Introduction

At its inception, the profession of nursing adopted a holistic approach toward health promotion and the
prevention of illness and injury. Florence Nightingale founded modern nursing on the tenet that the role
of the nurse was primarily to modify the environment in ways that enhanced health and healing. Her
classic text Notes on Nursing (Nightingale, 1860), the first volume to codify nursing practice, includes
topics such as ventilation and heating, health of houses, noise, light, food, and cleanliness. In
Nightingale's view, any factor that can affect the health of the patient and the health of the public was
relevant to nursing practice.
At the time that nursing began to emerge as a profession, the interaction of
the environment and health was difficult to ignore. Nurses worked predominately in the community,
overseeing the care of the sick in homes, work sites, and schools, where environmental threats
to health were often extreme and highly visible (DeWitt, 1990; Kalisch and Kalisch, 1986; Moore, 1990;
O'Reilly, 1990; Pierson, 1990; Scovil, 1990). In those early days, nursing care included responsibility for
"the construction, sanitation, and hygiene of all places where people pass their waking hours or sleep"
(Davis, 1990). However, despite the good fit between environmental health concerns, core nursing values,
and the profession's early history, over the years environmental factors increasingly came to be treated as
separate from the nursing domain. As hospitals assumed a greater role in the health care system, more
nurses were employed in noncommunity-based settings (Kalisch and Kalisch, 1986). Nursing care
focused increasingly on the individual patient's health, specifically, the treatment of disease and
rehabilitation. Less emphasis was placed on preventive care in general, including the elimination of
harmful environments and the enhancement of healthful environments.

This study focuses on Rubiano Family, a resident of Calara St, West Calaguiman, Samal, Bataan.
Rubiano Family lives with their 3 daughters. I will identified their cause of problem through home visit
where I will do an interview to know their biographic data and also their past and present illness.
 CHAPTER I
Initial Data Base

A. Family Structure and characteristics

  Family Name: Rubiano Family
Type of Family: Nuclear Family

A Nuclear Family  can also be called , elementary family, or conjugal family it is a family group

consisting of two parents and their children (one or more) Nuclear families typically center on
a married couple which may have any number of children. There are differences in definition among
observers. The "core" of the family is the nuclear family, the parents and their children. Nuclear Family is
defined as "the family of marriage, parenthood, or procreation; composed of a husband, wife, and their
immediate children -- natural, adopted or both."

 Mother
 Father
 Children ( one or more)

Rubiano Family, was a nuclear family, it consist of mother , father , and three daughter’s, who lives at
Calara St, West Calaguiman Samal Bataan. They have 1 mother, 1 father, and 3 daughter’s. The Rubiano
Family consists of two legally Married parents and 3 daughter’s. The Father is Edgar Rubiano, 53 years
old works as seaman. And the mother is Rosmelita Rubiano , 52 years old a house wife. And the eldest
daughter, Kennix Rubiano 20 years old a student of bs nursing, the second daughter, Krizette Rubiano 19
years old nursing student also, and the youngest 18 years old student in Arellano in 12 grade.

Family Age Sex Civil Status Relationship

Edgar Rubianno 53 M Married Father
Rosmelita Rubiano 52 F Married Mother
Kennix Rubiano 20 F Single Daughter
Krizette Rubiano 19 F Single Daughter
Kyle Rubiano 18 F Single Daughter

A. Socio-Economic and Cultural Factors

Health is determined by several factors including genetic inheritance, personal behaviors, access to
quality health care, and the general external environment (such as the quality of air, water, and housing
conditions). In addition, a growing body of research has documented associations between social and
cultural factors and health (Berkman and Kawachi, 2000; Marmot and Wilkinson, 2006). For some types
of social variables, such as socioeconomic status (SES) or poverty, robust evidence of their links to health
has existed since the beginning of official record keeping. For other kinds of variables—such as social
networks and social support or job stress—evidence of their links to health has accumulated over the past
30 years.
It should be emphasized at the outset that the social determinants of health can be conceptualized as
influencing health at multiple levels throughout the life course. Thus, for example, poverty can be
conceptualized as an exposure influencing the health of individuals at different levels of organization—
within families or within the neighborhoods in which individuals reside. Moreover, these different levels
of influence may co-occur and interact with one another to produce health. For example, the detrimental
health impact of growing up in a poor family may be potentiated if that family also happens to reside in a
disadvantaged community (where other families are poor) rather than in a middle-class community.
Furthermore, poverty may differentially and independently affect the health of an individual at different
stages of the life course (e.g., in utero, during infancy and childhood, during pregnancy, or during old
age).
In short, the influence of social and cultural variables on health involves dimensions of both time (critical
stages in the life course and the effects of cumulative exposure) as well as place (multiple levels of
exposure). The contexts in which social and cultural variables operate to influence health outcomes are
called, generically, the social and cultural environment.

