FFamily Case Study Compilation 2

THE “BAY-AN`S”: A FAMILY CASE STUDY
BANGYOD, Gemmarie L.
BENGUET STATE UNIVERSITY

COLLEGE OF NURSING
LA TRINIDAD, BENGUET
MAY 2017
159
ACKNOWLEDGEMENT
“Thankfulness creates gratitude which generates contentment”(Todd Stocker).
The nurse learner would like to express her deepest gratitude to the individuals who
unselfishly contributed in this case study.
Mr. Jude L. Tayaben, and Ms. Aprila T. Calasan the facilitators of the community
immersion for their support, comments, recommendation and patience during the community
immersion and the making of this case study.
To the members of the Sayangan Team especially the team who went to Gasal and Tollibeng
for their considerations and support in order to come up with this case study.
To the Bay-an family who unselfishly lended their time, cooperated, and accommodated the
nurse learners during the home visits and for approving for this case study.
To the family and friends for their moral support and words of encouragement.
Above all, to the Almighty Father, for the many countless blessings He bestowed upon the
researchers that they may have the courage and wisdom to pursue this study.
GEMMARIE L. BANGYOD
159
CHAPTER I
INTRODUCTION
Family may seem like a simple concept, but there is no simple definition of family. In
common words, a family is a group of individuals who share a legal genetic bond. They live
together with a special bond called love. Family stands on the pillars of responsibility, trust,
sacrifice and hope. Family structure played a special role to shape human history and helped
civilizations to carry their culture to the next generation.
Community is another fundamental concept because human civilization grows and develop
in the lap of community. It is well known fact that an individual rarely exists alone because he
always lives with his fellows in a group. An individual lives and establishes relations with those
people who reside in a close proximity with him. It is also obvious and natural that people
residing in a definite area develop likeness, cooperation and fellow feeling among themselves.
Community is the original and first abode of human civilization.
Community Health Nursing is the synthesis of nursing and public health practice applied to
promote and protect the health population. It combines all the basic elements of professional,
clinical nursing with public health and community practice. Providing treatment for community
members is often one of the primary duties of community health nurse. Community health nurses
don’t worry about the health of just one person at a time, but entire communities at a time. This
includes areas from small towns to entire countries and everything in between.
159
CHAPTER II
OBJECTIVES OF THE STUDY
GENERAL OBJECTIVE
At the end of the community immersion, the adopted family will be able to improve their
health status and become independent in maintaining and improving their health through
appropriate interventions and available resources.
SPECIFIC OBJECTIVES
After the 3 day home visits the family member will be able to:
1. Establish rapport with the nurse learner, give pertinent and factual information and
participate during home visits and assessment interviews.
2. Identify ways that are appropriate in keeping their family bond intact and in achieving the
optimum health of each of the family members.
3. Determine health problems which may be a hindrance in maintaining and improving their
health.
CHAPTER III
INITIAL DATABASE
A. Family Structure, Characteristics and Dynamics
NAME AGE SEX CIVIL POSITION OCCUPATI EDUCATION

STATUS IN THE ON AL
(Years) FAMILY ATTAINME
NT
Saturday 45 Male Married Father Farming High School
Graduate
Sunday 43 Female Married Mother Farming and High School

Housekeepin Level
g
White 22 Male Single Son Laborer ALS
Blue 18 Male Single Son Laborer Elem. Grad.
Yellow 16 Female Single Daughter Grade 10
Pink 12 Female Single Daughter Grade 5
Green 10 Female Single Daughter Grade 4
Violet 5 Female Single Daughter
Red 2 Male Single Son
Orange 11months Male Single Son
The Bay-an family is a nuclear type of a family. A nuclear family consists of a mother,
father, and their biological or adoptive descendants, often called the traditional family.a nuclear
family is an autonomous unit free from the control of the elders. Since there is physical distance
between parents and their married children, there is minimum interdependence between them.
Thus, a nuclear family is mostly independent. The Bay-an family is patriarchal in nature and they
are both natives of Kibungan, Benguet. Their residence is located at Tollibeng, Sayangan, Lubo,
Kibungan, Benguet. They owned their house lot. They husband and wife consult each other in
terms of decision making such as budgeting.
B. Socio-economic and Cultural Characteristics
The Bay-an family main source of income is farming. The estimated montly income of the
family is within 3,000-5,000 Php. They budget their monthly income in their foods, medicines,
bills and other expenses. However, the wife stated that their monthly income is not enough for
their family needs.
C. Home and Environment
Their house is made of wood and G.I. with 2 rooms they used for sleeping. They use fire
woods in cooking. Their comfort room is located outside the house and they have an open pit
toilet. Their water source is connected to a spring. They have an individual pit for garbage
disposal but sometimes they just burn their garbages and drainage system. They have dogs, and
chicken that are kept in their backyard.

D. Health Assessment of the Family
Mrs. Bay-an states that they are using both natural and artificial family planning specifically pils
and lactate amenorrhea. When one of the family members is sick they go to the nearest clinic and
hospital depending in the severity of the illness.
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN
1. Health Perception-Health Management Pattern
The mother claimed that her husband does not smoke however he drinks alcohol
occasionally. The family does not use any herbal medicines when illness occurs within the
family members due to the reason that they lack knowledge on the uses of herbal medicines.
2. Nutritional-Metabolic Pattern
When illness occurs they sometimes used over the counter drugs if available such as
paracetamol. They eat at least three times a day. Their meal consists of rice and a viand which is
usual vegetables like chayote, chayote tops, and potato and if they have extra money they buy
meat at least once a week. That’s why their source of protein is very low.
3. Elimination Pattern
The wife claimed that all of the family members have a regular bowel movement and has no
difficulty and abnormality in defecation and urination.

4. Activity-Exercise Pattern
Mrs. Bay-an stated that their means of exercise is farming and walking due to the far
distance of their home to their garden and to their relatives and neighborhood.
5. Sleep-Rest Pattern
The family members sleep regularly at least 8-10 hours a day. There is no report on
difficulty in sleeping or insomia.
6. Cognitive- Perceptual Pattern
During the interview, Mrs. Bay-an is coherent, is oriented to time, place and are able to
respond appropriately when asked. Verbal patterns of communication are noted to be
spontaneous.
7. Self-perception
Mrs. Bay-an claimed that during crisis they still think positively for them to find ways in
order to solve thy problems.
8. Roles and Relationships
The wife claimed that they have good relationship and open communication with all of the
family members. They have their own roles and they were able to do it appropriately.
9. Sexual Reproductive
According to Mrs. Bay-an they use both natural and artificial family planning such as pills
and lactate amenorrhea

10. Coping Stress
During crisis and stress, they rely on each others shoulder, asked for the advices of the elders
and they divert their attention.
11. Values- beliefs Pattern
All of the family members are a member of the CSPI religion.
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
All of their children completed their immunization with the help of the midwife and
barangay health worker except for Orange who still needs MMR immunization. However, they
were not dewormed for the last 6 months.

CHAPTER IV
FAMILY BACKGROUND
A. Family History
Bay-an Family is a nuclear type of family. A nuclear family consists of a mother, father, and
their biological or adoptive descendants, often called the traditional family.a nuclear family is an
autonomous unit free from the control of the elders. The husband is 45 years old while the wife
is 43 years old and they are both working as a farmer.
The Bay-an family is patriarchal in nature and they are both natives of Kibungan, Benguet.
They resides at Tollibeng, Sayangan, Lubo, Kibungan, Benguet. They owned their house and
lot.
B. Family Tree
SATURDAY SUNDAY
WHITE BLUE YELLOW PINK GREEN VIOLET RED ORANGE
LEGEND:
Husband and Wife
Children
CHAPTER V
TYPOLOGY OF NURSING PROBLEM
This section contains the assessed problems within the family utilizing appropriate nursing
diagnosis.
CUES/DATA FAMILY NURSING PROBLEMS
Subjective Data
Cough and colds as health deficit
“nan aanak ya manpanateng da ya man uyek
uray sak en ya si lakay nu mamingsan,” as A. Inability to recognize the existence of a
verbalized by the Mrs. Bay-an problem due to ignorance of facts
B. Inability to make decisions with respect
Objective Data to taking appropriate health actions due to:
-coughing episodes
1. Failure to comprehend the nature,
-runny nose
magnitude or scope of the problem
- cold weather
- inapproriate clothing 2. Lack of knowledge as to alternative
courses of action open to them.
Subjective Data: Presence of possible breeding sites of

“napo sinay ubog din danum me asi waday insects, mosquitoes and rodents as a
esa lang din drum mi sya din maipey-an din foreseeable crisis
danum “, as verbalized by Mrs. Bay-an
Inability to provide a home environment
conducive to health maintenance and
Objective Data: personal development due to:
Open Drums, plastic bottles and used Car a. Lack of knowledge on the
tires are directly placed on the wet ground importance of hygiene and
that can be breeding sites of mosquitoes sanitation.
b. Lack of knowledge regarding
preventive measures
CHAPTER VI
PRIORITIZATION OF THE NURSING PROBLEMS
This part contains the foundation of the prioritization of the Nursing problems
1.Health Deficit: Cough and Colds
Criteria Computation Score Justification
1. Nature of the Problem 3/3*1 1 This problem is a health

deficit.
2. Magnitude of the 2/4*3 1.5 One of the children is

affected which may affect
Problem other members of the
family.
3. Modifiability of the 3/3*2 2 The problem is highly

modifiable. Proper
Problem interventions are available
to manage the problem.
4. Preventive Potential 2/3*1 1.33 The problem can be

highly prevented through
proper health maintenance
and lifestyle.
5. Salience 2/2*1 1 The problem is as seen

serious that needs urgent
action since it is a concern
of all family members.
Total Score 6.83
2. Foreseeable Crisis:Presence of breeding sites,and poor sanitation.

1. Nature of the 2/3*1 0.67 This is a foreseeable crisis.

Problem
2. Magnitude of the 3/4*3 2.25 Breeding sites of insects and

Problem rodents are present.
3. Modifiability of 2/3*2 1.33 The problem is highly modifiable.

the Problem Proper interventions are available
4. Preventive 3/3*1 1 The ability of the family to

Potential minimize the proliferation sites of
insects is high with the utilization
of existing family resources.
5. Salience 1/2*1 0.5 It is not felt as a problem by the

couple.
Total Score 5.75
Prioritization of Problems
Problems Score
1. Cough and Colds 6. 83
2. Presence of breeding sites and poor 5.75

sanitation
CHAPTER VII
COMPREHENSIVE PATHOHYSIOLOGY
The figure shows a pathophysiology of cough and colds. The trigger factors
may include environmental or genetic factors such as congenital, dust,
allergies, etc.
CHAPTER VIII
FAMILY NURSING CARE PLAN
Family Nursing Goals and Nursing Interventions Evaluation Plan
Problem Objectives of Care
Cough and After the nu 1. Discuss with th After the nursing

Colds rsing e family the interventions, the
interventio causes, effects and family will be able
n the family complications of cough to:
will be able to and cold.
I n a b i l i t y t o eliminate 2. Provide adequate
the cough
make
and colds and knowledge on a. acquire adequate
decisions with the various ways of
respect w i l l prevent the re maintaining knowledge about
t o t a k i n g a p p r o currence of
cleanliness in their
priate the disease in the condition
surroundings
h e a l t h a c t i o n s d t h e future.
ue to a.) Acquire ade .3 . P r o p e r
lack of know quate intake of medicines
ledge information abo or a l t e r n a t i v e o
r e g a r d i n u t t h e disease, ne if resources
g i t s including signs a n d inadequate (ex. L
management symptoms a g u n d i ) a n d preventi
of the ve measures such as
disease, imm covering the
ediate mouth when sneezing
health care assist or coughing and
ance proper disposal
a n d p r e v of nasal or oral
e n t i v e discharges.
measures. b.) 4. Promote proper p
Be aware on how to ersonal and
reduce the chan environmental hygiene
c e s o f spreading among all members of
communicable the family.
diseases
to o t h e r f
a m i l y
members.

Presence of After 1-2 hours of 1)R e i n f o r c e the Goals and objectives

student nurse-client schedule for the cleaning
breeding sites,and interaction, the activity w/c was made were met if the
family will be able during the last home
poor sanitation. to effectively visit. family was able to
promote and
maintain an 2)Encourage the clean the house
environment family to reinforce the
Inability to provide conducive to health. house if ever spare especially the
a home environment money should be
conducive to health 1)Demonstrate available or through possible breeding
maintenance&perso effective cleaning, if alternative means such as
nal development not sanitizing the wood and hard plastic. sites and was able to
due to: different parts of
both their house & 3)Emphasize the
1.) Lack of their environment. importance of a clean enumerate and
inadequate 2)Know the &healthy environment.
observed teachings
knowledge of the correct basis 4)Discuss
importance of for cleanliness. w / techniques &methods regarding
hygiene 3))Give the used in cleaning
&sanitation. importance of a &sanitizing. elimination of
clean environment
5 ) M o n i t o r f o r places
that are prone as a breeding sites.
breeding sites and dirt.
CHAPTER IX
COMPREHENSIVE FILE OF THE FAMILY HEALTH INTERVENTIONS
NURSING INTERVENTIONS
GOALS OF CARE: T h e family will be able to eliminate the cough
a n d c o l d s a n d w i l l prevent the recurrence o f t h e d i s e a s e i n t h e future.
OBJECTIVES OF CARE: After the nursing interventions, the family will:
a.) A c q u i r e a d e q u a t e
i n f o r m a t i o n a b o u t t h e disease, including signs a n d
symptoms of the disease, immediate health care assistance
a n d p r e v e n t i v e measures.
b.) Be aware on how to r e d u c e t h e c h a n c e s o f spreading communicable diseases
to o t h e r f a m i l y members.
PROBLEM INTERVENTIONS RESOURCES
Cough and colds 1. Discuss with the family the Brochures about the problem
causes and effects of cough And books.
A. Inability to recognize the and colds. Tme
existence of a problem due to
ignorance of facts 2. Provide adequate
knowledge on the various
B. Inability to make decisions ways of maintaining
with respect to taking cleanliness around their
appropriate health actions due home.
to:
3. Explain the importance of
1. Failure to comprehend the proper food handling and
nature, magnitude or scope of preparation, good nutrition,
the problem adequate rest and sleep and
strengthening each family
2. Lack of knowledge as to
member’s resistance to illness
alternative courses of action
to prevent its occurrence.
open to them.
4. Promote proper personal
and environmental hygiene
among all members of the
family.
EVALUATION OF INTERVENTIONS: Goals met. After 2 home visits, the family was able
to identify causes, effects, signs and symptoms of cough and colds.
GOALS OF CARE: the family will be able to effectively promote and maintain an
environment conducive to health.
OBJECTIVES OF CARE:
1. Demonstrate effective cleaning, if not sanitizing the different parts of both their house &
their environment.
2. Know the correct basis for cleanliness.
3. Give the importance of a clean environmen
Presence of breeding sites, 1 . R e i n f o r c e the schedule Material Resources:
and poor sanitation as for the cleaning activity w/c Visual Aids on health
Foreseeable Crisis: was made during the last teaching.
Inability to recognize the home visit.
presence of the threat due to Human Resources:
lack of/inadequate 2 . E n c o u r a g e the family Time and effort of the nurse
knowledge. to reinforce the house if leaner and the family.
ever spare money should be
Inability to make decisions to available or through
take appropriate actions due alternative means such as
to failure to comprehend the wood and hard plastic.
nature of the condition. 3. Emphasize the
importance of a clean
&healthy environment.
4. D i s c u s s w / techniques
&methods used in cleaning
&sanitizing.
5. ) M o n i t o r f o r places
that are prone as a breeding
sites and dirt..
EVALUATION OF INTERVENTIONS: Goals met. After 2 home visits, family was able to
clean the house especially the possible breeding sites and was able to enumerate and observed
teachings regarding elimination of breeding sites.
CHAPTER X
CONCLUSION AND RECOMMENDATION
CONCLUSION
Community health nursing is one of the most complex part of the nursing profession. The nurse
learners will be able to see the real word and the complexities of life.
Based on the data gathered, the following conclusions were drawn:
a) The family willingly participated during the assessment done b the nurse learners.
b) The family gave enough and factual information needed for the survey and assessment.
c) The main income of the family comes from farming and laboring.
d) The overall health condition of the family is good except for poor sanitation.
RECOMMENDATION
In order to meet all of the objectives of this family case study I need the trust of the family
for them to cooperate effectively. Including also the cooperation of the community especially the
barangay health workers and officials to act as a role model in the community so that the
neighborhood will follow. They should know about the latest news and issues of the community
specifically on the aspect of health.
To Family Bay-an, they should implement all the teachings and interventions given and
demonstrated by the nurse learners to prevent illnesses. If an illness arise unexpectedly they
should consult immediately at the nearest health care facility depending on the severity. Lastly,
the family should accept opinions, teachings and suggestions about their health to be able to meet
the optimum health status.
CHAPTER XI
REFERENCES
FAMILY,Retrieved from https://www.majortests.com/sign-up
COMMUNITY HEALTH NURSING Retrieved from
https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/nursing_students/
comm_hlth_nsg_final.pdf
THE DE GUZMAN`S: FAMILY CASE STUDY
BAYENG, Jonilyn B.
COLLEGE OF NURSING
BACHELOR OF SCIENCE IN NURSING
MAY 207
ACKNOWLEDGEMENTS
The nurse learner would like to sincerely express their profound thanks and appreciation to
the following persons, who have in one way or another, make this a study possible.
To our clinical facilitators, Mr. Jude Tayaben and Mrs. Aprila Calasan, for their patience,
guidance, supervision and their pearls of wisdom they shared.
To De Guzman family who welcome us during our home visit and had gladly shared to us
their thoughts and knowledge.
As well as to our parents for their unending support, love and sacrifice.
Above all, to God Almighty, the author of knowledge and wisdom, for his countless love,
blessing and enlightenment he gave us for the completion of this research. The nurse learner
uplifts all their praises and honor to him alone. Truly, all things are possible to you.
Jonilyn B. Bayeng
CHAPTER I
INTRODUCTION
Community health nursing the utilization of the nursing process in the different level of
clientele-individual families, population group and communities, concerned with the health
promotion of health, prevention of disease and disability and rehabilitation (Maglaya, 2000).
Community health nursing as defined by Freeman (1970), is a service rendered by a
professional nurse to the four level of clientele in different health setting. It is the achievement
of the optimum level of functioning by teaching and delivery of care (Jacobson, 2000).
Community health nursing is a synthesis of nursing practice and public health practice
applied to promoting and preserving the health of population. The dominant responsibility is to
the population as a whole; nursing directed to individuals, families, or groups contributes to the
health of the total population. Health promotion, health maintenance, health education and
management, as well as coordination and continuity of care are utilized in a holistic approach to
the management of the health care of individuals, families, and groups in a community
(Hitchcock, Schubert,& Thomas, (2003).
In the Philippines Community Health Nursing is establishing as a professional field since
many decades. Conceptually it unite elements of nursing science and Public Health Nurses,
which are officially called Public Health Nurses, are linked into a net of governmental and non-
governmental national health services. The Department of Health practice regulative strength
over the health institutions and the appropriation of health service while their activities are
directed by a centrally controlled framework of action. With a decentralization of National

Health Service onto regional and local level the Philippine authorities hope to meet health
problems and needs of the clients better on the community level (Harking, 2001)
In Community Health Nursing, the nurses go for the home visit to assess the health of the
family wherein it is the primary technique for assessing the community health risks. Despite the
variations in family structure that are present in the United States today, “the family still the
basic social unit of our society” (Rueff, 2012). In addition family is a group of persons united by
ties of marriage, blood or adaptation, consulting a single household interacting in community
with each other in their receptive social roles (Kurian, 2013). Through home visiting,”nurses
enter the environment in which people live, and they practice in this environment, in sharp
contrast to the situation where the client enters the nurse’s 6 Community environment in a
hospital or clinic”. This is an especially valid point to consider when attempting to provide
preventive care to clients and families who are relatively isolated and thus do not receive regular
health care (Rueff, 2012).
To understand more about community health nursing community defined as a collection
of people who interact with one another and whose common interest or characteristics gives
them a sense of unity and belonging. The function of any community includes its members’
sense of belonging and share identity, values, norms, communication, and supporting behaviors.
Some communities who may share almost everything, while other communities (large, scattered
and composed of individuals) who may share only there common interest and involvement in
certain goals (Mengistu & Misganaw, 2006)
CHAPTER II

