DAVAO DOCTORS COLLEGE FAMILY CASE STUDY

SUBMITTED BY
GRETCHEN PAUSAL
 March 13, 2020

Table of Contents

i. Title Page………………………………………………………………..1
ii. Table of Contents…………………………………………………………...2
I. Introduction………………………………………………………………..3
II. Objectives………………………………………………………5
III. Initial Data Base
A. Family Structure……………………………………………….…….7
B. Socio-Economic and Cultural Characteristics…………………9
C. Home Environment………………………………………..… 10
D. Health Status of Each Member…………………………….. 12
E. Values and Practices on Health Promotion And Disease
Prevention....15
IV. Family Developmental Tasks……………………………………..17
V. Genogram……………………………………………………………19
VI. Ecomap………………………………………….…………..……..21
VII. Family Coping Index……………………………………….…….23
VIII. Prioritization of Problems………………………………….………25
IX. Family Nursing Care Plans……………………………….………..34
X. Health Teachings……………………………………………….35
XI. Implications of the Study to Nursing Education, Research and
Practice…….…..38
XII. References……………………………………………………….…….40

I. INTRODUCTION

One million children under five years old die each year in less
developed countries. The main symptoms are cough or difficulty in breathing,
diarrhea, fever and ear problem are one of the accounts for nearly half of
these deaths and malnutrition as an underlying condition. Effective and
affordable interventions to address these common conditions exist but they do
not yet reach the populations most in need, the young and impoverish.

To address this problem, the World Health Organization (WHO)

together with the United Nations Children’s Fund (UNICEF) developed and
introduced the Integrated Management of Childhood Illness (IMCI) strategy
since 1995. It is the major strategy which includes elements of prevention as
well as curative and addresses the main causes of childhood illness (Cough
or Difficulty in breathing, Diarrhea, Fever, Ear problem and Malnutrition). IMCI
has the objectives to decrease significantly global mortality and morbidity and
to contribute to a healthy growth and development of children and is based on
the combined delivery of essential interventions at community, health facility
and health systems levels.

IMCI was brought to the Philippines in the year 1997 and was
integrated to the Nursing and Midwifery curriculum starting 2001 up until the
present. The Sick young infant (birth to 2 months) and the Sick child (2
months to 5 years old) are children covered by the IMCI protocol. The
strategies include: Assess the child/young infant, classify the illness based on
the main symptoms, identify the treatment, treat the child, counsel the mother
and do follow-up.

The Community Health Nursing Rotation specifically IMCI is finding a

family with a sick young infant, child, and children’s presence. Family is the
basic unit of the society. Family is important. It is a title given to those who
hold dear to the hearts in every houses. Extended it to those who come into
our lives and no matter what, through thick and thin, seem to say. DNA is not
always shared, but the feeling is undeniably there. Family is loved ones and
perhaps a concept that is dealt with outmost care. It is an integrated and
functional unit of society. The Family is a basic unit of study in main social
sciences disciplines, such as sociology, psychology, economics,
anthropology, social psychiatry, and social work. It is also a unit of study in the
medical sciences especially in understanding the epidemiology and the
natural history of the disease (UNESCO, 2018). There are several types of
family structures namely: Nuclear family, Single Parent Family, Extended
Family, Childless Family, Step Family, and Grandparent Family, but the main
focus of the rotation is a family with a sick young infant or a sick child to be
treated through the guidance of Integrated Management of Childhood Disease
Concept.

The smiles of the people on the slum within the bright shade of sunlight
in the community health nursing is an important concept developed by the
collaboration of the World Health Organization and United Nations
International Children’s Emergency Fund — the Integrated Management on
Childhood Illness.  It is an integrated approach to child health that focuses on
the well-being of children and is a strategy for reducing mortality and morbidity
associated with major causes of childhood illness. Community Health Nursing
is the most suited field of nursing which centralizes both primary health care
and the nursing practice with the influence of public health administration. The
objective of the Community Health Nursing ensures the accessibility and
quality of the health care provision to improve the lives of every family
member in the community.
     
According to WorldoMeters (2019), the current world population is 7.7
billion as of March 2020. 51.8% of the total population are male while 48.2%
are female. 54% of which live in urban areas while the remaining 46%
decided to reside in rural areas. As the total populace increments, numerous
social puzzles additionally start to emerge including the Worldwide Health
Status. China, as one of the most crowded nations on the planet with a
population surpassing 1.4 billion, is one of only two nations with a population
of more than 1 billion, with India being the second. The following 11 nations
that are the most crowded on the planet each have population surpassing 100
million and they incorporate the Philippines. Worldwide future has likewise
improved lately, expanding the general population's future during childbirth to
a little more than 70 years old (World Population Review 2019)

The Philippines is an archipelagic country in Southeast Asia. Situated in

the western Pacific Ocean, it consists of about 7,641 islands. Nationally, the
current population of the country as of March 9, 2019, is 108,476,153 (World
Population Review, 2019). Our total land area is 342,353 km² and this year’s
density is around 316/km² with a growth rate of 1.37&. The country has a total
of 81 provinces, 145 cities, 1,489 municipalities, and 42, 045 barangays.
Results of the 2015 Census of Population (POPCEN 2015) revealed that of
the country's 24.22 million housing units, 92.57 percent or 22.42 million
housing units were occupied by households or household population
(Bersales, 2018). 

