NORTHERN CHRISTIAN COLLEGE ³The Institution for Better Life´ Laoag City

Family Nursing Case Analysis

By: Gilo, Gretchen Lagpacan, Marlon Nuval, Maria Katrina Pajarillo, Asher Nyce Palado, Jorge Andrew Salantes, Aleigna Lyn Sales, Noel Santos, Starlet Tabuyo, Kristine Joy Valenzuela, Myrtrelle Faye

2011

INTRODUCTION Community Health Nursing is to assist the individual, family and community in attaining their highest level of holistic health. To provide and promote healthy lifestyle choices through education, public awareness and community activities. Community development seeks to empower individuals and groups of people by providing these groups with the skills they need to effect change in their own communities. Community development as defined by the Federation for Community Development Learning (2007) is the process of developing active and sustainable communities based on social justice and mutual respect. Family, basic social group united through bonds of kinship or marriage, present in all societies. Ideally, the family provides its members with protection, companionship, security, and socialization. The structure of the family, and the needs that the family fulfills vary from society to society. The nuclear family²two adults and their children² is the main unit in some societies. In others, it is a subordinate part of an extended family, which also consists of grandparents and other relatives. A third family unit is the singleparent family, in which children live with an unmarried, divorced, or widowed mother or father.(Microsoft ® Encarta ® 2007. © 1993-2006 Microsoft Corporation.) In line with the subject NCM 104, our group was exposed to the community. Our study was rendered to Barangay 7 San Miguel, Ilocos Norte last February 5, 2011 as recommended by the RHU of San Nicolas. In this activity we were able to understand what community nursing is and we were able to focus on improving the overall health of the family by educating the members about health care issues, nutrition, childcare, and 1

disease prevention. We choose the family of Mrs. N as our case because compared to our first assessed family they need more knowledge about their health conditions as well as their family relationship. As we get in to their house we immediate saw and assessed that they are problems that would harm the family members infact as the interview go on we had come up with the health threat that are present in their household and some problem that may arise later in life. They belong to a big family which makes them more unite, indeed they all have a good relation to each one of them. They are cooperative during the assessment they provide all the information that we need. General objectives: This study aimed to understand and improved the belief that care directed to the individual, the family, and the group contributes to the health care of the population as a whole as well as to provide quality of care, by identifying health problems which are recognized by the people themselves for the promotion of healthy lifestyle choices through education, public awareness and community activities. Specific objectives: 1. For the family to become more practical in promoting health. 2. For the family to be able to recognize the importance of having a healthy lifestyle. 3. For the family to be able to expand information of having a healthy lifestyle. 4. For the family to understand the implications of their belief, values and practices in health. 5. Propose priority interventions as being recognized by the family members through a comprehensive health care plan. 6. Inorder for us student nurses, provide teaching in improving the ways and means of the family. 7. To improve our skills in helping the family by giving hints and teaching deal with the problems that will be identified. 8. To help the family in attaining the goal of care of this study. 2

Currimao. 68 years of age.H. and they live in Isabela at the family house of common law husband. they live with their 5 children namely son Ne currently living at Pangil.N Brgy. She had common law husband when she was still 14 years old. Ilocos Norte.N Brgy.N Nalbo. F F F M M F Widow Single Single Single Single Single Single HEAD 5th child 6th child 7th child 10th child 11th child 12 child 1st grandchild 2nd grandchild 3rd grandchild N/A Housekeeper Domestic helper Farmer and Construction worker N/A B. FAMILY STRUCTURE. the second child is daughter Ma. San Nicolas. Mrs. CHARACTERISTICS AND DYNAMICS RELATION TO HEAD CIVIL STATUS POSITION IN THE FAMILY RELIGIOUS AFFILIATION EDUCATIONAL ATTAINMENT NAME AGE SEX OCCUPATION ADDRESS MRS. Before.N Brgy.N Brgy. N.N F M M Child Child Child The family of Mrs.N Brgy. Ilocos Norte. who is also currently living with her own family at the same barangay.7 S.INITIAL DATA BASE FOR FAMILY NURSING PRACTICE A.7 S.W Segregator None None None Roman Catholic Born Again Born Again Roman Catholic Roman Catholic Born Again Roman Catholic Born Again Born Again Born Again Elementary Graduate Elementary Graduate High School Level Elementary level College level High school level College level KINDER N/A N/A Brgy.7 S. They are currently residing at Barangay 7 San Miguel. the third 3 . Laoag city Hongkong Brgy.7 San Miguel. the head of the family was born and raised in Brgy. San Nicolas.7 S.7 S.7 S. N Daughter M Daughter T Son F Son E Daughter A Son J Apo S Apo X Apo Z Daughter Daughter Son Son Daughter Son Grand Daughter Grandson Grandson 68y/o 44y/o 39y/o 36y/o 30y/o 27y/o 24y/0 5y/o 1y/o 7mons.7 S. their son Jo.7 S.N Brgy. N is considered as an extended family The family is composed of 8 members.