This chapter presents the general and specific objectives of the family case study.
General Objectives:
At the end of the learner-family relationship, the family should be able to display
means to improve the health status of every member.
Specific Objectives:
After a week of home visits and with nurse learner and family interaction, each of
these should be able to;
a. Express own perception and identify ways to improve interpersonal relationship
with their family
b. Identify practice and behaviors that support the interpersonal relationships within
the family.
c. Enumerate the importance of prevention of the disease
d. Utilize resource available in the community in resolving the problem.
e. Developed the good habits of personal hygiene and sanitation
f. Intervention the family will be able to demonstrate understanding of the health
teaching.
g. Will be able to demonstrate or enumerate some of the preventive measure regards
health related condition such as hyperthermia.
CHAPTER III
INITIAL DATA BASE

The initial data base includes the information about the family in various dimensions. It
includes the family structure, characteristics and dynamics, the socio-economic and cultural
characteristics, the home and the environment, the health assessment of each family member, and
the values, habits, practices on health promotion, maintenance and disease prevention.
A. Family Structure, Characteristics, and Dynamics
NAME AGE SEX CIVIL POSITION OCCUPATION EDUCATIONAL

STATUS IN THE ATTAINMENT
FAMILY
JD 40 Male Married Father Farming Elementary level
ID 40 Female Married Mother Farming High school level
JDD 20 Male Single Eldest student High school level
child
IDD 18 Male Single Second student High school level
child
IRD 15 Female Single Third child student High school level
JMD 12 Single student High school level
The De Guzman family is a nuclear type. As a nuclear family, it is composed of the
father Mr. J mother Mrs. I and their four JDD, IDD, IRD, JMD and a grandson KVD. The family
resides in sitio Baybaykan of Lubo Sayangan, Kibungan, Benguet for almost 7 years. Mr and
Mrs De Guzman share in making decisions in terms of planning and budgeting for the foods,
school fees and for the farm. For the children discipline, if someone did wrong either one of the
couple will be the one to give advice so that it will not be repeated.
B. Socio-Economic and Cultural Characteristics
The main source of income of the family is farming. Chayote and alstroemeria is
their product wherein they harvest chayote every week while the alstroemeria is gathered
once a week and the payment depends on the seller. Mrs. De Guzman claimed that it is
difficult to earn money due to the unstable prices of their product. As the head of the
family, Mr. De Guzman is the one who budgets the money for the school fees of their
children. In terms of educational attainment, Mr De Guzman finished high school level
while his wife finished elementary level. All their children are already in high school
that’s why the couples are willing to do everything to let their children finish their
studies.
Their house is a one one-story owned by the family, it is made up of concrete
materials and wood and composed of three rooms, two bedrooms and one room for the
dining area. Their source of lightning is electricity and their appliances they use are
radios, stove, oven toaster and thermos. In cooking, they use both LPG and wood. Spring
is their source of water and they store it in drums. The kind of comfort room they have is
a flush type. And just like the other households, they also burn their garbage’s except for
the biodegradable because they are using as a composed plants.
History of Past Illnesses
The family recounts having a history of arthritis specifically both on the lineage of
Mr. and Mrs. De Guzman. Mrs. I De Guzman claims that their father was diagnosed of
diabetes mellitus. Mr. J De Guzman denies history of other illnesses except arthritis.
Mrs I De Guzman had checkup at La Trinidad clinic due to backache last Oct. 15,
2015.
Mr. De Guzman had diarrhea last May 23, 2014 and was cured after 2 days.
Mr and Mrs De Guzman had dengue last June, they seek consultation and were not
hospitalized the doctor just gave prescription of Ibuprofen.
History of Present Illnesses
During the home visit, Mrs. De Guzman already appear healthy.
Family Assessment Based on Functional Health Pattern
1. Health Perception-health management pattern
Mr. De Guzman and his oldest son drink alcoholic beverages as claimed.
Mr. De Guzman starts drinking when he was 14 years old, he drinks
occasionally and it takes an estimate of 9-10 shot glasses of gin with his
friends, and it includes red horse and beer.
Despite, the parents still display knowledge evident of being able to
recognize the importance of having healthy well-being.
2. Nutritional-metabolic pattern
The diet of the family consists of rice, vegetables, noodles and sometimes
meat or fish. Furthermore, Mrs. De Guzman elaborated that their meal would
always be rice and a single viand like chayote, chayote tops or sweet potato
tops. They also stocked instant noodles and canned goods usually sardines.
Their children also love to eat junk foods and sweets though the mother
claims that she never had difficulty in feeding them.
In the morning, the family usually defecates 1-2 times a day and urinates at
an average of 3-6 times daily as said by the mother. Their urine is generally
light yellow in color.
4. Activity-exercise pattern
The family claims that they exercising regularly by walking when they will
be going to the farm and at school.
5. Sleep-rest pattern
The children sleeps for about 7-10 hours of uninterrupted sleep but during
summer vacation they slept more than while the couple sleeps for 7-8 hours
without interruptions and they also take nap during afternoon before they go
to work.
6. Cognitive-perceptual pattern
All the members of the family are oriented to time, place and are able to
respond appropriately with questions. Mrs. De Guzman is a little bit shy but
still she is able to retaliate as soon as she can and were able to rationalize
when asked to explain things.
7. Self-perception pattern
The parents together with their children were optimistic and observed to be
just teasing each other.
8. Roles and relationship
Upon observing, the family has an open communication. Children were
able to express their concerns and feelings.

9. Sexual or reproductive health
Mrs. De Guzman claimed that she undergone bilateral tubal ligation in
2003; this was done when she gave birth to her last child.
10. Coping stress
If one member of the family is observed to be in a stress mood, the parents
usually gave assurance and support to the member and they also gain strength
and motivation from each other.
11. Values/ beliefs pattern
Roman Catholic is the religion of the family. Sometimes, the family was
not attending mass because it is far from their home but the couple still
assures that their children are God fearing.
12. Values, habits, practices, on health promotion, maintenance and disease
prevention
The children already completed their immunizations. Mrs. De Guzman is
also aware of the importance of food preparation that’s why she prepares for
their food to ensure food safety. Though restrained financially, the couple
claims to budget the finances of the family to serve a healthy meals the best
they could. During illness, Mrs De Guzman usually cares an ill member of the
family but if it worsen they, seek consultation at Bobocco. Aside from being
the nearest and most accessible health assistance, the health care teams are
also approachable. The couple says that they self-medicate when they
themselves get sick.

CHAPTER IV
FAMILY BACKGROUND
A. Family History
Family De Guzman is composed of 7 members: Mr. J and Mrs. I De Guzman both 40
years of age and their children: JDD 19 years old, IDD 17 years old, IRD 15 years old, JMD 12
years old and grandson KVD 1 year old. A extended family, patriarchal in terms of authority and
belongs to Roman Catholic. Mr. De Guzman studied until 3rd year high school while the wife
finished elementary level. At present, their children are all at high school level. Their source of
income is farming and estimated monthly income goes around 3,000 to 5,000 but it is still
depends on the prizes of their crop.
A. Family Tree
Mr. J. De Guzman Mrs. I. De

Guzman
First Child Daughter-in-

IMDG law
IM
Second Child
IDDG First Grandson
KVDG
Third Child
IRDG
Last Child
JMDG
C. Family Genogram
Father of Mrs. De Guzman Last Child Father of Mr. De Guzman
(+) hemorrhage (Arthritis)
JMD
Mother of Mrs. De Guzman

(+) Diabetes & arthritis Third Child
Mother of Mr. De Guzman
IRD (Arthritis)
Second Child
Older Brother Older Brother
IDD
N R
First JDD’s
Child child
Mrs. De Guzman Older Sister
JDD KVD M
Younger Sister Older Sister

L M
Mr. J De Guzman
Younger Brother(+)Car
accident
W
Younger sister
L
Younger Sister(+) infection
J
Younger Brother
JJ
Younger Sister
R
Younger Brother
CHAPTER V
The De Guzman family usually seeks consultation at Bobocco clinic and Kapangan
Medicare Community Hospital whenever they have concerns about their health. They identified
cough and colds as the common illness in their community and added that they take some
medicines and herbal medicines. Luckily, the father and mother, as being informant, articulated
that there has been no serious illness or injury experienced for their year of stay on the place
except fever.
Cues or Data Family Nursing Problem

Subjective data: l. Hyperthermia as Health Deficit
“ nagkasaruno kami ken lakay ko nga nagsakit ti a. Inability to make decision with respect to
ulo na gapo ti dengue” as stated by the mother taking appropriate knowledge about
prevention and home remedies.
Objective data:
Reports that they’ve experienced:

flushed skin
Subjective data: ll. Presence of breeding sites of insects, rodents and
vectors as a Health threat
“ ag ur-ornong kami ti danum idjay drum tanu
maminsan ket awan supply ti danum karo nu a. Inability to recognize the possible diseases
summer” stated by the mother that could be acquired through the presence
of mosquitoes.
Objective data:
Moldy drums are used for storing water.
Subjective data: III. Open drainage system as a Health threat
“ dita likod lang ti balay mi ti pangibel-belengan mi a. Inability to provide home environment

ti danum paapan jy karayan” as stated by the which is conducive to health maintenance
mother and development
Objective data:
Visible traces (greenish) of water flowing from the

sink
CHAPTER VI
1. Hyperthermia as a health deficit

1. Nature of the 3/3 x 1 1 It is a Health Deficit that needed
Problem immediate action.
2. Magnitude of 1/2 x 2 1 The resources and interventions needed
the Problem to solve the problem are available.
3. Preventive 2/3 x 1 0.67 Severity of the disease may be prevented
Potential through proper health maintenance and
understanding of health teachings.
4. Salience 1/2 x 1 0.5 The family recognizes it as a problem.
Total Score: 3.17
2. Presence of breeding sites of vectors of diseases (mosquitoes, flies, etc.) as a Health

Threat

1. Nature of the 2/3 x 1 0.67 It is a Health Threat that needed
3. Preventive 3/3 x 1 1 Occurrence of Dengue, Malaria, and
Potential other communicable diseases can be
minimized.
4. Salience 2/2 x 1 1 It is not a felt problem.
Total Score: 4.67
3. Open Drainage System as a Health Threat
1. Nature of the 2/3 x 1 0.67 It is a Health Threat.

Problem
3. Preventive 1/3 x 1 0.33 Achievement of environment that is
Potential conducive for health of the family.
4. Salience 1/2 x 1 0.5 The family understands the consequences
of the problem.
Total Score: 2.50
PRIORITIZATION OF PROBLEMS
PROBLEMS SCORES
1. Hyperthermia 3.1
2. Presence of breeding sites of vectors of 4.6
diseases
3. Open Drainage System 2.5
CHAPTER VII
A family nursing care plan is the set of actions the nurse decides to implement to be able
to resolve identified family health and nursing problems (Llego, 2012).
CHAPTER VIII
HYPERTHERMIA
GOAL OF CARE: Within the home visit, the family will be able:
a) to gain more knowledge about their present illnesses.
b) to take extra care and precaution as to their nutrition and exercise.
OBJECTIVES OF CARE: Within the home visit, the family:
a) will be able to enumerate factors that can aggravate their illnesses.
b) will be able to demonstrate proper exercise and healthy eating habits.

Inability to make decision with 1. Assess the family's knowledge Human resources the time
respect to taking appropriate about fever. and effort of the nurse
knowledge and actions about 2. Discuss with the family the signs learner and the family
prevention and/or maintenance as and symptoms, or factors that
to their present illnesses. causes the illnesses.
nutrition and proper exercise, as
well as medicines to prevent
aggravating their present
condition.
EVALUATION OF INTERVENTIONS:
Goal partially met. After the nursing interventions, the family was able to acquire additional knowledge
about their illnesses and how to maintain a healthy lifestyle.
BREEDING SITES OF VECTORS
GOAL OF CARE: After an hour of nursing intervention, the family will be able to demonstrate
understanding of the health teaching regards to the possible causes and effects of the presence of
these vectors.
OBJECTIVES OF CARE: After an hour of nursing intervention, the family will be able to
demonstrate understanding of the health teachings, and breeding sites of mosquitoes will be
cleaned.
Inability to recognize the 1. Assess condition of the house Human resources: time
possible diseases that could be and level of knowledge. and effort of the nurse
acquired through the presence learner and the family
of mosquitoes. 2. Discuss the possible sources of
mosquitoes' presence.
3. Explain to the family all

possible harmful effects that
mosquitoes can cause to health
of the family.
4. Encourage on maintaining
cleanliness by regularly
cleaning the surroundings.
After the nursing interventions, the family made actions to avoid possible diseases that may be
due to the said problem.
OPEN DRAINAGE SYSTEM
GOAL OF CARE: After an hour of nursing intervention, the family will be able to understand
the importance of proper drainage system in relation to health and sanitation.
OBJECTIVES OF CARE: After an hour of nursing intervention, the family will be able to
demonstrate understanding of the health teachings, and the drainage system will be fixed.
Inability to provide home 1. Discuss the importance of proper Human resources such
environment which is drainage system in relation to the as time and effort of the
conducive to health family's health. nurse learner and the
maintenance and family
development. 2. Encourage the family to maintain
good sanitation.
After the nursing interventions, the family made actions to keep their environment clean and
conducive for health of their family.
HOUSEHOLD: 2
SITIO: BAYBAYKAN
Health Family Goal of care Objectives Intervention Method of Resource

problem nursing of care measures nurse- s
problems family required
contact
Hyperthermi Inability Within the Within the 1. Assess the Home visit Human
a as Health to make home visit, home visit, family's resources
Deficits decision the family the family: knowledge the time
with will be able: about and
respect to a) will be hyperthermi effort of
taking a) will be able to a. the nurse
appropriat able to demonstrat 2. Discuss learner
e prevent e or with the and the
knowledg recurrence enumerate family the family
e about of the some signs and
prevention disease in preventive symptoms,
and home the future. measures or factors
remedies. of fever. that causes
b) able to the illness.
gain 3. Explain
knowledge the
about importance
hyperthermi of nutrition,
a. rest and
sleep in
strengthenin
g one’s
resistance.
4. Instruct to
perform
tepid sponge
bath and
drink 2-3
liters of
water daily
Facilitator: Jude Tayaben, RN, MAN Date: May 8, 2016
Nurse Learner: Jonilyn B. Bayeng Name of Client: I. De Guzman
HOUSEHOLD: 2
SITIO: BAYBAYKAN
Health Family Goal of care Objectives of Interventio Method of Resource

problem nursing care n measures nurse- s required
problems family
contact
Open Inability to After an After an hour 1. Discuss Home visit Human
drainag provide hour of of nursing the resources
e home nursing intervention, importance the time
system environment intervention the family of proper and effort
as a which is , the family will be able drainage of the
Health conducive to will be able to system in nurse
threat health to demonstrate relation to learner
maintenance understand understandin the family's and the
and the g of the health. family
development importance health 2.
. of proper teachings, Encourage
drainage and the the family
system in drainage to maintain
relation to system will good
health and be fixed. sanitation.
sanitation.

HOUSEHOLD: 2
SITIO: BAYBAYKAN
Health Family Goal of care Objectives of Intervention Method of Resource

problem nursing care measures nurse- s required
problems family
contact
Presenc Inability to After an hour After an hour 1. Assess Home visit Human
e of recognize of nursing of nursing condition of resources
breedin the intervention, intervention, the house : time and
g sites possible the family the family and level of effort of
of diseases will be able will be able knowledge. the nurse
insects, that could to to 2. Discuss learner
rodents be acquired demonstrate demonstrate the possible and the
and through the understandin understandin sources of family
vectors presence of g of the g of the mosquitoes'
as a mosquitoes health health presence.
Health . teaching teachings, 3. Explain to
threat regards to the and breeding the family all
possible sites of possible
causes and mosquitoes harmful
effects of the will be effects that
presence of cleaned. mosquitoes
these vectors. can cause to
health of the
family.
4. Encourage
on
maintaining
cleanliness
by regularly
cleaning the
surroundings
.
CHAPTER IX
CONCLUSIONS AND RECOMMENDATIONS
Community health nursing is defined as the synthesis of nursing and public health
practice applied to promoting and protecting the health of population. It is a specialized field of
nursing that focuses on the health needs of communities, aggregates, and in particular vulnerable
populations. It is a practice that is continuous and comprehensive directed towards all groups of
community members. It combines all the basic elements of professional, clinical nursing with
public health and community practice.(ANA, 2006)
Through this, the nurse learner should focus on health promotion, health maintenance;
health education, coordination and continuity of care are utilized in a holistic approach to the
management of the individual, family group and community. The nurse’s actions and knowledge
is the need for comprehensive health planning, recognizing the influences of social and
ecological issues, giving attention to population at risk and utilize dynamic forces which
influence change.
The De Guzman family should also encouraged and informed by the nurse learners and
other families in the community because health designates the ability to adopt to changing
environments to growing up and to aging, to healing when damaged, to suffering and to peaceful
expectation of death (lllich 1975).

Chapter XI
REFERENCES
www.cartercenter.org
Cmai. Community Health Nursing. BI Publications Pvt Ltd, 1 January 2005. Page 314
www.family.lovetoknow.com
Janice E. Hitchcock, Phyllis E. Schubert, Sue A. Thomas. Community Health Nursing: Caring in
Action, Volume I. 2003. Page 346
www.nurseslab.com
THE ‘SEVERINO’S: A FAMILY CASE STUDY
CELIS, Grace R.
COLLEGE OF NURSING

MAY 2017
ACKNOWLEDGEMENTS
This is to say thank you to all the ones that made this case study possible. Who guided
me in my strife and challenges in making this case study.
First of all, I would like to thank the Lord for the guidance and prayers answered by him.
To Mrs. Doris S. Natividad, RN, MAN, Dean College of Nursing for allowing us to have this
community immersion and for all the support.
To Mr. Jude L. Tayaben and Mrs. Aprila Calasan, our ever supportive, kind and patient
instructors who went with us in the community. I thank you for being there for us, for sharing
suggestions and constructive criticism, which meant so much for the completion of this study.
To Family Severino, respondents of this study, for being approachable, cooperative and
for spending their time in answering all the questions being asked.
To my fellow group mates whom I asked for help. Thankyou!
GRACE
R. CELIS
INTRODUCTION
Community and health care nursing provide health education, care management and
primary care to individuals and families who are members of vulnerable populations and high
groups. Health nurse integrate community involvement and knowledge about entire population
with personal clinical understanding of health and illness experiences of individuals and families
within the population. Community and nurses focus on the prevention of illness, injury or
disability, the promotion of health and maintenance of the health of the populations, they work
with communities, target health promotion and disease prevention, they act as teachers,
counselors and plays an important roles in preventing wide spread illness and disease.
Community and public health nurse’s goals is to promote, preserve, and maintain the health of
populations through the delivery of personal health services to individuals, families, and groups,
and also the prevention of disease and disability, to promote and protect the community as a
whole. (Clayton, 2012)
Community health nursing defined as a collection of people who interact with one another
and whose common interest or characteristics gives them a sense of unity and belonging. A
community is a group of people in defined geographical area with common goal and objective. It
is defined as the synthesis of nursing and public health practice applied to promote and protect
the health of population. It is a specialized field of nursing that focuses on the health needs of
communities, aggregates, and in particular vulnerable populations. It is a practice that is
continuous and comprehensive directed towards all groups of community members. It combines
all the basic elements of professional clinical nursing with public health and community practice.
(Mengistus&Misganaw, 2006)
CHAPTER II
This chapter presents the general and specific objectives of the family case study. As nurses of
21st century we have duties and responsibilities to keep a dynamic balance with the ever
changing needs of the health of our society. To maintain well-informed with this societal needs,
we professional nurses must understand concepts and models of the community health nursing,
the importance of health promotion and disease prevention and health care planning,
implementation and evaluation of health care efforts for the advantage of the community.
General Objectives:
At the end of the nurse learner family relationship, the family should be able to display
expected means to improve the quality of life to improve the standard of living, to strengthen
self-care activities of individuals, health status of every family member and increase life span of
family members. Help to improve the community as one of the ways to deliver health
promotion in the society. Understanding the community and sharing health teachings to the
society can help elevate the condition of our society. Rendering health services to certain
individuals influences the neighborhood. Observing proper waste disposal to makes the
community aware of the health of their environment. We would also like to find out how the
family utilizes the resources available to cope up with the presence of health problems in the
community.
After a week of home visits and with the nurse learner and family interaction, each of the
family members should be able to;
a. Express own perception and identify ways to improve interpersonal relationships
within their family
b. Identify practices and behaviors that support and inhibit the interpersonal
relationship with the family.
c. The family will be able to know how to administer health care needed by family
members.
d. Determine the condition in which the family lives and identify the conditions that
affect their health and know how to manage it.

