HOME VISIT RECORD (HVR) #1

Name: Joie Aislinn F. Cabios

Year and Section: BSN2-F

BASELINE OF DATA:

Name: Janine Zamora_______________________ Age: 30 y/o__ Sex:__F___

Address: Purok Balabag, Hacienda Sto. Domingo, Brgy. Granada, Bacolod City
Date of Visit: September 15, 2021_
OBJECTIVES PLAN OF ACTIVITIES EVALUATION

after two hours of Greet the client and The client was very
nursing-client introduce self. Explain accommodating and
interaction, the the procedure to the immediately
client will be able client to gain their understood the
to: trust and cooperation explanation of the
and inform in procedure. Client
1. Establish rapport. advance for a return agreed to the return
visit. visit.
GOAL MET

Ask the client for a

table/flat surface in The client was able to
order to proceed with participate in the
the bag technique. student nurse’s taking
of vital signs through
2. Participate in the bag
student nurse’s technique.
taking of vital GOAL MET
signs through bag
technique.
Listen and be
attentive when the
client talks about The client explained
their present their situation and was
condition and past open to sharing about
3. Discuss the health status. Observe their lifestyle. The
family’s present the concerns the client had
health condition, client’s home and were her children
as well as the surroundings that may having
previous health be factors to the risk of occasional medical
Status. the family’s health conditions such as
condition. cough, fever,
 toothaches, and

4. Understand the Teach the importance diarrhea. The

importance of of properly storing the client’s partner
proper storage of food and water in also has
food and water. secured sealed tuberculosis. The client
Commend the containers to explained that they
client for boiling avoid any avail health services
water to keep it contaminations that from the barangay.
clean and further may lead to any The student nurse
discuss another illnesses. Continue observed that their
way to clarify that discussing that in order house is kept neat and
the water is clean to make sure if the clean.
and safe to drink. water is safe to drink, GOAL MET
keep it at boiling point
for at least 1 minute.
Explain that if the The client admitted that
water seems cloudy, let even though they tried
it settle and then filter to store their food and
it with a clean cloth or a water in covered
coffee filter. containers, it still gets
infested by insects.
After the nurse’s
teachings, the client
was able to
5. Understand the understand the
importance of importance of properly
proper hygiene securing their food and
and proper Teach the importance water, its positive
handwashing of taking care of the effects and its negative
body with proper effects to everyone’s
technique to the
hygiene like brushing health if it’s not given
client and other
teeth at least 2- 3 any solution. The client
family members.
times a day and was also able to
cleaning the body. demonstrate the two
Teach the importance different types of
of making sure if the
handwashing and drinking water is clean
demonstrate. Allow and safe to drink.
the client and other GOAL MET
family members to
 participate.

The client and the

other family members
were able to fully
understand the
importance of taking
care of the body with
proper hygiene and
were able to fully
demonstrate the
proper handwashing
technique.
GOAL MET

6. Understand the Further explain the The client was able

significance of importance of to fully understand
being wary about separating the family the
one family member’s personal explanation of the
member’s things like student nurse and
condition utensils that may be showed where the
(tuberculosis) and able to transfer the family member with
seeing the bacterial infection to TB kept his utensils,
importance of other family members other personal
being able to avail and simplify the belongings and the cot
services from the explanation of the where he sleeps. The
health center. harmful effects of client was delighted to
tuberculosis. Take note hear that the barangay
and commend the health services have
family for taking time numerous offers if they
to avail services from needed help during
the times where any family
barangay health center members get sick.
and further explain the GOAL MET
positive outcomes if
they availed them,
especially on
7. Schedule the necessary occasions.
next visit with the
client. The client agreed for
the next scheduled
Inform the client that visit and thanked us
there will be another for the first visit.
 GOAL MET

visit; discuss and agree

a scheduled time.
Thank the client and
other
family members for
their cooperation
during the first visit.