Family Educational Occupation Place of Work Religion Income

Member Attainment
Edgar Rubiano College Seaman TORM Roman 25,000
Shipping Catholic
 Company
Rosmelita College N/A N/A Roman 35,000
Rubiano Catholic
Kennix Currently N/A N/A Roman N/A
Rubiano Enrolled Catholic
Krizette Currently N/A N/A Roman N/A
Rubiano Enrolled Catholic
Kyle Rubiano High School N/A N/A Roman N/A
Catholic

Education - The current trend in nursing education is to put more emphasis on practice in the
community. Pre-service nursing education has included community health nursing as part of the
curriculum for several decades. Recently, there has been a renewed interest in how to best prepare
students to practise in the community setting. Most programmes focus on caring for individuals and
families in the community, while others emphasize the community as a client (McKnight & Van Dover,
1994). Experts suggest that nursing students working for the Bachelor of Science degree should work
with a group of people with different health issues such as the elderly, those with disability, etc.
(Baumann & Schmelzer, 1994; Caretto & McCormick, 1991), based on the belief that by improving the
health of the community, the health of individuals and families is improved. Some experts have suggested
that care should be given to the entire community as a client not merely to special groups (Flick, Reese, &
Harris, 1996; McKnight & Van Dover, 1994). The World Health Organization (WHO) recommends that
basic nursing education for community health practice should prepare nurses to identify, assess, plan,
implement, and evaluate the population at risk (WHO, 1985). 16 A framework for community health
nursing education According to the proposed four core functions, most basic nursing education
programmes have selected clinical contents and learning experiences related to community health
assessment and community health interventions, care, services, and the design and implementation of
interventions, care and service to varying degrees. Two of the other functions have appeared less
frequently in most recommendations for basic nursing education and have not been included in advanced
nursing practice, although research highly recommends them. It is crucial for a nursing education
programme to be responsive to the country’s health-care system. The competency requirements of nurses
working in community health care must be tailored to meet the country’s expectations, although common
features must be maintained. The key in attaining the challenges of the new paradigm of community
health care is a focus on preparing new nurse graduates to be generalists with strengths in community
health nursing interventions, not as specialists in community health care. Thus, the proposed four core
functions must be applied in the context of the health-care system and the functions must be
conceptualized in ways that are workable in the particular community health-care context. Educators must
be well aware that they are educating future nurses for the future community health-care system.

Expences Every Month Expences

Rice 1,100
Grocery 15,000
Gas 600
Internet 1,500
 Electric Bill 4,800
Tuition 6000
Total Expences 29,000

SOCIOECONOMIC STATUS

Mrs. Rubiano depends on the monthly income of Mr. Rubiano who has a salary of 60,000 a month. Mr.
Rubiano work is a seaman. Mrs. Rubiano said that Mr. Edgar Rubiano is a good husband and good father
to their daughter’s. Mr Edgar is the one who supports the financing and all of the expences of he’s family.
Mr. Edgar Rubiano always sending the 35,000 every month to Mrs. Rubiano for all the expences of their
family.

Environmental Factors

Environmental hazards and their health effects rarely lend themselves to simple solutions applied from a
single discipline. Effective interventions for environmentally related illness require collaborative efforts
from many disciplines due to the complex nature of environmental health issues, the rapidly advancing
science base in environmental health, and the need for primary prevention strategies that often must
involve professionals from fields other than nursing. Such collaboration includes ongoing dialogue and
fluidity of roles and responsibilities.
Nurses are accustomed to working with members of other disciplines toward a shared goal, although it is
often in a multidisciplinary manner, with members of each discipline performing their activities
independently and with clear role delineation. Various nursing associations and other health professions
advocate a more collaborative approach to health problems that is highly interactive and more likely to be
termed interdisciplinary. This issue is important to consider in order to most effectively address
environmental health issues.
The ANA's draft Nursing Social Policy Statement notes that nursing has an "external boundary" that
interacts with other professions in response to changing societal needs and the advance of scientific
knowledge. The boundaries are fluid rather than firmly defined, with members of various professions
cooperating in the exchange of knowledge, techniques, and ideas on how to deliver quality health care.
Collaborative practice, with some overlap of function, enables members of various disciplines to interact
with a shared overall mission (ANA, 1994).
The National League for Nursing (NLN) has described several aspects of the complex nature of health
care: technological advances that increase access to information, the need to educate professionals to
recognize patterns and engage in innovative problem solving rather than simply mastering didactic
content, and an increasingly broad and integrated knowledge base that is not discipline specific (NLN,
1992). These issues are particularly relevant to environmental health, a field that requires (1) an ability to
access information that is current and comprehensive, (2) the ability to recognize patterns of disease, and
(3) engagement in interdisciplinary actions to gain expertise from disciplines such as physics, sociology,
political science, history, and ecology as well as various health disciplines.