CHAPTER III
INITIAL DATA BASE
The Initial Data Base includes the information about the family in various dimensions. It
includes the family structure, characteristics, dynamics, the Socio-Economic and Cultural
Characteristics, the Home and Environment, the Health assessment of each family member, and
the Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.
POSITION
NAME AGE SEX CIVIL IN THE OCCUPA EDUCATIONAL
STATU FAMILY TION ATTAINMENT
S
MS 42 F M Mother Farming Elementary

Undergraduate
9
MS M S First child ----- Elem
Undergraduate
8
CS M S Second child ----- Elem
Undergraduate
6
GS F S Third child ----- Elementary
Undergraduate
The Severino Family is a nuclear type of family. As a nuclear family, the family is composed
of Father Severino and Mother MS and their four children, JS, MS, CS, and GS. A nuclear type
family is found in almost all societies although the length of time in which the family remains in
this from remains varies even with the same society. The nuclear family can be a nurturing
environment in which to raise their children as long as there is love, time spent with children,
emotional support, low stress, and a stable economic environment. In nuclear families, both
adults are the biological and adoptive parents of their children. (Jay, 2004). The Severino family
resides in Lubo, Panga, Kibungan. They have been living there since 48 years. Mother MS is
from Kibungan. Mrs. MB has the authority in decision making in their family. She is the one
budgeting and planning in their family. This is because their family is matriarchal, the mother
has the higher authority and she is alone in providing the needs of her children. In terms of the
health of the family, Mrs. MS is dominant in disciplining her children. She focused on
disciplining both the male and female children. Mr. Severino went to other place as Mrs.
Severino said, they have no communication at all.
The family’s main source of income is from Mrs. MS’s salary as a farmer. She works every day
on the sayote farm. She is paid per month and not daily basis and earned 2,000 pesos. With her
little salary, she budgets the money for them to have something to eat and to pay the school fees
of her son who is in elementary grade. The family’s main source of food is chayote because most
of them planted chayote to sell. Mrs. Severino claimed that she did not go to school and they
only want to work for them to have something to eat.
There is only one bedroom where they all sleep and a one story building owned by the
family. They sleep together in a wooden bed near the entrance door which also serves as the
receiving area. The house is made up of mainly wood and GI material with the woods on the
sides. The house is not well ventilated and there is inadequate lightning. Breeding sites of
mosquitos, flies are inevitable due to open drainage and poor environmental sanitation. Their
house was located nearly at the bottom of the mountain under chayote farm. They use wood in
cooking. They prefer to use wood as their source of lightning because the family cannot afford to
pay the electricity. The only thing that found in their house is a radio. They also have a good
source of water because it was connected to the river water near their house. They use plastic
containers in storing their water but they do not have toilet in their house. Mrs. MS said that they
just go to the river as their comfort room but they have a small space near their house for them to
take a bath which is covered only by a sack. She claimed that they burn their garbage or even
throw to the river.
The overall surrounding of the family is unhygienic and their drainage system is open and
very proximate to their house.
Mrs. Severino denies history of illnesses because they did not even go to hospital or to the
clinic for them to have a check-up because the health care facility is too far and they do not have
enough money for consultation.
1. Health Perception- health management patterns
The member of tha family claims that they do not drink any alcoholic beverage and they
don’t smoke. Mrs. MS doesn’t engaged herself in drinking or even smoking, she did not try
anything doesn’t want to try even a little.

The family specially, Mrs. Severino display evident of being able to recognize the importance
of having a healthy well-being.
2. Nutritional Metabolic Pattern
Mrs. Severino is not taking any medicine when having cough and colds but she is resting
and drinking a plenty of water. She claimed giving her children paracetamol when they have
fever. She is not giving vitamins to her children because she cannot afford to buy one and there
are no supplies in the center.
Daily food intake consists of rice and sayote. Mrs. Belino further elaborated that their meal
would always be rice and a single viand but sometimes they just eat rice. The viand may either
be vegetable, egg or sardines, instant noodles this is because Mrs. MS can’t afford to buy meat
for them.
The mother verbalized that she defecate everyday usually in the morning but her child
defecate every other day usually in the morning. She claimed that every day they eliminates with
an average of 5 times of urine. No difficulty in voiding.
The family does not regularly exercise but claims that her work being a farmer serves as her
exercise because she walks every day and walks throughout the mountain under the chayote
farm. The children are always playing and running outside their house and it serves as their
exercise.
5. Sleep pattern
The children as claimed by the mother have a sleep of 7-8 hours of uninterrupted sleep. Mrs.
MS on the other hand has around 5-6 hours of sleep because of her work that she needs to wake
up early to walk going to the farm. She also reports that she at times takes a nap in the afternoon
after lunch with her children.
6. Cognitive- perceptual pattern
All the member of the family are oriented to time, place, place and they are responding
appropriately with questions. The mother is confident in explaining things and she also justify
every question asked. Verbal communication is spontaneous and comprehends to every question.
7. Self-Perception/Self concept
Mrs. MS generally are optimistic and are observed to be just teasing each other with issues
around. Mrs. MS discloses that her husband and are separated but she is still hopeful to her
husband. She claimed that she wants her children to be educated for them to have a better future.
Mrs. MS and her children even in their young age are observed to have open communication.
The children are noted to express their concerns and feelings to their mother openly. It was noted
that she enforce discipline to her children in an acceptable manner. Mrs. MS talks in a firm voice
when the children rowdy during the home visits. Mrs. MS talks to her children for them to listen
to us and the children participated in our activities during our visits.
9. Sexual or Reproductive Health
No active sexual reproductive since she is separated with her husband. Also she shared that she
is using pills that the midwife is giving her before when she is with her husband.
10. Coping Stress
Mrs. MS claims to gain strength and motivation to her children. Her assurance and support to
their children even if she cannot give everything to them. She reports that she allow her children
to experience despair and disappointments for them to be prepared in life.
11. Values/ Beliefs Pattern
The family is from Kibungan Benguet and Born Again. Mrs. MS claimed in our interview that
she have a strong fear to God even if she’s not going to church every Sunday because of the
distance of the church to their house and because of her work because she needs to work every
day for them to have something to eat.
12. Values, Habits, Practices on Health Promotion, Maintenance, and Disease
Prevention
The children in the family have not yet completed their immunization. The mother is cognizant
in the importance of food preparation but reports that she cannot do anything to buy them some
meat and poultry because of her low income and status in life. Mother claimed self-medication
when they got sick.
CHAPTER IV
FAMILY BACKGROUND
A. Family History
The Severino family is composed of mother, and four children. Mrs. MS educational
attainment is elementary undergraduate (grade 1). She is now a 42 years old and currently
working as a farmer. Her daughter JS is 20 years old her educational attainment is also
elementary undergraduate (grade 1). MS, CS, and GS don’t go to school because Mrs. MS don’t
have enough money to send her children in school. The family claimed that they only have
cough and colds for the past months.
B. Family Tree
Mr. Severino Mrs. Severino
MS CS GS
CHAPTER V
Cues or Data Family Nursing Problems
Subjective data: I. Cough and colds as a health deficit
A. Inability to provide adequate
- “aguy-uyek ken muteg da ya” as nursing care to the sick member of
verbalized by the mother the family due to:
a. Knowledge deficit related to
Objective data: management of the problem.
- Cold weather Inadequate resources of family to manage the
- productive cough problem.
Subjective Data: II. Poor personal hygiene as a health
- “Haan kami kanayun man ames ta threat
nalamin ya” as verbalized by the A. Inability to make decisions with
mother. respect to taking appropriate
health action due to failure to
Objective data: comprehend the presence of the
- Dirty and untrimmed finger and toe problem.
nails
- Children have dirty clothes
Subjective data: III. Risk for diarrhea to unsafe drinking
- “ Haan mi amu nu nadalus jay danum water as a foreseeable crisis.
ta gapu ubog” as verbalized by the A. Inadequate knowledge in
mother. preventive measures on diarrhea
Objective data: or any disease that may cause by
- No sign of illness assessed intake of unsafe water.
Subjective data: IV. Inadequate Living space
- “ Basit toy balay mi, agsisiniksik A. Inability to provide resources for
kami, kurang pagturugan” as better living space and Inadequate
verbalized by the mother. resources of family to manage the
problem.
Objective data:
- Inadequate space
CHAPTER VI
This section contains the basis for the prioritization of the nursing problems.
I. Cough and Colds as a Health Deficit

1. Nature of the Problem 3/3x1 1 This problem is a health
deficit
2. Magnitude of the 4/4x3 3 Almost of all the family
problem members are at risk.
3. Modifiability of the 2/3x4 2.66 The problem is moderately
Problem modifiable. The family and
the community have the
necessary resources to treat
cough and colds.
4. Preventive Potential 2/3x1 0.66 The possibility of
transferring infection to
other members of the
family is high and should
therefore be given
immediate attention.
Mother knows ways of
treating cough and colds
and has used herbal
medicines.
5. Salience 1/2x1 0.5 Although there is a
possibility of transferring
infection to other family
members, the infection is
not life threatening.
Total score 7.82

II. Poor personal hygiene as a health threat

deficit
2. Magnitude of the 4/4x3 3 Their three children lack of
problem personal hygiene.
3. Modifiability of the 2/3x4 2 The problem is moderately
Problem modifiable to solve the
problem.
4. Preventive Potential 2/3x1 0.66 The problem could be

highly preventive. This
could be done measures to
prevent or maximize
improper hygiene.
5. Salience 1/2x1 0.5 The problem does not seen

as immediate attention
according to the family.
Total score 7.16

III. Risk for diarrhea to unsafe drinking water as a health deficit

1. Nature of the Problem 1/3x1 0.33 This problem is a health
deficit
2. Magnitude of the 3/4x3 2.25 Anyone in the family can
problem be affected
Problem modifiable. Appropriate
interventions are very
available to manage the
problem.
prevented. This could be
done if the family will be
educated on measures to
prevent or minimize the
possible factors of having
diarrhea like proper hand
hygiene and boil their
water to drink.
5. Salience 1/2x1 0.5 The problem requires

immediate attention
Total score 6.4

V. Inadequate Living space

deficit
2. Magnitude of the 4/4x3 3 All of them are affected
problem
3. Modifiability of the 2/3x4 2.66 The problem is not
Problem modifiable. To solve the
problem, they should build
an adequate space for the
house.
4. Preventive Potential 1/3x1 0.33 The problem could be low
preventive. This could be
done measures to maximize
space.
5. Salience 1/2x1 0.5 The problem does not need

immediate attention
according to the family
Total score 7.15
PRIORITIZATION OF PROBLEM
PROBLEMS SCORES
1. Cough and colds as health deficit 7.82
2. Poor personal hygiene as a health threat 7.16
3. Risk for diarrhea to unsafe drinking water as a health 6.4

deficit
4. Inadequate Living space 7.15
CHAPTER VII
COMPREHENSIVE PATHOPHYSIOLOGY
A cough is a common reflex action that clears the throat of mucus or foreign irritants. Coughing
to clear the throat is typically an infrequent action, although there are a number of conditions that
can cause more frequent bouts of coughing. (Irwin, R. S., 2006)
Cough and Colds
VIRUS
Obstruction of nasal
passages
Inflammation (Chemical mediators)
Infection of epithelial cells

of nasal passages Blood vessel permeability Edema
Exudation of serum rhinorrhea
Mucus secretion
Cholinergic stimulation
Sore throat, sneezes
Airway receptor irritation
Bronco Cough
constriction
CHAPTER VII
Health Problem Family Nursing Goal of Care Objectives Of Nursing Method Of Resources
Problems Care Interventions Nurse-Family Required
Contact
>Cough and 1.Knowledge After home After nursing >Establish > Home visit >Nurse
Colds as health Deficit related visit the family intervention rapport and Health learners’
deficit to management will be able to family will be >Assess the Education thorough
of the problem comply on the able to family health knowledge of
Subjective: management demonstrate status the plan of care.
-“aguy-uyek 2.Inability to given, practice understanding >Discuss nature > Time
ken muteg da provide a ways in on the health and causative determination
ya” nursing care for preventing teachings given factors of and effort of
the sick cough and regarding the cough nurse learners
members due to colds and nature and >Perform and family.
Objective: inadequate maintaining causative procedure on
-Productive resources of the airway factors of the effective
cough family specially clearance. identified coughing as
in financial problem. follows and
-Crackles on resources instructed to do
both lung fields so:
a. Deep
breathing
exercise and
coughing
exercise
b. Sit up
straight
c. Bronchial
tapping
>Reiterated
them to
increase intake
of vit.C such as
suha, lemon,
guava which
are readily
available.
Instruct family
to increase
fluid intake to
1-2 liters per
day
>Instruct
family to
increase fluid
intake 1-2 liters
per day
Contact
>Poor personal >Improper Within a day of Within 3 hours >Establish >Home Visit > The time,
hygiene Hygiene as a nursing of nursing rapport effort and
health threat interventions, intervention, perseverance of
Subjective: the family will the family will >Check if the Nurse learners
be able to be able to: family is aware and family
-“Haan kami identify, > Recognize on their health members
kanayun man recognize and the need for practices. involved.
ames ta perform the proper hand > Demonstrate
nalamin ya” health practices washing before the proper hand
habitually. and after meals washing and
Objective data: These hygienic as well as after instruct them to
measures as using the toilet. do so.
-Dirty and follows: proper > Enumerate > Perform ear
untrimmed hand washing, factors that cleaning and
finger and toe taking a bath, promote in nail clipping to
nails trimming finger unhygienic the children.
and toe nails practices. >Emphasize the
and so on. > Be importance of
-Children have
knowledgeable proper hygiene
dirty clothes
in ways on how in preventing
to maintain health problem
hygiene. such as
> Accept the illnesses.
importance of > Listen to the
proper hygiene concerns of the
in the activities family
of daily living. regarding the
> Exhibit the hindrance to
desire to practice such as
change the hygienic
current practices.
unhygienic >Encourage to
practices. verbalize
feelings and
concerns.
Contact
>Inadequate - Inadequate > After the > After nursing >Establish > Home visit > Time and
Living space Living space nursing intervention rapport effort of nurse
intervention, family will be learners and
Subjective: -Crowding of the family will able to >Assess factors family.
the members be able to >Determine that contribute > Cooperation
-“ Basit toy during bed develop or plan and to the problem. of the family
balay mi, time. to maximize demonstrate to >Suggest ways
agsisiniksik the space. maximize the on how to
kami, kurang space such as maximize the
pagturugan” proper available living
arrangement of space by
Objective: the clothing rearrangement.
and appliances. > Advise the
-Inadequate >Verbalize family to store
space understanding the unused
on the materials to
importance of their storage
- The space as
adequate living area.
seen to be
space. >Discuss the
limited and
crowded for the advantages
family /disadvantages
and possible
outcome or
effects of
inadequate
space that may
lead to
transmission of
diseases.
>Help the
family on
planning to
maximize their
space
CHAPTER IX
COMPREHENSIVE FILEOF THE FAMILY INTERVENTIONS
This section contains how the planned nursing interventions were carried out.
I. Cough and colds
Goal Of Care: After a home visit the family will be able to show compliance on the management
given, practice ways in preventing cough and colds and maintaining airway.
Objectives of Care: After nursing intervention family will be able to demonstrate understanding
on the health teachings given regarding the nature and causative factors of the identified problem.
PROBLEM INTERVENTION RESOURCES

Cough and colds as health >Establish rapport > Nurse learners’ thorough
deficit > Assess the family health knowledge of the plan of
status care
> Discuss nature and causative > Time, determination and
factors of cough effort of nurse learners’
> Perform procedure on and family
effective coughing as follows
and instructed to do so: a. deep
breathing exercise and coughing
exercise b. sit up straight c.
bronchial tapping
> Reiterated them to increase
intake of Vit. C such as suha,
lemon, guava which are readily
available.
>Instruct family to increase
fluid intake 1-2 liters per day
EVALUATION OF INTERVENTIONS: After home visits, the family was able to
demonstrate understanding on the health teachings given regarding the nature causative factors
of the identified problem.
II. Poor personal Hygiene
Goal Of Care: After the nursing intervention, the family will be able to identify, recognize
and perform the health practices habitually. These hygienic measures are as follows: proper
hand washing, taking a bath, trimming the finger and toe nails and so on.
Objectives of Care: After nursing intervention family will be able to: recognize the need
for proper hand washing before and after meals as well as after using toilet.

Poor personal hygiene >Establish rapport > Time, determination
> Check if the family is and effort of nurse
aware of their health learners’ and family
practices. > Cooperation of the
>Demonstrate the proper family
hand washing and instruct
them to do so.
> Perform ear cleaning and
nail clipping to the children.
>Emphasize importance of
proper hygiene in preventing
health problem such as
illnesses.
>Encourage to verbalize
feelings and concerns.
EVALUATION OF INTERVENTIONS: After home visits, the family was able to

demonstrate understanding on the health teachings given regarding the nature
causative factors of the identified problem.
III. Inadequate Living Space
Goal Of Care: After the nursing intervention, the family will develop ways on how to
minimize the problem as evidenced by rearrangement of furniture to maximize the space.
Objectives of Care: After nursing intervention family will be able to identify factors that
contribute to the congestion in the area such as unused things. Demonstrate techniques to
promote good environment condition such as proper arrangement of appliances.

Inadequate living space >Establish rapport > Time, determination
> Assess the family health and effort of nurse
status learners’ and family
> Suggest ways on how to > Visual aids for the
maximize the available living demonstration
space by rearrangement.
>Advise the family to
separate things they don’t use
anymore.
>Inform the family regarding
the easy transmission of
disease due to inadequate
space.
>Explain to the family the
advantage of having
adequate living space and aid
the family in maximizing the
living space.
EVALUATION OF INTERVENTIONS: After discussion, the family was

demonstrated good techniques to promote good environment condition such as
arrangement of appliances.
CHAPTER X
CONCLUSIONS
e) Family participate actively during home visit and assessment interviews,
f) Gives pertinent and factual information during surveys and interviews,
g) Mrs. Severino cannot provide her family needs because of low income just working in
the sayote farm,
h) The Severino family is not risk with other genetic illnesses,
i) Severino family is open to change and new health teachings in turn taking the proper
interventions to address problems.
RECOMMENDATIONS
Community health nursing has been a part of every nurse learners’ life. It is a nurse’s duty to
provide immediate health care to the community people’s health problems before going to the
higher health care facilities. Promotion and preservation of healthy lifestyle and disease
prevention through proper health teachings, appropriate application of health actions, community
activities are some ways to build a stepping stone for the certain aims of community health
nursing. To fulfill the certain objectives, the cooperation and collaboration of not only the
assigned family, community but also with the barangay health officials and workers of Barangay
Lubo are needed. To be able to help and provide proper health care services, the workers of the
Barangay Health centers should continue portray being role models to the residents of the
community. They should be more open and accommodating in order to be effective health
teachers. Lastly, they should be updated with the latest studies and researchers for prevention and
the betterment of the quality of health services.
To Family Severino, In order to acquire more knowledge regarding health, they
should engage in certain different programs that can serve as a basis in handling health matters at
home. If they encounter a certain illness, they should go to the Barangay Health Center for
proper consultation and diagnosis. They should also be open to the suggestions and introduction
of health teachings for her to practice regularly at home to manage good health conditions.
CHAPTER XI
REFERENCES
Meadows, P. (2009). Community Health Nursing. American Journal of Nursing
Clayton (2012) Essay community Health Nursing
Irwin, R. S., 2006,
Jay 2004,
Nanda (2011)
Mengistus&Misganaw, 2006)
THE “SEGUNDO`S”: A FAMILY CASE STUDY
DANIEL, Rhoda S.
BENGUET STATE UNIVVERSITY
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGMENT
First, I would like to thank the Almighty. For without Him this case study will not be
possible. For giving me health and strength for this continually be done. For blessing me a family
and friends: who support and give me the courage to finish this work.
Also I would like to express my gratitude to Ma’am Aprilla Calasan and Sir Jude
Tayaben for guiding us during the immersion.
To my teammates thank you for accompanying and support. Live long Team Sayangan
I would like to express my sincere gratitude to the community of Sayangan, Kibungan for
welcoming us to be a part of the community and counting as a part of their family. Also for their
time and effort in answering our survey.
I would like to express my gratitude to The Segundo Family whom they gratefully and
willingly welcome me to their house. I highly appreciate their hospitality and very thankful for
their cooperation. For being the subject of this research, thank you making it possible.
Above all, glory to His name for He guided and protected us throughout the 8 days
immersion
Rhoda S. Daniel
CHAPTER I
INTRODUCTION
Community health Nursing is defined as the synthesis of nursing and public health
practice applied to promoting and protecting the health of population. It is a specialized field of
nursing that focuses on the health needs of communities, aggregates, and in particular vulnerable
populations. It is a practice that is continuous and comprehensive directed towards all groups of
community members. It combines all the basic elements of professional, clinical nursing with
public health and community practice. It Community Health Nursing 19 synthesizes the body of
knowledge from public health science and professional nursing theories to improve the health of
communities.( Mengistu & Misganaw, 2006)
Community is a group of people who live in same area. It’s a group of people who have
the same interests, religion, race and others (Merriam- Webster dictionary, 2015). The condition
of community depends on the status of the composer. Especially on health, our involvement in
Sayangan makes an impact on their lifestyle. That’s monitoring the community is a must.
Family is a group of people affiliated either by , affinity or co-residence some combination
of these. Members of the immediate family may include spouses, parents, brothers, sisters, sons,
and daughters. Members of the extended family may include grandparents, aunts, uncles,
cousins, nephews, nieces, and siblings-in-law. Sometimes these are also considered members of
the immediate family, depending on an individual's specific relationship with them. (Merriam-
Webster dictionary, 2015)

CHAPTER II
General Objectives:
At the end of this emersion, the family will be able show improvement on their lifestyle that
would benefit their health status as a family.
1. After six days of family interaction; the family will be able to understand and apply
the following:
a. Identify the problem and enumerate practices that could promote health condition.
b. Participate and willingness in family health intervention that will be advocated.