a BHW in Brgy. son E. second child. son S. Daughter T. They don¶t have communication with the first father of his child while the father of her two sons is through texting. Five years after Mrs. first child. the fourth child is now currently living at Leyte and daughter Mi. Apo X. 25 years old. thrid child who is a welder. N¶s first common law husband death she married his second common law husband and they resided at # 7 San Nicolas at their family house. Her second law husband died last 2000 because of hypertension. male . Son J. At present Mrs. fifth son who is living with Mrs. 28 years old . Ilocos Norte and the last child is son J. daughter A and her three children are born again because they are influence by daughter M while Mrs. Daughter A. E and J is Roman Catholic The father of daughter A¶s children is not living with them because the father of her first and only daughter has his legitimate family as well as the father of her two sons.36 years old. son F. They were gifted with 7 children namely daughter T. a domestic helper in Hongkong. Daughter A relationship with her first partner was not good they don¶t have communication and he never support his daughter while her second partner sometimes visit but never stay for a 4 . the last child is currently living at Nalbo. female. fourth son who is living with his family at the same barangay but different house. Son E. the sixth child is daughter A.child who is also currently living at the same barangay but different house.. N. the three kids of Daughter A (Apo S. son F. N is living with Son F. N. N. son Y. 7 San Nicolas. Laoag City who is a stay in housemaid. and living also with Mrs. Daughter Flo. 39 years old.a farmer and a construction worker. and Apo Z) and son S and her family but not included in the above table because they have separated things and income.

Whenever problem arises within the family such as conflicts and misunderstanding they would usually settle it right away. N and daughter A since daughter M is working in Nalbo. N do not have hard time in terms of decision making because they tend to consider each other¶s opinion first before coming up with the final decision especially regarding health matters. and ³tita´. Also.long time. they share things when there are extras. Mrs. their family is considered as patrilocal since their family lives at the house of her second law husband. As claimed. daughter M and daughter A decides but most of the time Mrs. their family has a good relationship with each other. N. N. Their family is considered as an extended type of family. Since they are oriented with both the mother and fathers¶ kin. N still support and never got angry with daughter A Daughter A takes a role of a mother and a father so she provides her full support to her children. they head called ³nana´ by her children and grandchildren. They also use ³manong ´. Mrs. Son F serves as the head of the family since he is the primary person who provides the needs of the family. they are considered to be bilateral descent type of family. ³manang´. they have worship every Tuesday on their house. Mrs. ³tito´. Mrs. ³ading´. Since the relationship of daughter A is not legal. Respect is also valued as evidenced by the egalitarian form of authority. N makes most of the decision about family matters but not regards to the health problems. each one of them knows how to understand someone¶s situation thus conflict rarely occurs. 5 . The family values connection to God. As to endearments. According to Mrs. they also have good relationship with their neighbors. In fact.

currently working at Hong Kong as domestic helper since year 2005 and sending Php 3000 a month. The father of her two sons is giving money worth Php 4.500 per month for the expenses of the family. Socio economic Status The educational attainment of the family seems to be an obstacle for them since most of them was not able to graduate in college. Second is daughter T a high school graduate. N. The monthly income of the family is 6 . working as a farmer receiving 8 cavans per crop rotation and selling 3 cavans for the expenses use in farming such as ³abono´ and irrigation and use the 5 cavans for food. but they still thankful because even they don¶t have stable job still they can provide every member of the families need.440 quarterly. working as a housemaid at Laoag City Ilocos Norte receiving Php 3. an elementary graduate is a plain housekeeper and the one helping her daughter A in taking care of her grandchildren. Their combined monthly income as contributed by the family members is approximately Php 8.B. N.000 a month for their daily expenses.400 a month and if unfortunately none and since he is the one who stand as the father of the family he contributes all of his salary if there is. working at Coca Cola Plant and giving Php 500 per month. 7 San Nicolas receiving Php 1. The youngest child is Son J. He also work as a construction worker (per contract) as his part time job receiving Php 2.000 per month. ³uray jak napagturpos dagitoy anak ko iti kolehiyo ket agyamanak ta makastrek da met lata ti trabaho ta dida met napili´. As verbalized by Mrs. Her first daughter namely daughter M is an elementary graduate. Mrs. Next is son F an elementary graduate. a college graduate.000-15.000 per month and contributing Php 1. Daughter A attained high school level and is presently serving as a BHW at Brgy.700-5.

transportation. 4000 goes to the childrens expenses such as vitamins (tiki-tiki. 5000. and another 6.5% 33. vices and medication. 7 . They help each other in making decisions about money and how they spent it. the highest percentage is allotted for their food which is 37. milo. About 10.33 % or Php. About 4.72 % or Php. milk. 1. Family Monthly Budget Allotment 4.42% 37.enough if Son F and Son J have a job but if none they need to borrow money from their neighborhood. toys. prophan and cherifer) diaper.42 % or Php. 800 is spent for their home necessities such as gasoline and groceries the rest is serve as payment for their debt and sometimes serve as their savings. clothes and educations.72% 10.17% 6.5 % or Php.33% Food Children expenses Miscellaneous Electricity Home expenses Based on the pie graph above.550 is allotted for their miscellaneous such as load. 33. They have no relatives who are helping them and that they are striving on their own.17 % or Php 500 is spent for their electricity and water bill.

