FAMILY HEALTH NURSING PROCESS 

a systematic approach of solving an 

existing problem/meeting the needs 
of family 
R apport 
A ssess
ment P 
lanning 
I 
ntervention 
E valuation 
I. RAPPORT 
 

✔✔​ ​ ​Trust building 

✔✔​ ​ ​Knowing your client 

✔✔​ ​ ​Adjusting to the situation and 

environment

✔✔​ ​ ​RESPECT 
II. ASSESSMENT 
 

Data Gathering​:​ ​tools or instruments used 

during​ ​survey: 
✔✔​Interview​ 
✔✔​Observation​ 
✔✔​Questionnaires​ ​-mostly patronized & used in 
CHN 
✔✔​Records​ ​ ​& Reports available 
Consolidation or Collation:​ ​collecting 
back the​ ​questionnaires, tabulate and 
summarize 
 Validation:​ ​uses statistical approaches 
 

Statistical Approaches​: 
1. Central Tendencies: 
3 M’s ​Mean​=average 
Median​=range (Highest – Lowest Score) 
Mode​=frequency of occurrence of a variable, 
used if​ ​there’s too many variable occur 
  
2. Standard Deviation: ​used if there are too 
many​ ​variables available to be treated 
which is seldom used in CHN 

SD=√ ∑ (x-x)  ∑=summation of 

 
n-1  x=variables available 
 
x=mean (given special 
attention) 
n=# of existing variables 
 

3. Percentile (%) Method: 

most commonly used in CHN by adding all 
cores then multiply by 100 
Presentation of  Polygon-connec
 

Data  ting the results 

Series 
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Series 
1. Table/Chart  2 
Categ  Series 
3 6 
Categ 
4 
2. Graph:  Categ  2 
Categ  0 
Pie   
Bar-2 variables  0  20
only 
Line 
 2nd Qtr  1 
Ca
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Sales 
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2 
Ca
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1st Qtr 
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Series 

Histograph-2 or more 
variables & appear adjacent to each other 
 TYPOLOGY OF NURSING PROBLEMS 
 

A. First Level Assessment​: to determine 

problems of​ ​family 
Sources of Problems using IDB 
Family: use of Initial Data Base 
(IDB) 
Nature: Health Deficit (HD), Health Threat 
(HT), Foreseeable Crisis (FC) 
 USE OF INITIAL DATA BASE (IDB)​: 
 

1.Family Chart Structure: 

Nuclear​ -Father, mother, 
children 
 
Extended​ (3​rd​ generation)-Relatives staying with the family 
Multi-generational extended​-“apo sa tuhod” or “apo sa 
talampakan” ​Dyad​ -Husband & wife only (childless couple) 
 
Blended​ -widow married another widow & have 
children ​Gay​ -Same sex living together 
 
Matriarchal​ -Mother is the decision maker 
Patriarchal​ -Father is the decision maker 
Communal​ -different families forming a 
community 
  
2. Socio-economic:​ poverty level, 
educational attainment & nature of 
occupation of members of the family 
(sources of income) 
 
 

3. Socio-cultural:​ different nature of 

religion 
 
 
 
4. Home environment:​ assessment 
according to ES, treatment of garbage, 
preparation of food, availability of toilet, 
water & food sanitation, sources of 
diseases 
  
4. Medical history:​ history of certain disease, 
family member with disease 
 
 
 
5. Resources​ available in community for use by 
the family: 
5 Generalized M’s in resources available in 
community: 
▪▪​ ​Man/Manpower 
▪▪​ ​Money 
▪▪​ ​Machine 
▪▪​ ​Materials 
▪▪​ ​Methods 
 
DEFINE THE PROBLEM AFTER 
IDENTIFYING IT ACCORDING TO 
NATURE 

Health Deficit (HD) 

- if identified problem is an abnormality, 
illness or disease, there’s a 
gap/difference between normal status 
(ideal, desirable, expected) & actual 
status (the outcome/result/problem 
encountered on that actual day) 
Health Threat (HT) 
 

-any  condition  or  situation  which  will  be 

conducive  to  health  alteration,  health 
interference & health disturbance. 