Davao, the 11th region in the Philippines, is located on the southeastern

portion of Mindanao and is comprised of 5 provinces, 11 districts, 43
municipalities, and 6 cities.  As of the 2015 census, the city had a population
of 1,632,991. 1,162 barangays comprise Davao and Barangay 37-D located in
Jacinto District, Davao City was chosen to be the assigned locale of the study
wherein the subject family of five resides. Its population as determined by the
2015 census was 6,740. This represented 0.41% of the total population of
Davao City. The subject family, residing in the said barangay, is composed of
six members. The live-in couple, AG and GG, and the 4 children, RMB, AJG,
ARG and AMG. The subject of the case study is a family with an infant,
through the guidance of family developmental tasks, with a blended or
stepfamily structure. The couple has been staying in their residence for 9
years
          The contextual investigation directed by six understudies from the
second subgroup of the second group of BSN 2H flows the use of the ideas of
Community Health Nursing in genuine settings which brings together on the
health advancement, wellbeing anticipation, health support, rebuilding, and
recovery of the selected subject family and the utilization of the Integrated
Management of Childhood Illness Concept. Through the examination, the
understudies had the option to evaluate one of the kids in the family K, a five-
month-old young baby girl with ailments of fever and flu-like symptoms. The
case study commenced on February 22, 2020, and finished on March 14,
2020. During the conduction of the examination, the understudies have used
information assortment techniques including perception, inside and out
meetings, reviews or records to accumulate a generous measure of the
required information and the evaluation through the IMCI recording sheets.

II. OBJECTIVE
General Objective:
After 3 days of visiting in our chosen client, the student nurses will be able to

improve communication skills and establish rapport to the family. We will be able also

to find problems and prioritize it by giving them health teachings and imparting them

with knowledge, skills, and attitude at the end of our duty.

Specific Objective
After three days of home visit, the student nurses will be able to:
a) Select a family that has the qualifications to be subject for this case study.
b) Gather important information of the family for the initial data base
c) Conduct an IMCI check-up if one of the children has 1 or more of the major

symptoms and if he/she is an infant or 5 years and less.

d) Be able to trace the health conditions and diseases linked to the family’s

health background for our genogram.

e) Identify existing and potential problems of the family in their environment,

safety, personal hygiene, finances, resources, social relationships, or

spirituality.
f) Gather and organize the data by prioritizing and rating which problems have

the highest scores.

g) Choose 8 problems from the prioritization with the highest score for the

family nursing care plan.

h) Provide innovative strategies to replace the past practice of the family for

promotion of health.
i) Give health teachings for the family based on the problems from the

prioritization.
j) Determine the implication of this case study to nursing education, research
and practice.
III. INITIAL DATA BASE
A. Family structure, characteristics and dynamics

Below are the information about the family members, their appropriate
ages, gender, marital status, relationship to the head of the family,
educational attainment and their present residing address:

Age Relationship
Family Educational Present
(years) Sex Marital Status to Family
Members Attainment Address
Head
Trading

College Boulevard,

A.B 55 M Single/Married Father Graduate – Barangay 37-

AB History D, Davao

City
Trading

Boulevard,
Highschool
G.G 28 F Single Mother Barangay 37-
Level
D, Davao

City
Trading

Boulevard,
Elementary
R.M.B 9 F Single Daughter Barangay 37-
Level
D, Davao

City
Trading

Boulevard,
Elementary
A.J.G 8 F Single Daughter Barangay 37-
Level
D, Davao

City
A.R.G 2 F Single Daughter Elementary Trading

Level Boulevard,
 Barangay 37-

D, Davao

City
Trading

Boulevard,
Elementary
A.M.G 5 mos. F Single Daughter Barangay 37-
Level
D, Davao

City

Length of Residency: 9 years

Place of Origin: Magsaysay, Davao del Sur
Bislig, Surigao del Sur
Religion: Husband: Roman Catholic Wife: Roman Catholic
Tribe: Husband: Wife:
Type of Family Structure: Reconstituted Family
Dominant Family Member: A.B

Their family structure is a reconstituted family, which is commonly

described as when two families joined together after one or both partners
have divorced their previous partners. A.B is the head of the family, he is 55
years old male, and not married to her current partner G.G - a 28 year old
female. Both of them have the same religion, Roman Catholic. A.B buys and
sells plastics, while G.G is a housewife. They currently lived in a rented house
for almost 9 years at Trading Boulevard, Barangay 37-D, Davao City. A.B’s
family is originally from Magsaysay, Davao del Sur, while G.G’s family lived in
Bislig, Surigao del Sur. Their family is in the stage of Family with School-age
children. Generally, the family members communicate with each other well
and coordinate together in decision-making. They communicate through
personal interactions with no observable conflicts during the period of the
assessment.
B. Socio-Economic and Cultural Characteristics

Highest
Family Employment Other Source
Educational Occupation Income
Members Status of Income
Completed
College Self- Buy-and-sells Php 250 – Delivers
A.G
Graduate employed (Sando Bag) 300 Plastic
Highschool
G.G Unemployed Housewife
Level

The family is residing in an urban neighborhood. A.B is the only one

who has a job and suports the needs for his growing family. The estimated
monthly income of A.B is below Php 5,000.00. The family belongs to the
working class. The working class pertains to those groups of people in the
community who use special skills in their jobs and are usually paid by the
hour. It is also defined as individuals in the labor force who do not have
bachelor’s degrees. It includes the unemployed, who are counted as still in
the labor force as long as they are actively looking for work.