CHAPTER III
INITIAL DATE BASE
This chapter contains the information about the family data in different areas. It includes
family structure characteristics and dynamics, the socio-economic and cultural characteristics,
the home environment, the health assessment of the each family member, and the values, habits,
practices on health promotion, maintenance and disease prevention.
This table show the summary of the family data regarding name, age, sex, civil status,
position in the family, occupation and educational attainment.
Name AGE SEX CIVIL POSITON OCCUPATIO EDUCATIONAL
STATUS IN N ATTAINMENT
THE
FAMILY
PA 43 Male Married Father Farmer Elementary level
MA 35 Female Married Mother housewife Elementary level
CI 10 Female Single Eldest Student Grade 5
(on going(
CII 9 Female Single Second child Student Grade 3
(on going)
CIII 7 male Single Third child Student Grade 1
(on going )
CIV 3 Male Single Last child ------------- -------------

The family is a nuclear type of family which primarily composed of a father, mother and
their children. The family resides in Panga, Sayangan, Lubo, Kibungan since 2015. Father pa is
from Tulmod, Sayangan, Lubo, Kibungan and Mother is from Panga where they reside. They
were married in 2005 and have four children. Most of the time mother Ma do the household
matter such us budgeting, household chore, and disciplining their children but even though her
husband still do contribute in disciplinary measure the mother can’t.
B. Socio-Economic and cultural characteristics
In Sayangan most of their main source of income is from gardening. The Segundo
family is no exception, father Pa is a farmer. He said that he have a boss who supply his
demand for seedlings, fertilizers and other things he needs in gardening. We all know the
unstable prizing of vegetable in our place which affects economic stability of the families
and their salary depends on it. Father Pa claims that his salary in monthly basis is 2500-
3000 peso and mother Ma budgets it on the need of the family.
Family Segundo’s house is made of woods and galvanize sheet. They have one
room where in they slept and serve as living room. Outside is a makeshift made of woods
and stick (runno) which serves as their kitchen and dining room. They use wood for
cooking and electricity for lighting.
The source of their water is the spring. They use pail, plastic container and drums
for storage. Their toilet facility is in open pit and blind or close drainage. They burn their
garbage for non-biodegradable and for the biodegradables they put it on the plants
outside and decompose there. They have a pet specifically 3 dogs. Their house is along
the river and garden where in the possibility of breeding sites and area of hazard accident
has a high probability.
History of Past Illness
Both the parents claim that no one from their ancestor died because of illness or
any history of it but instead they pass away because of aging.
Recently mother Ma claims that due to the drastic changes of weather her children
easily get cough and cold specifically the 3rd and last child. They didn’t seek consultation
due to availability of facilities and financial matter. Instead they use medicinal plant
available which is taught to them by the previous students.
Father Pa claims that he doesn’t have past illness aside from body ache and head
ache due to work.
Mother Ma claims that she experienced colds. She claims she get infected with
the colds od her children because of the possibility of sleeping in one room.
E. History of the Present Illness
Father Pa was tired and exhausted due to work when the home visit was conducted.
Mother Ma appears healthy during the visit and was busy fixing the “sayotes”
Child I, II, III was not present during the visit because they still have their classes
in Sapda-an Elementary School. While C IV was busy playing. Appears to be
strong and physically fit appropriate on his age.

F. Family Assessment based on Functional Health Pattern
The member except for father Pa claims not to drink any alcoholic beverages.
Father Pa states that he drinks gin and beer occasionally. He started drinking
when he was 19 years old. He can consume 9-10 shot glass of gin and he recount
3-5 bottles of 4x4 during drinking with his friends.
The family specially, the parents display knowledge and are evident of being
able to recognize the importance of health concerning sanitation and hygiene.
2. Nutritional- metabolic pattern
The parent claims that their children did not take vitamins due to financial
matters. Only those distributed by the health centre at Bobocco and the nurse
learners,
If one of the family members has cough or colds they take herbal medicine
such lagundi and oregano.
There daily meal consists of rice and vegetable which come from their garden.
They rarely eat meat, sea foods and imported fruits due to lack money. The
children seldom eat candies and junk food unless if somebody share and give
them. Mother Ma claims that the children were never choosy about the foods.
3. Elimination pattern
The family members claim to defecate every day usually morning or after
dinner. All of them urinate at an average of 6 times daily. They observed that the
colour of their urine is light yellow.

4. Active-exercise pattern
Mother Ma claims that they don’t have regular exercise and their works
serves as their daily exercise. The C I, II, III walk an hour on there way to school
and back home which serve as their morning and evening exercise. The children
are active and playful. On their vacant time and weekend they go to the garden to
help.
Mother Ma states that the children sleep 8-9 hours. Father Pa sleeps 5-6
due to his work. He has to wake up early and she sleeps 6-7 hours because she has
to prepare foods for her family.
6. Cognitive Perceptual pattern
All of the family members are active and receptive to the question being
ask. They respond oriented to time and place. Though mother Ma was shy, she
was able to respond and answer the question correctly.
7. Self-perception/ self-concept
Father Pa claims that he is very helpful to others and he can handle every
problem the family encounter. On the other hand, mother Ma is very shy and is
difficult to approach. They state their family is very important to them, especially
the health of their children.
The family has strong bonding and open to each other. Though the
children tease each other at the end they just laugh. They approach each other if
they have problem.

9. Sexual/ reproductive Health
Both mother Ma and father Pa are still on their reproductive age. Mother Ma
claims that she goes to the clinic every six months to receive her daily dose of
injectable (Depo-Provera). When they are asked about family planning the four of
their children are enough.
10. Coping stress
The family claims that they are strong and carefully decide on facing those
troubles. They motivate each other and ensure that they will overcome them.
11. Values/belief pattern
The family is from Kibungan and SPI. They claim that they have a strong
faith on God even though they are not attending mass every Sunday. As family
they pray and thank the Almighty for his providence.
12. Values, Habits, Practice on health promotion, maintenance and desire prevention
The four of the children completed their immunization. The parents state the
important of proper diet, hygiene and sanitation. They observe cleanliness and
hand washing especially on handling foods. They claim that when the herbal
cannot treat the illness they find ways to bring the family member to the nearest
health facility.
Chapter IV
Family Background
A. Family History
Segundo family is nuclear type. Father Pa is 43 years old and wasn’t able to finish
elementary. He is a farmer. On the other hand, mother Ma is 35 and like Pa she didn’t
finish elementary. Most of the she is the one left at home to take care of house and the
children. The have four children, CI who is currently 10, CII who is 9, CIII who is 7 and
lastly CIV who is 3.
B. Family Tree
Pa Ma
SEGUNDO SEGUNDO
CI CIII
CII CIV
SEGUNDO SEGUNDO
SEGUNDO SEGUNDO
C. Family Genogram
Male
Female
1974 1974
Well Pa Ma
SEGUNDO SEGUNDO
Sick
CI CII CIV
CIII
SEGUNDO SEGUNDO SEGUNDO
SEGUNDO
2007 2008
2007
2014
CHAPTER V
This chapter contains the assessed problem within the family using appropriate nursing
diagnosis.
U Family Nursing Problem
Subjective data: 1. Cough and Colds as health threats.
- “Gapo Sinan pabali-baliw ay panawen yan
nalaka ay manpanpanateng danan ubing” A. Inability to bring nursing care to the sick
stated by the mother family member due to:
Objective data: a. Financial matter
- Runny nose b. Distance of the nearest health facility.
- One of the children is having cough.
Subjective data: 2. Presence of breeding site and possibility of
- “Wada mampay d kaso di dengue ed dengue bites are health threat:
school da yan inayan nu makat da si lamok,
asin nan danum mi sayat masoksokdo tan A. Inability to make decisions to take
magapo c ubog” stated by the informant appropriate actions due to:
Objective date: a. Failure to comprehend the nature of the
- The house was near to a river where problem.
stagnant water may be possible.
- Water containers are not properly sealed or
covered.
- Children from the school free plays on the

water.
Subjective data: 3. Risk for gastrointestinal diseases such as
- “Insoru iman da din mamanang ya incontinent bowel movement, loose bowel
mamanong yo sindoi d iyat manuwas, asi et movements and such due to improper
doi nu manbisin da uno kagapgapo da nan hygiene.
ayayam yan maling-lingan da ai manuwas”
stated by the mother
Objective data:
- Improper handling of foods.
- Unwashed hands before and after handling
the foods.
- Untrimmed toe and finger nails.
Objective data: 4. Inadequate living space as foreseeable
- Crowded space which is not enough for the crisis
ideal family size. A. Crowding of the members during bedtime.

CHAPTER VI
PRIORITIZATION OF THE NURSING PROBLEM
This chapter present the basis of the prioritization of the Nursing problems.
I. Cough and colds as health deficit
1. Nature of the 3/3x1 1 It’s health deficit that needs immediate
problem attention and management to reduce
likelihood to transfer of the disease to the
other family member.
2. Magnitude of the 2/4x3 1.5 Two of the children previously suffer
problem cough and colds.
3. Modifiability of 2/2x2 4 The problem is highly modifiable.
the problem Appropriate intervention is very available
4. Preventive 2/3x1 0.067 The probable of acquiring the disease
Potential cannot be prevented if the disease is not
yet solve.
5. Salience 1/2x1 0.5 It does not need an immediate attention
because the family was able to accept their
illness and to a health care provider.
Total 7.067
score
II. Presence of breeding site and possibility of dengue bites are health threat:
Criteria Computation Scor Justification
1. Nature of the 2/3x1 0.67 This is a health threat
problem
2. Magnitude of 4/4x3 3 Almost all of the family members
the problem could be affected.
3. Modifiability of 1/2x2 1 The problem is moderately modifiable.
the problem To solve the problem, possible
breeding site around their houses must
be eradicated or secured.
4. Preventive 1/3x1 1 The problem could be highly
Potential prevented. This could be done if the
family will educated on measures to
prevent or minimize the possible
formation of the breeding sites.
5. Salience 1/2x1 0.5 The problem those not require
immediate attention according to the
family.
Total 6.17
score
III. Risk for gastrointestinal diseases such as incontinent bowel movement, loose bowel
movements and such due to improper hygiene.
1. Nature of the 2/3x1 0.67 This is a health threat.
problem
2. Magnitude of 3/4x3 2.25 Almost all the children could be
the problem affected
3. Modifiability of 1/2x2 1 The problem is moderately modifiable
the problem
4. Preventive 2/3x1 0.67 The problem could be highly
Potential prevented. This could be done if the
family will be educated further on
hygiene.
5. Salience 2/3x1 1 The problem needs an immediate
attention because it may harm the
family especially the children.
Total 5.59
score
IV. Inadequate living space as foreseeable crisis
1. Nature of the 2/3x1 0.67 This problem is a foreseeable crisis.
problem
2. Magnitude of 4/4x3 3 Almost all the family member could be
the problem affected.
3. Modifiability of 1/2x2 1 The financial resource of the family is
the problem not sufficient to expand their living
space.
4. Preventive 1/3x1 0.33 Most of the family member are
Potential exposed to the problem since they live
in same house.
5. Salience 1/2x1 0.5 Most of the family members are
exposed to a problem since they live in
same house.
Total 5.5
score
Prioritization of problem
PROBLEMS POINTS
1. Cough and colds 7.067
2. Presence of breeding site and 6.17
possibility of dengue bites
3. Risk for gastrointestinal diseases such 5.59
as incontinent bowel movement, loose
bowel movements and such due to
improper hygiene
4. Inadequate living space as foreseeable 5.5
crisis
CHAPTER VII
= Performed procedure on effective coughing a

Productive cough = Reiterated them to increase intake of vitamin
Due to drastic changes of weather and underlying diseases such as allergies.

Cough and colds
Coughing Sore throat

Fatiguesneezing
Dyspnearunny nose
CHAPTER VII
This chapter presents the family nursing care plan.
HEALTH FAMILY GOAL OBJECTI INTERVENTION PLAN

PROBLEM NURSIN OF VES OF NURSING METHODS RESOURCE
G CARE CARE INTERVENT OF NURSE- S
PROBLE ION FAMILY REQUIRED
MS CONTACT
Cough and Inability After the After Establish - Home - Nurse
colds due to to bring home nursing rapport visits learners’
drastic nursing visit the intervention Assess family - Interview knowledg
change of care to the family members of member and method e on the
weather. sick will be the family family(as - observatio plan of
Subjective: family able to will be able whole) current n care
“Gapo Sinan member comply to condition - Determina
pabali-baliw due to with the demonstrat - Discuss tion, time,
ay panawen financial health e in return the and effort
yan nalaka matter and teaching and causative of the
ay distance regarding enumerate factor and nurse
manpanpana of the managem ways in effects of learner.
teng danan nearest ent of managing cough and
ubing” health cough cough and colds if
stated by the facility. and colds. left
mother colds. unthreade
Objective d.
data: - Demonstr
- Runny ated the
nose procedure
- One of and
the instructed
children the family
is member
having to do so
cough on the ff.:
a. Deep
breathin
g and
coughin
g
exercise
b. Sit up
straight
c. Bronchi
al
tapping.
- Reiterated
the
importanc
e of the
ff.:
a. Intake of
vitamin C
rich food
like citrus
food such
as
oranges,
lemon and
suha.
b. Intake of
water up
to 2-3
liters daily
or as
tolerated.
c. Intake of
regular
diet.
EVALUATION PLAN
After the nursing intervention the family will be able understand and apply it on their daily life.
HEALTH FAMILY GOAL OBJECTIV INTERVENTION
PROBLEM NURSING OF E OF CARE PLAN
PROBLEM CARE NURSING METHODS RESOURCE
S INTERVENTION OF NURSE- S
FAMILY REQUIRED
CONTACT
Presence of Inability to After the After the - Assess the a. Home - Nurse
breeding site make home home visit status of their visits learners’
and possibility decisions to visit the the family environment b. Interview knowled
of dengue take family will be - Discuss and method ge on the
bites are appropriate will be determine to perform the c. observati plan of
health threat actions due cautious clean and following: on care
Subjective to: about observe a. The cause and - Determin
data: a. Failure to their sanitation on effect of dengue ation,
- “Wada compreh environm their that can be time, and
mampay d end the ents environment accumulated on effort of
kaso di nature of status to be more the stagnant the nurse
dengue ed the and be cautious of water: to the learner.
school da problem. more their health. community and
yan observant most probably
inayan nu on the their family.
makat da surroundi b. Ways to
si lamok, ng. eradicate the
asin nan breeding site.
danum mi c. Signs and
sayat symptoms,
masoksok possible home
do tan medication of
magapo c dengue when a
ubog” member is
stated by infected.
the
informant
Objective
data:
- The house
was near
to a river
where
stagnant
water may
be
possible.
EVALUATION PLAN
HEALTH FAMILY GOAL OBJECTIVE INTERVENTION PLAN
PROBLEM NURSING OF OF CARE NURSING METHODS RESOURCES
PROBLEMS CARE INTERVENTION OF NURSE- REQUIRED
FAMILY
CONTACT
Risk for Risk for After the After nursing a. Observe family a. Home a. Nurse
gastrointestina gastrointestin home intervention members visits learners’
l diseases al diseases visit the members of attitude when b. Interview knowled
such as family the family handling foods. method ge on the
Subjective incontinent will be will be able b. Assessed current c. Observati plan of
data: bowel able to to environment and on care
“Insoru iman movement, comply demonstrate home status. b. Determin
da din loose bowel with the in return and c. Discuss ation,
mamanang ya movements health enumerate misconception time, and
mamanong yo and such due teaching ways in about hygiene effort of
sindoi d iyat to improper regarding managing and reminded the nurse
manuwas, asi hygiene. managem gastrointestin them the goal learner.
et doi nu ent of al disease and importance
manbisin da gastroint such as of hygiene.
uno estinal diarrhea. d. Instructed them
kagapgapo da disease on the ff.
nan ayayam such as 1. Hand hygiene
yan maling- diarrhea. before and after
lingan da ai handling food
manuwas” 2. Observe
stated by the sanitation when
mother serving foods.
Objective
data:
a.Improper
handling of
foods.
b.Unwashed
hands before
and after
handling the
foods.
c.Untrimmed
toe and finger
nails.
EVALUATION PLAN
HEALTH FAMILY GOAL OBJECTIVE INTERVENTION PLAN
PROBLEM NURSING OF S OF CARE NURSING METHODS RESOURCES
PROBLEMS CARE INTERVENTION OF NURSE REQUIRED
-FAMILY
CONTACT
Inadequate Crowding of After the After the a. Assessed the 1. Home 1. Nurse
living space the members home nursing environment of visits learners’
as during bedtime. visit the intervention the house such 2. Interview knowled
foreseeable family the family rooms and method ge on the
crisis will be will be able sanitation. 3. Observati plan of
Objective able to to” b. Ask for their on care
data: understan a. Understa opinion and 2. Determin
a. Crowde d the risk nd the understanding ation,
d space of factors regarding time, and
which is crowded that may crowding. effort of
not room. affect c. Discuss the nurse
enough their possible risk of learner.
for the health. crowding such
ideal b. Verbalize as:
family their 1. Transmission of
size. understan illness.
ding 2. The possibility
regarding of poor cycle of
the oxygen in the
matter. room due to
crowding.
EVALUATION PLAN
CHAPTER IX
COMPREHENSIVE FILE OF THE FAMILY HEALTH INTERVENTION
Family is an important part of the community; therefore health worker must put attention
of their health condition whether sick or well. On my intervention with the family I reiterated,
performed and discuss them on health management and procedures. Reiterated the importance of
a hygienic and sanitize home. In this way they may avoid illness. Performed hand hygiene and
reminded the importance of hygiene and the benefit they may have. Importantly discuss them the
danger of dengue outbreak in some municipality of Benguet and the danger it bring.
Management and home medication they may do if illnesses occur such as cough and colds. That
is accessible in their environment. Help them understand the disadvantage of crowding and effect
to their health that may help them in planning for the better. Advice the family on the following:
instead of relying on the vitamins that are given, they may intake fruit that are available in their
place which are vitamin rich. Also to be cautious about the thing they enter their mouth such as
their food and water. They must ensure that the water is boiled to avoid diarrhea and amoebaisis.
To always observe proper hygiene especially in taking care of foods and wounds. That before
and after the must wash their hands. Lastly encourage them freely verbalize their feeling and
understanding on the said matter.