X and Z). Their kitchen consist of a table with four plastic chairs. flat iron. With regards to their kitchen. One room was occupied by Mrs. The living room has a two plastic long chairs and a center table. They live in a 2 storey house which is about approximately 7m x 7m.C. Home and environment The family is living together at Barangay 7 San Miguel. it is located in the left side of their first floor upon entering on the front door. Their living room is found on the first floor at the right side of their house upon entering. San Nicolas. They have appliances in the living room like TV. They have 2 bedrooms at the second floor which is consists of 1 foamed bed. cement. an LPG tank. daughter A. The chairs available can be climbed by the children. 8 . and a caha de oro. The floor is cemented. metals. radio and 2 electric fans. N. galvanized iron and glass. a kitchen and a room which is divided with a curtain under their stairs where son E sleeps. and the other room was occupied by son S and her family while Son F and son J sleeps in their living room. Their stairs have no rails connected to the second floor made up of wood. There are toys and souvenir items on the divider. a gas ranged stove. a covered water jag and a dish shelf covered with a clean cloth. The first floor is divided into a living room. and her 3 kids(Apo S. Their house is basically made of woods. Scattered empty cans and a hammer were seen on the surrounding of the house which could cause accident or injury. Ilocos Norte.

9 . The family use mosquito repellants such as Bigon once a week. are kept away from children and are placed in an organizer. However. the water remains stagnant which makes it a breading site for mosquitoes. usually on a Saturday afternoon as precaution to diseases caused by mosquitoes. Drinking water is bought from refilling stations. They do not segregate garbage. The deep well is owned by the family and it is chlorinated by the BHW of their barangays. Their clay stove is located at their backyard. They store their drinking water in a covered container. Kitchen utensils. they put it all together in a sack. which is approximately 20 meters away from their source of water. it is covered with a plate and place in the kitchen table. was used for cooking. Whenever there are leftovers. There is a canal in front of the house. The water that was fetched is placed in a pail. They use pour flush in using their toilet facility. They prepare just enough food for the family members like noodles most of the time combined rice and egg sometimes. it is approximately 15 meters away to the toilet facility. and sometimes charcoal. and are collected by garbage tracks ones a week. Their water is from the deep well beside their old bathroom which is used for bathing and flushing the toilet located at the front side of their house. which should be ideally used as a drainage system. They are also supplied by the Nawasa which they use in cooking and washing dishes. Instead.LPG. especially knives.

N they do believe in quack doctors but they still consult medical doctors. They manage mumps with the traditional µ¶akot akot¶¶ mixed with vinegar and applied during bed time while they manage measles by wearing black t-shirt. She can¶t remember the management done. The family members had experienced chicken pox. N also told us that they don¶t usually visit the R. Last 2003. They only experience cough. they increase their oral fluid level. instead. According to Mrs. She claimed also that they don¶t have any known hereditary disease. She was confined at Gertes Clinic by Dr. As Mrs. They also avoid eating oily foods during that time like fried eggs. a) Health Status of each Family Member Medical and nursing history indicating current and past significant illnesses or beliefs and practices conducive to health and illness. Paracetamol (biogesics) 500mg for fever and Neozep 500 mg twice a day for common colds. They take Carboceistine 500mg once a day to manage cough and oregano one teaspoon for the children. He prescribed Metropolol as her maintenance drug and if ever she feels dizzy and aching of the nape. N was diagnosed to have hypertension by Dr. with these 3 ailments.D. After three days of confinement. measles and mumps. she prefer to rest and lay on bed when she feels dizzy. N. Mrs. they onlyto the RHU if their illnesses are not managed by taking the said medicine. she was discharged and she never had her check up again. Ko due to the high blood pressure.H. Mrs. colds and fever. municipal doctor. S. claimed they don¶t usually manage chicken pox they just leave it and wait until the vesicles disappears. she ask her neighbor who is a BHW to check her blood pressure and the result is always high which is not lower than 180/100mmHg.U.N. At this time her BP 10 .

Son F is the third child of Mrs. they continuously talk with son E as an emotional support. Few years later. long haired. They thought of consulting a specialist and a Rehabilitation center but never try to go because they don¶t have enough money. N.monitoring is already done by her daughter A. long balbas and has a dark complexion compared to the grooming of his other member of the family. 11 . used prohibited drugs (SHABU) when he was in 2nd year college. Since 2007. Son E is suffering from arthritis and taking Athro as a medication which is prescribed by the RHU doctor but he just takes it if he feels joint pain. As a farmer and carpenter. During the interview. Son E never mingles with other people since he stops to use drugs. she never takes her nape ache up to now. N to her 2nd husband. Mrs. Ka. Mrs. he is a so skinny. he experienced to have wound and he manage it by taking Mefenamic acid 250mg twice a day for pain and cleansing with betadine and dressing it with a clean cloth to cover the wound. delivered her 12 children through normal delivery at home assisted by a partera and to prefer to breastfeed her child. He prefers to stay on his room than to go out and have friends with their neighbors. her 5th child on her second husband. He hasn¶t suffered from any serious illnesses as well as son J. N mentioned that her Son E took a medicine for 6 months for cough and she cannot recall what the name of the drug is was. When they first knew that son E is using prohibited drugs. N claimed that Son E. as a normal response of a parent they were problematic and angry but then as time passed by. Mrs. During our second home visit we saw son E. who is now a BHW in their barangay. The medication was prescribed by Dr.

