Name of the Family: Duhaylungsod Family Date: Oct.

20, 2020
Name of Student:  Suan, April Joy A.
Are of Assignment: Barangay Biniruan (near the dumpsite)

Name of CI: Pro. Mary Lou Mamaril

General Objective: Within 30-45minutes of home visit, the student nurse will be able to help the family to see the problem in their
environment and help them to maintain a healthy environment and healthy living for the family specially to their children.

Time Specific Objectives Activities Contents Resources Evaluation

Allotment/
Time Frame

3-5 minutes The family will be Knocking the “Magandang umaga Student
able to acknowledge door. Ma’am/Sir nandito po ulit ako nurse and Goal met: The family
the presence of the Greetings. sa inyo”. family. was able to
student nurse. acknowledge the
presence of the student
nurse.
5-10 minutes The student nurse will Health teaching Student
be able to provide and problem “Ma’am/Sir alam niyo po ba nurse and Goal met: The student
health teaching and interventions ang possibleng epekto ng family. nurse was able to
problem interventions pagkain ng inyong mga anak provide health
to the family ng junk foods?” teaching and problem
interventions to the
“Dapat po bago kumain ay family
maghugas muna ng kamay”

“Lagi po kayong kumain ng

masusutansyang pagkain
upang maging malusog ang
 inyong pamilya lalong lalo na
po kayo maam dahil kayo po
ay buntis ”

“Kailangan din po sanang

maligo sa umaga hindi lang po
tuwing gabi upang ma
maintain po ang tamang
hygiene
Student
nurse and
3-5 aminutes The Student Nurse Termination of Goal met: The student
“Ma’am/Sir, nandito po ako family.
will be able to present visit. nurse was able to
upang sabihin sa inyo na ito na present the termination
the termination visit ang huling araw na mag ka-
to the family. of the visit.
conduct po ako ng home visit”.

“Ma’am/Sir, maraming Student

The student nurse and Termination of salamat po sa kooperasyon at nurse and Goal met: The student
1-5 minutes the family will be visit. sa oras na inyong binigay” family. nurse and the family
able to acknowledge were able to
the termination of the acknowledge the
home visit. termination of the said
visit.