.
On the other hand, non communicating hydrocephalus also
known as obstructive hydrocephalus is caused by a CSF –flow
obstruction (either due to external compression or intraventricular
mass lesions).
We believed that the youngest member of the Salic Family who is
a 39 days old infant is manifesting the said condition upon
assessment. The infant manifests abnormal reflexes (no rooting, and
moro reflexes), a bulging forehead with prominent fontanel, a slowed
heartbeat and respiratory rate, and a thin transparent scalp.
Besides from the emerging problem of the infant, other members
of the family, the mother of the infant and the second child also
manifests some chronic condition like asthma.

FAMILY CASE STUDY

I. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS


NAME AGE SEX CIVIL EDUCATIONAL RELIGION
STATUS ATTAINMENT
FATHER:
COLLEGE
Jaffar Salic 39
M MARRIED GRADUTE
ISLAM

(BS CRIMINOLOGY)

MOTHER:
COLLEGE
Edna Salic 37
F MARRIED GRADUTE
ISLAM

(BS BIOLOGY)
CHILDREN:

Abdul Jabar Salic 10 M S GRADE 5


I
I
Jehan Salic 7 F
N GRADE 2 S
G L
Jirah Salic 3 F N/A
L A
Abdul Raffy Salic 39 M E N/A M
days
old

TYPE OF FAMILY STRUCTURE:

The type of family structure is said to be extended, since the family


with their other relatives, specifically the mother, live together within the
same household sharing a common goal and interest.

DOMINANT FAMILY MEMBERS IN TERMS OF DECISION MAKING ESPECIALLY IN


MATTERS OF HEALTHGCARE:

Since the father is away, the mother takes the responsibility and is
dominant in the entire decision making especially in matters of health care.

GENERAL FAMILY RELATIONSHIP/DYNAM ICS:

The Salic family lives in the same household peacefully. Whenever


there is a problem in their family member, they make an immediate
response to it. When it comes to money matters, the mother is the one who
decide and in terms of physical aspect, both husband and wife decide
together Ergo. Their family share common interests and goals as well.

II. SOCIO-ECONOMIC

The father is a policeman and is currently working at Ramayan and


sometimes somewhere in Cotabato City. The mother is a fulltime
housewife. The father earns 22,000 pesos every month. But the family only
receives 1,500 pesos every fifteenth day of the month because of the
deduction such as loans and debt. Fortunately the mother verbalized that
the income is adequate to meet the basic necessities of the family.
Since the mother is the who is dominant in the family, she is also the
one who makes decision about money matters and how it is spent. Also,
the mother of Mrs. Salic, who is living with them, supervises her daughter
and helps in the expenses of the family through a small sari-sari store and
with the help of her pension as well.

III. HOME ENVIRONMENT.

1. HOUSING

A. LIVING SPACE

The house consists of 5 bedrooms, adequate for a family of 7


members. It measures 71 sq. meters. The living room has adequate space
for the members to move. Things inside the room are organized, but some
things like the plates and other cooking utensils are placed in the sink
unwashed.

B. SLEEPING ARRANGEMENT

The family, as well as their mother and brother has their own room.
Mrs. Salic sleeps together with her three children in their room.

C. PRESENCE OR BREEDING/RESTING SITES OF VECTORS

Upon our observation at the house, it is well cleaned and there is no


noticeable areas where rodents and other vectors could reside in.

D. PRESENCE OF ACCIDENTAL HAZARDS

The house is located in a safe place, away from the busy streets of
highways nor near or under the coconut trees. Sometimes, the mother left
the house with his 10 year old child. But the mother verbalizes that the child
could be trusted because she had done it many times with the child left
alone at home. Unfortunately, the house has stairs made of concrete with
no hand drills and some are stiff particularly when going to the rooftop
where the family hangs in their clothes.

E. FOOD STORAGE

The family has 2 refrigerators enough for their uncooked and cooked
foods to be stored.

F. COOKING FACILITIES

The family uses charcoal as their main cooking facility. Other than
that, they also have enough cooking utensils such as cooking pot, frying
pans, plates, drinking glasses, spoons, forks and etc. Their cooking area is
located outside the house near their room.