They cook at least ½ ganta of rice every meal.8 kgs Healthy weight normal BMI range: 14.85 kg/m2 Apo Z 7 kg (17. b.14. During Sunday.5 . As she claimed the she feed Son Z through mixed feeding but mostly breastfeeding as well as to Son X when he still a baby but he is now using bottle feeding.8 . for a few hours after the ³ilot´ session the fever subsides while his cough was relieved few days after.98 kg/m2 Apo X 12 kg (26.8 kg/m2 normal weight range for the height: 4.2 kgs BMI = 24.5.5 kgs Apo S 15 kg(33lbs) 0.16.62 kg/m2 (Overweight) normal BMI range: 13.2 kg/m2 normal weight range for the height: 9. The following day they consulted a ³mang-ngilot´. Son X was also confined August last year because of non healing cough. She delivered her 3 kids through normal delivery at GRBASMH.5 .82m BMI = 17.94m BMI = 16.9 .5lbs) 0.According to daughter A she was able to obtain the 5 shots of tetanus toxoid vaccines.3lbs) 0.12.16.8 kg/m2 normal weight range for the height: 11.18.57m BMI = 25 kg/m2 The family eats 3 times a day and sometimes they eat their snack in the afternoon. Since then they first consult quack doctors than medical doctors. they 12 . He was admitted at Gertes Clinic and was confined for 5 days but due to mot improving condition they decided to take him home. by taking oregano extract. Nutritional Assessment Weight in kg Names Height in m BMI Category At risk of overweight normal BMI range: 13.7 .9 .

And at around 7 in the evening they take their dinner and they cook vegetables and the leftover food are all consumed. A stated that. N. her son F can consume 3-4 sticks of cigarette per day. if there is a leftover food from their dinner they put it in the covered in the kitchen table and reheat it in the following day. Their merienda are usually consisting biscuits and 1 liter of juice at around 3-4 pm and for the children they are found in eating junk foods. Ms. N and son F mostly eat 2 pieces of pandesal and a cup of coffee while son E and J don¶t usually eat their breakfast. A claims that her 3 children are taking vitamins everyday Tiki-tiki(5 cc) for Apo Z. But they mostly eat vegetables and fish since they are not eating in eating meat. ³toy anakko nga ina-una ti umuna nga mangan ti pamigat ta mapan agbasa ket no anaman ti tedda na isunto lang ti kanen mi kidetoy anakko nga maikadwa. At around 12 noon they take their lunch and they usually cook vegetables and sometimes meat and fish. As practiced by the farmer¶s son F usually rise to bed early in the morning at exactly 5 o¶clock as his daily routine. As stated by Daughter A. Mrs. They claimed that most of the time they cook noodles the morning and sometimes it is combined with egg. In the morning they usually cook 2 packs of noodles as their breakfast and sometimes they buy pandesal as an alternative to noodles at around 7:00 in the morning.´ Mrs. Ms.cook at least 1 ganta of rice because some of the family members are going home. N stated that son F smoked cigarette after meals and sometimes the remaining one stick he smoke it during at night before bed 13 . Prophan(1 table spoon) for Apo X. According to Mrs. he only go to the farm after work. But when he has a construction work. and Cherifer (1table spoon) for Apo S.

he has still the chance to do this in his later life. He is delayed to accomplish this task though he has still time to do this in his later life The client passed this task that is appropriate to 8 months ± 9 months old children. Mrs. N also claimed that even at that age. she still drinks liquor with their neighbors every afternoon 2 times per week. The client was not able to do this task. and can improve and master this task as he goes older. The client passed this task that is appropriate to 8 months ± 9 months old children. He is delayed to do this thus. The client passed this task that is appropriate to 8 months ± 9 months old children. MMDST (METRO MANILA DEVELOPEMENTAL SCREENING TEST) 8 months (Year) 2011 2010 0 (Month) 02 6 7 mos (Day) 4 11 23 days Task Personal (social) Main: Wave bye-bye Result F Indicate wants P Play pat a cake Back: Feed self R P Work for toy F Fine motor (adaptive) Main: Bang 2 cubes held in hands P Interpretation The client was not able to do this task matched to his age. and can improve and master this task as he goes older. 14 .time. The client refused to do this task. and can improve and master this task as he goes older.

and can improve and master this task as he goes older. The client passed this task that is appropriate to 8 months ± 9 months old children. The client was able to do this task appropriate to the age bracket being able to say the word mama. he has still to accomplish and master using scribbles. The client was able to do this task but with a few seconds only with assist to her mother. and can improve and master this task as he goes older. The client failed this task since this task is not appropriate to her age.Thumb-finger grasp P Advance: Put block in cup P Scribbles F Language Main: Dad/Mama specific P Advance: 1 word P 2 words Gross Motor: Main: Get to sitting F P Pull to stand Advance: P Stand 2 seconds F The client passed this task that is appropriate to 8 months ± 9 months old children. The client failed to do this task which is matched to his age. The client was able to do this task since this task is appropriate to 8 months ± 9 months old old children. Even though he is delayed to do the task. The client failed to do this task since this is not 15 . and can improve and master this task as he goes older. The client passed this task that is appropriate to 8 months ± 9 months old children.

She can still do this task as he reaches the right age. Even though he is delayed to the task. She can still do this task as he reaches the right age. The client was able to do this task but with an assistance to his mother. 21 months (Year) 2011 2009 1year (Month) 02 4 9 mos (Day) 4 22 12 days Task Personal (Social) Main: Wash and dry hands Result P Brush teeth P Put on clothing P Advance: Name friends F Fine motor (Adaptive) Main: Tower of 4 cubes Tower of 6 cubes Advance: Imitate vertical line F P R Interpretation The client was able to pass this task and can still further improve and master this task as he goes older. The client refuses this task. Analysis: The child was not able to pass all screen test. he has still time to accomplish and master in naming his friend. The client failed to do this task which is matched to his age. The client was able to pass this task and can still further improve and master this task as he goes older.appropriate to her age. The client was able to pass this task and can still further improve and master this task as he goes older. 16 . The client failed to do this task since this is not appropriate to her age. His developmental milestone was partially achieved because come of the task are not yet able to carry out by Apo Z so the result is still NORMAL. He was behaved during the assessment.