Foreseeable Crisis (FC) 

-stress points, anything which is 
anticipated/ expected to become a 
problem 
 

Jobless Father

Suffering from TB
Wife is pregnant for the 8​th​ time
2 y/o youngest child lacks immunization
9 y/o eldest child is 3​rd​ degree

malnourished
Poor environmental sanitation
 III. PLANNING 
 

Four (4) Standard Steps: 

Prioritization​ -start if there are multiple 
identified problems 
Formulation of objectives​ -planning a 
procedure will start here if there is only one 
problem 
Developing strategies of action 
Formulation of evaluation tools​ for the 
identified strategy developed 
 CRITERIA IN IDENTIFYING THE PROBLEM 
 

Criteria Score Weight

I. Nature: assess by PHW
Health deficit (HD) 3 1
Health threat (HT) 2
Foreseeable Crisis (FC) 1
II. Modifiability
Easily 2 2
Intermediate (moderate) 1
Not modifiable 0
III. Preventive Potential
Highly 3 1
Moderate 2
Low 1
IV. Salience of the Problem
Problem needing urgent 2 1
attention
Problem not needing 1
urgent attention
Not a felt problem 0
 

▪▪​ ​Steps: 
a.Decide on a score 
b.​  Score x  weight 

----------------- 
Highest Score 
 
b.​ ​ Get the sum total of all the 
scores ​▪▪​ ​Interpretation: 
Perfect score=5, if score nearing 5 then prioritize the 
problem 
Criteria 1, 2 & 3 has to be assessed objectively by the 
health worker 
Criteria 4 has to be assessed by the perception of the 
family 
 
rd​
Compute for 3​ Degree Malnutrition
IV. INTERVENTION 
 

✔✔​Is​ ​ ​the capacity to provide management 

✔✔​Is​ ​ ​the professional phase of nursing 

process 
✔✔​Is​ ​ ​the time when the PHN executes the 
standard​ ​function of an RN 
✔✔​Three​ ​ ​(3) Standard Functions of RN: 

▪▪​ ​Dependent-giving of medicines 
▪▪​ ​Independent-monitor, assess, provide, 
educate 
▪▪​ ​Interdependent-referrals 
 V. EVALUATION 
 

Three (3) Things to be evaluated: SPO 

1.​  Structure of program & activity ​-what articles, 
equipments, supplies are​ ​utilized 
2.​  Process utilized ​-steps used 
3.​  Outcome of activity ​-results can be: 
▪▪​ ​ ​Desirable -to be implemented, 

advocated, strengthen​ ▪▪​ ​ ​Undesirable 

-to be avoided 
Two (2) Aspects to be evaluated in the Outcome: 
▪▪​ ​ ​Quality -characteristic or kind of outcome; no numerical value, 

not measurable​ ▪▪​ ​ ​Quantity -from the word “quantum”, with 

numerical value, measurable 

 
 
 
POLICIES ​FOR SCHISTOSOMIASIS 
CONTROL​ ​PROGRAM (SCP): ​CHES 

C ase Finding 
H ealth Education 
E nvironmental Sanitation 
S nail Eradication 
 CASE FINDING​: 
 

6 Aspects or Thing to Know 

▪▪​ ​Disease:​ ​Schistosomiasis 

▪▪​ ​Other name​: Bilhariasis or Snail Fever 

▪▪​ ​Causative agent:​ ​Schistosoma-a blood fluke (parasite) 
3 Types of Species: 
✔✔​Schistosoma​ ​ ​japonicum-endemic in the Philippines 
&​ ​affecting Indonesia, China, Japan, Korea Vector: 
Oncomelania quadrasi 
✔✔​Schistosoma​ ​ ​mansoni 
✔✔​Schistosoma​ ​ ​haematobium 
 

▪▪​ ​Laboratory Procedures​ ​to rule out Schistosomiasis: 

Blood Examination: ↑ eosinophil level indicates 
parasitism 
Fecalysis: Kato Katz (plain stool exam that uses a 
special apparatus resembling a feeding 
bottle sterilizer) 
Procedure: 
✔✔​Collect​ ​ ​specimen 

✔✔​Have​ ​ ​the test tube undergo 

centrifugation for 20​ ​minutes 
✔✔​Get​ ​ ​specimen from precipitate & swab it on glass 
slide 

✔✔​Observe​ ​ ​it on microscope 

 