G. WATER SUPPLY

The family has its own water supply via faucet. Unfortunately, the
water supply at their area is not doing well. The water flow sometimes for
two hours at most time. As verbalized by the mother, the water is well
chlorinated. As for drinking water, they bought from a near water refilling
station.

H. TOILET FACILITY

The family has 3 toilet facilities, one for the family, one for the other
members and one for the visitors and with good sanitary condition.

I. GARBAGE DISPOSAL

The family has their own trashcan capable of storing garbages for 1
week at most, and it is at good sanitary condition.

J. DRAINAGE SYTEM

The kind of drainage system the family have is blind and it is at good
sanitary condition.

2. KIND OF NEIGHBORHOOD

The Salic family is situated at Barangay Pala-o, and it is a rural area,


approximately 2-3 kilometers away from the city.

3. SOCIAL AND HEALTH FACILITIES AVAILABLE

The family benefits from the services offered by the Barangay Health
Center; this is where their children received their full immunizations except the
youngest son due to anxiety of the mother. The other facilities within the
community are the recreational facilities like basketball court and volleyball court.

4. COMMUNICATION FACILITIES AVAILABLE

Salic family does not have a telephone connection. They only use
cellphone as a means of communication.

5. TRANSPORT FACILITIES AVAILABLE

The Salic family owns one “sikad” but “jeepney” is their main
transportation going to the city.

III. HEALTH STATUS OF EACH FAMILY MEMBER

1.
Medical history & Past illness Medication
hereditary diseases taken/treatment done
Father: No hospitalization Aspilet
Hypertension experienced
Mother: No hospitalization Herbal Plants
Allergy(crabs) experienced

Children:
1) No past illness No hospitalization
experienced

2) Allergy(crab), Check-up (City Hospital Allerkid (syrup)


under Dr. Gomez)
asthma

3) No past illness no

4) Hydrocephalus Aug. 30, 2009 (City Tiki-tiki( for


Hospital under Dr. Lim, Dr. supplementation)
Gomez, Dr. Bilario

2. BELIEF AND PRACTICES RELATED TO HEALTH AND ILLNESSES

They usually self-medicate for themselves using their stored


knowledge to treat a certain disease. They used herbal plants such as
“tawa-tawa”, ”bugayana”, guava leaves, etc.

3. NUTRITIONAL ASSESSMENT
A. Anthropometric Data

HEIGHT WEIGHT UPPER ARM


CIRCUMFERENCE
CHILD 1 (10yrs old) 137cm 25kg
CHILD 2 (7yrs old) 110cm 18kg
CHILD 3 (3yrs old) 92cm 14kg
CHILD 4 (39 days 49cm
old)

B. Dietary History indicating quality and quantity of food intake per day

They usually eat three (3) times a day. They usually eat fish,
vegetables as viands but sometimes they will just buy to the neighborhood
or the ready made viands like vegetables etc. Since the family is Maranaos,
they don’t it pork.
C. EATING/ FEEDING HABITS PRACTICES

They usually eat three (3) times a day with the typical meal.
They used to have snacks between meals and the grandmother is very strict
in implementing no junk foods during snacks. The family consumed about ½
galloon of water everyday.

4. DEVELOPMENTAL ASSESSMENT OF INFANT, TODDLERS, AND


PRESCHOOLERS

As we had our assessment regarding the infant growth and


development manifested the following sectors. , the infant First we had
assessed the child and noticed that he is a hydrocephalic child.
In the physical development, his weight and height are below normal. His
head and chest circumference are not also developing. During the reflexes,
the infant doll’s eye and dance reflex are fading. The infant’s posterior
fontanels are closed, and the crawling reflex also disappears. Abdomen
when prone, can even turn his head side to side when prone, and lifts head
momentarily from bed. The infant has marked head lag, especially when
his pulled from lying to sitting position but cannot hold head momentarily
parallel and in mid-line when suspended in prone position. When held in
standing position, the body is limped to his knees and hips. But when
placed in sitting position, the back is not uniformly rounded with absence of
head control. During the fine motor assessment, the infant’s hands are
predominantly close with strong grasp reflex and hard clenches on the
contact of the rattle.
In his sensory development, the infant wasn’t able to fixate on moving
object in range of 45 degrees. When held at a distance of 20-25cm. The
infant also follows light to mid-line and quiet when hears a voice. In his
vocalization development, the infant cannot able to cry to express his
displeasure. But can make comfort sounds during feeding. In his
socialization development, the infant was not in sensorimotor stage and
can’t able to watch the patient face intently as she talks to the infant.
During the reflex assessment, the infant was able to perform the grasp,
babinsky, sucking, stepping but not in moro reflex.