Positive Environmental Factors Negative Environmental Factors

Home Structure- Concrete (owned) Insect Mosquitoes, flies

Have owned excreta

no close neighbors

Have proper waste of disposal

No near shops and transport (tricycle)

Adequate living space Slippery Area

Peaceful and quiet

Free from pollutions

Have own Drainage

 A. Health Assessment Each Family 

Family member: Rosmelita Rubiano

Date of Birth: January 6, 1968
Age: 52 years old
Gender: Female

History

Mrs. Rosmelita Rubiano is an 52 years old with a history of appendicitis and gallstone surgery.
She has no known allergies. She also said that she have a complete immunization when she was a
child. Mrs. Rubiano also said that she is healthy. Mrs. Rubiano also verbalize that she was
hospitalized when she found out that she has a vertigo.  She also said when she feels dizzy she
takes care of herself to prevent the presence of vertigo. And Mrs. Rubiano have no maintenance
medicine. Also she got her first pregnancy at the age of 30 and now he has a 3 daughter.

         She lives in #326 Calara St, West Calaguiman, Samal Bataan. Their home has an inadequate
living space , 2 rooms ,have a small kitchen inside and has dirty kitchen outside the house have 1 
toilet room. And the house space is exact for the whole family.

Family member: Rosmelita Rubiano

 Date of Birth: January 6, 1968
Age: 52 years old
Gender: Female
Functional Health Pattern
A.Health Perception/
Health Management
B. Nutrition-Metabolic
Analysis
Subjective Data:
Mabilis akong mapagod dahil ako
lang din ang nag aayos at nag
lilinis ng bahay. Hindi na rin ako
makatayo ng matagal at mabilis
na akong mangawit.
As verbalized by the patient.
Objective Data:
 Vitals are taken as
follow:
 BP: 130/80
 Temp 36.2
 RR: 23 breaths/minute
 PR: 60 beats/minute
Subjective Data:
Madalas naming ulam ay puro
karne, at manok pero sa isang
lingo hindi naman mawawala ang
gulay at isda. Tama naman ang
pagkain ko sa araw araw sakto
lang ang kanin ko at hindi ako
kumakain ng matatabang
pagkain. Madalas akong mag
kape at nag gagatas naman ako
minsan sa umaga at gabi.
Kadalasan na kinakain ko kapag
gabi ay Tinapay lang at minsan
kapag gabi na at patulog na ako
umiinom ako ng Ovaltine o gatas
sa gabi pero mas madalas ang pag
kape dahil nakaktulong iyon
sakin upang makatulog. As
verbalized by the patient.
BREAKFAST:
- 1 slice bread
-1 egg
-1 hotdog
- 1 glass of coffee
LUNCH:
- 1 cup Rice
 - 1 serving of chicken
Adobo
- 1 glass of coke

DINNER:
- Half cup of Rice
- 1 serving of Tocino

C. Elimination Subjective Data:

Nadudumi ako palagi ng isang
beses sa isang araw. At madalas
akong umihi dahil mahilig ako sa
tubig siguro nakaka ihi ako sa
isang araw ng mga 3-5 beses na
pag ihi. Wala naman akong
nararamdaman kapag dumudumi
at sa pag ihi ko. Ayos naman
lahat. As verbalized by the
patient.

Color of urine: Amber

Consistency of stool: Type 3

D. Activity Exercise Subjective Data:

Pag maaga akong nagigising ay
nag eexercise ako sa loob ng
bahay pero madalas sa gabi nag
iinat inat ako kapag hindi ako
makatulog. Pero madalas pag
gising ko nag liligpit at nag aayos
at nag lilinis ako ng bahay
naming. at iyon na ang exercise
ko sa araw araw. As verbalized
by the patient
E. Cognitive Perceptual Subjective Data:
Madami akong ginagawa at
iniisip kaya madalas akong
makalimot sa mga ibang bagay
katulad ng kung saan saan ko
nilalagay ang mga bagay na
nabitawan ko. As verbalized by
the patient.
F. Sleep-Rest Pattern Subjective Data:
Madalas akong makatulog ng
mga 11 o 12 na ng gabi dahil
hindi ako nakakatulog ng maaga
At nagigising ako ng 6 ng umaga

G. Role Relationship
pero nakakatulog naman ako
kapag tanghali. As verbalized by
the patient.
Subjetive Data:
Halos ako lahat ang nag lilinis ng
bahay at nag aayos dahil ang mga
anak ko ay nag aaral. At ang mga
anak ko naman ang taga luto, at
taga hugas.
As verbalized by the patient.