▪▪​ ​Signs & Symptoms 

✔✔​CNS:​ ​ ​High grade fever→​ ​cerebral convulsion 

✔✔​GIT:​ ​ ​Nausea & vomiting, Diarrhea→​ ​Chronic 
dysentery​ ​(prolonged diarrhea of more than 2 weeks 
& consistency is mucoid & bloody (with streaks of 
blood) 
✔✔​Liver:​ ​ ​Presence of infection manifested by 
jaundice &​ ​hepatomegaly 
✔✔​Spleen:​ ​ ​Infection of spleen→​ ​inflammation→
enlargement of​ ​organ (Splenomegaly)→ abdominal 
 distension→ abdominal pain on the right upper 
quadrant 
✔✔​Blood:​ ​ ​Anemia & weakness 
 

▪▪​ ​Treatment:​ ​Drug of Choice-Praziquantel (Biltricide) 

60 mg/KBW/day 
✔✔​Example:​ ​ ​If patient is 50 kg, 50 kg x 60 
mg/KBW/day=3000​ ​mg/day 
✔✔​Initial​ ​ ​treatment: 1​st​ ​2 weeks=3000 mg/day, then do 
stool​ ​exam after 2 weeks→ if still (+), extend treatment 
for another 2 weeks. Repeat stool exam, if still (+) after 
the extended week, continue treatment for 2 weeks 
again. No adverse effect or over dosage even if 
extended for a year. 
✔✔​Length​ ​ ​of Treatment: takes months to a year 
 
Health Education: ​It affects mostly farmers so educate 
them to​ ​wear rubber boots 
Environmental Sanitation: 
Snail is the 1​st​ concern 
Water where snail thrives is the 2​nd 
concern Toilet=3​rd​ concern 
Food 
Garbage 
Snail Eradication: ​Use​ ​molluscicides​ ​treat the entire 
suspected soil with chemical solution that kills snails 
 
 CASE FINDING​: 
 

▪▪​ ​Disease:​ ​Malaria 

▪▪​ ​Other name:​ ​Ague 

▪▪​ ​Causative Agent:​ ​Plasmodium-a protozoa 
4 Types of Species: 
✔✔​Plasmodium​ ​ ​falciparum-more fatal that affects the 
Philippine 
Vector: Female Anopheles Mosquito (FAM) 
✔✔​Plasmodium​ ​ ​vivax 
✔✔​Plasmodium​ ​ ​ovale 
✔✔​Plasmodium​ ​ ​malariae 
 

▪▪​ ​Laboratory Procedure:​ ​Malarial smear-extract blood 

at the​ ​height of fever because plasmodium is very 

active & ruptures at this period. 

▪▪​ ​Signs & Symptoms of Malaria: 

1​st​ Stage=Cold: ​Chilling sensation for 1-2 hours 

2​nd​ Stage=Hot: ​High grade fever lasting for 3-4 hours 
3​rd​ Stage=Wet: ​Diaphoresis (excessive 
sweating/perspiration) 
 

▪▪​ ​Treatment:​ D
​ rug of Choice-Quinine 
2 Forms: 
 
a) Chloroquine (Aralen) 
 
b) Primaquine 

If Quinine is not available, may use 

Sulfadoxime-an antibacterial drug paired 
with pyrinthamine 
 PERSONAL PROTECTION​: 
 

▪▪​ ​Sleep under a mosquito 

net​ ▪▪​ ​Sleep in a screened 

room​ ▪▪​ ​Sleep with long 

sleeve attire 

▪▪​ ​Use repellents that contains DET (diethyl 

toluamide or​ ​toluene which has a pungent odor 
that drives away mosquitoes & an irritant to 
 mucous membrane of respiratory tract when 
inhaled 
▪▪​ ​Plant a Neem Tree using the leaves 
CLEAN: 
 