As we assess Jairah, a three year old daughter of Mrs. Salic, she


also manifested different sectors. In her physical development, she gain
weight normally and stands 92cm.
In her gross motor development, she could jump of bottom step, and
stands on one foot in a few seconds. She could also goes upstairs using
alternate feet.In her fine motor, she couldn’t build a tower of 9-10 cubes,
but could build bridge with 3 cubes. In drawing, she could copy a circle,
imitates a cross and names of what has been drawn.
In her language development, she doesn’t have a vocabulary of 900 words.
She can’t also complete a sentence from 3-4 words. However, she could
repeat sentences with 6 syllables and even asks many questions.
In her socialization development, she dresses herself almost completely.
And she even could feed herself completely. She could also prepare simple
meals such as cereals and milk. She also has fears especially in dark when
going to bed. She knows her own gender, and also the gender of others
and engaged to learn simple games, but she often follows her own rules.
In her cognitive development, she is in preconceptual phase, has beginning
to understand time, has improved her concept of space and has the
beginning ability to view concepts from another perspective.
When it regards to her family relation, she always attempts to please her
parents, and conform to their expectations. She is less jealous to her
younger siblings, she’s aware of family relationships and even in sex role
functions. She has an increased the ability to separate easily to her parents
for short period.

As we have assessed Jehan, the elder sister of Jairah, shows a gain


in her weight as well as her height also. Her maxillary incisors and lateral
mandibular incisors erupt. Her jaw begins to expand to accommodate
permanent teeth.
Her mental development, she could easily notice that certain items are
missing from pictures. She can also copy a diamond, repeats 3 numbers
background, develops concepts of time and more mechanical in reading.
She can also attends second grade. In her adaptive development, she
knows how to use a knife for cutting. She can also brush and comb her hair
acceptably without help. She also likes to help and have a choice.
In her personal-social development, she’s becoming a real member of the
family group, always takes part in group play, spends a lot of time alone.

Abdul Jabbar is a 9 year old child. He also shows a gain in height and
weight. In his mental development, he attend fifth grade. Could write short
letters to friends or relatives on his initiative. Uses telephone for a practical
purposes and respond to magazine, radio, and other advertising. He also
reads for practical information or own enjoyment.
In his adaptive development, could make useful articles or does repair
work, also cook or sew in small way, washes and dry own hair. Also
responsible for a thorough job of cleaning hair, but may need reminding to
so. He is also sometimes left alone in home for an hour. However, he is
successful in looking after own needs or those of other children left in
his/her care.
In his personal-social development, he loves friends and talks about them
constantly, chooses friends more selectively and enjoys a conversations.
He also develops interest in opposite sex, likes family, and likes mother
who wants to please her. Also demonstrate affection, likes his father who is
admired and may be idolized and respect his parents.

5. PHYSICAL ASSESSMENT INDICATING PRESENCE OF ILLNESS


STATES

6. LABORATORY/ DIAGNOSTIC RESULTS


V. VALUES, PRACTICES, ON HEALTH PROMOTION/ MAINTENANCE
AND DISCUSS PREVENTION

A. IMMUNIZATION
According to Mrs. Salic, her children had undergone complete
immunization including BCG, OPV, DPT, Measles, Hepatitis
immunization except for the youngest son due to his condition.

B. EXERCISE
The daily activities of the family members serve as a form of
exercise.

C. PROPER DIET
The Salic family have a balanced meal regarding their diet.

D. STRESS MANAGEMENT
The mother has an effective stress management due to the
condition of her baby. She has only 2 hours of sleep.

E. SMOKING/ALCHOLIC DRINKS
The father is the only one who smokes and drinks in the family but
he is always not around. Therefore, the family is not directly exposed
to second hand smoke. No one in the family uses drugs.

F. SLEEP AND REST


The mother has only 2 hours of sleep. The children sleeps at least
10 hours every day and they don’t manifest problems with their
sleeping habits.