Language Main: Speech half understandable P Name 1 picture P Point 2 pictures P Combine Words P Point 2 pictures P Name 6 body parts F Back: 6 words P Gross Motor Main: Throw ball overhead P The client passed this task that is appropriate to 21 month old children. The client passes this task since this task is appropriate to 21 month old. tita and many more. especially in naming picture of animals.3. tito. lola. wen. The client was able to pass this skill which we had manifested by saying: mama. The client passed this task that is appropriate to 21 month old children. The client passes this task since this task is appropriate to 21 month old. and can still 17 . The client was not able to do this task matched to age. but he can improve when is life goes on. especially in pointing the named picture of animals. The client was able to pass this task since this task is appropriate to 21 month old children. and can improve and master this task as he goes older. and can still further improve and master this task as he goes older. as she was able to point a picture like the picture of his mother and father. popo. The client was able to pass this task since this task is appropriate to 21 month old children.

and can still further improve and master this task as he goes older. and can still further improve and master this task as he goes older.Jump up P Kick ball forward P Broad Jump P Advance: Balance each foot 1 second P Balance each foot 2 second F further improve and master this task as he goes older. and can still further improve and master this task as he goes older. The client was able to pass this task since this task is appropriate to 21 month old children. The client was able to pass this task since this task is appropriate to 21 month old children. The client was able to pass this task since this task is appropriate to 21 month old children. and can still further improve and master this task as he goes older. and can still further improve and master this task as he goes older. The result is NORMAL because most of the sectors are achieved. The client was able to pass this task since this task is appropriate to 21 month old children. 5 years old (Year) 2011 2005 5 (Month) 2 9 4 mos (Day) 4 8 26 days 18 . The client was able to pass this task since this task is appropriate to 21 month old children. Analysis Apo X does not able to pass the entire main task but he was cooperative and able to perform more main task assigned to his age group.

and can still further improve and master this task as he goes older. The client was able to pass this task since this task is appropriate to 5 month old children. and can still further improve and master this task as he goes older. The client was able to pass this task since this task is appropriate to 5 month old children. The client was able to pass this task since this task is appropriate to 5 month old children. and can still further improve and master this task as he goes older. The client was able to pass this task since this task is appropriate to 5 month old children. The client was able to pass this task since this task is appropriate to 5 month old children. The client was able to pass this task since this task is appropriate to 5 month old children. and can still further improve and master this task as he goes older. and can still 19 . and can still further improve and master this task as he goes older. and can still further improve and master this task as he goes older.Task Fine Motor (Adaptive) Main: Copy square Result P Draw person ± 6 parts P Copy square ± demonstrate P Language Main: Define 7 words P Opposite 2 P Count 5 Blocks P Gross Motor Main: Balance each foot 6 seconds P Interpretation The client was able to pass this task since this task is appropriate to 5 month old children.

Their meals consist of rice. E. Analysis Apo S was a shy type kid but able to perform correctly the task requested to carry out during the assessment since she is a pre-schooler. 20 . The client was able to pass this task since this task is appropriate to 5 month old children. She passed all the task under her age so as a result it is NORMAL. They would only have a meal of meat if they feel like to eat. Habits. Daughter A claimed that her 2 older children has completed their vaccination proven that she showed us the yellow card of her children. HEPA A&B. The youngest among her children received BCG. Values. and she can master this task as she goes older. Practices on Health Promotion. N said that she doesn¶t know if she received immunizations also with her children if they were given vaccines because she is not aware of such program of the government. 2&3. The client was able to pass this task since this task is appropriate to 5 month old children. and can still further improve and master this task as she goes older. Maintenance and Disease Prevention Mrs.Heel to toe walk P Balance each foot 5 seconds P further improve and master this task as he goes older. fish and instant noodles since they are not fond of eating meat. vegetable meal. He does not yet receive an anti measles vaccine since he is still 8 months old. She also claimed that she received five TT (Tetanus Toxoid) vaccines throughout her pregnancies. DPT and polio vaccine 1.

and matches are place in their proper place for the children not to reach and play on it. They usually sleeps together at around 9-10pm after they have done all the household chores and wake up around 6 in the morning while the children of daughter A usually wakes up around 7-8 in the morning. On their free time. The first room located at the second floor is being used by Mrs. The children also play inside their house with the supervision of daughter A and sometimes Mrs.The family member usually takes a bath once a day and the children usually have half bath before going to bed. N. electric fan and mosquito coil. There is also a room located in the first floor which is divided by a curtain from their living room. N claimed that doing their household chores is their form of exercise. The family has a good relationship with their neighbors. They brush their teeth twice a day during morning and evening. there is a worship service in their house together with their neighbors. N sees to it that sharps objects. daughter A usually goes to their neighbors to have some chitchat. Every Tuesday night. is being used by Son J and Son F. 21 . N. Mrs. The family has three bedrooms in their house. They use shampoo and soap in bathing. daughter A and daughter A¶s 3 children while the other bedroom is used by her son S and his family. When they sleep. They sometimes go walking with daughter A in the afternoon but just around near their house. they used mosquito net. Mrs.