Chemical Method=insecticide spraying 

at night Larvae eating fish=Tilapia 
Environmental Sanitation & 
Health Education=insect, 
water, trash 
Anti-mosquito soap=basil citronelli 
Neem tree=banana, banaba, gabi, 
eucalyptus provide repellent effect 
--------INTRO TO COMMUNICABLE DISEASES
• EPIDEMIOLOGY
• The study of disease, but they involve different aspects of disease.
• Epidemiologist - Studies the factors that determine the frequency, distribution and determinants of diseases in human populations.
• John Snow- British physician, designed and conducted an epidemiologic investigation of a cholera outbreak in London
• COMMON TERMS RELATED TO INFECTION
1. INFECTION – implantation and successful replication of an organism in the tissue of the host, resulting in signs and symptoms, as
well as immunologic response
2. Carrier – is an individual who harbors the organism and is capable of transmitting it to a susceptible host but does not show
manifestations of the disease
3. Communicable disease – is an illness caused by an infectious agent or its toxic products that are transmitted directly or indirectly to
a well person through an agent, vector or inanimate object.
4. Contact – is any person or animal that is in close association with an infected person, animal, or freshly soiled materials.
5. Contagious disease – is one that is easily transmitted from one person to another through direct or indirect means.
6. Disinfection – is the destruction of pathogenic microorganisms outside the body through direct physical or chemical means.
a. concurrent disinfection – is a method done immediately after the infected individual discharges infectious material/secretions,
i.e., it is done while the patient is still the source of infection.
 b. terminal disinfection – is applied when the patient is no longer the source of infection (either because the patient has died or has
been discharged). Everything the patient had used, including the room he/she occupied, is disinfected.
7. Habitat – is a place where an organism lives or where an organism is usually found.
8. Host – is a person, animal, or plant on which a parasite depends for its survival.
9. Infectious disease – is transmitted not only through ordinary contact but also requires direct inoculation of the organism through a break
on the skin or mucous membrane. Hence, all contagious diseases are infectiuos.
10. Isolation – is the separation from other persons of an individual suffering from a communicable disease.
11. Quarantine – is the limitation of the freedom of movement of persons or animals which have been exposed to a communicable disease/s
for a period of time equivalent to the longest incubation period of that disease.
12. Reservoir – is an animal or plant in which an infectious agent lives and reproduces in such a manner that it can be transmitted to man.
13. Surveillance – is the act of watching.
• What is infection?
• Is the invasion and multiplication of microorganisms in the tissues of the host, resulting in signs and symptoms, as well as
immunologic response. The production of microorganisms injures the patient by:
1. Competing with the host’s metabolism
2. Cellular damage produced by the microbes, or
3. Intracellular multiplications
Such damage could be localized (such as infected pressure ulcer) or systemic.
The severity of infection varies with the disease-producing ability, and the number of invading organism, and the strength of the
host’s defenses, among others.
To determine whether an infection exists in a health care facility or geographic area, investigators study the current incidence of the
disease in that area and compare it with past incidence rates.
✔ SPORADIC DISEASE – are diseases that occur occasionally and irregularly with no specific pattern
example: tetanus, gas gangrene
✔ EPIDEMIC DISEASES - are diseases that occur in a greater number than what is expected in a specific area over a specific time.
example: dengue, malaria, polio
✔ PANDEMIC – is an epidemic that affects several countries or continents.
examples: cholera, HIV/AIDS, SARS, Influenza AH1N1, Covid-19
✔ ENDEMIC DISEASES – are present in a population or community at times. They usually involve few people during specific periods.
• Why infection occurs
 There are various complex reasons why the microbes that cause infectious diseases are so difficult to overcome.
1. Some bacteria develop resistance to antibiotics.
2. Some microbes such as influenza viruses have so many different strains that a single vaccine cannot protect against all of them.
3. Most viruses resist antiviral drugs.
4. New infectious agents occasionally arise. (HIV, coronaviruses)
5. Some microbes localize in areas of the body (bones, CNS), which makes treatment difficult.
6. Opportunistic organisms can cause infection in immuno-compromised patients.
7. Most people have not received immunizations.
8. Increased air travel can cause the spread of the virulent organism to a heavily populated area in hours.
9. Biological warfare and bioterrorism using organisms such as anthrax and plaque is an increasing threat to public health and safety
throughout the world.
10. The expanded use of immunosuppressive drugs and invasive procedures increases the risk of infection.
• The nurse and communicable diseases
As a member of the health team, the basic function of a professional nurse is the nursing care of patients with communicable
diseases. However, the nurse’s responsibilities extend beyond the immediate care of the patient. He/she must be knowledgeable of the
following:
1. The nature of the specific microorganism and its capacity for survival both within and outside the body;
2. The most effective method of destruction of the specific organism;
3. How the organism invades the host and its route of escape from the body;
4. The incubation period, prodromata, and length of communicability;
5. How specific drug alters the clinical signs and infectious course of the disease
6. The most recent methods and concepts of prophylaxis for communicable diseases; and
7. The rationale and control measures, including isolation techniques.
• NURSING CARE
The nursing of patients with communicable diseases involves the following:
1. self-protection;
2. Prevention of the spread of the infectious agent through medical asepsis and concurrent disinfection;
3. Physical care of the patient;
4. Emotional support of the patient; and
5. The provision of the spiritual aspect of care