SAINT MICHAEL’S COLLEGE OF

LAGUNA
Platero, Biñan, Laguna

SCHOOL OF NURSING

Submitted By:

Sharmaine C. Castroverde

Submitted To:

Sir Joemil C. Amerna

Objectives

 To assess family conditions and problems related to health through the

establishment of baseline data.
 To be able to acquire knowledge about the disease.
 To educate well the people around the community in which they can
maintain proper cleanliness in their compound.
 To improve health status of the families in the community.
 To reduce mortality rate in the community.
INTRODUCTION

Upper respiratory tract infections (URI or URTI) are the illnesses caused
by an acuteinfection which involves the upper respiratory
tract: nose, sinuses, pharynx or larynx. This commonly includes:
tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold.

Signs and symptoms

Acute upper respiratory tract infections

include rhinitis, pharyngitis/tonsillitis and laryngitis often referred to as
a common cold, and their complications: sinusitis, ear infection and
sometimes bronchitis (though bronchi are generally classified as part of the
lower respiratory tract.) Symptoms of URI's commonly include cough, sore
throat, runny nose, nasal congestion, headache, low grade fever, facial
pressure andsneezing. Onset of the symptoms usually begins 1–3 days after
the exposure to a microbial pathogen. The illness usually lasts 7–10 days.

Group A beta hemolytic streptococcal pharyngitis/tonsillitis(strep throat)

typically presents with a sudden onset of sore throat, pain with swallowing
and fever. Strep throat does not usually cause runny nose, voice changes or
cough.

Pain and pressure of the ear caused by a middle ear infection (Otitis media)
and the reddening of the eye caused by viral Conjunctivitis are often
associated with upper respiratory infections.

URI, seasonal allergies, influenza: symptom comparison

Symptom
Allergy URI Influenza
s

Itchy, Rare (conjunctivitis

Soreness behind eyes,
watery Common may occur with
sometimes conjunctivitis
eyes adenovirus)
Nasal
Common Common Common
discharge

Nasal
Common Common Sometimes
congestion

Sneezing Very common Very common Sometimes

Sometimes
Sore throat (postnasal Very common Sometimes
drip)

Common (mild to Common (dry cough, can be

Cough Sometimes
moderate, hacking) severe)

Headache Uncommon Rare Common

Very common (100-102°F (or

Rare in adults, higher in young children),
Fever Never
possible in children lasting 3–4 days; may have
chills)

Malaise Sometimes Sometimes Very common

Very common, can last for

Fatigue,
Sometimes Sometimes weeks, extreme exhaustion
weakness
early in course

Muscle
Never Slight Very common, often severe
pain

Cause

Over 200 different viruses have been isolated in patients with URIs. The most
common virus is called the rhinovirus. Other viruses include
thecoronavirus, parainfluenza virus, adenovirus, enterovirus, and respiratory
syncytial virus.

Up to 15% of acute pharyngitis cases may be caused by bacteria,

commonly Group A streptococcus in Streptococcal pharyngitis ("Strep
Throat").

Influenza (the flu) is a more severe systemic illness which typically involves
the upper respiratory tract. Influenza is a relatively uncommon cause
of influenza-like illness.

Treatment

Treatment depends on the underlying cause. There are currently no

medications or herbal remedies which have been conclusively demonstrated
to shorten the duration of illness. Treatment comprises symptomatic support
usually via analgesics for headache, sore throat and muscle aches.

Judicious use of antibiotics can decrease unnecessary adverse effects of

antibiotics as well as out-of-pocket costs to the patient. But more importantly,
decreased antibiotic usage will prevent the rise of drug resistant bacteria,
which is now a growing problem in the world. Health authorities have been
strongly encouraging physicians to decrease the prescribing of antibiotics to
treat common upper respiratory tract infections because antibiotic usage does
not significantly reduce recovery time for these viral illnesses. Some have
advocated a delayed antibiotic approach to treating URIs which seeks to
reduce the consumption of antibiotics while attempting to maintain patient
satisfaction. Most studies show no difference in improvement of symptoms
between those treated with antibiotics right away and those with delayed
prescriptions. Most studies also show no difference in patient satisfaction,
patient complications, symptoms between delayed and no antibiotics. A
strategy of "no antibiotics" results in even less antibiotic use than a strategy
of "delayed antibiotics". However, in certain higher risk patients with
underlying lung disease, such as chronic obstructive pulmonary
disease (COPD), evidence does exist to support the treatment
of bronchitis with antibiotics to shorten the course of the illness and decrease
treatment failure.

