Family Case Study Presented to

The Faculty of the College of Nursing

Of The University of St. La Salle

Bacolod City

In Partial Fulfillment

Of the Requirements for the Degree

Bachelor of Science in Nursing

By:

Beatrice Higgins

BSN3A

Group 2

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 TABLE OF CONTENTS

I. OBJECTIVES 3

II. PROFILE OF THE FAMILY

III. INITIAL DATABASE FOR FAMILY NURSING PROCESS

A. FAMILY STRUCTURE AND CHARACTERISTICS

B. SOCIO-ECONOMIC AND CULTURAL FACTORS

C. ENVIRONMENTAL FACTORS

D. HEALTH ASSESSMENT OF EACH MEMBER

E. VALUE PLACE ON PREVENTION OF ILLNESS

IV. CUES AND DATA 6

V. PRIORITIZATION 6

VI. FAMILY NURSING CARE PLAN

VII. QUESTIONNAIRE 9

VIII. SPOT MAP

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 I. INTRODUCTION

A community refers to a group of people who interact with each other. It is a social group
determined by geographic boundaries, common values and interest. The family is present in all
communities. They are considered as the basic unit of care in the community health nursing. It is
in the family where a member develops his health values, beliefs and practices. Hence, the
family is a major influence in the health behaviors of an individual. It is important that families
in a community are aware of the things and practices pertaining to their health.

Being exposed in the community did not only provide an avenue to apply what we have
acquired in the classroom but it also gave us an opportunity to serve our fellowmen. A day spent
in the community is always a learning experience for us. Because we are able to socialize and
interact with different people in the community, we are able to see the real world. Every
exposure gives us realizations that make us become better versions of ourselves. Though tiring as
community health nursing can get, reaching out to the families gives us the sense of fulfillment
as we share our knowledge, skill, and time to aid in uplifting the conditions of each family.

As community health nurses, we strive to promote prevention over treatment. Our role as
educators is to provide clients with information that allows them to make healthier choices and
practices. In order to improve individual, family, and community health, correct knowledge,
attitude and skill should be taught and subsequently practiced. By correcting poor health
practices and maintaining a safe home or work environment, patients lower risks to their health
and require fewer visits to health care facilities.

Through the family case study, we are able to have a better understanding of the
multidimensional nature of health which can enable us to plan and implement health promoting
interventions for our clients. In this way we are able to give the utmost family-centered care to
our clients making us even more effective community health nurses.

II. OBJECTIVES

General Objectives:

AFTER ONE WEEK OF NURSE – CLIENT INTERACTION THE STUDENT

NURSE WILL BE ABLE TO:

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  Apply the learned knowledge and skills in assessing family health status and
prioritizing family health problems in the community for health care, promotion and
prevention.

Specific Objectives:

AFTER ONE/TWO DAYS OF NURSE – CLIENT INTERACTION THE STUDENT

NURSE WILL BE ABLE TO:

 Conduct an initial assessment to determine the presence of health problems.

 Identify and prioritize family health problems.
 Formulate family nursing care plan for the priority family health problems.
 Identify the prevention and treatment of the client’s health problem.
 Promote wellness through health teachings.

III. NARRATIVE REPORT

A. Family Structure and Characteristics:

The family is an extended type of family. It is composed of five people: the grandmother
the parents, and the two children. Mr. Sandro Espada, 33 years old, is the father and the head
of the family. He works as a fisherman in their barangay and he is responsible for providing
the needs of the whole family and the family’s daily expenses. Sheena Espada,32 years old, is
the wife of Mr. Sandro Espada. She is currently 4 months pregnant. She is only a housewife
and she is in charge of taking care of the children as well as doing the household chores. Her
mother, Maria Mercedes Magbanua, 70 years old, lives with them and she helps her daughter
with the daily household activities. Mr and Mrs. Espada have two kids: a boy named Sean
Cedric Espada who is 7 years old followed by a girl named Kathleen Faith Espada who is 5
years old. Sean Cedric, a grade2 student, together with his sister Kathleen, who is still in
kindergarten, are currently enrolled in Maria Rosario Araneta Elementary School.

My client and her family have their own house made of concrete situated near her brother,
Mr. Magbanua, who also has his own family. Maria Mercedes Magbanua, my client’s mother,
owns the lot and has resided there since she was born which means that their length of stay
lasted for over 70 years already. My client’s family has their own refrigerator, television,
washing machine, and a water sealed toilet. The house also has electricity and the family’s
means of water supply is from Bago City Water District.