CHAPTER X
Being together and healthy is one thing that makes a family happy. The Segundo family
is living’ simple but they are happy and contented of they have. They are practical about their
life style. Their children at the early age were discipline and taught on simple ways of living.
Having a small amount of salary per month and budgeted by mother Ma for the family need is
not easy. Nut you can see on how see stands her role as a mother and wife. The father as the
main branch of the family, the one who most of the decision comes: you can see how strong he
has been for his family.
On the next visit I recommend that with the health teaching given to them, evaluation
must be done. From the way the health teaching is applied in the household and changes the
status of their living. Also to give more info that will be benefiting the family about taking care
of their health holistically.

CHAPTER XI
REFERENCES
Reyala, Nisce, Martinez, Hizon, Ruzol, Dequina, Alcantara, Bermudez, and Estipona.(2000)
Community Health Nursing Services in the Philippines. Retrieved from
https://www.cebookshop.com at 05/16/2017;9:26 pm
Merriam-Webster Dictionary (2015). http://www.merriam-webster.com. Retrieved in 08-04-
2016; 7:09 pm
Mengistu, D & Misganaw, E (2006). LECTURE NOTES For Nursing Students: Community
Health Nursing Retrieved from
https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/nursing_students/
comm_hlth_nsg_final.pdf
THE ‘KILONGAN’S: A FAMILY CASE STUDY
EBAN, Christine Joy M.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
This study has furnished with the shade of patience guide by knowledge and rooted with
love and wisdom. Developed by hindrances, guided by problems and matured with the
encouragement, assistance and supervision of the people around this study.
First and Foremost, I would like to express my deep sense of thanks and Gratitude to
our Clinical Facilitator, Mr. Jude Tayaben for the guidance, patience and understanding during
the Family Case Study. To my Family for Providing all the support, love and encouragement.
I would also like to Thank each Person who helped me during the survey, to my friends
and teammates for actively participating during the interview. To the Kilongan Family who
gladly welcome us during the home visit, for sharing their life stories, for their generous
cooperation and time.
Above all who showers wisdom divine and assistance and make all things possible, to
the Almighty and God Be the Glory.
CHRISTINE JOY M. EBAN

Chapter I
INTRODUCTION
“The family is the nucleus of civilization.”
-Will Durant
"Family" is defined as a unit/group as a system of the OR operation of individuals, i.e.,
living people, having the recognition of belonging by other constituent member(s). Family
support seeks, for all family system units, from those in a state of well-being to those in a state
of ill-being, to realize wellbeing for the family system unit in all segments of growth and
development. 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 family is the smallest unit of the society and the natural fundamental core of the
community and consequently, it is considered as the primordial recipient of the nursing effort,
which is contributory to the development, and progress of the community through
active involvement and self – responsibilities of each constituent. It is composed of persons,
male and female, being molded to be as one, working hand in hand to maintain a good
atmosphere among the family members.
Community refers to a group of people who interact with each other; it is a social group
determined by geographic boundaries, common values and interest. It functions within a social
structure, exhibits and creates norms, values, and social institution. (Microsoft ® Encarta,2009).
The community is a group of people sharing geographic boundaries and/or values and interests.
(Maglaya, 2004) No two communities are alike. A nurse exposed in the community learns how
to interact and adapt to different kinds of people. The family is considered as the basic unit of
care in the community health nursing. It is in the family where a member develops his health
values, beliefs and practices. The family is a major influence in the health behaviors of an
individual. With this, it is important that families in community are aware of the things and
practices pertaining to their health.
In a community we can find a lot of families and a lot of problems also. Problems like
diseases which are categorized by communicable and non-communicable, so a nurse has to
make an action to prevent the problems they might be encountering. Knowing that not all
people in a certain community are financially capable and educated. Large number of people
has a low level education.
Problems are often unidentified because they lack knowledge about the signs,
symptoms, the nature and treatment of a particular diseases and Community health nursing is
a response to the health needs of the people. It does not focus on a particular class or family. It
iscomprehensive and general in approach. Community health service is notepisodic as it
requires continuous observation and monitoring of the community as a whole promotion and
preservation of the health of its different clients (individual, family, group or community) is the
primary goal of community health nursing
As a student nurse who came here in Sayangan, Lubo, Kibungan Benguet should makes
action to educate people by helping them identify their needs, identify problems in their family
and render their service and give health teachings, preventive measures and enhances the
people’s knowledge about health promotion and disease prevention.
CHAPTER II
This chapter presents the general and specific objectives of this family case study.
Setting objectives provides direction for planning a family nursing intervention. It facilitates
motivation for the client and the nurse by providing a sense of achievement. (Kozier, Erb et. al.,
2004).
General Objectives
At the end of this Nurse Learner-Family Relationship, the adopted family should be able
to improve their health status and become dependent in maintaining their health with
appropriate intervention in a given time frame.
Specific Objective
After a week of home visits and nurse learner-family interaction, the family should be
able to:
a. Established rapport and trust with the nurse learner
b. Give pertinent and factual information during surveys and interviews
c. identify health threats, health deficit, and stress points present in their family
d. enhance their knowledge about health promotion and disease prevention
e. Carry out the planned interventions together with the Nurse Learner and Perform the
health teachings taught by the SN.
f. Evaluate changes in condition after giving Interventions

CHAPTER III
INITIAL DATA BASE
includes the Family Structure, Characteristics and Dynamics, The Socio-Economics and Cultural
Characteristics, the Home and The Environment, the Health Assessment of Each Family
Member, and the Values, Habits Practices on Health Promotion, Maintenance and Disease
Prevention.
A. FAMILY STRUCTURE, CHARACTERISTICS, AND DYNAMICS

Name Age Sex Civil Position in Occupation Educational
(Code (Years) Status the Family Attainment
Name)
Father K 47 Male Married Father(Head) Farmer High School
Graduate
Mother K 47 Female Married Mother Housewife High School
Undergraduate
FK 25 Female Married Eldest Child Housewife High school
Graduate
SK 22 Male Single Second Child Farmer High School
Undergraduate
TK 16 Male Single Third Child Student Grade 14
(ongoing)
FK 11 Male Single Fourth Child ------------ Elementary
level
BK 4 Male Single Grandson ------------ -----------
GK 1 Female Single Granddaughte ------------ ------------

r
Kilongan Family is an Extended Family composing of Father Mother Their Three

children SK, TK, FK and FK’s Son BK.extended family can also be called a complex family,
joint
family, or multi-generational family. This type of family unit has multiple generations and
additional relatives other than just the parents and their children living in the same household
and taking on responsibilities for that household. In most cultures, the "core" of the family is
the nuclear family, the parents and their children, while additional relatives are considered
"extended." The key characteristic of the extended family is that there are multiple adults in the
family that are not parents of the children, though they may also have parent-like roles and
share in the responsibilities for providing for the whole family, either by contributing financially
or in other ways.
The Family resides in Sayangan Proper, Sayangan, Lubo, Kibungan Benguet for Almost
twenty-two years (22). Both Father K and Mother K are native of Kibungan. They got Married
by
the Year 1990 and agreed to start a Family and raised children there. Father K, Being the Head of
the family work in their farm to supply the family’s need. He has been planting chayote,
cabbage and potatoes depending on the season. Mother K is a housewife who take care of the
children and her grandson, she also helps in the farm especially during planting and harvesting
time.
In decision making Mother K and Father K share equal opportunities and rights to raise
opinions and suggestion for the best of the family. And Father K is more dominant in
disciplining the children.
B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

The Family’s main source of income is from farming. They claimed that their monthly
income depends on the price of vegetable they will encounter by chance. However
they claimed to have P1,000.00 monthly income roughly estimated. they budget the money for
special and emergency use only like for food and electric bills and Mother stated that they
don’t usually spend money because they live in rural area where life is simpler.
B. HOME AND ENVIRONMENT
The house and lot where the Family resides is their own property. They have 2
structured house made of GI sheet as walls and roof and woods as flooring and post. The
smaller structure serves as a kitchen and dining area wherein they have inside fireplace where
they cook aside from the LPG which can be reach by their grandson. While The bigger house as
a main house composes of 3 bedrooms and a wide Sala.
At the back of the kitchen is the comfort room /bathroom room which is a water sealed
type. they have faucets and hose connected from the tanks and spring that delivers water
directly to the CR and Kitchen. They also used Drum as a water storage and Tire as a holder of
basin for washing. The surroundings are clean and planted with Flowers and some plants but
the way going down the house was narrow.
The house is near the church and Daycare Center that can be walked for 7
minutes. However, the nearest Health Facility is located to Sitio Bobocco which they claimed to
be one hour walk from the house. Transportation is not a Concern to the Family since they have
their Jeep.
D.HEALTH ASSESSMENT OF THE FAMILY

History of Past Illness
The family recounts of having a history of Hypertension especially at Father K’s Lineage.
Father K claims that her mother was diagnosed with Hypertension. He and His brother have
same illness diagnosed by a physician (for his brother) and midwife for Mr. Kilongan.
Father K lineage:
Father-Mr. T Kilongan
Mr. T. Kilongan passed away year 1975 by undiagnosed ulcer disease.
Father K also admits that his Father was a mild alcohol drinker and tobacco smoker. His Sister,
Dona has a diagnosed ulcer.
Mother-Mrs. M. Kilongan
Currently a 60 years old resident of Sayangan, Lubo with High Blood
Pressure where Father K may acquire HPN. She is Currently taking Metoprolol, an
antihypertensive to as maintenance.
Mother K’s Lineage:
Father-Mr. B Madiano
Passed away at the age of 60, year 1981due to undiagnosed Ulcer
Disease. Mother K claims that their family doesn’t have any serious disease except for her
among her siblings who is also diagnosed with Gastric Ulcer at Benguet General hospital last
2014.
Mother-Mrs. D Madiano
Passed away at age of 65, year 1994 due to suspected liver disease
(undiagnosed by health professionals)
History of Present Illness

The family has no present illness during the past 6 months except for their grandson BK
who have cough and cold during the home visit.
1.Health Perception –Health Management Patterns
The Kilongan Family claimed that they do not drink alcoholic beverages except for the
father who drink gin, beer and wine occasionally with estimate of not more than one-fourth of
the bottle and 1-2 small cups of rice wine. Father K began to drink alcoholic beverages when he
was 19 years old.
The family specially, the parents display knowledge evident of being able to recognize
the importance of having a healthy well-being.
2.Nutrional –Metabolic Pattern

The family take herbal products in treating illnesses such as boiling the guava leaves for
wound. But due to lack of resources, they don’t have every plant to cure other diseases. They
too claim to take paracetamol for headache and body pain.
Daily Food intake composed of rice, vegetables and sometimes one kind in a three-day
meal straight, while meat, egg, fish and canned goods are being consumed occasionally. The
Chaldeans ate what is being served and they never had problem with feeding. They drink water
from spring as their water source and sometimes boil it but they prefer fresh from the water
spring. There was no problem encountered regarding their drinking water.
3.Elimination Pattern
The Family claims to defecate and urinate any time of the day. Mother K said that they
seldom suffer with problems related defecation like constipation and diarrhea. The family has a
range of 4-6 times of urination in a day.
4.Activity –Exercise Pattern

The family does not regularly exercise but claims that their work specially Father K and
SK being a Farmer serves as their exercise and other member of the Family make daily
household chores as their exercise.
5.Sleep-Rest Pattern
The family usually have 7-8 hours of uninterrupted sleep, while Mother K at 6-7 hours of
sleep because she need to wake up early to prepare breakfast and do some errands and Father
K claims that she naps for at least one hour after lunch before going back to farm.
6.Cognitive –Perceptual Pattern

During the interview the family members are oriented to time, Place and are able to
respond appropriately with the questions except for the last child(FK) who is shy and remain
silent during the interview. He Diagnosed with ADHD, he can understand simple word and
perform instruction. Verbal Patterns of Communication with the Family are noted to be
spontaneous.
7.Self Perception/Self Concept

Mother K claims that the family stay positive and strong in every troubles and family
situation they face, they talk and stay together to make decision. When problem arises, they
talk to each other and give advices. The Family are also adaptive and flexible to stressful
situation.
8.Roles and Relationship

The Kilongan Family observes open communication, the children, except for the
youngest son. They express their concerns and feelings to their parents openly. In like manner
the couple also displays openness to the concern of their children and one another.
9.Sexual and Reproductive Health

Both Parent are now not in Reproductive Age and Claimed that they don’t use any
Family Planning Method since then because they are afraid of its side effects.
10.Coping Stress
The Family claims to get strength and motivation from each other during stressful times
by consulting, supporting and comforting one another. Likewise, they lift it to God through
Prayers.
11.Values and Belief Pattern

The Family is from Kibungan and Member of Emmanuel Reaching Out Ministry Inc., Born
Again Church. The family claimed that they attend mass almost every Sunday and Stated that
they always look up and lift everything to God.
12.Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

The children in the family have completed their immunization. Mother K always make
sure that proper food handling is observed, she usually prepares nutritious foods fresh from the
garden and avoid the use of seasoning to maintain the natural taste, also to avoid diseases
caused by this.
During illness, they go to the health center at Sitio Bobocco or at Kapangan Hospital
because it is said to near. But sometimes they do home treatment.
CHAPTER IV
FAMILY BACKGROUND
A. Family History
Kilongan Family is an extended family composing of Father K, Mother K, their three
children second child(SK), Third Child(TK), Fourth Child(FK) including their four-year-old
grandson (BK). Mother K is an undergraduate of High School while Father K is a High school
Graduate. The eldest daughter also a high school graduate is currently not living with the
Kilongan Family but her First born BK stays with Mother K and Father K as she took care of her
ten-month old baby and her husband at Balili, La Trinidad Benguet.
Father K is now working as a farmer in their own farm, helped by his Second Child (SK)
and during School breaks TK who is studying at Balacbac Kapangan Benguet, ongoing Grade
14 also helped at the farm. The Youngest who was diagnosed with ADHD stays at home and
Sometimes lives with his Grandparents in Nagawa, Sayangan. He was previously enrolled in a
Special Learning Center(SPED) but Mother K and Father K decided to bring him home since
they claimed that there is no improvement/progress.
Mr. and Mrs. Kilongan’s grandson stays at home with his Grandmother who took care of
him and often plays with the youngest Child.
B. Family Tree
MOTHER K FATHER K
FK SK TK FK
FK’s Husband BK GK
C. Family Genogram
MOTHER FATHER
LOLA LOLO LOLO LOLA
*ulcer * liver disease * ulcer *HPN
MOTHER K DONA FATHER K
BRO
*Gastric Ulcer *ulcer *HPN
*HPN
FK *ADHD
FK SK TK
CHAPTER V
This chapter contained the assessed problems within the family utilizing appropriate
Nursing diagnosis.
Cues or data Family Nursing Problem
Subjective Data I. Cough and Cold as Health Deficit
- “Ny panag-uuyek n, man uyuyek et nan apok
di July 22 pylang” A. Inability to prevent disease due to
a. lack of knowledge related to disease
Objective Data transmission.
-The grandson is having cough and nasal
congestion B. Ineffective airway clearance evidenced by
-not covering mouth when sneezing or coughing increase in rate and changes in rate and depth of
respiration and cough
Subjective Data II. Presence of Possible Breeding site of insects,
- “man ururnong kami si danum san tanke ya rodent and vectors as a health threat
drum”
A. Inability to recognize the presence of the
Objective Data threat due to lack of knowledge
-Moldy drums
-Drums were not properly Covered B. Inability to make decision to take appropriate
-tire with water accumulates is present action due to:
a. failure to comprehend the nature of the
problem
Subjective data III. Poor hygiene as a health threat
- “mahilig I man ayayam csa ruar, kumpormi
ig-igenan na Sunga malem ko n I ug-ugasan “ A. Inability to provide home environment
conductive to health and maintenance due to
Objective Data improper hygiene technique
-Dirty hand, feet and soiled clothes
-unclipped Fingernails
Subjective Data IV. Unsanitary Waste Disposal as a Health
- “Pupu-uran mi wenno kaibasu-basura kami Threat
csa iged san basura”
A. Inability to decide about taking appropriate
Objective Data action due to:
-Improper waste disposal a. Failure to comprehend the nature and
-unsegregated waste products scope of the Problem
Objective Data V. accident Hazard as Health threat
-inside fireplace is easily reached by children -
Stairway without fences A. inability to provide a home environment
-sloppy and slippery way going to their house conductive to safety due to:
a. Failure to comprehend the nature and
scope of the problem
CHAPTER VI
PRIORITIZATION OF THE NURSING PROBLEM
This section contains the basis of the prioritization of the nursing Problem
I. Cough and Colds as a Health Deficit
Nature of the 3/3x1 1 This is a Health Deficit
problem
Magnitude of the 1/4x3 .75 The family only see this as a minor
Problem Concern
Modifiability of the 2/3x4 2.67 The problem is partially
Problem modifiable .Health teachings are needed
to reduce factors causing sickness
Preventive potential 3/3x1 1 The problem is highly preventable due
to modifiable hygiene habits.
Salience 1/2x1 0.5 The problem doesn’t require immediate
attention according to the family
Total score 5.93
II. Presence of possible Breeding sites of Insects, rodent and Vector as Health Threat
Nature of the 2/3x1 0.67 This is a health threat
problem
Magnitude of the 4/4x3 3 Almost all of the family member could
Problem be affected
Modifiability of the 2/3x4 2.67 The problem is moderately modifiable.
Problem To solve the problem, possible breeding
sites should be removed.
Preventive potential 3/3x1 1 The problem could be highly prevented
by health teaching on how to prevent the
possible formation of breeding sites of
insects…
Salience 1/2x1 0.5 The problem does not require immediate
attention according to the family
Total score 7.84
III. Poor Hygiene as Health Threat

Nature of the 2/3x1 1 This is a health threat
problem
Magnitude of the 3/4x3 2.25 Two family members are observed to
Problem have poor hygiene
Modifiability of the 3/3x4 4 The problem is highly modifiable.
Problem Appropriate Intervention like
handwashing and good hygiene are
available to manage the problems
Preventive potential 3/3x1 1 The problems can be totally prevented
through assistance and understanding
the importance of hygiene
Salience 2/2x1 1 The problem is seen as serious needing
urgent attention since it deals with the
health of young Family Members.
Total score 9.25
IV. Unsanitary Waste Disposal as A Health threat

Nature of the 2/3x1 0.67 This is a health threat
problem
Magnitude of the 3/4x3 2.25 This problem may attract pest which
Problem may cause another problem
Modifiability of the 3/3x4 4 This is highly modifiable .Appropriate
Problem interventions are very available to
manage the problem related to waste
management
Preventive potential 3/3x1 1 It is highly preventable by the
implementation on preventive measure
which are easy to perform
Salience 1/2x1 0.5 The problem does not require immediate
attention.
Total score 8.42
V. Accident Hazard as a Health Threat

Nature of the 3/3x1 1 This is a health threat
problem
Magnitude of the 1/4x3 0.75 It affects entire households safety
Problem
Modifiability of the 2/3x4 2.67 The problem is moderately modifiable
Problem
Preventive potential 3/3x1 1 The problem can be prevented by the
effort of the family to ensure safety of
each member
Salience 1/2x1 0.5 The family recognized it as a problem
but it does not require immediate
attention
Total score 5.92
PROBLEMS SCORES
1. Poor Hygiene as Health Threat 9.25
2. Unsanitary Waste Disposal as A Health threat 8.42
3. Presence of possible Breeding sites of Insects, rodent and Vector as 7.84
Health Threat
4. Cough and Colds as a Health Deficit 5.93
5. Accident Hazard as a Health Threat 5.92
CHAPTER VII
Cough and Colds
CHAPTER VIII
HEALTH FAMILY GOAL OF OBJECTIV INTERVENTIO METHO RESOURCE

PROBLE NURSING CARE ES OF NS D OF S
M PROBLEM CARE NURSE REQUIRED
FAMIL
Y
CONTA
CT
Inability to Within the 1.Identify 1.Assessed the Home 1.Time and
practice nursing the health family’s degree of visit efforts of the
proper intervention, problems awareness related nurse learner
POOR hygienic the family that may to the topic and family
HYGIEN care due to will be able possibly
E AS lack of to identify cause by
HEALTH resources and apply spread of 2.Educate and 2.Visual
DEFICIT for infection encourage the Aids
maintainin hygienic family regarding
g measures the proper
cleanliness, 2.introduce personal Hygiene
lack of proper
proper hygienic
practice in measures 3.Discuss the
terms on importance of
hygienic hygiene
care, and 3.Identify
failure to ways on
see benefits maintaining 4.Discuss about
with proper the consequences
regards on hygiene of most common
having diseases that may
proper acquire.
hygiene 4.Enumerate
within the
himself. importance
of Hygiene
HEALTH FAMILY GOAL OF OBJECTIVE INTERVEN- METHOD RESOURCES