C. Home and Environment

Computation of Home Ventilation:

1. Determine the Total Floor Area (TFA)
2. Determine the Total Window Opening (TWO)
3. Apply the formula
Total Floor Area:
Part of the House Length Width Total
Living Room (X1) 2.6m 1m 2.1sqm
Living Room (X2) 3.1m 0.5m 1.55sqm
Bedroom (X3) 2.1m 2.1m 4.41sqm
TFA 8.06sqm

Total Window Opening:

Part of the House Length Width Total
Door 1.25m .5 .62sqm
Bedroom Window .5m .5m .25 sqm
TWO .87sqm

House Diagram Representaion

Calculation
Ventilation:
20% Good Ventilation
18% – 19% Fair Ventilation
17% and below Poor Ventilation
Interpretation Poor Ventilation
 The family is currently residing at Barangay 37-D, Davao City. The
house they lived in for a year is like a boarding house, several families within
a building so they rented a part of that house. The type of housing materials
used is mixed since their house is made up of cemented floors and walls with
a division of plywood walls inside from the other tenants. They have a multi-
purpose kind of house which consists of the living room, dining room, and
what they consider as their bedroom.
Our client’s house has a score of 10.8% ventilation therefore we conclude that
our family’s house has poor ventilation. Our client lives by a huge open canal littered
with garbage. This can be a breeding ground for mosquitoes. Their house is dim,
damp, warm, and moist which is a good environment for fungal growth and mosquito
likes to stay in places like those.
Our client’s door is too small for them to be able to run in times of
emergency and it has a hurdle which prevents small children from running outside
swiftly. It is also worth nothing that their way of exit in times of fire can be impeded as
they cook just outside their house in front of the door.
Presence of rodents and cockroaches has been observed and the place
is an ideal nesting ground for these pests which can transmit deadly diseases such
as leptospirosis. Garbage is observed everywhere with no signs of waste
segregation.
Our client lives near the health center and the closest hospital in the area is San

Pedro Hospital.

D. Health Status of Each Family Members

FAMILY WEIGHT HEIGHT
BMI INTERPRETATION
MEMBERS (kg) (cm)
23.2 kg/m2 NORMAL
AB 59.4 Kgs. 160 cm.
(18.5 – 25)
31 kg/m2 OBESE
GG 61.7 kgs.. 141 cm.
(30-35)
 23.0 kg/m2 NORMAL
RB 43.8 kgs. 138 cm.
(18.5 – 25)
2
15.2 kg/m UNDERWEIGHT
AL 22.6 kgs. 122 cm
(17-18.5)
2
15.1 kg/m NORMAL
AR 11.2 kgs. 85 cm.
(18.5 – 25)
2
14.6 kg/m NORMAL
AG 6.9 kgs. 64 cm.
(18.5 – 25)

The family body mass index was computed using the formula, BMI = wt. in

kg/ht. in m2. The head of the family, AB shows a BMI of 23.2 kg/m2 which is

interpreted as normal according to the World Health Organization standards. The

mother GG shows an abnormal result according to the World Health Organization

because of her weight of 61.7 kgs and height of 141 cm that resulted 31 kg/m 2 body

mass index. The eldest daughter RB weight 43.8 kgs and height of 138 cm that

resulted to 23.0 kg/m2 body mass index which interpreted as normal. The second

child is AG which underweight because of her body mass index of 15.2 kg/m 2. AR

has a body weight of 11.2 kgs and height of 85 cm as a result of 15.2 kg/m 2 body

mass index which interpreted as 18% percentile according to the WHO standards for

the interpretation it is normal Body Mass Index for children ages 2 years old to 19

years old. Lastly, AG has a normal result for Body Mass Index as proven by 7%

percentile of body mass index which interpreted as normal according to World Health

Organization this was proven by her weight of 6.9 kgs and height of 64 cm.
For the immunization status of the family member, according to the parents

they are completely vaccinated. RB, AL, and AR completed all the doses and vaccine

of all the available immunization in the health center such as BCG, HEP-B, OPV,

RTV, PCV, pentavalent, MMR, and measles vaccine. AG needs her last dose of

BCG, Hep-B, OPV, PTV, IPV, and RTV when she turns 6 months. Measles vaccine

when she turns 9 months.

The father has a history of coughing in the past month and the mother

sometimes suffers from headache due to the hot environment. There is no severe
illness that the family members experienced except for high fever that AG and AB

recently experienced.