With regards to the relationships of each member in the family, they all love each other
unconditionally. They make relationships a priority, communicate effectively and provide
support for each other. The best characteristic my client’s family holds is that when they face
problems, they don’t let this affect them but instead they learn how manage this as a family.

My client is always in charge in the decision-making for the family’s health. She is the
one accompanying her children to health facilities for immunizations and check-ups. She
knows more about the happenings in the household compared to her husband since he spends
most of his time fishing.

B. Socio Economic and Cultural Factors

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 My client is a 4th year high school graduate and she is only a house wife. Her husband,
who stopped schooling during his college years, works as a fisherman in their barangay. He
used to work as a waiter in Tratorria Uma located at Bacolod City but because the wage was
not enough to provide the needs of his family, he decided to resign. My client claims that her
husband’s earnings in a day would range from P200-P250 which means they have an income
of at least P1,200 in a week. This can already cover the basic needs of the whole family inside
the house. She says that this is better compared to his earnings in Trattoria Uma where he
would spend most of it on his fare. However, incomes in fisheries are highly variable because
it is dependent on the weather. My client reports that during bad weather, her husband’s
earnings are not that good. Hence, the whole family does their best in saving for future crisis.

My client is also very active in community activities. She would always attend the
meetings or the events held in their barangay. The relationship of the whole family with the
other members in the community is also good. Most of their neighbors would describe them
as being generous. They would always share their resources to the other members in the
community.

C. Environmental Factors

Humans are in constant interaction with the environment. There are a lot of substances
found in the air, soil and water that can affect our health. The house of my client is in a
congested type of neighborhood where people do not practice proper garbage segregation and
where there is presence of rodents and insects. Compared to the other houses, my client’s
house is more spacious. She would always clean the house and practice good sanitation.
During home visits, the house is always organized. However, there is presence of flies inside
the house making their food at risk of being contaminated.

My client and her family avails the health services in the barangay health station. Because
she is particular about the health of the family, she always avails the health services in the
barangay health station. Whenever there are free consultations like medical missions, she
would always take advantage of this opportunity. Since my client is pregnant, she makes sure
that her prenatal check-ups are up to date.

D. Health Assessment of Each Member

Every home visits, I would always assess the health of each member in the family to
determine any presence of a health problem. During my interview with my client, I found out
that she is 4 months pregnant. Her LMP was on April 2, 2015, EDC is on January 9, 2016 and
her AOG is 16 5/7 weeks. She is also diagnosed with Peptic Ulcer. Everytime this occurs, she
would experience stomach pains which makes her vomit any food she is taking in. Her
medical management is that she is injected with Ranitidine for every 8 hours. Even with the
occurrence of Peptic Ulcer, my client still loves indulging in salty, spicy, and sour food that
intensifies the symptoms. Prior to this, health education about Peptic Ulcer was given. My
client together with her mother and daughter were also diagnosed of having Urinary Tract
Infection. As a result, health education was also given where I emphasized on practicing good
sanitation. Regarding the health status of the children, my client claims that they have
completed their immunization: DPT, BCG, Polio, Hepa B, Measles, and Flu.. However, both
of them have not gone through Newborn Screening. My client also reported how her two
children have very poor appetite but loves eating junk food throughout the day. She complains

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on how thin they are even though she is providing them with milk and vitamins. When I
adviced her to have them referred to the health center for deworming, she refused because she
believes that once the worms are excreted out of the body, there are no chances of the eggs to
be left inside. The mother and the children would also sometimes skip meals during the day.
With regards to the father, he is in a good and stable condition. He seldom experiences any
health problems. My client’s only concern for him is that every time he comes home from
fishing, there are presence of rashes below his knee down to his feet.

E. Values Placed on Prevention of Disease

My client knows the importance of investing wisely in both clinical and community
preventive services. She agrees that prevention is better than cure. However, my client and her
family don’t apply preventive measures in their daily lives. Even though they are aware of
what prevention can do, it is useless if they don’t put this into practice.