PROBLEM NURSING CARE OF CARE OF
PROBLEM TIONS NURSE REQUIRED
FAMILY
CONTACT
1.Inability t After the 1.identify 1.Assess the Home 1.Assessment

Unsanitary o Nursing the different family’s visits
Waste Interventi ways on perceptions
Recognize 2.Discussion
Disposal as on the proper with regards to
presence the problems
A Health Family disposal of
threat of imprope will be garbage identified
3.Time &
r garbage able to Effort by the
2.Assess the sur
disposal apply rounding and student nurse
due to proper 2.define the the house of the and the
inadequate waste meaning of family family
knowledge manageme proper member
nt garbage 3.Provide the
disposal and family
2.Inability its information
to advantages; about the proper
ways on waste
make disposal such as
decisions 3.recognize segregation
with the possible 4.Explore

respect to effects of with the family
taking garbage the advantages
appropriate burning; and
health disadvantages
action due of the different
to low 4.understan methods
ding about of waste
salience of
the disposal
the
problem/co importance
5.Emphasize th
ndition of practicing
e importance of
proper practicing
waste proper garbage
disposal disposal with
the family
HEALTH FAMILY GOAL OF OBJECTIVES INTERVENTIONS METHOD RESOURCES

PROBLEM NURSING CARE OF CARE OF REQUIRED
PROBLEM NURSE
FAMILY
CONTACT
inability Within the After the 1.Assess the Home 1.Assessment

to provide nursing Nursing family’s Visit
a home intervention Intervention perceptions with
Presence environme s the family the Family regards to the 2.Discussion
of nt will be able will be able problem
possible conducive to identify to:
Breeding to health breeding 2.Discuss the
importance and 3.Time &
sites of maintenanc sites. Effort by the
Insects, e 1.able to of proper
sanitation student nurse
rodent and person eliminate
and the
and al the presence 3.Cite the cause family
Vector as developme of the and effect of member
Health nt due to: breeding these pest around
Threat sites home
2.Recognize 4.Help the
1.Ignoranc
the essence family clean the
e of the
of breeding surroundings
importance
site such as
of hygiene 5.Instruct Family
to prevent
and to prevent
the
sanitation accumulation of
occurrence
of disease stagnant water
2. Lack 3.Be
of knowled knowledgea
ge ble in ways
of regardin on how to
g preventiv lessen or
e measures eradicate
breeding
places
HEALTH FAMILY GOAL OF OBJECTIVE INTERVENTION METHOD RESOURCES

PROBLE NURSING CARE S OF CARE S OF REQUIRED
M PROBLEM NURSE
FAMILY
CONTACT
After nursing 1.Discuss with the Home Visit 1.Assessment

intervention, family the causes,
Inability to after the
the family effects and
make nursing
Cough and will: complications of 2.Discussion
decisions intervention
Colds as a cough and cold.
with respect the family
Health
Deficit to taking will be able
appropriate to eliminate
1.acquire 2.Provide 3.Time &
health the cough
adequate adequate Effort by the
actions due and cold and
information knowledge on the student nurse
to: will prevent
about the various ways and the family
the
disease, of maintaining member
recurrence of
including cleanliness in
a. lows the disease in
signs and their surroundings.
salience the future
symptoms of
of the proble
the
m/condition
disease, 3.Explain the
b. immediate importance
Lackof/inad health care of proper food
equate assistance preparation, good
knowledge/i and nutrition, rest and
nsight to preventive sleep in
alternative measures; strengthening
courses of one’s resistance
action open against illness, so
to them 2.be aware as to prevent
on how to occurrence of
reduce the cough and colds
chances of
spreading
communicabl 4.Cite ways in
e diseases to eliminating the
their family disease and
members; limiting the
occurrence
transmission by
3.utilize suggesting courses
community of action such as
resources medications
openly
available in
resolving 5.Promote proper
personal and
environmental
hygiene among all
members of the
family.
6.Provide
information on
health centers in
the vicinity
for immediate care
assistance.
HEALTH FAMILY GOAL OF OBJECTIVES INTERVENTIONS METHOD RESOURCES

PROBLEM NURSING CARE OF CARE OF REQUIRED
PROBLEM NURSE
FAMILY
CONTACT
Inability to Within 4 Within 4 1. Assess the Home 1.Assessment

Accident make hours of hours of family’s Visit
Hazards decisions nursing nursing perceptions with
with interventio intervention regards to the 2.Discussion
as a
Health respect to ns, the s, the family problems
taking family will will be able
Threat appropriate be able to to: identified 3.Time &
health identify the Effort by the
1.recognize
action due risk factors student nurse
the possible 2. Discuss with
to: on the and the family
risk factors the family the
actual member
A. Failure with regards possible risk
condition
to to the factors that will
and make
comprehen condition result with the
plans to
d the identified; occurrence of the
modify the
nature/mag problem
deep well
nitude of
and to
the 2.enumerate
prevent any
problem/co various 3.Emphasize to
accidents
ndition ways on the family the
maintaining importance of
safety solving the
B. Low problem and on
salience of maintaining an
the 3.select a environment
problem course of which is safety at
and action to home
condition correct and
solve the
problem 4.Provide suggest
ions about solving
the problem and
preventive
measures on
accident hazards
CHAPTER IX
GOAL OF CARE: Within the nursing intervention, the family will be able to identify and
apply hygienic measures
OBJECTIVE OF CARE:
1.Identify the health problems that may possibly cause by spread of infection
2.introduce proper hygienic measures
3.Identify ways on maintaining proper hygiene
4.Enumerate the importance of Hygiene
PROBLEMS INTERVENTIONS RESOURCES

Poor Hygiene as  Assessed the family’s degree of  Time and efforts of
health threat awareness related to the topic the nurse learner and
 Educate and encourage the family family
regarding the proper personal  Visual aids
Hygiene  Health teachings
 Discuss the importance of hygiene
 Discuss about the consequences of
most common diseases that may
acquire.
EVALUATION OF THE INTERVENTION: After the Nursing Intervention the Family will
be able to improve their physical appearance and personal hygiene
GOAL OF CARE: After the Nursing Intervention the Family will be able to apply proper waste
management
OBJECTIVE OF CARE:
1.identify the different ways on proper disposal of garbage such
2.enumerate the proper techniques on keeping the surroundings clean and through using proper
method of waste disposal;
3.define the meaning of proper garbage disposal and its advantages;
4.recognize the possible effects of garbage burning;
5.understanding about the importance of practicing proper waste disposal

Unsanitary  Assess the family’s perceptions with  Home Visits
Waste regards to the problems identified  Assessment
Disposal as A  Assess the surrounding and the house of  Discussion
Health threat the family  Time & Effort by
 Provide the family information about the the student nurse
proper ways on waste disposal such as and the family
segregation member
 Explore with the family the advantages and
disadvantages of the different methods
of waste disposal
 Emphasize the importance of practicing
proper garbage disposal with the family
EVALUATION OF THE INTERVENTION:After 2 home visits conducted with nursing
interventions, the family WILL be able to understand the importance of practicing the proper
method of waste disposal
GOAL OF CARE: Within the nursing interventions the family will be able to identify
breeding sites.
OBJECTIVES OF CARE: After the Nursing Intervention the Family will be able to:
1.able to eliminate the presence of the breeding sites
2.Recognize the essence of breeding site such as to prevent the occurrence of disease
3.Be knowledgeable in ways on how to lessen or eradicate breeding places
4.exhibit the desire to change the current practice that allows the insects multiply
Presence of  Assess the family’s perceptions with  Home Visits
possible regards to the problems identified  Assessment
Breeding sites  Discuss the importance and purpose of  Discussion
of Insects, proper sanitation  Time & Effort by
rodent and  Cite the cause and effect of these pest the student nurse
Vector as around home and the family
Health Threat  Help the family clean the surroundings member
 Instruct all Family members to prevent
accumulation of stagnant water around
the house
EVALUATION OF INTERVENTION: After the nursing intervention the family will be able
to eradicate the possible breeding sites of insects, rodent and vector and remain a home
environment conductive to health.
GOAL OF CARE: after the nursing intervention the family will be able to eliminate the cough
and cold and will prevent the recurrence of the disease in the future
OBJECTIVES OF CARE:After nursing intervention the family will:
1.acquire adequate information about the disease, including signs and symptoms of the
disease, immediate health care assistance and preventive measures;
2.be aware on how to reduce the chances of spreading communicable diseases to their
family members;
3.utilize community resources openly available in resolving the condition experienced
Cough and  Discuss with the family the causes, effects  Home Visits
Colds as a and complications of cough and cold.  Assessment
Health Deficit  Provide adequate knowledge on the  Discussion
various ways of maintaining cleanliness  Time & Effort by
in their surroundings. the student nurse
 Explain the importance of proper food and the family
preparation, good nutrition, rest and sleep member
in strengthening one’s resistance against
illness, so as to prevent occurrence of
cough and colds
 Cite ways in eliminating the disease and
limiting the occurrence transmission by
suggesting courses of action such as
medications
 Promote proper personal and
environmental hygiene among all
members of the family.
 Provide information on health centers in
the vicinity for immediate care assistance
EVALUATION OF INTERVENTION: The family WILL be able to overcome cough and

colds
GOAL OF CARE:Within 4 hours of nursing interventions, the family will be able to identify the
risk factors on the actual condition and make plans to modify the deep well and to prevent any
accidents
OBJECTIVES OF CARE: Within 4 hours of nursing interventions, the family will be able to:
1.recognize the possible risk factors with regards to the condition identified;
2.enumerate various ways on maintaining safety and to prevent accidents
3.select a course of action to correct and solve the problem 4.make plans to
choose appropriate ways to prevent any occurrence of injuries;
5.identify the positive outcomes upon planning the solution to the problem
Accident  Assess the family’s  Home Visits
Hazards as a perceptions with regards to  Assessment
Health Threat the problems identified  Discussion
 Discuss with the family the  Time & Effort by the student
possible risk factors that will nurse and the family members
result with the occurrence of
the problem
 Emphasize to the family the
importance of solving the
problem and on maintaining
an environment which is
safety at home
 Provide suggestions about
solving the problem and
preventive measures on
accident hazards
EVALUATION OF INTERVENTION: The family will remain safe
CHAPTER X
CONCLUSION
This community Immersion help us to be with people, with families and with the
community. Community people are simple and contented in their own life yet they lack
knowledge about their health.
The Kilongan Family is one of the families here in Sayangan, they identified One health
deficit which is cough and colds and four health threats the, Poor Hygiene, accident hazard.
Unsanitary waste disposal and Presence of possible Breeding sites of Insects, rodent and
Vector. With this problems Family Nursing care plans and Family Health Interventions were
formulated by the nurse learner and the family to address the identified problem and hopefully
the goals and objective will be meet for the next immersion though the family was participative
and cooperative with the plans given.
RECOMMENDATION
Further study is needed to be able to conduct proper way of dealing with the families.
Since we’ve been able to identify and prioritized problems and needs of the family we should
give the families commendations like:
 The family should be able to verbalize understanding related to health teaching shared
by the nurse learners.
 The family should facilitate the eradication of identified breeding sites of insects, rodent
and vectors
 The family should be encouraged to apply proper waste disposal
 The family should make effort to make the surrounding and self-clean
 The family should be recognizing the environmental hazards
 The family should know something about their health
CHAPTER XI
REFERENCES
"New Family Health Care Nursing: Theory, Practice and Research," 2010. Retrieved from
http://www.familynursing.org/
Sample Family Care Study (N107).Retrieved from
https://www.scribd.com/doc/86639440/Sample-Family-Care-Study-N107
Lovetoknow.2010-2016.Retrieved from
http://family.lovetoknow.com/about-family-values/definition-extended-families
Infectious Disease Section of Microbiology and Immunology On-line. February 17,
2015,Retrievedfromhttp://www.microbiologybook.org/Infectious%20Disease/Upper
%20respiratory%20tract.htm
https://www.google.com.ph/search?
q=COMPREHENSIVE+FILE+OF+THE+FAMILY+HEALTH+INTERVENTIONS&espv=2&b
iw=1366
https://www.scribd.com/doc/6004412/Family-Nursing-Care-Plan
THE MINES: A FAMILY CASE STUDY

EDECO, Jazelyn P.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
I would like to acknowledge God, for giving me the breath of life and for His eternal
love. Thank you for all the blessings, for the assurance that I am safe every day. For
strengthening me: that I can do all things and make all things possible.
To our Clinical Facilitator, Mr. Jude L. Tayaben who were always there to help and support
in every activity. I am grateful for the patience, understanding our differences in the group. For
the guidance that you gave.
I also owe special gratitude to Mr. and Mrs. Mines for accommodating, welcoming and for
trusting to share basic and personal information that made the case study.
I would also like to extend my special regards o my parents and guardians for their undying
love, guidance, support.
Finally, I wish to extend my thankfulness to my classmates especially our group in Sayangan

for the experiences and friendship, for the team work in all activities and working all together.
JAZELYN P. EDECO
CHAPTER I
INTRODUCTION
Community health nursing is the synthesis of nursing andpublic health practice applied to
promote and protect the health of population. It combines all the basic elements of professional,
clinical nursing with public health and communitypractice.Community health nursing is essential
to increases the health status of individuals, families, groups and the community through.
A community is a group of people in defined geographical area with common goal and
objective and the potential for interacting with one another (Dryer’s den). A nurse exposed in the
community learns how to interact and adapt to the people of the community. Family is
considered the basic unit of care in the community health nursing. It is where the family
develops their health values, beliefs and practices. The family is the major influence in the health
behaviors of an individual. So, it is necessary that the families in a community be aware of the
practices relating to their health.
Conducting a family case study is a means by which n a nurse learner reaches and feels the
responsibilities to keep a dynamic balance with the ever changing needs of the health of the
community, through its basic structure, the family. Through this, health related problems are
identified, thus giving the nurse learner a hint on how to act and how to intervene. To come up
with a family case study, it gives a sense of fulfillment to the nurse learner as they given the
opportunity to share their wisdom and skills to uplift the living condition of a family.
The family that was chosen by the nurse learner is a picture of the majority of the family
here in the community. A family living in a poor environmental condition, without enough
resources and lack of knowledge on health information. Through tiring as it is, reaching out to
this family and mingling with them makes the nurse learners feel the fulfillment.
CHAPTER II

This chapter presents the general and specific objectives of this family case study. Setting
objectives provides direction for planning a family nursing intervention. It facilitates motivation
for the client and the nurse by providing a sense of achievement, (Kozier and erb, 2004).
General Objectives:
At the end of the nurse learner-family relationship, the family should be able to display
expected means to improve their health status and become self-reliant in maintaining their health
through appropriate interventions in a given time frame.
After a week of homes visits and with the nurse learner and family interaction, each of the
family members should be able to:
a) Give pertinent and factual information during surveys and interviews.
b) Participate actively during home visits and assessment interviews.
c) Generates interventions considering the nurse learners’ capabilities, community and the
family’s resources.
d) Carry out planned interventions together with the nurse learner.
e) Perform the health teachings taught by the nurse learner.
CHAPTER III
INITIAL DATA BASE

The Initial Data base includes the information about the family in various dimensions. It
includes the family structure, Characteristics and Dynamics, the Socio-Economic and Cultural
Characteristics. The home and Environment, the Health Assessment of each family member, and
the values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.
A. Family Structure, Characteristics, and Dynamics.
This is summarized in a tabular format. It also contains further discussion on the other
characteristics of a family like decision making and others.
NAME AGE SEX CIVIL POSITION OCCUPATIO EDUCATIONA

(code (years) STATU IN THE N L
name) S FAMILY ATTAINMENT
Alpha 58 Male Married Father Farmer Elem. Graduate
Beta 55 Female Married Mother Farmer Elem. Graduate
The Mines family is a nuclear type of family. They reside in Salipang, Sayangan,Lubo,
Kibungan, Benguet for 21 years. Mr. Alpha is the one who decides for the family.
Mines family main source of income are from their earnings as a farmer. Mr.
Alpha and Mrs. Beta are both industrious to work. Their earnings depend on to the crops
they are selling. Mines family budgets their money to buy foods, necessary things needed
in their house and electrical bills. No water bills and no house rent payment.
Mines family owned the house. It was made of wood and galvanized iron and
cemented floor. They have one bed with two windows and their dirty kitchen is outside.
They use fire woods in cooking most of the time and LPG sometimes.
Outside their house, they do not have toilet, an open pit instead.
The family recounts having a history of hypertension specifically on the lineage of Mr. and
Mrs. Mines. Due to their ages they cannot recall other illnesses of their family. Their siblings
also had a history of hypertension.
Both Mrs. Mines were diagnosed of hypertension and diabetes by a physician in Bengeut
General Hopital.
Family Assessment based on Functional Health Pattern
1. Health Perception- health management patterns
Mr. and Mrs. Mines were somewhat knowledgeable about their health.
When one is having muscle pain, they both just rest and have enough sleep as
claimed by Mrs. Mines.
Daily food intake consists of rice, vegetables, root crops and meat. Most of the
time, their food intake are more on vegetables.
Mr. and Mrs. Mines do not exercise regularly but claims their work serves as their
exercise.
5. Sleep- rest pattern
Mr. and Mrs. Mines were oriented to time, place and are able to respond
appropriately with questions when asked. Verbal patterns communications are
noted to be spontaneous.
7. Self-Perception or Self Concept
8. Roles and Relationship
Mr. Mines is more dominant in the house; he decides what to be done most of the
time. During the home visit, they are very hospitable.
9. Sexual or Reproductive Health
Mr. and Mrs. Mines were not sexually active anymore, because of their old age.
10. Coping Stress
11. Values or Beliefs Pattern

12. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
CHAPTER IV
FAMILY BACKGROUND
A. Family History
According to Mr. and Mrs. Mines both their parents have hypertension, but they
are not sure because they were not diagnosed.

CHAPTER V
Cues or data Family Nursing Problem

Subjective Data: I. Hypertension as a health deficit
- “ nangatopyjyBPk” as verbalized by A. Client does not take maintenance
Mrs. Mines medications due to:
Objective Data: a. Inadequate knowledge on
- BP ranging from 140/100 mmHg to preventive measures
150/ 110 mmHg b. Inability to visit RHU/Clinic for
regular check-up
Objective Data: II. Presence of breeding sites of
- “nu malem ket ada dagiyay da babasit insects, rodents and vectors as
ngai nga lamok.” As verbalized by Mr. health threat
Mines A. Inability to make decisions with respect
to taking appropriate health actions due
to:
a.) Low salience of the problem or
condition.
b.) Lack of knowledge regarding the
problem.
CHAPTER VI
I. Hypertension as a health deficit

1. Nature of the 3/3x1 1 This problem is a
Problem health deficit.
2. Magnitude of 3/3x2 2 Both of them are
the problem affected.
3. Modifiability of 2/2x2 2 The problem is
the problem partially
modifiable if the
family will seek
medical
assistance.
4. Preventive 2/3x1 0.67 The problem is
Potential moderately
preventable.
5. Salience 2/2x1 1 The problem
requires
immediate
attention.
Total score 6.67
II. Presence of breeding sites of insects, rodents and vectors as a health threat

1. Nature of the 2/3x1 0.67 This problem is a
Problem health threat.
2. Magnitude of the 3/3x2 2 Both of them are
problem affected.
3. Modifiability of the 2/2x2 2 The problem is
problem easily modifiable
if the family will
maintain an
environment
conducive to good
health.
4. Preventive Potential 2/3x1 0.67 The problem is
moderately
preventable.
5. Salience 2/2x1 1 The problem
requires
immediate
attention.
Total score 6.34
PROBLEMS SCORES
1.Hypertension as health threat 6.67
2.Presence of breeding sites of insects, rodents and vectors 6.34
CHAPTER VII
Hypertension
FAMILY NURSING CARE PLANS
CHAPTER IX
GOAL OF CARE: After effective nursing interventions, the patient will be able to remind
him/herself in taking of her medication and also the importance of having regular check-up. The
client will be able to impart her knowledge to his/her family members the things that will be
discussed regarding preventive measures by health care provider.
OBJECTIVES OF CARE: After effective nursing interventions, the client will be able to:
a.) Educate his/her family about the importance of regular check-up.
b.) Explain the importance of proper diet or food intake.
c.) Enumerate the diseases that might develop if hypertension is not prevented earlier.
d.) Educate client on the Do’s and Dont’s of hypertension.
HYPERTENSION as a Health Establishing rapport (Good eye-to-eye BP apparatus
Deficit contact)
Home visit
Health teachings regarding hypertension.
Re-iterate other people who are smokers

and as well as alcohol drinkers to at least
limit consumption of liquors or to stop it
together with smoking.
Encourage them to consider lifestyle

modification for their benefits.
Teach them on how to take blood pressure

on their own.
Educate them the proper way of taking

good care of their health and food intake
EVALUATIONS OF INTERVENTIONS: Goal met after effective nursing interventions, the

client was able to:
a.) Educate her family on measures about the importance of regular check-up
b.) Explain importance of proper diet or food intake.
c.) Enumerate the diseases that might develop if hypertension is not prevented earlier and
Do’s and Don’t’s of hypertension
REFERENCES: Family Nursing Care Plan
GOAL OF CARE: After nursing intervention the family will be able to eradicate the presence of
these unwanted sites of vectors causing diseases and therefore will maintain a home environment
conducive to health.
OBJECTIVES OF CARE:After nursing intervention the family will:

a.) Be aware and be more knowledgeable about the importance of proper sanitation
especially at home;
b.) Be able to eliminate the presence of these breeding sites of vectors
Recognize the causes of breeding sites such as to prevent the occurrence of diseases.