Integrated Management and Childhood Illness

AM is 5 months old. He weighs 7 kg. Her temperature is ??? degrees
celsius. The mother said she has fever for two days. She does not have any
danger signs and difficulty in breathing, with ??? breaths per minute. The
student nurse assesed for the presence of stridor, wheezing, and chest
indrawing but there were none recorded.
The mother said that, JE does not have diarrhea. As the student nurse
assesed her, she does not have fever and measles in the last 3 months but
malaria risk is high because they live in in Barangay 37-D, Davao City.
JE has no ear problem. As the student nurse checked for malnutrition
and anemia, client JE does not have edema on both feet and no severe
malnutrition. She completed her immunizations and deworming but does not
have regular dental check up.
E. Values, Habits, Practices on Health Promotion, Maintenance, and
Disease Prevention.
Once a person is infected the whole community will be affected. We are living

in a world full of diseases and it is our obligation that together we protect the basic

unit of society which is our family. If one does not start protecting his or her family,

one becomes the carrier of a threat to the society and protecting start with

immunization. For the immunization status, the family members except for the 5

months old baby are fully immunized as verbalized by the mother and as evidenced

by the baby book. The mother also completed her tetanus toxoid vaccination.
For the practices of health promotion, while conducting the interview we

asked the mother if they have thermometer and they said they don’t have. They only

use their senses to identify if someone is not feeling well. They used to drink

medicine when someone is sick and they will visit at the health center if they can’t

handle the situation. For the food that they are eating, they have vegetables, shell,

and rice as their meal which is very healthy and is full of nutritional components. The

kids used to eat snacks such as ube calamay and candies which can destroy the

foundation of the teeth. This was then proven because we witnessed every time we

visit. But some of the family members have an abnormal result for their body mass

index some of the family members resulted to obese and underweight. Also, they buy

their foods at Bangkerohan public market.

For the healthy lifestyle practices, the client said in order to achieved healthy

lifestyle they eat three times a day – breakfast, lunch and dinner on time. Every

afternoon they enjoyed eating their snacks such as bread, biscuits, and soda. For

their exercise and activity pattern, walking during afternoon is their way to do
exercising. Their first and second child used to play chinese garter at school and

enjoy running in the fields.

For the family’s rest and sleep pattern, our client verbalized that their sleeping

time is 8 to 10pm and the patriarch sleeping time is around midnight or pass midnight

due to his work at roxas night market. They usually wake up at 6am. The kids will go

to school at 7:30 am and the husband will do his job to deliver plastic cellophane in

different stores.
For the use of protective measures, they use slippers outside their house to protect

their foot from bacteria and they are barefooted when entering their house to avoid

dirt. In the cloth that they are wearing, they usually wear thin and shirts and shorts

because they are inside their house and it is too hot inside because there is no

window opening and there is only one ceiling fan.

IV. FAMILY DEVELOPMENTAL TASKS

Family with School-age Children:

Task of the Family Achieved/ Justification

 Not achieved

1. Adjusting to the Not achieved When asked, the mother said they cannot

activity of school go whenever there is activity in the school

age children because no one was able to watch over

their youngest child and her husband is

working during day time.

2. Promoting joint Achieved When asked, the father said that whenever

decisions they have decisions as a family, they

between children include their children in making decisions

and parents but sometimes it depends on what they will

talked. Also, they allow their children to do

what they want under their supervision.

3. Encouraging and Achieved They always join in school activities even

supporting though they are not encouraged by their

children’s parents to do so.

educational

achievements

V. GENOGRAM
VI. ECOMAP
VII. FAMILY COPING INDEX
Family Coping Index helps the individual to assess the need of nursing
care to the particular family which deals with the problem that measures the
family capacity to deal with the problem associated with the health care.
Scaling Cues:
1 – No Competence 
3 – Moderate Competence 
5 – Complete Competence
 