IV. RECORDS AND REPORTS

 Home Visit Records
 ARAS
 Health Teaching Plan on UTI, Peptic Ulcer, and Good Nutrition

V. PROBLEMS IDENTIFIED ACCORDING TO PRIORITY

PRESENCE OF MANY FLIES

ACTUAL
CRITERIA COMPUTATION
SCORE
1. NATURE OF HEALTH PROBLEM
2/3 X 1 0.67
HEALTH THREAT

2. MODIFIABILITY OF PROBLEM

NOT MODIFIABLE 0/2 X 1 0

3. PREVENTIVE POTENTIAL

MODERATE 1/3 X 1 0.33

4. SALIENCE

A PROBLEM BUT NOT NEEDING

IMMEDIATE ATTENTION 1/2 X 1 0.5

TOTAL: 1.5

PREGNANCY

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 ACTUAL
CRITERIA COMPUTATION
SCORE

1. NATURE OF HEALTH PROBLEM 1/3 X 1 0.33

FORESEEABLE CRISIS

2. MODIFIABILITY OF PROBLEM
NOT MODIFIABLE 0/2 X 2 0

3. PREVENTIVE POTENTIAL

MODERATE
2/3 X 1 0.67
4. SALIENCE

A PROBLEM BUT NOT NEEDING

IMMEDIATE ATTENTION
1/2 X 1 0.5

TOTAL: 1.5

LOSS OF JOB

ACTUAL
CRITERIA COMPUTATION
SCORE
1. NATURE OF HEALTH
1/3 X 1 0.33
FORESEEABLE CRISIS

2. MODIFIABILITY OF PROBLEM

PARTIALLY MODIFIABLE 1/2 X 2 1

3. PREVENTIVE POTENTIAL

LOW 1/3 X 1 0.33

4. SALIENCE

A PROBLEM BUT NOT NEEDING

IMMEDIATE ATTENTION 1/2 X 1 0.5

TOTAL: 2.16

OCCURRENCE OF PEPTIC ULCER (IN THE MOTHER)

ACTUAL
CRITERIA COMPUTATION
SCORE

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 1. NATURE OF HEALTH 3/3 X 1 1
HEALTH DEFICIT

2. MODIFIABILITY OF PROBLEM
0/2 X 2 0
NOT MODIFIABLE

3. PREVENTIVE POTENTIAL

HIGH 3/3 X 1 1

4. SALIENCE

A SERIOUS PROBLEM,
IMMEDIATE ATTENTION 2/2 X 1 1

TOTAL: 3

PRIORITIZE PROBLEM: FAULTY EATING HABITS

ACTUAL
CRITERIA COMPUTATION JUSTIFICATION
SCORE

1. NATURE OF IT IS HEALTH
HEALTH THREAT SINCE IT IS
PROBLEM A CONDITION
CONDUCIVE TO
HEALTH
2/3 X 1= 0.67 0.67 DISEASE.
THREAT

IT IS EASILY
MODIFIABLE:
2. MODIFIABILITY
THERE IS A CHANCE
OF PROBLEM 2/2 X 2= 2 2
OF SUCCESS IN
EASILY ERADICATING THE
MODIFIABLE PROBLEM.

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 IT IS HIGH BECAUSE
IT CAN BE
3. PREVENTIVE
PREVENTED FROM
POTENTIAL
HAPPENING AGAIN
HIGH 3/3 X 1=1 1 THROUGH
DEVELOPMENT OF
PROPER EATING
HABITS IN THE
FAMILY.

4. SALIENCE
IT IS A SERIOUS
A SERIOUS PROBLEM THAT
PROBLEM, NEEDS IMMEDIATE
IMMEDIATE 2/2 X 1=1 1 ATTENTION
ATTENTION BECAUSE IT MAY
LEAD TO DISEASES
OR COMPLICATONS
IN THE FAMILY’S
HEALTH.

TOTAL: 4.67

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 VI. CONCLUSION AND RECOMMENDATIONS

Being the community health nurse of my client’s family has given me the opportunity to give my
utmost care to them. Through continuous health assessments and interactions, I was able to
identify their health problems. As a result, nursing intervention was given specifically giving of
health educations to correct their lifestyle practices.

As to my recommendations for the betterment of the whole family, they should do the ff:

1. Eat a variety of foods everyday to have an adequate source of nutrients.

2. Stop eating junk foods and eat a well balanced diet.
3. Continue availing of health services especially prenatal check-ups.
4. Strict practice of good personal hygiene by washing hands before and after
eating, taking a bath as well as oral hygiene, keeping oneself away from dirty
places or making the environment always clean, and using slippers all the time.

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VII. BIBLIOGRAPHY AND REFERENCES

 Public Health Nursing In The Philippines by Frances Prescilla L Cuevas

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