______________________ ______________________
Student’s Signature Client’s Signature

HOME VISIT RECORD (HVR) #2 (4TH Day of Duty)

Name: Joie Aislinn F. Cabios

Year and Section: BSN2-F
BASELINE OF DATA:
Name: Janine Zamora_______________________ Age: 30 y/o__ Sex:__F___
Address: Purok Balabag, Hacienda Sto. Domingo, Brgy. Granada, Bacolod City Date
of Visit: September 29, 2021

OBJECTIVES PLAN OF ACTIVITIES EVALUATION

4. Show
after two hours of wary the
Greet about oneand
client The client
Rapport was showed
re
willingness to join
nursing-client family member’s
introduce self again. willingness to
established. Thejoin the
client
thethe
interaction, condition
Follow up the client’s Culminating
was Activity
able to follow up
Culminating
client will be able (tuberculosis)
family conditionandand afterexplain
and the student nurse
the family’s
to: Activity. seeing the importance
state the purpose of discussedsince
condition the the
of being able to avail
the planned
first visit. activities to
1. Re-establish servicesvisit.
second from the be done.
GOAL MET
rapport. health center. GOAL MET

The client was able

Briefly explain the to share the
5. Schedule the contents of the The client talked with
important
next visit with the worksheet. Ask the the student
details needednurse
for and
student nurse. Invite the client to
client(informant) all the was able
the worksheet.to agree to a
join the Culmination
important details scheduled
GOAL METtime for
2. Participate in the and
needed for the the next visit. The
student nurse’s worksheet. activities
discuss the client
interview for the to be done on the showed appreciation
Worksheet C day of the for the student
(Community Culminating Activity. nurse’s 2nd visit and is
Health Profile looking
Worksheet) Health
forwardsteaching
for thewill
Discuss the importance be done by the 5th
next visit.
of proper storage of GOAL
day METduty.
of the
food and water. GOAL NOT MET
Inform the
Discuss the client that
importance
3. Participate in the there will be another
of proper hygiene and
student nurse’s visit; discuss and agree
proper
health teaching. a scheduled time.
handwashing
Thank thetoclient
technique and
the client
other
and other family
family members
members. Explainforthe
their cooperation
significance of being
during the second
visit.
______________________ ______________________ Student’s Signature Client’s
Signature
HOME VISIT RECORD (HVR) #3 (5TH Day of Duty)

Name: Joie Aislinn F. Cabios

Year and Section: BSN2-F

BASELINE OF DATA:

Name: Janine Zamora_______________________ Age: 30 y/o__ Sex:__F___

Address: Purok Balabag, Hacienda Sto. Domingo, Brgy. Granada, Bacolod City
Date of Visit: September 30, 2021
OBJECTIVES PLAN OF ACTIVITIES EVALUATION

after two hours of Greet the client and Rapport was re

nursing-client introduce self again. established. The client
interaction, the Follow up the client’s was able to follow up
client will be able family condition and and explain the family’s
to: state the purpose of condition since the
the first visit.
1. Re-establish second visit. GOAL MET
rapport.

The client was able

Discuss the importance to understand the
of proper storage of importance of proper
food and water. hygiene and
Discuss the importance enumerate the
of proper hygiene and different practices,
2. Participate in proper demonstrate the
the student handwashing proper handwashing
nurse’s health technique to the client technique and
teaching. and other family recognize the
members. Discuss the significance of the
significance of the safety measures for
safety measures to be consuming food and
taken in order to make water.
sure that the food and GOAL MET
water is safe to be
consumed.

Invite the client to The client showed

 willingness to join the
Culminating Activity
after
join the Culmination
and
discuss the activities to

3. Show
willingness to
join the
 Culminating be done on the day of the student nurse
Activity. the Culminating discussed the
Activity. planned activities to
be done.
GOAL MET

4. Schedule the
next visit with Inform the client that The client talked with
the client. there will be another the student nurse and
visit; discuss and agree was able to agree to a
a scheduled time. scheduled time for
Thank the client and the next visit. The
other client
family members for showed appreciation
their cooperation for the student
during the second visit nurse’s 2nd visit and is
looking
forwards for the
next visit.
GOAL MET

______________________ ______________________
Student’s Signature Client’s Signature