According to a Cochrane review single oral dose of nasal decongestant in the

common cold is modestly effective for the short term relief of congestion in
adults; however, "there is insufficient data on the use of [Decongestants] in
children." Therefore decongestants are not recommended for use in children
under 12 years of age with the common cold. Oral decongestants are, also,
contraindicated in patients with hypertension, coronary artery disease, and
history of bleeding strokes.

The use of Vitamin C in the inhibition and treatment of upper respiratory

infections has been suggested since the initial isolation of vitamin C in the
1930s. Some evidence exists to indicate that it could be justified in persons
exposed to brief periods of severe physical exercise and/or cold environments.

There is no evidence to support the age-old advice to rest when you are sick
with an upper respiratory illness. In fact, moderate exercise in sedentary
subjects with a URI has been shown to have no effect on the overall severity
and duration of the illness. Based on these findings, it was concluded that
previously sedentary people who have acquired a URI and who have initiated
an exercise program may continue to exercise.

Pathophysiology

Contributing Factor Predisposing factor

bacteria Age

Staphylococcu
s pneumoniae

Organisms enter the

respiratory tract through
inspiration/aspiration

Activation of defense
mechanism

Lose effectiveness of
defense mechanism
 Penetrate the sterile lower
respiratory tract (lungs)

alveoli

multiplie Irritation of airway

s

colonizatio Increase goblet

n cell
Release damaging
toxins
C
A
A BB C
C

infection Occluded Increase

the airway mucus
production
Exudates
come from
bacteria inflammati
erode the on
coug crackles
lung h
vasodilatio
n

Dead Increase blood hyperventilati Airway

space flow on constriction
happened
Plasma and CHON
rich fluid leakage Increased Difficulty of
respiratory breathing
rate
Accumulation of
edematous fluid

Inflammed and fluid

filled filled alveolar
sacs Impaired Ventilatory
O2 and CO2 demands
exchange
 Alveolar air
sacs become
engorged

Decrease
CO2

Lung
consolidation

hypoxi
a

Scale of Ranking Health Conditions and Problems

According to Priorities

Criteria Weight

1. Nature of the condition or problem 1

presented. 3
Scale: Wellness state 3
Health deficit 2
Health threats 1
Foreseeable crisis 2
2
2. Modifiability of the condition or 1
problem. 0
Scale: Easily modifiable
Partially modifiable 1
Not modifiable 3
2
3. Preventive potential 1
Scale: High 2
Moderate
Low 2

4. Salience 1
Scale: A condition or problem,
needing immediate attention
 0
A condition or problem not
needing immediate attention

Not perceived as a problem

or condition needing change

Typology of Nursing Problems in Family Nursing

Practice

FIRST-LEVEL ASSESSMENT

Presence of Health Deficits

-Presence of an actual problem occurring in the family. Instances of

failure in health maintenance.

A. Inability to provide a home environment conducive to health maintenance

related to the presence of breeding sites

Presence of health threat

- conditions that are conducive to disease, accident or failure top realize

one’s health potential.

 Threat of cross infection from a communicable disease case.

 Family size beyond what family resources can adequate provide.

A. Poor environmental sanitation.

B. Inadequate living space

SECOND-LEVEL ASSESSMENT
1. Inability to recognize the presence of the condition or problem due to poor
hygiene and poor environmental sanitation.

Cues/Data Community Nursing Problem

 Mother is very busy earning a  Inability to make decision with

living that she cannot take care
of the children
 Poor environmental sanitation
and poor hygiene
respect to taking appropriate
health actions due to lack of
knowledge.
 Inability to provide a home
environment conducive to
health maintenance and
personal development due to:

a. Ignorance of preventive
measures.