The family is active in the barangay activities. The family also believed in a ³mangngilot´ and quack doctors and sometime they have more belief on it than with the health care given by RHU. They also used alternative medicines such as oregano for cough. 22 . They family don¶t usually seeks health of the RHU. Daughter A performs her role as a BHW and involved themselves in community activities like Oplan dalus. On their free time they usually stay on their living room watching their favorite TV shows and sometimes listening to their radio. whenever a member of the family is sick. They also use OTC drugs such as Biogesic 500mg tablet once a day for fever and Neozep 500mg tablet twice a day for colds as well as Carboceistine 500mg once a day for cough.

TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE 1. P1. P3. P1. S1-2 y The family member usually takes a bath once a day and the children usually have half bath before going to bed. vegetable meal. They sometimes go walking with Miss A in the afternoon but just around near their house. P5. E. E. colds and fever. Presence of wellness condition Healthy Lifestyle y The family eats 3 times a day and sometimes they eat their snacks in the afternoon. S3 y Their meals consist of rice. They use shampoo and soap in bathing. E. And if Sunday¶s they cooked at least 1 ganta of rice that is because some of the family members are going home. S1-3 y Mrs. N claimed that doing their household chores is their form of exercise. P2. fish and ³pancit mami´ since they are not fond of eating meat. They would only have a meal of meat if they feel like to eat. with these 3 ailments. D-b. S1-2 Health Maintenance/Health Management y They only experience cough. They take Carboceistine 500mg once a day to manage cough while oregano one teaspoon for the children. S7-8 23 . They brush their teeth twice a day during morning and evening. D-a. They cook at least ½ ganta of rice every meal. they increase their oral fluid level. Paracetamol (biogesics) 500mg for fever and Neozep 500 mg twice a day for common colds.

P4. S4 24 . A claims that her 3 children are taking vitamins everyday Tikitiki(5 cc) for Apo Z. A. P1. P3. S12 y Daughter A claimed that her 2 older children has completed their vaccination proven that she showed us the yellow card of her children. S4 y When they first knew that son E is using prohibited drugs. P7. S2 y The children also play inside their house with the supervision of daughter A and sometimes Mrs. HEPA A&B. P3. S8 y Ms. She also claimed that she received five TT (Tetanus Toxoid) vaccines throughout her pregnancies. Prophan(1 table spoon) for Apo X. and Cherifer (1 table spoon) for Apo S. N still support and never got angry with daughter A. S2-5 Parenting y Since the relationship of daughter A is not legal. E. 2&3. DPT and polio vaccine 1. D-a.y Son E is suffering from arthritis and taking Athro as a medication which is prescribed by the RHU doctor but he just takes it if he feels joint pain. E. N. Mrs. they continuously talk with son E as an emotional support. D-a. as a normal response of a parent they were problematic and angry but then as time passed by. The youngest among her children received BCG. He does not yet receive an anti measles vaccine since he is still 8 months old. D-b. P1.

P3.2 Fall hazards y Their stairs have no rail which is connected to the second floor made up of wood. Poor home/environmental condition/sanitation c. S3 y The living room has a two plastic long chairs and a center table. S1 b. Accident hazards b.1 Lack of food storage y Whenever there are leftovers. C. S1 2. P6. P2. Presence of risk factors of specific disease y Since 2007. D-a. S1 y Daughter T. C. P3. P7.Spiritual well-being y The family values connection to God. In fact.1 sharps objects y Scattered empty cans and a hammer were seen on the surrounding of the house. she never takes her nape ache up to now. C. son F. they have worship every Tuesday on their house. daughter A and her three children are born again because they are influence by daughter M while Mrs. S4 25 . Presence of health threat a. it is covered with a plate and place in the kitchen table. C. P5. S2 c. The chairs available can be climbed by the children. A. A. E and J is Roman Catholic. P2. N. S7 b.

Unhealthy lifestyle and personal habits/practices d. S4 y y 26 . P2. P9. Mrs.2 Presence of breeding or resting sites of vectors of disease There is a canal in front of the house where the water remain stagnant sine there are plastic and dry leaves. S1-2 d. However. P10. S1-2 c. the water remains stagnant which makes it a breading site of mosquitoes. C.c. S3-4 d. N stated that son F smoked cigarette after meals and sometimes the remaining one stick he smoke it during at night before bed time. D-b. her son F can consume 3-4 sticks of cigarette per day. N.1 cigarette/tobacco smoking According to Mrs. P9. However.3 Improper drainage system y There is a canal in front of the house where the water remain stagnant sine there are plastic and dry leaves. C. the water remains stagnant which makes it a breading site of mosquitoes. E.2 self medication y They also use OTC drugs such as Biogesic 500mg tablet once a day for fever and Neozep 500mg tablet twice a day for colds as well as Carboceistine 500mg once a day for cough.