H. Sexuality- Reproduction Subjective Data:

Menopause nako sa edad na 50.
Yung panaganay kong anak
ipinanganak kong normal pero
yung dalawang sumunod ay
caesarean na. Nakunan ako ng
isang beses dahil hindi ko alam
na buntis pala ako. Kompleto din
sa buwan ang lahat ng mga anak
ko noong pinanganak ko sila. As
verbalized by the patient
I. Coping- Stress Subjective Data:
Tolerance Hindi naman nako madalas
mastress ngayon. paminsan
minsan nag kakaproblema, pero
naaayos din naman at hindi nako
nag papa stress. Kapag may
problema ay nanunuod nalang
ako ng mga teleserye. As
verbalized by the patient
K. Sensory- Perceptual pattern Subjective Data:
Hindi kona Makita ang maliliit na
bagay meron naman akong
salamin sinusuot ko ito pag ako
ay nag susulat at nanunuod.
Malinaw pa naman ang pandinig
ko at pang ramdam. As
verbalized by the patient.
M. Values - Belief   Subjective Data:
Kapag masama ang katawan ko
at pakiramdam ko at sa tingin ko
hindi nakakayanin ang sakit nag
pupunta nako sa mang hihilot
dahil iyon ang nakasanayan
namin pero kapag nag susuka at
nahihilo ay nag pupunta ako sa
ospital. As verbalized by the
patient.
  L. Substance Use Subjective Data:
 Vitamin B complex takes it
everyday

Family member: Kyle Rubiano

Date of Birth: August 27, 2002
Age: 18 years old
Gender: Female

History

Ms. Kyle Rubiano is 18 years old. According to her, her childhood illness she had chicken fox and she
was hospitalized by infection. She has no known allergies. And she had complete immunization when she
was a child. Ms. Rubiano have no maintenance medicine.

Functional Health Pattern Analysis

A. Health Perception/ Subjective Data:

Health Management Kpag nakakaamoy akong polluted
air, mabilis akong sipunin. At
paminsan minsan bigla bigla nalang
akong namumutla. As verbalized
by the patient
Objective Data:
Vitals are taken as follow:
 BP: 120/90
 Temp 36.1
 RR: 20 breaths/minute
 PR: 50 beats/minute

B. Nutrition-Metabolic Subjective Data:

Madalas naming ulam ay karne at
manok Kapag almusal naman
madalas akong hindi nakakin ng
almusal dahil late na akong
nagigising. Minsan naman
kumakain ako ng almusal tinapay
lang tsaka gatas. Sa tanghali naman
malakas akong kumain at sa gabi
ay minsan tinapay lang or cereals
pero madals kanin din sa gabi. As
verbalized by the patient

BREAKFAST:
- 1 cup of Rice
- 1 egg
 - 1 hotdog

LUNCH:
- 1 cup of Rice
- 1 serving of pork
(sinigang)
- Juice

DINNER:
- 1 cup of Rice
- 1 serving of Cornbeef
C. Elimination Subjective Data:
Sa isang linggo dalawang beses
lang akong dumumi. Madalas
naman akong umihi dahil madalas
akong uminom mga 5 beses akong
umihi sa isang araw. As verbalized
by the patient
Color of urine: White
Consistency of Stool: Type 3 and
Type 2

D. Activity - Exercise Subjective Data:

Minsan nag lalakad ako sa labas ng
bahay namin dahil maluwag ang
daan doon. Minsan naman nag
jujumping rope ako sa hapon. As
verbalized by the patient