Priority Setting

Priority # 1 Presence of Health Deficit

A. Illnesses state, regardless of whether it is diagnosed or

undiagnosed (cough and colds). Pneumonia

Criteria Computation Actual Justification

Score

Nature of the 3/3 X1 1 The problem is a health

condition or deficit and requires more
problem immediate intervention.

Modifiability of 2/2 X2 2 It is easily modifiable in

the condition which the resources and
or problem interventions is needed to
solve the problem that must
be available to the family.
 Preventive 3/3 X1 1 By performing proper
potential hygiene of the body and
proper environmental
sanitation.

Salience 0/2 X1 0 It is not a felt problem

Total 3 2/3

Priority # 2 Presence of Health Threat

A. Poor environmental sanitation

Criteria Computation Actual Justification

Score

Nature of the 2/3 X1 2/3 It is a health threat.

condition or
problem

Modifiability of 2/2 X2 2 Resources are available and

the condition intervention are feasible.
or problem

Preventive 3/3 X1 1 Occurrence of parasitism

potential and other communicable
diseases is maximized
minimized.

Salience 1/2 X2 1 Not needing immediate

attention
 Total 3 2/3

Priority # 3 Presence of Health Threat

A. Inadequate living space

Criteria Computation Actual Justification

Score

Nature of the 2/3 X1 2/3 It is a health threat that

condition or does not demand
problem immediate action

Modifiability of 1/2 X2 1 Increasing the living space

the condition will require quite a financial
or problem expenditure. The family’s
resources are presently not
adequate.

Preventive 3/3 X1 1 Increasing the living space

potential will:
a. Provide for privacy to
members.
b. Provide bigger space
to allow adequate
movements when
 performing housework and
joint recreational, leisure or
play activities.
Salience 2/2 X1 1 It is not a felt problem

Total 2 2/3

Family Assessment Guide

Family Name: Cesista family

Address: Sitio Pitong gatang

I. Demographic Data

Household No:

II. Family Data

Length of Residency: 15 years

Place of Origin: Bicol

Religion: Roman Catholic

 III. FAMILY MEMBERS CHART

Name Ag Se Civil Family Relations Educationa Occupati

e x Status Positio hip to l on
n the attainment
family
head

Mabel 32 F Married Mother 1st year

High school

Noel 33 M Married Father Husband Grade 2 Constructi

on worker

Manuel 7 M Single 1st child Son Grade 2

Raymo 6 M Single 2nd child Son

nd

Maan 5 F Single 3rd Daughter

Shane child

Arrol 2 M Single 4th child Son

Jae

IV. Family Characteristics: type of family structure

Extended Patriarchal

√ Nuclear Dominant Family members

Matriarchal Others, pls. Specify:

V. General Family Relationship/ Dynamics

Criteria Criteria Additional Information

Observable conflicts (-)

between family
members

Characteristics of (+)
communication
Interaction patterns (+)
among members

VI. Family Dietary Habits

Breakfast Coffee, rice
√

Lunch Rice, Viand(monggo)

√

Dinner (Food that are left over in lunch time)

√

VII. Household and Environment

A. Type of House B. Is the living space adequate?

Wood  Yes
√ Mixed
No
Concrete
Makeshift

C. What are the appliances owned by the family?

Cabinet

D. Garbage Disposal E. Type of Waste Disposal

Collected √Burning Flush

Waste segregation Burying Wrap and throw

Feeding to animals throw in the  Water sealed

river
Pit privy
Open Dumping

F. Type of Drainage System G. Source of Water Supply

√ Open Owned Bought

Close √Shared √Deep well

H. Containers Used for Water I. Drinking Water Storage

Pitchers Jars, clay pot Refrigerator Uncovered

√ Bottles Pails √ Covered

J. Food Storage/ Cooking K. Common Household pests

√ Covered Cabinet √ Cockroach Lizards

Uncovered Pots/ pans √Ants others, pls.

Specify:
Stove Refrigerator
Rodents

L. Are breeding site for these pests M. Common Household pets

present at home?