COPING RATI
JUSTIFICATION
AREA NG
All members of the family was able to perform their activities
1. Physical
3 of daily living, and partially provides the needs of each family
Independence
members especially caring for their children.
Whenever one of the family member is sick, the mother
quickly initiates to go for check up or go in the health center in
order for her to know what will be the proper ways on how to
manage the sickness of the certain family member. She
2.Therapeutic
3  verbalized, “Tung nag-ubo ang akong anak kay giadto dayun
Independence
nako sa health center ma’am kay hadlok na baya ang
panahon karon, kailangan jud nato maghaanda. Nag hatag
man sad og tambal ang health center Ma’am.” as verbalized
by the mother.
3. Knowledge The parents immediately applies the certain measures and
of Health 3 does not hesitate to follow the order of the Health Center
Condition because they want to take good care of their children.
Although the parents are cooperative and obedient in terms of
4. Application
their health, ironically, there are some aspects that they failed
of principles of
to recognize such as the principle of basic hygiene.
Principles and 1
Uncovered kitchen utensils is one of the example that
General
classifies this problem because disease carriers such as flies
Hygiene
is present in their environment.
As verbalized by the mother, “Naga butang ko ug basa na
panyo or towel nagamay sailang agtang para mahuwas-
5. Health Care
3 huwasan ang ilang kalintura.”. This shows that the family
attitudes
somehow has knowledge pertaining to the basic home
remedies or basic management for illnesses specifically fever.
Each of the family member are in good terms, has a wonderful
atmosphere and does not have any problems in their
emotional aspect. As what the students have observed, during
6. Emotional
3 the days of assessment, all display smiles within their faces
Competence
despite of all the existing problems in their residence. In
addition, the mother stated that they are happy and contented
of what they are now as a family.
7. Family living 3 As verbalized by the father, “Buotan man ang akong mga
Patterns
anak Ma’am, nagatuman man sila sa akong mga ginasugo
sad. Gitudluan pod namo sila na magbless, Ma’am. Kiat lang
jud Ma’am pero okay nasad Ma’am kay magkasinabot man
 sila akong mga anak bisan na ayus sa ila na dili sila igsuon sa
mama.” For the sector of the family living patterns as one of
the guidelines in community health nursing, this shows that
the family are closely bonded together with effective
coherence or in other words, prosperous harmony with one
another.
In terms of the structural pattern of their residence, it falls on
the category of poor and unsafe condition because of the
presence of some problems such as prone to of accident
hazards, some missing parts of the roof, inadequate
8. Physical
1 ventilation because of limited windows, lack of space or
environment.
overcrowding, and lastly lack of facilities for food preparation.
“Lisod na man ni mabuhatan og bintana kay sumpay lang ang
balay namo sa among silingan, mura raman ni og kwarto ang
amo.” As verbalized by the Father.
9. Use of The family stated that whenever they want to seek help when
Community 3 one of the member is ill, they immediately take action by going
Families to the health center for proper management.

VIII. PRIORITIZATION OF THE PROBLEMS

1. Unsanitary food handling and preparation

 Criteria Computatio Actual Score Justification
n
1. Nature of It is a health threat because it
the Problem can lead to unhealthy lifestyle
2/3 x 1 0.67
and eventually will alter their
health development.
2. Modifiability It is partially modifiable
of the Problem because the family’s
1/2 x 2 1 cooperation and willingness to
be taught is enough to cope
to this problem.
3. Preventive Microorganisms that is
Potential present in their food can be
3/3 x 1 1 reduced if they will be able to
handle and prepare food
properly.
4. Salience of The client sees it as a
the Problem 1/2 x 1 0.5 problem but does not take
immediate action.
TOTAL =
3.17

2. Inability to provide a home environment conductive to health

maintenance and personal development due to: inadequate knowledge
to the importance of personal hygiene.

Criteria Computatio Actual Score Justification

 n
1. Nature of It is a health threat because it
the Problem 2/3 x 1 0.67 can increase the risk of the
transmission of disease
2. Modifiability It is partially modifiable
of the Problem because the equipment that
1/2 x 2 1
will be used is common and
cheap
3. Preventive It can be partially modified
Potential because the family is
3/3 x 1 1 cooperative enough to
perform tasks and is open to
new ideas or suggestions
4. Salience of The client sees it as a
the Problem 1/2 x 1 0.5 problem but does not take
immediate action.
TOTAL =
3.17

3. Accident hazard specifically fire hazards

Criteria Computatio Actual Score Justification
n
1. Nature of It is a health threat because it
2/3 x 1 0.67
the Problem can lead to fire accident
2. Modifiability 1/2 x 2 1 It is partially modifiable
of the Problem because resources are
available like, pot with sand
that can be effective to
eliminate fire or can be
substituted as an extinguisher
which is cheaper and more
 attainable.
3. Preventive It can be partially modified
Potential because the family is
3/3 x 1 1
cooperative enough to
perform tasks
4. Salience of The client sees it as a
the Problem 1/2 x 1 0.5 problem but does not take
immediate action.
TOTAL =
3.17

4. Poor home/environmental condition/sanitation – Poor lighting and

ventilation
Criteria Computatio Actual Score Justification
n
1. Nature of It is a health threat because
the Problem circulation of fresh air and
exiting of contaminated air is
2/3 x 1 0.67
ineffective which may lead to
transmittable airborne
diseases.
2. Modifiability It is partially modifiable since
of the Problem they have an appliance being
used like electric fan but is not
1/2 x 2 1
enough to eradicate
congestion and poor
ventilation.
3. Preventive 2/3 x 1 0.67 It is low since their kind of
Potential ventilation is almost a year.
Also due to their excessive
number in the house, there will
 be more CO2 circulating than
O2.
4. Salience of The family experiences
the Problem 1/2 x 1 0.5 difficulty regarding the problem
but it is not their priority.
TOTAL =
2.84