Daughter A relationship with her first partner was not good they don¶t have communication and he never support his daughter while her second partner sometimes visit but never stay for a long time. S5 y The father of daughter A¶s children is not living with them because the father of her first and only daughter has his legitimate family as well as the father of her two sons. P2. Presence of health deficits a. A. Illness state y Last 2003. They don¶t have communication with the first father of his child while the father of her two sons is through texting. D-a. Mrs. S1 y Since 2007. P2. N was diagnosed to have hypertension by Dr. Parenthood y Daughter A take a role of a mother and a father so she provides her full support to her children.N. A. P4. D-a. S. she never takes her nape ache up to now. P4 S1-3 27 . S1 b. municipal doctor. Presence of stress points/foreseeable crisis situations a. A.3. Illegitimacy y The father of daughter A¶s children is not living with them because the father of her first and only daughter has his legitimate family as well as the father of her two sons. S7 4. P4.

b. Poor home/environmental condition/sanitation a. Fall hazard Inability to provide home environment conducive to health maintenance and personal development due to inadequate knowledge of preventive measures as manifested by no rails of stairs. 2.Second Level Assessment Health Threat 1. Presence of risk factors of specific disease Inability to make decisions with respect to taking appropriate health action due to negative attitude towards the health condition or problem as manifested by not complying maintenance drug for her hypertension. Lack of food storage Inability to make decisions with respect to taking appropriate health action due to low salience of the 28 . Presence of risk factors of specific disease a. Accident hazards a. Sharp objects Inability to provide home environment conducive to health maintenance and personal development due to lack of knowledge in carrying out measures to provide home environment as manifested by presence of scattered cans in front of their house. 3.

5. b. Self medication Inability to provide adequate nursing care to the sick. dependent or vulnerable at risk member of the family due to inadequate knowledge in carrying out necessary treatment as manifested by taking unprescribed medications. c. disabled. Cigarette smoking Inability to recognize the presence of the health condition or problem due to inadequate knowledge as manifested by smoking.problem or condition as manifested by placing left over foods at kitchen table. Improper drainage system Inability to provide home environment conducive to health maintenance and personal development due to inadequate knowledge of importance of hygiene and sanitation as manifested by presence of stagnant water in their drainage system. Unhealthy lifestyle and personal habits/practices a. b. 29 . Presence of breeding or resting sites of vectors of disease Inability to provide home environment conducive to health maintenance and personal development due to lack of skills in carrying out measures to improve home environment as manifested by presence of stagnant water in their drainage system.

Parenthood Inability to provide adequate nursing care to the dependent member of the family due to altered role performance as manifested by the father of her child is not living with the family 2. disabled. Foreseeable crisis 1. Illness state Inability to provide adequate nursing care to the sick. dependent or vulnerable at risk member of the family due to absence of responsible member as manifested by the father is not married with daughter A.Health deficits 1. dependent or vulnerable at risk member of the family due to inadequate knowledge about the health condition and its severity as manifested by not complying with the prescribed maintenance medication. disabled. 30 . Illegitimacy Inability to provide adequate nursing care to the sick.

Scale for Ranking Health Problems According to Priorities Criteria Nature of the Problem Scale: Health Threat Health Deficit Foreseeable Crisis Modifiability of the Problems Scale: Easily Modifiable Partially Modifiable Not Modifiable Preventive Potential Scale: High Moderate Low Salience Scale: A serious problem that needs immediate attention A problem but not needed immediate attention Not a felt need problem 3 2 1 2 1 0 3 2 1 Weight 1 2 1 2 1 1 SCORING Decided a score for each criteria Dive the score by the highest possible score and multiply by the weight SCORE Score/Highest Score x Weight 31 .

The preventive potential is high because educating the family about the possible threats which maybe brought 32 .00 JUSTIFICATION It is a health threat because the condition of the family may aggravate and may lead to more serious complication It is partially modifiable because educating the family will give them knowledge about the problem It is highly preventive because teaching and educating the family will prevent the occurrence of serious complication as well as the aggravation of the disease. Problem needs immediate attention because they may put the health of the family at risk.67 SCORE 1 4. It is easily modifiable because it can be done by simply gathering the empty cans and put it only one place.Presence of risk factors of specific disease COMPUTATION Nature of the problem 3/3x1 Modifiability of the problem SCORE 1 1/2x2 1 Preventive potential 3/3x1 1 Salience 2/2x1 TOTAL SCORE Sharp Object Hazards COMPUTATION Nature of the problem 2/3x1 0. having a garbage pit/sack where they can compile /collect the cans and putting the hammer in safe and proper place. Modifiability of the problem 2/2x2 2 Preventive Potential 3/3x1 1 JUSTIFICATION It is classified under health threat because scattered cans and hammer may cause injury when any of the family members accidentally step on it.

67 JUSTIFICATION It is classified a health threat because the stair without rails is conducive for accidents especially to their children wherein they tend to be willfully assertive. It is partially modifiable because railings can be easily constructed especially there is a carpenter in the family but no resources available.5 TOTAL SCORE Lack of food storage COMPUTATION Nature of the problem 2/3x1 2. TOTAL SCORE Fall Hazards COMPUTATION Nature of the problem 2/3x1 4.Salience 1/2x1 0. The family recognize it as a problem but it does not need immediate attention in order for them to keep themselves safe from accident or injury. Modifiability of the problem 1/2x2 1 Preventive Potential 2/3x1 0.84 SCORE 0. It is a moderately preventive because it can be avoided by constructing the rails to minimized the risk of injury It is identified as a problem but does not need immediate attention because they always supervise their children and always reminding them not to climb the stairs.67 JUSTIFICATION It is classified under health threat because lack of food storage can result to poor home physical condition since 33 .67 Salience 1/2x1 0.5 about by leaving empty cans and hammer scattered.17 SCORE 0.