Presence of breeding sites of -Discuss the importance and purposes of Time and effort
insects, rodents, and vectors as proper sanitation. on the part of the
a health threat -Cite the causes and effects of the nurse learner and
prevalence of these unwanted pests around family
the home.
-Suggest alternatives or methods that
would eliminate the breeding sites of
vectors
-Explore with the family the ways of
improving home sanitation considering its
limited resources.
-Emphasize to the family the proper
storage of food that may attract vectors.
-Instruct all family members to prevent
accumulation of stagnant water around
their home since this is a good breeding
place for insects.
EVALUATIONS OF INTERVENTIONS: Goal met after effective nursing interventions, the

client was able to:
a.) Eliminate the presence of breeding sites.
b.) Eradicate the presence of unwanted vectors.
c.) Understand the importance of having a home environment conducive to health.
d.) Enumerate the diseases that might develop if the vectors are not eradicated earlier.
REFERENCES: Family Nursing Care Plan

CHAPTER X
CONCLUSIONS
After a two day home visits and with the nurse learner and client interaction, Mr. and
Mrs. Mines can provide resources of their needs because they help one another and they are very
industrious in working. They need more information dissemination for her to be able to: give
pertinent and factual information during surveys and interviews; participate actively during home
visit and assessment interviews; generates interventions considering the nurse learners’
capabilities, community and the family’s resources; carry out planned interventions together with
the nurse learner; and perform the health teachings taught by the nurse learner.
RECOMMENDATIONS
Community health nursing has been a part of every nurse learner’s life. It is a nurse’s
duty to provide immediate health care to the community people’s health problems. Promotion
and preservation of healthy lifestyle and disease prevention through proper health teachings,
appropriate application of health actions, community activities are some ways to build a stepping
stone for the certain aims of community health nursing. I would like to recommend:
To the Barangay Health Officials and Workers

To continue helping and providing proper health care services, and give more effort in
portraying being a role models to the people of the community. They should be updated with the
latest studies and researches for the betterment of the quality of health services.
To Mr. and Mrs. Mines
They should engage in certain different programs that can serve as a basis in handling health
matters at home in order for them to gain more knowledge regarding health. They should be
more open to the suggestions of health teachings for them to practice regularly at home for them
to manage good health conditions.
To the Nurse Learners
Community Health Nursing strengthens the meaning of being a Nurse learner. It allows
certain opportunities to handle real situations in the community and allows them to deal and
interact with the people of community. The nurse learners should put more effort in reading to
acquire more knowledge and to update themselves about health trends in order for them to
properly provide a quality of care. They should always ask for God’s guidance, because
hardships and obstacles are nothing if they are working with Him
CHAPTER XI
REFERENCES
1. Daniel Mengistu&EqulinetMisganaw. Community Health Nursing, Ethiopia Public
Health Training Initiative, 2006
2. nursingcrib.com/pathophysiology/pathophysiology-of-hypertension/
THE ‘APASEN`S’: A FAMILY
CASE STUDY
ESPINO, Leena Joy M.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
I would like to express my sincere gratitude to all who encouraged and helped me
throughout the study. Most especially for the following people for their valuable assistance and
unfailing support for the completion of this work which can only be acknowledged but never
repaid.
To the Apasen Family who warmly welcomed us and shared their knowledge to us during
the home visits.
To our instructors, Mr. Jude Tayaben and Mrs. Aprila Calasan, for their patience,
motivation, valuable guidance and immense knowledge to make this study possible.
To my family, friends and groupmates for their moral and financial support which
encouraged me to finish this study.
And above all, to the Almighty God, for giving me knowledge, wisdom, strength and
enlightenment through the tough times in preparing this study.
Leena Joy M. Espino

CHAPTER I
INTRODUCTION
Background of the Study
The community is a group of people sharing common geographical boundaries and often
common values and interests. The community may be of any size composed of individuals,
families and population groups. The Health Services offered by a professional nurse to the
community and its members at home, in health centers, in clinics, in schools and in places of
work for the promotion of health, prevention of illness, care of the sick and rehabilitation is
referred to as community health nursing (Freeman, 1958). Community health nursing is
composed of three major concepts: the community as the client, health as the goal and nursing as
the means. In order to reach the goal of the community we must start with the family.
The Family is defined as the basic unit of the community traditionally consisting of two
parents rearing their children (Merriam-Webster, 2016). The Definition of ‘family’ has changed
drastically over the few decades and the 21st century now showcases a variety of family units,
some very different from the standard of the 1950s. Today, children are also often raised in
single parent homes, by grandparents or by homosexual parents. Some families such as the main
characters of this case analysis cannot have children, or opt to have no children due to some
medical or emotional barrier. The idea that parents and children make a family is a basic
definition. In relation to this, family health nursing should adapt to the changes in the structure of
the family.
Family health nursing is the process of providing for health care needs of families that are
within the scope of nursing practice. Family care is any service or support that a family may need
because of a disabled, geriatric, or chronically ill family member. There is a sequence of
activities in Family Health Nursing Practice. The first of which is establishing a working
relationship with the family and this is achieved by conducting a home visit.
Community health nursing incorporates several basic concepts, including the promotion of
healthy living, prevention of disease and health problems, medical treatment, rehabilitation,
evaluation of community health care delivery and prevention systems, and research to further
community health and wellness. A community nurse may provide direct care, educate
individuals or the public, advocate for health improvements and perform research in community
health. She might also lead or collaborate with other health care professionals, organizations,
political figures and members of the community to promote health for her community.
A home visit is a family-nurse learner contact which allows the health worker to assess
the home and family situations in order to provide the necessary nursing care and health related
activities. In performing home visits, it is essential to prepare a plan of visit to meet the needs of
the client and achieve the best results of desired outcomes.

CHAPTER II
This presents the general and specific objectives of the study. This aims to understand
and identify the problems of the chosen family.
A. General Objectives:
At the end of nurse learner-family relationship, the family should be able to demonstrate
expected means to improve the health status of every family member.
B. Specific Objectives:
After the home visit and the nurse learner and family interaction, each of the family
members should be able to:
A. Identify ways to manage the disease or condition of every family member
B. Identify practices and behaviors that support and inhibit the interpersonal
relationship within the family
C. Express understanding on the health teachings given.
159
CHAPTER III
INITIAL DATA BASE

(years) STATUS IN THE ATTAINMENT
FAMILY
Family Elementary
OA 72 Female Widowed Farmer
Head Undergraduate
The Apasen family is a single-parent type of family. A single-parent type of family
structure involves a single person plus dependent children. However, the Apasen family is
merely composed of the mother OA because her first son died years ago while her second son
already has a family of his own. Her youngest son is living with her other relatives, so Mrs. OA
is currently living alone for 3 years now. She had let her relatives take care of his youngest son
because his son has a mental illness and Mrs. OA stated that she can no longer take care of him
since she`s already old. Mrs. OA claimed that she can no longer remember the date when her
husband died but she was certain that he died due to an accident. Mrs. OA denies ever using any
method of family planning. The Apasen family currently resides in Digway, Sayangan, Lubo,
Kibungan, Benguet. Mrs. OA has lived there since her mother died. She said that she inherited
the land which her deceased mother used to stay at.
159
B. Socio-Economic and Culture Characteristics
The family’s main source of income is OA's monthly income in radish gardening. Her
monthly income ranges from Php 3,000-4,000 monthly and depends on whether her radish is
sold. Since OA lives alone, her monthly income is sufficient in paying for her daily living
expenses. Most of her budgeting is allotted to her food and electric bill, some are set aside for
trips to Madaymen whenever she wishes to see her youngest son. As she has decided to stay in
Sayangan, she has essentially adapted to the community’s culture. Before OA`s husband died,
she reminisces that she used to live in Madaymen with her sons and husband.
The Apasen residence can be found by a mountainside in Digway, Sayangan relatively far
from the bulk of the community. She has no immediate neighbors and her house is situated atop
a steep slope. OA`s house is a one-storey building made of mostly wood and galvanized iron and
the floor is cemented. The residence’s front yard is not that wide but flowers and sayote plants
are present. The house is very spacious taking into consideration that OA is the only occupant.
There are no room divisions since OA lives alone.
There is a different building for and dining area where a fireplace can be found. It is also
made of wood and galvanized iron. It is located 3 meters away from the main house. OA doesn`t
have a comfort room, so whenever she wishes to defecate, she`ll just find a spot on her garden
and dig a small hole. The water is not free flowing so she stores it in pails and drums. The house
is powered by electricity which also powers her radio.

OA claims that she does not have a chronic or infectious disease as of the moment.
However, she stated that she had cough and colds a week before the home visit. OA generally
appeared well in terms of body built and grooming.
OA admitted that she never went to the clinic for consultation. She claimed that she
managed the condition by drinking calamansi juice and lots of water.
Family Assessment Based on Function Health Pattern
1. Health Perception-health Management Patterns
OA claimed that she never smoked nor drink. Generally, she displayed knowledge of
being able to recognize the importance of having a healthy well-being and maintaining a healthy
lifestyle.
2. Nutritional-metabolic Pattern
The family member only takes medications when the healthcare provider in the clinic
tells her to do so. Most of the time, she resorts first to herbal medicines before taking in
medications.
OA claims that she usually has vegetable and rice almost every meal every day because
of the lack of budget to purchase meat or fish on a daily basis. Sometimes, however, when she
has extra income, she claims that she buys fish, meat, or canned goods.
OA denies having any sort of problem with defecating and urinating.
4. Activity-exercise Pattern
OA admits that she does not exercise but she claimed that her work as a farmer serves as her
exercise. Her daily activities include cooking, cleaning and washing.
5. Sleep-rest Pattern
OA claimed that she makes sure that she sleeps for 7-8 hours since she`s already old and she
needs adequate rest.
6. Cognitive-perceptual Pattern
The member of the family is oriented to time, place, and person and is appropriately
responsive to questions. OA was very welcoming as it had been a long time since she last had
visitors. Verbal patterns of communication were spontaneous.
7. Self-Perception/Self Concept
OA expressed loneliness in being alone as her sons are away from her. Although her nieces
would visit during holidays, she claims that she misses having people to converse with. In
contrary, she is verbal that she is contented of the simple life she has.
Since OA is living alone, she was always visited by her niece who lives in Tolmod. She
seemed to have an open communication with her niece. Though she is aloe most of the time, she
accordingly tries her best to cope with life.

9. Sexual/Reproductive Health
OA is already old so she is no longer sexually active.
10. Coping Stress
She claims to gain strength from her other relatives. When OA`s husband and eldest child
died, her brother and other siblings as well as her niece had become her strength. She also states
that her second is very supportive.
11. Values/Beliefs Pattern
OA claimed to have no religion, so she does not go to church.
OA states that she visits the clinic whenever water therapy and herbal medicines doesn`t
work. She acknowledges that proper medical checkups are essential to the maintenance of health
but argues that it is also a matter of faith and beliefs.

Chapter IV
FAMILY BACKGROUND
A. Family History
The Apasen family is a single-parent family consisting of the mother and her two sons,
but she currently lives alone. Mrs. OA is a 72-year-old gardener who was born and raised in
Madaymen. She was not able to finish elementary because of financial problems. After Mrs.
OA`s mother`s death, she moved to Digway where she started to live alone.
B. Family Tree
APASEN
FAMILY
OA
Husband
(DeceaseD)
Eldest Son Second Son BA Youngest Son GA

(Deceased) (Married) (Lives in Madaymen)_
159
C. Genogram
Husband OA
(Accident) (Cough and
Colds)
Eldest Son Second Son Youngest Son

(Unrecalled)
BA GA
Mental Illness
Legend:
= Married
= Offspring
= Deceased
Chapter V
This section contains the assessed problems within the family utilizing appropriate
nursing diagnoses.
CUES OR DATA FAMILY NURSING PROBLEMS

Subjective Data: I. Presence of breeding sites of vectors as a
 “Idta mi nga itamtambak dagijay nausar nga health threat
container” A. Inability to recognize the presence of
Objective Data: the threat due to lack of knowledge
 It was seen that there were big containers that
contains water.
 The family has an open drainage so stagnant
water was observed in canals.
Subjective Data: II. Cough and colds as a health deficit
 “nag panpanateng ken uyuk ak, uso tadta nga A. Inability to provide nursing care to
nalamin ti panawun” the family member due to:
Objective Data: a. Financial constraints
 The patient was sniffing and coughs b. Lack of knowledge about the
occassionally. extent of nursing care needed
Subjective Data: III. Poor Health Sanitation as a foreseeable
 “idta ruwar milang nga ikabkabil jay basura crisis
mi pati jay container to fertilizer” A. Inability to make recognize crisis
Objective Data: due to lack of knowledge
 Some garbage is scattered at their backyard.
 The chickens are roaming around the kitchen.
159
CHAPTER VI
I. Health threat:Poor Environmental Condition: Presence of breeding sites of

vectors
Criteria Computation Actual Justification
Score
1. Nature of the 3/3 x 1 1 It is a health threat.
problem
2. Magnitude of the 4/4 x 3 3 The whole family can be
Problem affected.
3. Modifiability of 2/3 x 4 2.67 The inadequacies of the
the problem family’s knowledge and
resources are barriers.
4. Preventive 3/3 x 1 1 The condition may be
potential prevented through practice of
proper hygiene.
5. Salience of the 1/2 x 1 0.5 The family does not feel the
problem need to solve the problem.
Total Score: 8.17
II. Health Deficit: Cough and colds

Score
1. Nature of the 3/3 x 1 1 It is a health deficit.
problem
2. Magnitude of the 2/4 x 3 1.5 The child sniffs and still
Problem coughs occasionally.
3. Modifiability of 3/3 x 4 4 Current knowledge,
the problem interventions and resources
are available to solve the
problem.
4. Preventive 3/3 x 1 1 Severity or occurrence of
potential disease may be prevented
through proper health
maintenance.
5. Salience of the 1/2 x 1 0.5 The family doesn’t consider
problem it a serious problem but gives
attention to it.
Total Score: 8
III. Foreseeable Crisis:Separation of the children due to schooling

Score
1. Nature of the 3/3 x 1 1 It is a foreseeable crisis.
problem
2. Magnitude of the 1/4 x 3 0.75 The actual problem is yet to
problem exist.
3. Modifiability of 2/3 x 4 2.66 Current knowledge,
the problem intervention and resources
4. Preventive 1/3 x 1 0.33 It is highly preventable since
potential all they have to do is clean.
5. Salience of the 2/2 x 1 1 It is a perceived problem.
problem
Total Score: 5.74
PROBLEMS SCORES
1. Presence of breeding sites of vectors as a health threat 8.17
2. Unproductive cough as a health deficit 8
3. Poor Health Sanitation 5.74
Chapter VII
Virus
Infection of epithelial cells of

nasal passages
Sore throat
Sneezes
Bronchoconstriction
Cough
Simple cough starts with a virus that infects the epithelial cells of the nasal passages.
Once these cells are infected, the airway receptors are then irritated. The infection of these
epithelial cells can also lead to sore throat and sneezing. Cholinergic stimulation then takes
place. Cholinergic stimulation is the response of the somatic motor neurons when a stimulus
is present. It reacts by releasing acetylcholine from the synaptic vesicles found in the neurons.
The chemical neurotransmitter is crucial for the propagation of nerve impulse.
(Genericlook.com) The bronchi in the lungs now constricts and it directly causes coughing.
159
Chapter VIII
Family Nursing Goals and Objectives Nursing Evaluation Plan

Problem of Care Interventions
Cough and cold as a After nursing 1. Discuss with  After the
health deficit: intervention, the the family nursing
 Inability to following are members the interven-
make expected to take importance of tions, the
decisions with place: knowing the family will be
respect to 1. The chances of necessary able to recite
taking spreading information importance of
appropriate disease to about the treating cough
health actions other family disease to and cold
due to: members will prevent earlier. The
 Failure to be slim. spreading family will be
compre- 2. The recurr- them. able to know
hend the ence of cough 2. Provide remedies and
nature, and colds adequate manage-
magnitude or among the knowledge on ment of the
scope of the family various ways problem.
problem. members will of maintaining
 Lack of be prevented cleanliness in
knowledge as or minimized. their surroun-
to alternative dings.
courses of 3. Explain the
action open to importance of
them. proper food
preparation,
exercise and
rest in
strengthening
ones against
illness.
4. Provide
information on
health centres
in the vicinity
for immediate
health care
assistance.
II. PRESENCE OF POSSIBLE BREEDING SITES OF INSECTS, RODENTS AND
VECTORS AS A HEALTH THREAT:
FAMILY NURSING GOALS/ NURSING EVALUATION

PROBLEM OBJECTIVES INTERVENTION
OF CARE
Presence of possible After nursing 1. Discuss the After nursing
breeding sites of insects, intervention, the importance and intervention, the
rodents and vectors as a member will be purposes or proper family was able to
health threat: able to eradicate sanitation. clean the house
A. Inability to the presence of 2. Cite the causes especially the
recognize the these unwanted and effects of the possible breeding
presence of the breeding sites, prevalence of the sites of the
threat due to lack rodents and unwanted pests mosquitoes like
of or inadequate vectors causing around the house. open drainage and
knowledge. diseases and 3. Suggest surroundings of
B. Inability to make therefore will alternatives/metho the house. Able to
decisions to take maintain a home ds that would reiterate methods
appropriate environment eliminate the on how to
actions due to; conducive to breeding sites of eliminate
a. Failure to health. vectors. breeding sites of
comprehend 4. Instruct and the vectors.
the emphasize the
nature/magnit proper storage of
ude or food that may
condition of attract vectors and
the problem. to prevent
accumulation of
water around their
house.
5. Instruct to cover
the drum and other
water containers.
6. Reinforce a
schedule for
cleaning activity.
7. Emphasize the
importance of a
clean and healthy
environment.
III. POOR HEALTH SANITATION AS A FORSEEABLE CRISIS
FAMILY NURSING GOALS/ NURSING EVALUATION