5. Family Size Beyond What Family Resources Can Provide

Criteria Computatio Actual Score Justification
n
1. Nature of It is a health threat because it
the Problem can be a cause of inability to
2/3 x 1 0.67
provide health actions such as
hospitalization emergencies.
2. Modifiability The problem can be partially
of the Problem modified since the client will be
1/2 x 2 1
educated on what is the other
ways to generate income.
3. Preventive The preventive potential of the
Potential family is moderate because if
the family can adapt and utilize
2/3 x 1 0.67
the said technique, then it can
alleviate the intensity of the
problem.
4. Salience of The family recognizes it as a
the Problem 0/2 x 1 0 major problem needing an
immediate attention.
TOTAL =
2.34
6. Lack of necessary facilities, equipment and supplies for care as
health threat

Criteria Computatio Actual Score Justification

n
1. Nature of It is a health threat because it
the Problem will compromise the needs of
the family especially to their
2/3 x 1 0.67
health because they have no
resources to be utilized in case
of emergencies.
2. Modifiability It is partially modifiable
of the Problem because there are cheap
1/2 x 2 1
equipments that can be utilized
by the family.
3. Preventive It is low since the family has
Potential low income monthly, therefore
2/3 x 1 0.67
they cannot prioritize this
problem
4. Salience of The family does not perceive
0/2 x 1 0
the Problem this as a problem
TOTAL =
2.34

7. Inability to recognize the presence of the condition or problem due to:

Lack of or inadequate knowledge

Criteria Computatio Actual Score Justification

n
1. Nature of 2/3 x 1 0.67 It is considered as a health
the Problem threat due to lack of or
 inadequate knowledge to
analyze and address the
problem properly.
2. Modifiability The problem can be partially
of the Problem modifiable because we will
help them educate on what will
be the proper ways to cope up
1/2 x 2 1
with the problem through
educating them on the different
methods of family planning and
its benefits.
3. Preventive The preventive potential of the
Potential family is moderate because if
2/3 x 1 0.67 the family will follow the health
teachings, then therefore it can
solve the problem.
4. Salience of The family does not perceive it
0/2 x 1 0
the Problem as a problem.
TOTAL =
2.34
X. FAMILY NURSING CARE PLAN
(See attached pages)
XI. HEALTH TEACHINGS
1. Lack of necessary facilities, equipment and supplies for care as health
threat
Home care is a care that allows a person with special needs stay in their home. It
might be for people who are getting older, are chronically ill, recovering from surgery,
or disabled. Thus, having necessary equipment such as thermometer and first aid kit
is a must to prevent any complications.
The thermometer is a medical toolkit which is used to check the body temperature. It
is the utmost convenient and beneficial of all the medical tools that we can use in our
home especially if there is a febrile person. Also, to gain more knowledge, we can
give health teachings to the family who has a febrile person such as
o Advise the person to take a complete rest to minimize unnecessary energy
expenditure which may increases body temperature.
o Anticipate the person's needs and keep things within reach to avoid activity
on his part.
o Inform the person of his condition and treatment to reduce apprehension and
anxiety
o Dress the person with lightweight clothing.
o Keep the person cool by providing a fan or nurse him in air-conditioner room.
o Sponge the person with tepid water.
o Take a cool bath if necessary.
o Increase fluid intake if the person has no fluid restriction. Fluid can be in the
form of water, iced drinks, ice-blocks, jelly, juices, or whatever he will drink.
o Severe anti-fever medicine (paracetamol eg. Panadol) if the temperature
reaches at least 39oC for adults
o Provide oral hygiene to keep the mouth and lips moist.
o If the person is lying on bed, frequent changing of position and linen help to
reduce discomfort.
o Frequent changing of clothes is also necessary because of increased
sweating.
o Use a lightweight blanket if the person feels cold or is shivering

Furthermore, The fundamental definition of first aid is the immediate assistance

given to a victim of an injury or illness. First aid involves relatively basic

techniques that can be performed by a bystander with simple equipment until

professional medical assistance arrives. First aid kits are a must have for every

home. First aid kits are necessary so that you can treat ailments and injuries that

happen at home. From the minor ailment to the more serious injury a first aid kit

can help reduce the risk of infection or the severity of the injury. They are

necessary for every household no matter the age of who lives in the home.

Injuries can happen anytime and anywhere. When you have a first aid kit within

easy access of wherever you are you will ensure the safety of everyone. First aid

can reduce infections from open wounds and injuries. It can also reduce the

severity of an injury. We cannot always keep our family from getting hurt but we

can protect them when they get injured with a first aid kit.
2. A. Family Size Beyond What Family Resources Can Provide – Family

Planning
 Family Planning (FP) is having the desired number of children and when you
want to have them by using safe and effective modern methods. Proper birth spacing
is having children 3 to 5 years apart, which is best for the health of the mother, her
child, and the family.
Family planning provides many benefits to mother, children, father, and the family.

Mother
 Gives enough time and opportunity to love and provide attention to her
husband and children.

 Gives more time for her family and own personal advancement.

Children
 Healthy mothers produce healthy children.

 Will get all the attention, security, love, and care they deserve.

Father
 Lightens the burden and responsibility in supporting his family.

 Enables him to give his children their basic needs (food, shelter, education,
and better future).

 Gives him time for his family and own personal advancement.

What are the family planning methods available in the Philippines?