E. Cognitive-Perceptual Subjective Data:

Minsan nakakalimot ako katulad ng
anong nangyare sa mga bagay
bagay.
As verbalized by the patient
F. Sleep-Rest Pattern Subjective Data:
Sa ngayon nakaktulog ako ng 1 am
minsan ay 2 am na at nagigising
ako ng 9-10 am. Paminsan minsan
ay 12.
A. Sexuality-Reproduction AsSubjective
verbalizedData:
by the patient
Irregular ang menstruation ko
paminsan minsan hindi ako
nagkakaron ng period sa isang
buwan. As verbalized by the
G. Role-Relationship Subjective
patient Data:
B. Coping-Stress Tolerance Ako ang taga
Subjective saing sa bahay at
Data:
minsan nag luluto
Na-sstress ako pag at nag wawalis
madaming
walis ako sasaloob
ginagawa ng bahay.
school Para
pag nag
naman
sabay makatulong
sabay lahatako sa
ng gawaing
mga
bahay. As verbalized
requirements by the
at exams. Atpatient
ang
ginagawa ko naman upang
hindi ako madala sa pag ka-
stress ko ay nakikinig ako ng
music at nag gigitara ako. As
verbalized by the patient
C. Sensory- Subjective Data:
Perceptual pattern Maayos naman ang mata ko
hindi pa siya Malabo pero
meron akong stigmatism kaya
kelangan na laging suot ko ang
salamin ko lalo na pag
nanunuod at nag gagadgets. As
verbalized by the patient
D. Values - Belief Subjective Data:
Minsan pag masakit ulo ko
nilalagyan ko lang ng vix or
kapag masakit naman ang
katawan ko ay nag lalagay lang
ako ng salompas. Naniniwala
naman ako sa mga tawas dahil
sa mama ko. At wala namang
mali kung maniniwala ako don
at nakita ko din naman na
maayos at effective naman ito.
As verbalized by the patient
E. Substance Use Subjective Data:
Vitamins; Celine and Growee
she takes the vitamins everyday
 DATA BASE: PHYSICAL EXAMINATION
                                       (Head to Toe Assessment)
Family member: Rosmelita Rubiano
Date of Birth: January 6, 1967
Age: 52 years old
Gender: Female
                              VITAL SIGNS
 BP: 130/80
 Temp: 36.2
 RR: 23 breaths/minute
 PR: 60 beats/minute

Area Method Findings Interpretation

Integumentary Skin Inspection Color of skin is light Normal

Palpation brown. Generally uniform
except in areas exposed to
the sun
No edema
Skin  temperature is in
normal range When
pinched, skin springs back
to 
 previous state.
_ She have scar in lower
neck area, because of
warts. Scar due to pregnancy

Hair Inspection She have a dry hair Normal due to aging

Have a black hair
Nail Inspection -smooth texture Normal
Palpation - light pink
- the blanch test of
capillary refill is less than
3 second

Head Skull and Face Inspection -The shape of the face Normal
Palpation Rounded with frontal,
parietal, and occipital.
-symmetric facial
movements

Eyes and Vision Inspection “pag maliit na letra hindi Risk for injury
ko na mabasa , medyo R/t environmental hazards
 malabo narin ang
paningin ko’’ as
verbalized by the patient.
- She uses glasses
- Her eyelash and
eyebrows are Normal
evenly
distributed.
- in her eyelids
there is no Normal
discharge, no
discoloration lids
close
symmetrically
Ears and Hearing Inspection -No presence of Normal
Palpation tenderness masses and
drainage. Symmetrical
ears and equal in size
aligned on the outer
canthus of the eye 

Nose and Sinuses Inspection -Symmetric and straight Normal

Palpation No discharge or flaring
Uniform color

-Not tender; no lesions 

-Nasal septum intact and

in midline 

-Air moves freely as the

client breathes through the
nares

Mouth and Oropharynx Inspection Mucosa pink Clear, Normal

watery discharge No
lesions.
No dentures 
Has 20 teeth
Ability to purse lips
Tongue easily move in all
directions with presence
of whitish spots, moist
and with gag reflex.

Neck Muscles Inspection -Muscles equal in size; Normal

Palpation head centered

-Coordinated, smooth
 movements with  no
discomfort.

-Head flexes 45° 

-Head hyperextends 60°

-Equal strength 

Abdomen Inspection -No constipation Normal

Palpation
Percussion -Uniform color
Ausculation
-Flat

-Audible bowel sounds

-Absence of arterial bruits

-Absence of friction rub

 Musculoskeletal
It appears regular with no evident of masses, lesions ,
Head and Neck foreign bodies or other abnormalities. No tenderness
to palpation. Neck and shoulder are stable. Range of
motion and tone are within normal limits
Left upper extremity It appears regular symmetric with the right upper
extremity. No evident of masses, lesions , foreign
bodies or other abnormalities. No tenderness to
palpation. Joints are stable.
Right upper extremity It appears regular symmetric with the Left upper
extremity. No evident of masses No tenderness to
palpation. Joints are stable.