TOTAL SCORE 2.Modifiability of the problem 1/2x2 1 Preventive potential 3/3x1 Salience 0/2x1 0 1 left over food will be easily spoil and it can be a good site of microorganism which may cause disease. Preventive potential The preventive potential is high to prevent the occurrence 3/3x1 1 of dengue or it can be a good breeding site of insects. The family does not recognize it as a problem and does not needs immediate attention because the leftover food are usually eaten on the following meal. It is partially modifiable by educating the advantage and disadvantages of having a proper storage but resources are not yet available. The preventive potential is high because if there is a proper storage.67 Presence of breeding or resting sites of vectors of disease COMPUTATION SCORE JUSTIFICATION Nature of the problem It is classified under health threat because presence of breeding sites of vector increases the possibility of 2/3x1 0. GI disease would be minimized. Salience The family does not recognize 0/2x1 0 it as a problem because they 34 .67 acquiring vector-borne diseases and may result to poor environmental sanitation Modifiability of the It is partially modifiable problem because it can be done by improving the drainage system 2/2x2 2 in order to let the water free flow.

67 SCORE 0. It is highly preventable because from the start of smoking he already lessen the number of stick he use a day The problem does not need .67 2/2x2 2 JUSTIFICATION It is a health threat because the problem can cause pollution and it is very unsanitary. TOTAL SCORE Smoking COMPUTATION Nature of the problem 2/3x1 4.67 Modifiability of the problem 1/2x2 1 Preventive potential 3/3x1 Salience 0/2x1 35 1 0 JUSTIFICATION It is considered as health threat because the patient may develop a disease because it may cause various type of respiratory disease. TOTAL SCORE Improper drainage system COMPUTATION Nature of the problem 2/3x1 Modifiability of the problem Preventive potential 3/3x1 Salience 2/2x1 1 1 3. It is partially modifiable because the client is still willing to minimize the number of stick he use a day. Problem is not recognized as a serious one because they didn¶t yet experience to have dengue and the risk for lots of diseases are wide spread. It is highly preventive because they are willing to cooperate and improve their drainage. It is easily modifiable because digging deeper drainage can be easily done.does not yet experience to have dengue in and there is no need for change because they are not only the family who is using the canal.67 SCORE 0.

67 SCORE JUSTIFICATION It is a health threat because it may lead to danger towards the family such as over dosage. The family is not perceived as a problem because they stated that there is no side effect felt by the family.34 3/3x1 1 Modifiability of the problem 1/2x2 1 JUSTIFICATION It is classified under health deficit because not taking maintenance drug for hypertension that may aggravate the condition and it may result to failure in maintaining health condition It is partially modifiable because it can be done by educating her about the advantage and disadvantages 36 . 2. It is moderately preventable because collaborating the effect of OTC to the family will prevent the possible threat brought about by taking OTC drug. TOTAL SCORE Self Medication COMPUTATION Nature of the problem 2/3x1 Modifiability of the problem 2/2x2 2 0. It is easily modifiable because educating and teaching with regards the effect of the used OTC drugs will give them better idea on how to use the drug immediately.67 Preventive potential 2/3x1 0.immediate attention because the client is trying to control his self.67 Salience 0/2x1 TOTAL SCORE Illness state COMPUTATION Nature of the problem SCORE 0 3.

Preventive potential 3/3x1 1 Salience 0/2x1 0 of taking maintenance for her hypertension and encouraging her take it religiously but the attitude and the belief of the patient must be consider in order to do so. The preventive potential is high because if she will comply to the treatment it may prevent the aggravation of diseases. 0/2x2 0 0/2x1 0 TOTAL SCORE 0. It is not modified because the father of the children has their own family It is low preventive because daughter A can still do her part being a mother and a father. The family does not recognize it as a problem but not needing immediate attention because they cannot do otherwise because the father¶s of Daughter A¶s children have different family.33 0.33 SCORE JUSTIFICATION It is a foreseeable crisis because it causes a negative effect to the development of the children.00 Parenthood COMPUTATION Nature of the problem 1/3x1 Modifiability of the problem Preventive potential 1/3x1 Salience 0.66 37 . The family did not recognize it as a problem because the patient doesn¶t feel any symptoms of her disease and she believes that not taking the medication is just fine. TOTAL SCORE 3.

33 0.84 2.00 2. 0/2x2 0 RANK 1 2 3 4 5 6 7 8 9 10 11 PROBLEM Improper drainage system Sharp Object Hazards Presence of risk factors of specific disease Presence of breeding or resting sites of vectors of disease Self Medication Illness state Fall Hazards Lack of food storage Smoking Parenthood Illegitimacy SCORE 4. The problem is low because the children do not yet know the importance of having a father. The problem is not perceived as a problem because they are not married.67 3.34 3.66 38 .66 0.67 2.Illegitimacy COMPUTATION Nature of the problem 1/3x1 Modifiability of the problem Preventive potential 1/3x1 Salience 0/2x1 TOTAL SCORE 0 0.67 0.66 0.17 4.00 3.33 SCORE JUSTIFICATION The problem is foreseeable because it may affect the perception and development of young children.67 4. The problem is not modifiable since the father of her children are married.

Sign up to vote on this title
UsefulNot useful