One way of family planning is to use birth control methods or methods that
can help prevent unplanned pregnancy. There are different types of birth control
methods that can be chosen to be more effective if used correctly. Some of the types
of birth control methods available in the Philippines are as follows:

 Condoms
Proper use of condoms is estimated to be 98% effective in preventing
unplanned pregnancy. Misuse of it often causes its effectivity to decrease. In addition
to providing unprotected pregnancy protection it is also the best protection against
sexually transmitted diseases or STDs.

 Birth control pills

Birth control pills are 99% effective when used correctly and at the same time.
This is one of the most effective methods of family planning and is used by most
women. But unlike condoms, it does not provide protection against STDs and can
produce positive and negative side effects according to studies.
Some of the positive effects of birth control pills on women are blooming or having
clearer skin. Meanwhile, some side effects include erratic mood swings and weight
gain. For those who don't mind taking pills you can set an alarm to remind you.

 IUD or Intra-uterine device

Meanwhile the one type of birth control with 99% and longest effectivity in a
woman is the IUD. It is a small piece of T-shaped metal that is placed into a woman's
uterus. It is designed to prevent the sperm from entering the female's vagina and
reaching the egg cells. It also prevents the uterus from forming a lining that is
fertilized by a fertilized egg.
An IUD can last in a woman's uterus for up to ten years. But unlike condoms it does
not provide protection from STDs.

 Calendar or Rhythm method

Unlike previous family planning methods, the calendar or rhythm method is a
natural way to avoid unexpected pregnancies, if a woman is fertile.
But it is more effective and it is advisable for women with regular menstruation
because the calendar day and number of menstrual cycle days of a woman is the key
to this procedure.
A woman is more likely to become pregnant before or during ovulation.
Ovulation occurs only once a month, usually 12 to 16 days after menstruation. Once
the egg has come out of the ovary, its lifespan can take only 24 to 48 hours.
In the meantime, the male sperm can survive long on the female's body, up to the
fifth day after the male releases it into the sex.
Therefore, the female who is sexually active is fertile or may become
pregnant during the 5th day before ovulation, on the day of ovulation, and at the 12th
to 24th hour after ovulation. These are the days when contraceptives or condoms
such as condoms are needed to prevent a woman from getting pregnant.
To do the calendar method, mark on the calendar all days of menstruation or monthly
twice, for 6 months. Here you will see how many days your average cycle will last.
This is for women with regular menstruation cycles.
 If the monthly twenty is 28 days, count the first ten days of menstruation: this
is the "safe period" because the woman is not fertile.

 The next 8 days are not "safe" for those who do not want to get pregnant, as
this is the FERTILE period. Unsafe sex should be avoided these days. The
 next 10 days, or 19 days from the first day of menstruation that month, are
“safe” again, and the woman is not fertile.

 Withdrawal method

The withdrawal method or pull-out method is one of the types of birth control
method with the lowest percentage of effectivity. It is also called coitus interruptus or
the removal of the male penis from the vagina before ejaculation to prevent a
woman's pregnancy. This is so that the sperm cannot enter the woman's vagina.
The withdrawal method requires self-control and proper timing in order to perform
properly. Its effectivity is low because a man may still produce semen before
ejaculation or pre-ejaculation.
These are the types of family planning methods in the Philippines. If you are
planning to start using such birth control methods simply go to the health center in
your area to better understand and find out which method is best suited for your
family.

2. B. Family Size beyond what family resources can adequately provide –

Increase Extra Income
One of the main problems of the family in community health
nursing is their source of income. Source of income is what keeps up the
family to survive daily. It provides their needs, it can be social,
psychological, spiritual, economical, and cultural. Family resources play an
important role because it will be the basis on how their family achieve
success in all aspects. In some other countries, Family resources is their
basis of status and is highly sensitive topic to be discussed unlike in
Philippines, it is more normal and does not really seem to be a serious
topic.
The purpose of the health teaching is to address the existing problem
about the inadequacy of resources for the family to utilize because it is
considered as a health threat. Helping the family provide and enlighten
ways on how to earn more and to think out of the box is a really
appreciated help. Introducing new ways to earn income such as starting a
mini business is the strategy that will be taught to the family. The name of
the product is Choco Balls where it does not seem to have a need of large
capital but it has a potential to have a satisfying gain for the family.
After the implementation of the intervention, the family will be able to
increase their income with a progress starting from the bottom going to the
top is possible. The said product is suited for the seller who is one of their
children and can have more percentile of having a great amount of
success of the mini business since the target consumers is children as
well because we all know that children loves sweet pastries. If the family
will like the new way of increasing their income, then therefore the
expectation sooner or later will be the reality.

