COLLEGE OF NURSING & PHARMACY
C-RLE 104 Community Health Nursing 1 (Individual & Family)
First Semester | AY 2021-2022
Family Case Analysis
I. Introduction
II. Purpose of the Case Analysis
A. General Objectives
B. Specific Objectives
III. Assessment
A. Initial Database
1. Family Structure, Characteristics and Dynamics
2. Socio Economic and Cultural Characteristics
3. Home and Environment
4. Health Status of Each Family Member
5. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
B. Family Coping Index
1. Initial
2. Final
IV. Nursing Diagnosis
A. Typology of Nursing Problem
Cues / Data First Level Assessment Second Level Assessment
Health Problems Family Nursing Problem
Subjective Hypertension as a Health Inability to recognize the
Objective Deficit presence of the problem
related to…
NOTE: Identify at least 3 problems
V. Planning
A. Problem Prioritization
Problem #1: ________
Criteria Computation Actual Score Justification
Nature of the problem
Modifiability of the
Problem
Preventive Potential
Salience
Problem #2: _______
Problem #3: _______
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COLLEGE OF NURSING & PHARMACY
C-RLE 104 Community Health Nursing 1 (Individual & Family)
First Semester | AY 2021-2022
B. Problem Ranking
Problem Score Rank
C. Family Nursing Care Plan
Health Family Goal Specific Nursing Rationale Methods of Resources Evaluation
Problem Nursing of objectives Interventions Nurse Family Required
Problem Care of Care Contact
Note: Prepare Family Nursing Care Plan for every identified problem
VI. Implementation
A. Lists of daily nursing actions done to the family
Day 1 (Date)
Objectives:
Activities done (narrative)
Documentation
Minimum of 5days interaction with the family maximum of 10 days interaction with the family.
VII. Evaluation
A. Tool for evaluation
(How are you able to evaluate the activities done)
B. Summary of Evaluation
NURSING CARE PLAN #1
Criteria Met Partially Met Not Met Remarks
Objective1
Activity #1
1
2
3
Activity #2
1
2
3
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COLLEGE OF NURSING & PHARMACY
C-RLE 104 Community Health Nursing 1 (Individual & Family)
First Semester | AY 2021-2022
C. Overall evaluation of the home visit to the family.
Kategorya Palagi Madalas Madalang Hindi
(10puntos) (8puntos) (5puntos) (3puntos)
1. Ipinakilala ang sarili
2. Ipinakilala ang mga kasama
3. Gumamit ng naangkop na salita sa
pakikipag-usap
4. Nagpakita ng katapatan sa
pagtulong
5. Madaling pakisamahan
6. Nagpakita ng kagandahang asal
7. Gumagamit ng oras upang
magturo ukol sa kalusugan
8. Tinitiyak na naintindihan ang mga
naituro
9. Ipinaliwanag ang mga terminong
medical
10. Naisagawa ng maayos at mabilis
ang trabaho
Karagdang obserbasyon:
Total Score
VIII. Summary / Conclusion / Learning Derived
A. Summary
B. Conclusion
C. Learning Derived
IX. References
Guidelines in the preparation of the Family Case Analysis
1. Review the lecture in NCM 104
2. Identify a family
Selection of a Family from the neighborhood considering the following criteria:
a.) One member is pregnant, postpartum
b.) With newborn
c.) A member with non-communicable disease condition (DM, hypertension, kidney problem)
d.) Family with many children (at least 5 kids)
e.) Family with elderly member
3. Specifications:
a.) Font Size: 11
b.) Font Style: Cambria
c.) Spaces: Single, 1.15
d.) Place heading (e.g. I. Introduction)
e.) Size of bond paper: A4
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COLLEGE OF NURSING & PHARMACY
C-RLE 104 Community Health Nursing 1 (Individual & Family)
First Semester | AY 2021-2022
4. For the references, follow the APA format
5. Coordinate to your respective clinical instructors for any clarifications
6. After the presentation, all recommendations must be considered in the revision before the final grade
will be given
FRONT PAGE FORMAT
UNIVERSITY of the ASSUMPTION
COLLEGE OF NURSING AND PHARMACY
FAMILY CARE ANALYSIS – DIZON FAMILY
_________________________
IN PARTIAL FULLFILMENT OF THE REQUIREMENTS FOR
RELATED LEARNING EXPERIENCE 104
FOR THE BACHELOR OF SCIENCE IN NURSING
_______________________
PRESENTED BY:
NAME OF STUDENT
PRESENTED TO:
NAME OF CLINICAL INSTRUCTOR
DECEMBER ___, 2021
DATE
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