Yes None

√No

N. Are there accident hazard present at home? √ No Yes

VIII. Health and Health Practices

A. Common illness encountered for the last six months and the
treatment done.

Cough, colds, Fever Biogesic

B. Whom do you consult for health related problems?

Manghihilot Albularyo Health Worker Brgy. Health Workers

Midwife Nurse Doctor √ Health Center

C. For problems other than health, whom do you consult?

√ Family Members Priest/s Friends

Relatives Brgy. Officials

D. Immunization status of the family

√Complete (BCG/ DPT/ OPV/ Hepa B/ AMV/ TT)

Incomplete

None

E. Have you have adequate?

1. Rest and Sleep? √ Yes No
 2. Exercise √Yes No

3. Relaxation √Yes No
Activities?
4. Stress √Yes No
Management
IX. Community Awareness Organization

1. Are you aware of an existing √ Yes No

organization in your
community?
2. Name all organization you are in. New Hope

3. Are you aware of its activities and projects?

√ Yes No

4. How are you involved in its activities?

√Attend meetings Evaluation

Planning Give Donations

Implementation Not involved

Daily Accomplishment

First Week

November 15, 2010

It was our first day of duty with Sir Joemil. We first went to San Antonio
RHU, we had our meeting there regarding all our activities for 2weeks. Then in
the afternoon, we went to Sitio Pitong gating in Mamplasan, Biñan. We had
our ocular survey for us to choose a family that we will concentrate on.

November 17, 2010

 In the morning, we went to Sitio Pitong gating to have our written
survey. We were able to finish surveying 48 families by noon. After having
lunch, we went to San Antonio RHU for our preparation for “Lola’s Program”.

November 18, 2010

In the morning, we prepared all the things for the lola’s program. We
also had our practice for the intermission number. At 1:30pm, we went to
Malaban, and held the program. We were able to finish at 3pm.

Second Week

November 22, 2010

We went in Sitio Pitong gatang in the morning to look for potential

leaders that will come and accompany us in endorsing our proposed projects
to different organizations to ask for help. after that, we went to the Barangay
Health center of Mamplasan, we had our lunch there. And after that, we were
divided into groups for the dissemination of works for the

proposed projects. then before going home, we took some vitamins and
medicines for the children in Sitio Pitong gatang.

November 23, 2010

We came early at Pavillion mall, our meeting place. When we are

complete, we were divided into groups: one will go to organizations to give
the letter for solicitation, then the others will go to Sitio Pitong gatang to held
our “mini” medical mission for children. I am one of those assigned in Sitio
pitong gatang. We took all the names of the children ages 2years and above.
Then we took their weights and assessed them if they have cough and colds,
because we cannot give them the medicines for the worms if they have. Then
after that, we held a meeting for all the citizen in the Sitio, regarding our
proposed projects: renovation of their CR, Planting, and solar panel for them
to have electricity. In the afternoon, we talked about the inventory of all the
expenses for the renovation of the CR.

November 24, 2010

We are divided again into groups: one group will give the letter to
Doctor Asiño, the other one will go with sir Joemil and Sir Jhay in the Municipal
hall for the seeds, and othe other one will go to the Sitio to take some pictures
for our documentation. At the end of the day, we all accomplished our
assigned works.

November 25, 2010

It was supposed to be our last day in the community, but because we

have our wellness program in school, we are only required to attend to that.
But we meet the next group to endorse the ongoing activity in the community.
 FAMILY CARE PLAN
HEALTH FAMILY GOAL OF CARE OBJECTIVE OF CARE NURSING METHODS OF
PROBLEM NURSING INTERVENTION NURSE-
PROBLEM FAMILY
CONTACT

Unsafe Inability to After nursing After nursing a. Established

environment make decisions interventions interventions the rapport
Home Visit
as a health with respect to the family will family will:
b. Discuss the ways
threat taking be able to
a. Practice safe on how to prevent
appropriate know the
-Inadequate disposal of or control
health action different
living space secretions themselves from
due to: method and
having cough and
-Sick children alternative to b. Have their
a. Lack of colds
are being keep sick family
knowledg
close to those themselves members c. Encouraged on
e/ insight
who are not from being consult to proper secretions
as to
infected such health care and waste
alternativ
as not to join providers disposal
e courses
themselves (health
of action d. Emphasized
with the ones center)
open to proper hygiene
who have
them c. Have their
colds and
cough family
b. Lack of
especially their members kept
living
children. distance to
space for
those who
the whole
have cough
family
and colds