Right lower extremity It appears regular symmetric with the Left lower
extremity. No presence of swelling and tenderness in
joints.

Left lower extremity It appears regular symmetric with the right lower
extremity. No presence of swelling and tenderness in
 joints. Have some scar because of the warts due to
pregnancy.

        

DATA BASE: PHYSICAL EXAMINATION

                                       (Head to Toe Assessment)
Family member: Kyle Rubiano
Date of Birth: August 27, 2002
Age: 18 years old
Gender: Female
                              VITAL SIGNS
 BP: 130/60
 Temp: 36.2
 RR: 20 breaths/minute
 PR: 50 beats/minute

Area Method Findings Interpretation

Integumentary Skin Inspection Color of skin is light Normal

Palpation brown. Generally uniform
except in areas exposed to
the sun
No edema
Skin  temperature is in
normal range When
pinched, skin springs back
to 
 previous state.
- She has no scar
Normal
Hair Inspection -She have a smooth hair Normal
-Have a black hair
Normal
Nail Inspection smooth texture Normal
Palpation - light pink
- the blanch test of
capillary refill is less than
3 second

Head Skull and Face Inspection -The shape of the face Normal
Palpation Rounded with frontal,
parietal, and occipital.
-symmetric facial
 movements.

Eyes and Vision Inspection “Maayos naman ang mata

ko hindi pa siya Malabo Risk for injury
pero meron akong R/t environmental
stigmatism kaya kelangan hazards.
na laging suot ko ang
salamin ko lalo na pag
nanunuod at nag
gagadgets.” As
verbalized by the patient
-her eyebrows and eye
lashes is evenly
distributed.
-in her eyelids there is no
discharge, no
discoloration lids close Normal
symmetrically.

Ears and Hearing Inspection -No presence of  Normal

Palpation tenderness masses and
drainage. Symmetrical
ears and equal in size
aligned on the outer
canthus of the eye

Nose and Sinuses Inspection Symmetric and straight Normal

Palpation No discharge or flaring
Uniform color

Not tender; no lesions 

Nasal septum intact and in

midline 

Air moves freely as the

client breathes through the
nares

Mouth and Oropharynx Inspection Mucosa pink Clear, Normal

watery discharge No
lesions.
No dentures 
Has 28 teeth
Ability to purse lips
Tongue easily move in all
directions with presence
of whitish spots, moist
and with gag reflex.
 Neck Muscles Inspection Muscles equal in size; Normal
head centered

Coordinated, smooth
movements with  no
discomfort.

Head flexes 45° 

Head hyperextends 60°

Equal strength

Abdomen Inspection, auscultation, No constipation Normal

percussion and palpation
Uniform color

Flat

Audible bowel sounds

Absence of arterial bruits

Absence of friction rub

 Musculoskeletal
It appears regular with no evident of masses, lesions ,
Head and Neck foreign bodies or other abnormalities. No tenderness
to palpation. Neck and shoulder are stable. Range of
motion and tone are within normal limits
Left upper extremity It appears regular symmetric with the right upper
extremity. No evident of masses, lesions , foreign
bodies or other abnormalities. No tenderness to
palpation. Joints are stable.
Right upper extremity It appears regular symmetric with the Left upper
extremity. No evident of masses No tenderness to
palpation. Joints are stable.

Right lower extremity It appears regular symmetric with the Left lower
extremity. No presence of swelling and tenderness in
joints.
 Left lower extremity It appears regular symmetric with the right lower
extremity. No presence of swelling and tenderness in
joints.

E. Health Status of Each Family Member

Name of Family Past illness Diagnosis Health Action
Member
Edgar Rubiano No Past Illness
Kennix Rubiano No Past Illness
Krizette Rubiano No Past Illness
Kyle Rubiano No Past Illness
Rosmelita Rubiano No Past Illness

  CHAPTER II
                                             FIRST LEVEL OF ASSESSMENT

Identifying health threats, health deficit and foreseeable crisis/stress points.

A.Health Threat  conditions that promote disease or injury and prevent people from realizing
health potential or disease to a person
Insects

Consider it as health threat because mosquito bites can cause serious diseases such as viruses malaria and
dengue virus. The family member may be transmitted of serious disease like, Zika and West Nile virus.
That can lead to potentially deadly effects.

Insects like mosquitoe have a health threat like mosquitoes bites that causes serious diseases like malaria,
dengue viruses that can lead the family members to serious diseases and might have deadly effects such
as ( encephalitis, meningitis, from mosquitoes carrying certain viruses or parasites can cause severe
illness.