3. Inability to provide a home environment conductive to health

maintenance and personal development due to: inadequate knowledge

to the importance of personal hygiene.

a. Enumerate different types of personal hygiene and how to perform each

one:

 Toilet hygiene

 Wash your hands after you use the restroom;

 Scrub with soap for 20 to 30 seconds, and be sure to clean

between your fingers, on the back of your hands, and under your

nails. Rinse with warm water, and dry with a clean towel;
 If you don’t have running water or soap, an alcohol-based hand

sanitizer will also work. Use one that’s at least 60 percent alcohol

 Shower hygiene
 Showering with soap helps rinse away dead skin cells, bacteria,

and oils;
 You should also wash your hair at least twice a week;
 Shampooing your hair and scalp helps remove skin build-up and

protects against oily residues that can irritate your skin;

 Use antibacterial and mild soap

 Nail hygiene

 Trim your nails regularly to keep them short and clean;

 Brush under them with a nail brush or washcloth to rinse away

build-up, dirt, and germs;

  Tidying your nails helps you prevent spreading germs into your

mouth and other body openings

 Teeth hygiene

 Brush at least twice a day for 2 minutes;

 Aim to brush after you wake up and before bed. If you can, brush

after every meal, too

 Hand hygiene

 Wash hands:
 When you handle food and before you eat
 When you sneeze
 Any time you touch an animal; if you handle garbage

4. Unsanitary food handling and preparation

a. Explain importance of proper food handling:

 Help stop bacteria from spreading and growing;

 Promote healthy eating;

 Eat and prepare food clean and proper;

b. Enumerate the methods of preparing food:

1.) Wash your hands;
2.) Keep working area clean;
3.) Separate raw foods from ready to eat foods;
4.) Check label, expiration date;
5.) Cook with appropriate temperature;
6.) Keep utensils clean;

c. Identify and explain possible diseases which we might get from

unsanitary handing and preparing food

 Diarrhea

 Typhoid fever

 Amoeba
 5. Poor home/environmental condition/sanitation – Poor lighting and

ventilation
a. Define what is poor lighting and ventilation:

 Poor lighting is when there is no adequate light;

 Poor ventilation is when there is no fresh air or not enough air coming

through the house.

b. Enumerate the effects of poor lighting and ventilation:

 Headache;

 Hypertension;

 Nausea;

 Shortness of breath;

 Strain eyes;

 Eye discomfort;

 Fatigue

c. Explain how to improve lighting:

 House must have atleast 3sources of light;

 Replace bulb when needed according to the manufacturer’s date;

 Paint walls and ceiling light colors in order for the light to reflect;

 Open blinds or curtains from windows to let the light in.

d. Explain how to improve ventilation:

 Open the windows and doors regularly;

 Open the window slightly at night;

Place plant near windows or outside nears the door for oxygen and carbon dioxide

exchange;
6. Accident hazard specifically fire hazards as health threat.
A. Be careful in the kitchen, fire often starts here.
 Do not leave when you’re still cooking.
 Clean the discarded oils.
 Keep the papers or utensils that can be burned away from the stove.
 Whenever cooking, holding cups, or pans should be placed inward or away from

the fire.
B. Be careful when using candles.
 Keep them away from children or pets and make sure they are properly

smothered.
 Also make sure the candle holder is firm enough to keep from falling
C. Study your area where you can pass in the event of a fire.
 Inspect those that may block the door or window in the event of a fire.
 Make sure the windows can be opened easily.

XII. IMPLICATIONS OF THE STUDY TO NURSING STUDIES, RESEARCH,

and PRACTICE

Nursing practice
Children brought for medical treatment in the developing world are often
suffering from more than one condition, making a single diagnosis impossible.
As future nurses, the group must be aware and must know different types of
diseases so that they can give the proper care, treatment and interventions to
those who are in need of their help. This study equips them to be proficient in
handling different kinds of situations and circumstances whenever problems
arise.

Nursing Education
IMCI is an integrated strategy, wherein it takes into account the variety of
factors that put children at serious risk. This study can be use as a platform or
a foundation for student nurses to propel them deeper into various medical
fields with the necessary knowledge and skill that will enable them to provide
unbiased assistance to those who are not only financially stable but also to
those who are unstable financially.

Nursing Research
This study will enable future nurses to enhance their researching skills and
to practice deeper research abilities. It enable the group to be more
competent and diligent to the never-ending research. Also, this study equips
student to be persistent to search for an answer to any unanswered
questions.

XIII. REFERENCES

Kaylee L. (2016). The True Meaning Of Family.Retrieved 03-09-2020 from

https://theodysseyonline.com/the-true-meaning-of-family.
Rahul S. (2013). The family and Family structure Classification Redefined for
the current times. Retrieved 03-09-2020 from

https://ncbi.nlm.nih.gov/pmc/articles/PMC4649868/
Worldometer (2020). Current World Population. Retrieved 03-09-2020 from
https://worldometers.info/worldpopulation/
Philatlas (2015). Historical Population of Brgy. 37-D. Retrieved 03-09-2020

from https://philatlas.com/mindanao/r11/davao-

city/barangay-37-d.html
World Health Organization. (2017). Enhancing the role of community health
nursing for universal health coverage. World Health Organization.
https://apps.who.int/iris/handle/10665/255047. License: CC BY-NC-SA
3.0 IGO
Worldmeters. (2019). World Population. Retrieved on September 25, 2019,
from https://www.worldometers.info/

World Population Review. (2019). World Population Review. 2019

World Population by Country. Retrieved on September 27, 2019, from
http://worldpopulationreview.com/