No close Neighbors

Consider it as a health threat for all the members of the family because no neighbors are difficult to
handle because like if your in an emergency, and you need to go to the hospital it’s difficult to go ask for
help in the middle of the night. And you have nothing to call incase of emergency. Though not having a
neighbor is good but there is also a threat or a side effect of not having it. Because having a neighbors can
help you onto something. Especially when it’s life threatening. Although having a neighbors have bad
effects too because some people are complaining about their neighbors but in terms of health having a
neighbor is good to help each other’s in terms of emergency.

No near shops and Transports

It is consider as a health threat because If you, or your family needs something important to buy like
medicines or first aid but you don’t have choice to just go in a town. Also if you’re in a emergency or in a
hurry you need a faster transport but you don’t have choice but to go to the corner and wait for the jeep to
come. It’s difficult especially when you’re in a emergency especially at night there’s no transport and
neighbors to call for an emergency.
Slippery Area

Consider it a health threat because it can cause a possible injury to a Family member because of the
slippery area.

Slippery floor is dangerous for children and elders, because it can cause accidents. Like when they slip
suddenly on the floor. It can cause break bones or worst. And They came here when they will get
something and when they are doing laundry. If they don’t maintain the cleanliness it can cause them
harm and accidents and worst is injury.

CHAPTER III
SECOND LEVEL OF ASSESSMENT
LIST OF PROBLEM IDENTIFIED

SUBJECTIVE CUES AND DATA FAMILY NURSING PROBLEM

Insects (mosquitoes and flies) Inability to provide a proper home environment

(HEALTH THREAT) which is conductive to health maintenance and
personal development due to : lack of proper health
environment

No neighbors Inability to provide the proper health safety of the

(HEALTH THREAT) family members and for the environment . Due to
lack of people in the community
No near shops and transport Inability to provide the needs of the family in the
(HEALTH THREAT) environment Due to not residential area.

Slippery Area Inability to recognize the risks/hazards due to

(HEALTH THREAT) inadequate knowledge about future illness or
disease.

CHAPTER IV
SCALE FOR RANKINGS
A. CRITERIA
CRITERIA SCORE WEIGHT

Nature of problem
a) Health deficit
b) Health threats
c) Forseeable crisis
Modifiability
a) Easy
b) Moderate
c) Non Modifiable

Preventive/Potential
a) High
b) Moderate
c) Low

Salience of the problem

a) Problem needing
urgent attention
b) Problem not needing
urgent attention
c) Not perceive as a
problem

B. SCORING

Decide on score on each Criteria

Divide score by the highest possible score and multiply by the weight.
Score
------------------x weight
Highest Score
Sum up the scores for all the criteria. The highest score is 5, equivalent to the total weight.
 The higher the score (near 5 and above) of a given problem, the more likely it is taken as
PRIORITY

With the available scores, the nurse then ranks the health problem accordingly.

 CHAPTER V
                                              Chapter V
                  Ranking and Scoring Of Each Health Problem

List of health problems ranked according to priorities

Health Problems Score

Prone to insects

No neighborhood

No near Shop and Transsports

Slippery Area

a. Insects

CRITERIA SCORES JUSTIFICATION

Nature of problem
a) Health deficit
b) Health threats
c) Forseeable crisis
Modifiability
a) Easy
b) Moderate
c) Non Modifiable
Preventive/Potential
 a) High
b) Moderate
c) Low
Salience of the problem
a) Problem needing
urgent attention
b) Problem not needing
urgent attention
c) Not perceive as a
problem

Total Score :

NEIGHBORHOOD

CRITERIA SCORES JUSTIFICATION

Nature of problem
a) Health deficit
b) Health threats
c) Forseeable crisis
Modifiability
a) Easy
b) Moderate
c) Non Modifiable
Preventive/Potential
a) High
b) Moderate
c) Low
Salience of the problem
a) Problem needing
urgent attention
b) Problem not needing
urgent attention
c) Not perceive as a
problem
 Total Score :

C. NO NEAR SHOPS AND TRANSPORTS

CRITERIA SCORES JUSTIFICATION

Nature of problem
d) Health deficit
e) Health threats
f) Forseeable crisis
Modifiability
d) Easy
e) Moderate
f) Non Modifiable
Preventive/Potential
d) High
e) Moderate
f) Low
Salience of the problem
d) Problem needing
urgent attention
e) Problem not needing
urgent attention
f) Not perceive as a
problem

Total Score :

D. SLIPPERY AREA

CRITERIA SCORES JUSTIFICATION

Nature of problem
g) Health deficit
h) Health threats
i) Forseeable crisis
Modifiability
 g) Easy
h) Moderate
i) Non Modifiable
Preventive/Potential
g) High
h) Moderate
i) Low
Salience of the problem
g) Problem needing
urgent attention
h) Problem not needing
urgent attention
i) Not perceive as a
problem

Total Score :

Chapter VI

Family Nursing Care Plan

HEALTH FAMILY GOAL OBJECTI NURSING METHO RESOURC

PROBLEM NURSING OF VES OF INTERVE D OF ES
PROBLEM CARE CARE NTIONS NURSE- REQUIRE
FAMILY D
CONTAC
T
Insects Inability to After the After the Educate the Home visit Time and
(mosquitoes and provide a nursing nursing family to get effort of the
flies) proper home Interventi interventio rid and student
(HEALTH environment on the ns the prevent all nurse and
THREAT) which is family family will the insects family
conductive will be be able to inside the members.
to health able to know the environment
maintenance clean the harmful / community
and personal entire effects of -Teach the
development environm insects family on
due to : lack ent to bites and how to clean
of proper prevent the proper a proper the
health insects way to proper
environment prevent it. environment
to get rid all
the insects.

HEALTH FAMILY GOAL OF OBJECTI NURSING METHOD RESOURCES

PROBLE NURSIN CARE VES OF INTERVEN OF REQUIRED
M G CARE TIONS NURSE-
PROBLE FAMILY
M CONTAC
T
No Inability After the After the Educate the Home Visit Time and effort of
neighbors to provide nursing nursing family on the student nurse and
(HEALT the proper Intervention Intervention how they family members
H health the family s the family should
THREAT safety of will be able will be able protect and
) the family to know the to know the do in terms
members differences difficulties of
and for the of not having of not emergency
environme a neighbor having a situation
nt . Due to neighbors
lack of and the
people in consequenc
the es of it.
communit
y
HEALTH FAMILY GOAL OF OBJECTIV NURSING METHOD RESOURCES
PROBLE NURSING CARE ES OF INTERVEN OF REQUIRED
M PROBLEM CARE TIONS NURSE-
FAMILY
CONTAC
T

No near Inability to After the After the Educate the Home Visit Time and effort of
shops and provide the nursing nursing family they the student nurse
transport needs of the intervention intervention should do and and family
(HEALTH family in the s the family s the family immediately members.
THREAT) environment will be able should know buy before
Due to not to do a all the and after the
residential adjustments important situation for
area. to have all things to do the readiness
their needs in terms of of the family
for the emergency member in
future needs. terms of
emergencie emergency
s. situation.
HEALTH FAMILY GOAL OF OBJECTIVE NURSING METHOD OF RESOURCE
PROBLEM NURSING CARE S OF CARE INTERVEN NURSE- S
PROBLE TIONS FAMILY REQUIRED
M CONTACT

Slippery Inability to After nursing After the Teach the Home Visit Time and
Area recognize interventions nursing family effort of the
the the family interventions member on student nurse
risks/hazard will be able to the family will how to clean and family
s due to maintain the be able to the slippery members.
inadequate cleanliness of know the area
knowledge the area harmful effect
about future of slippery
illness or floor
disease.
 Chapter VII

                 SUMMARY , CONCLUSION AND RECOMMENDATION

SUMMARY

#326 Calara st, West Calaguiman Samal Bataan is the area where Rubiano Family Resides,
Their Religion is Roman Catholic. They are composed of 5 members in the Family, ( Edgar
Rubiano, Rosmelita Rubiano, Kennix Rubiano, Krizette Rubiano, Kyle Rubiano) were considered
as Nuclear Family, this is composed of 2 Parents, and 3 daughters. Rubiano Family has no history
of illness.

Conclusion

Maintaining of our good health is very important. Having a healthy body accompanied by a
healthy mind can lead to a healthy living. Taking care of your mind and body will obtain with
healthy choices for diet, exercise, and a positive outlook that can improve your over health.
The simplest and most effective way to eat healthy is to focus in real food. Nourished
your body with real foods with regular exercise can help to reduced risk of other diseases
   
A. Recommendations

As a student nurse I advised to Mrs. Rosmelita Rubiano to:

- Maintain her regular exercise because it is good for the body. 
-Avoid eating food that is not allowed to her to maintain health
(ex. Salty foods, fatty foods)
-Have maintaining diet
-Always go to the Center to check her daily BP monitoring
-Always maintain the cleanliness of area of the floor.