PROBLEM OBJECTIVES OF INTERVENTION
CARE
POOR HEALTH After nursing 1. Assess the After nursing
SANITATION AS A intervention, the level of intervention, the
FORSEEABLE member will be able understanding member will be able
CRISIS: to determine the regarding the to demonstrate how to
Improper waste importance of identified dispose and segregate
disposal and open practicing proper problem. waste materials. Also
drainage system just methods on waste 2. Assess the reiterated the
beside their house that disposal. surroundings importance of proper
turns out to be 1. Identify and the house. waste disposal.
favorable reservoirs different ways 3. Provide
for certain vectors. on proper information
- Uncovered disposal of about the
containers, garbage such proper ways
cans, bottles, as; on waste
wheels, wastes a. Use of disposal such
and so on that compost pit. as segregation
are not kept in b. Segregate non- of non-
proper garbage biodegradable biodegradable
receptacles. and to
biodegradable biodegradable
materials. waste and
c. Recycling or demonstrate
selling of the methods.
some garbage 4. Discuss
like cans, techniques and
bottles and methods used
plastics. in cleaning
and sanitizing.
5. Monitor for
places that are
prone to
soiling and
dirt.
6. Emphasize the
importance of
a clean and
healthy
environment.
Chapter IX
The family’s knowledge on health maintenance and the existing conditions plays an
essential role in the preservation of the good health of each member. It is therefore the nurse
learner’s plan to provide enough information regarding the identified nursing problems of the
family.
Despite the fact that there had been zero recent cases of Dengue in the sitio, the family
still has to know and practice the preventive measures provided by the Department of Health
(DoH). The nurse learner will not only discuss but will also demonstrate for the family to see.
Also, other vector-borne diseases including their signs and symptoms shall be discussed to the
family.
Herbal medicines for minor health conditions (such as cough, colds, and fever) will be
introduced. The knowledge on the DoH – approved herbal medicines and its preparation and
concentration will also be imparted. The importance of seeking professional health care will as
well be reiterated.
The family will also be reminded of the significance of maintaining a good relationship
among members. The members are encouraged to voice out their concerns on anything so that
the problem or issue can be addressed by the family appropriately.
Lastly, it shall be reiterated that it is essential to maintain a good health, not only the
physical aspect but as well as psychological, emotional, and spiritual aspect.
159
Chapter X
Conclusions
Due to poor sanitary conditions, the Apasen family is at risk for vector-borne diseases
such as dengue.
According to the World Health Organization, dengue is a fast emerging pandemic-prone
viral disease in many parts of the world. Dengue flourishes in urban poor areas, suburbs and the
countryside but also affects more affluent neighborhoods in tropical and subtropical countries. It
is transmitted by the bite of a mosquito infected with one of the four dengue virus serotypes. It is
a febrile illness that affects infants, young children and adults with symptoms appearing 3-14
days after the infective bite.
The said disease is not transmitted directly from person-to-person and symptoms range
from mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle
and joint pain, and rash. There is no vaccine or any specific medicine to treat dengue.
Recommendations
The only current method of controlling or preventing dengue virus transmission is to
effectively combat the vector mosquitoes. Proper solid waste disposal and improved water
storage practices, including covering containers to prevent access by egg-laying female
mosquitoes are among methods that are encouraged to eradicate the spread of the virus.
159
CHAPTER XI
REFERENCES
Bryan, C. (2015, February 17). Upper Respiratory Tract Infections and Other Infections of the
Head and Neck. Retrieved August 8, 2016, from Microbiology and Immunology Online:
http://www.microbiologybook.org/Infectious%20Disease/Upper%20respiratory%20tract.ht
Genericlook.com. (n.d.). Cholinergic Stimulation. Retrieved August 7, 2016, from
Genericlook.com Medical Encyclopedia: http://medicalterms.info/anatomy/Cholinergic-
Stimulation/
Kozier, B. & Erb, W.H. (2004). Fundamentals of Nursing. 9th Edition
Maglaya A. (2004). Nursing Practice in the Community (4th Edition ed.). Marikina City:
Argonauta Corporation.
Winsome St John; Helen Keleher., Allen and Unwin, 2006. CommunityNursing Practice:
Theory, Skills and Issues

THE “CALIS”: A FAMILY CASE STUDY
GALAO, Teresita C.
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
Firstly, I would like to express my unfeigned gratitude to God, for showering me an
endless support and guidance, for giving the strength and patience to complete this case study.
And also to my family for providing financially and morally support.
This case study was partially supported by our instructors; Sir Jude Tayaben and Ma’am
Aprila Calasan , I thank my colleagues from them for providing insight and expertise that greatly
assisted my case study, for continuous support, for their patience and motivations during those
days of interview.
Besides of our instructors, I would also like to emit my deepest gratitude to those who
gladly participated in the conduct of this study. The Calis family, for sharing their pearls of
hospitality and cooperation to us during the course of interview. And also I would like to thank
the community people for participating in the activities and programs.
I also immensely grateful to my team members;Cristine joy Eban and Shanaya Rose
Paac, who provided me opportunity to join their team in tolmod and sayangan proper, and who
gave their best to help me gather the information needed in the study. Without their precious
support it would not possible to conduct this study.
Teresita C. Galao
CHAPTER I
INTRODUCTION
This is no coincidence. God organizes us into families so that we can grow up in
happiness and safety, and so that we can learn to love others selflessly is the key to true joy.
Within the family is the best place to learn to love others the way Heavenly Father loves each
one of us. Maybe we are one of the lucky ones who were raised in a happy and secure family
with two loving parents. Maybe we weren’t, and growing up was tough without the love and
support we longed for. Likely, as an adult you want a happy home for your family. Living
peacefully in a family isn’t always easy, but in God’s restored Church, marriage and families is
the most important social unit now and in eternity. People who have lived through a disaster
never say, "All I could think about during the earthquake was my bank account." They almost
always say, "All I could think about was my wife and children." It shouldn’t require a disaster
for us to know this truth. But too often, we let earning money, chasing pleasure, or even the
needs of people outside our families divert our attention. There are such types of family;
The nuclear family is a family unit that includes two married parents of opposite genders
and their biological or adopted children living in the same residence. However, the term "nuclear
family" can mean several different things in today's society. Understanding the classic roles in
this type of family and how it is defined can help you understand the relationships in your own
family, whether it's nuclear or not. The nuclear family was once widely held to be the most basic
and universal form of social organization. Anthropological research, however, has illuminated so
much variability of this form that it is safer to assume that what is universal is a
“nuclear family complex” in which the roles of husband, wife, mother, father, son, daughter,

brother, and sister are embodied by people whose biological relationships do not necessarily
conform to the Western definitions of these terms. In matrilineal societies, for example, a child
may be the responsibility not of his biological genitor but of his mother’s brother, who fulfills
the roles typical of Western fatherhood. Closely related in form to the predominant nuclear-
family unit are theconjugal family and the consanguine family. As its name implies, the conjugal
family is knit together primarily by the marriage tie and consists of mother, father, their children,
and some close relatives. The consanguine family, on the other hand, typically groups itself
around a unalienable descent group known as a lineage, a form that reckons kinship through
either the father’s or the mother’s line but not both. Whether a culture is patrilineal or
matrilineal, a consanguine family comprises lineage relatives and consists of parents, their
children, and their children’s children. Rules regarding lineage exogamy, or out-marriage, are
common in these groups; within a given community, marriages thus create cross-cutting social
and political ties between lineages.
Community health Nursing is the synthesis of nursing and public health practice applied
to promote and protect the health of population. It combines all the basic elements of
professional, clinical nursing with public health and community practice. Community health
nursing is essential particularly at this point in time because it maximizes the health status of
individuals, families, groups and the community through direct approach with them. Today,
community participation and involvement is getting a due attention before the occurrence of
illnesses as life-style changes to continue to play a significant role in morbidity and mortality.
Chronis illnesses, tobacco smoking, road traffic accident (RTA) …etc, and environmental
changes that affect health are steadily becoming the major concerns influencing human health in
our country.
CHAPTER II
OBJECTIVES OF THE CASE STUDY
This chapter should present the general and specific objectives of the family case study.
Setting objectives serves as road map for the planning of the nursing interventions.
General objectives:
At the end the nurse learner-family relationship, the family should able to make plan and
perform actions to the identified problems.
Specific objectives:
After a week of home visits and with the nurse learner and the family interaction, each of the
a. collaborate actively and participate in the assessment
b. perform the health teaching taught by a nurse learner
c. Utilize time to plan an action for the implementation of the nursing
interventions
d. Recognize the prioritized problem as health deficit, health threat, and
foreseeable crisis.
e. Evaluate the changes of condition after nursing interventions implemented.

CHAPTER III
INITIAL DATA BASE
A.Family Structure, Characteristics and Dynamics
FAMILY AGE SEX OCCUPATION CIVIL POSITIO EDUC.
MEMBERS STATUS N IN THE ATTAINMENT
FAMILY
SC 60 M FARMING MARRIE FATHER PRIMARY
D UNDERGRADUATE
CC 60 F FARMING MARRIE FATHER PRIMARY
D UNDERGRADUATE
RC 14 M STUDENTS MARIED CHILD GRADE 6
The Calis family is a type of nuclear family. As a nuclear family, the family is composed of
father SC, mother CC and their one and only child RC. A nuclear family is found in almost
all societies although the legth of time in which the family remains in this form remains vary
even the same society. The nuclear family can be a nurturing environment in which to raise
children as long as there is love, time spent with children, emotional support, low stress, and
a stable economic environment. In nuclear families, both adults are biologicaland adoptive
parents of their (child, Jay, 2004).The Calis family resides in Tolmod, Sayangan, Lubo,
Kibungan, Benguet.In terms of the health of the family, Mr.SC claims that is more dominant
while Mrs.CC claims that she is more dominant in disciplining their child. Mr. and Mrs.
Clover reported that the discipline and training of their child are shared by both of them.
B.Socio-economic and Cultural Characteristic
The income of the Calis family is mainly come from farming specifically from planting
sayote. Their income depends on the price of vegetables in season and it varies in the quality.
They stated that 1, OOO pesos monthly income is budget for their foods, electric bills and for
their child expenses in the school.
They occupied their own house and lot. Their house is build up with wood and G.I. Within
the house there are 3 rooms for sleeping and there is accessible kitchen. They utilize electricity
as a source of light, Also wood and LPG for cooking. Mainly source of their water supply is
spring and they used drum as storage and some closed bottles.
In terms of drainage system, open drainage is common. They also burning their non
biodegradable garbage’s but disposing the biodegradable under the plants. Their toilet is flush
type and water for cleaning and flushing is abundant and accessible.
C. Health Assessment of the Family
History of past illnesses
The Calis family elaborated the common illnesses they’ve suffered in the past such as fever,
cough and colds and also body pains at sometimes. But they haven’t consult doctors but they
take self-medication and rest at homes.

History of present illnesses
The Calis family has no present illnesses
1. Health perceptions-health management pattern
Mr. SC started smoking at age 12; He said it was not that easy to stop since he started at
young age. He drinks alcohol specifically 2x2 in a week. Mrs. CC consumed 1 pack
regularly. The family also drinks coffee occasionally but limits after they have heard that too
much coffee has side effects that can affects health.
The daily food intake of the family is consist of their main products the vegetable and rice.
They eat meat and fishes sometimes.
Mrs.CC said that they often used herbal medicine as a primary treatment for cough and
colds, but they take over the counter medication like paracetamol and ibufrofen for fever,
and also vit. C, bioflu and neozep for cough.
3. Elimination-pattern
The family said that they have no problem in elimination patterns, they urinates and defecate
regularly.
4. Activity –Exercise pattern
The daily activity of the family is to work in the farm except their child who goes to school,
they considered walking from house to the farm and working as their exercise.
5. Sleep-rest patterns
Mrs.CC claimed that their child sleep for 6-7 hours uninterrupted while she and his
husband sleep for 5-6 hours because they needed to wake up early in the morning to prepare
their food and “baon” for their child and to be able to go in the farm early.
6. Cognitive-perceptual patterns
The family members are oriented to time, place and are able respond appropriately with
questions; they were able to rationalize when asked to explain things. Verbal patterns of
communication are noted to be spontaneous.
7. Self-perception/self concept
All family members are adaptive and flexible to any situations, such as stressful situation.
They take an action to manage or cope with it.
They observed open communication in all members of the family and also outside the
family. The family maintained stable relationship to each individual.
9. Sexual/Reproductive health
Mrs. CC stated that they are not able reproduce child ever since due to infertility and their
child was adapted.

10. Coping Stress
The family is able cope up with stress as long as they will help each other, as stated by Mrs.
CC.
11. Values/beliefs pattern
The family is kankanaey and they are born again. They said that they have fear in God.
Though they do not always go to church on Sundays, they know how to pray.
Mrs. CC claims that she prefers vegetables rather than instant good.
Though restrained financially, Mrs. CC said to budget the finances of the family to serve
healthy meals the as she could. During illnesses, they deny consulting a neither doctors nor
midwives, but they take self medication at homes.

Chapter IV
FAMILY BACKGROUND
A.Family history
Mr.SC is son of Mr. and Mrs. C of Kibungan Benguet, Mrs. CC is daughter of Mr.
and Mrs. C of Kibungan. Their child RC was adopted in year 2004.
B.Family tree
Mr.SC Mrs.C
RC
FATHER
MOTHER
Child
C.Family Genogram
Mr.SC
MRS.cc
RC
SMOKE
HPN
Chapter V
TYPOLOGY OF NURSING PROBLEMS
Cues and Data Family Nursing Problems
Subjective data: I.cough and colds
-“nu mamingsan yan kanauuyek A.inability to provide adequate nursing care to the
ta ya pananteng”, as stated by sick member of the family due to;
the father
A. lack of knowledge about the nature,
Objective data: severity and complications of cough and colds
-The father is having cough and
nasal congestion
-health center is far from the
place
Subjective data:
II.smoking
-“Ayeh,palalo ay adak man
A. Inability to make decisions to take appropriate
makaya ay adi mansigarilyu si
actions due to;
esay agew,tan enggay dadlo
naing saak” , as verbalized by a. low salience of the problem
the father
Objective data;
-father suddenly smoke just after
the interview
Subjective data;
-“Adik maiwasan man karkaro

III. Alcohol dringking
nu wday umawis et ayeh,mayat
A. Inability to make decisions to take appropriate
c agas di buway”, as verbalized
actions due to;
by the father
a. Inadequate knowledge about the effects of

Objective data;
too much alcohol in the body.
-lot of alcohol bottles consumed
was displayed in the house.
IV. presence of accident Hazards

Subjective data;
A. inability to provide home environment which is

-“Masalog nan danan ay umali
conducive to health maintenance and personal
sina bebeey et nakadlis karkaro
development.
nu panag uudan”, as stated by
the mother
Objective data;
-slippery way down to their
house
Objective; V. presence of breeding sites for mosquito and
insects
-breeding sites of mosquito such
as uncovered drums and water A. Inability to make decisions to take appropriate
containers at their backyards actions due to;
a. low salience of the problem
b. failure to comprehend the magnitude of
condition.
Chapter VI
I. Cough and Colds
1. Nature of the 3/3 x 1 1 This problem is a
2. Magnitude of the 2/2x1 1 One of the family
Problem members is affected
3. Modifiability of 2/2x2 2 The problem is easily
the Problem modifiable.
4. Preventive 3/3x 1 1 The problem could be
Potential highly prevented. This
could be done if the
family implements
preventive measures
which are easy to
perform.
5. Salience 2/2x 1 1 The family is aware of
the problem and
willing to use
alternatives to solve
the health problems.
Total 6
Score
II.Smoking
2. Nature of the 2/3 x 1 0.66 Health threats
Problem
4. Magnitude of the 2/2x1 1 All of the family
Problem members will be
affected
8. Preventive 2/3x1 0.66 The problem could be
Potential highly prevented.
10. Salience 2/2x 1 1 The problem is a views
by family needed
immediate action
Total 5.32
Score
III. Alcohol drinking
2. Magnitude of 2/2x1 1 One of the members
the Problem is affected
3. Modifiability of 2/2x2 2
the Problem
4. Preventive 2/3x1 0.66
Potential
5. Salience 2/3x1 0.66
Total 5.32
Score
IV. Presence of accident Hazards
1. Nature of the 3/3x1 1 This problem is
Problem health threats
2. Magnitude of 2/2x1 1 All members are
the Problem affected
3. Modifiability of 1/2x1 0.5 The problem is
the Problem modifiable

4. Preventive 2/3x1 0.66 Moderately
Potential preventable
5. Salience 1/2x1 0.5 The family expressed
readiness and
recognized as a
problem but not
needing an urgent
attention
Total 2.67
Score
V. Presence of mosquito breeding sites
1. Nature of the 1/3 x 1 0.33 This foreseeable
Problem crisis
2. Magnitude of 2/2x1 1 All of the family
the Problem members are affected
4. Preventive 1/3x 1 0.33 The problem could be
This could be done if
the family will be

educated on measures
to prevent or
minimize the possible
formation of breeding
sites of the insects,
rodents and vectors.
5. Salience 1/2x 1 0.66 The problem needs
immediate attention
according to the
family.
Total 3
Score
PROBLEMS Score
I. Cough and Colds 6
II. Smoking 5.33
III. Alcohol drinking 5.33
IV. Presence of accident Hazards 2.67
V. Presence of mosquito breeding sites 3
Chapter VII
COUGH AND COLDS
Weak resistance
TRIGGER FACTOR
TRIGGER FACTOR
Airway
inflammation
Mucus production Swollen bronchial

membranes
Air muscle tightening
Narrow breathing passage
Wheezing, coughs, Shortness

of breaths
22
Chapter VIII

HEALTH FAMILY GOAL OF OBJECTIVES INTERVENTION PLAN
PROBLEMS NURSING CARE OF CARE NURSING METHOD RESOURC
PROBLEMS INTERVENTIONS OF NURSE ES
FAMILY REQUIRED
CONTACT
Health 1. Inability to After nursing 1.After 1.Discuss with the Time and
deficit; recognize the interventions, nursing of family the effort of
Alcohol presence of the Mr. SC. Will intervention, consequences of Home the nurse
drinking condition due to take Mr. SC will drinking alcohol visit learner
inadequate necessary able to; 2.Emphasizes the and the
knowledge. action to a. lessen disadvantages and family
2.Inability to prevent intake of advantages of
make decisions complications alcohol drinking alcohol
with respect to of b. implement 3.Explore with the
taking Alcohol appropriate family especially
appropriate drinking actions and with the couple of
health action correct wrong encouraging ways
due to notions about to minimize
Failure to drinking drinking alcoholic
comprehend the beverages beverages.
nature/magnitu
de of the
condition.
PROBLEMS NURSING CARE OF CARE NURSING METHOD RESOURCES
PROBLEMS INTERVENTION OF REQUIRED
NURSE-
FAMILY
CONTACT
Foreseeabl 1. Inability to After nursing After nursing 1.Asses the family Time and
e crisis; recognize the intervention, intervention ‘s awareness and Home effort of
Presence presence of the the family will the family: level of visit the nurse
of possible condition or take knowledge learner and
breeding problem due to necessary a. Would be 2.Discuss the the family
sites of lack of measures to able to state importance of
mosquito. knowledge. eradicate the effects of proper sanitation
breeding sites presence of 3.Cite the causes
2. Inability to around their breeding sites and effect of
make decisions house and the to safety of prevalence of the
with respect to family will be individual and unwanted pests
taking educated on family. around home.
appropriate measures to b. Would be 4.Facilitate in the
health action prevent or able to eradication the
due to failure to minimize the enumerate identified
comprehend the possible the health breeding site.
nature of the formation of risks/complica 5.Emphasize the
problem. breeding sites tions brought importance of
of the insects, by insects, eradicating the
rodents and pests, and breeding site of
vectors. rodents. insects.
c. Would
select
appropriate
action in
reducing the
presence of
these
breeding sites.

PROBLEMS NURSING CARE OF CARE NURSING METHOD RESOURCES
PROBLEMS INTERVENTIONS OF NURSE REQUIRED
FAMILY
CONTACT
Health Inability to After nursing After nursing -Asses smoking Time and
threat; provide interventions, interventions , history. effort of the
smoking adequate Mr. SC will to Mr. Culnis will -identify reasons Home nurse and
nursing care at reduce able to: of smoking visit the family
risk member of smoking a. Identif -Asses
the family habits. y precipitating
related to; effect factors that
a. Inadequat s of increases smoking
e nicoti habits
Knowledge ne -Asses risk factors
and skill in b. Enum -discuss smoke
carrying out erate and its effects
significant disadv -Teach about
interventions. antag contents of
es of cigarettes and
smoki mechanism of
ng action
c. Practi -Discuss
ce disadvantages of
effecti smoking
ve -Teach effective
way ways to minimize
to smoking
reduc -Encourages to
e verbalize concern
smoki
ng
HEALTH FAMILY GOAL OF CARE OBJECTIVES INTERVENTION PLAN

PROBLEMS NURSING OF CARE NURSING METHOD RESOURCES
PROBLEMS INTERVENTIONS OF NURSE REQUIRED
FAMILY
CONTACT
Health Inability to The family will The family 1.Assist family
threat; make decisions able to identify will able to ; members in Time and
Presence with respect to some safety a. recog identifying those Home effort of the
of accident taking measures to nize environmental visit nurse and
hazards appropriate lessen risk of envir hazards present in the family
health action accidents onm their environment
due to failure to ental To let be aware in Expenses for
comprehend the hazar those threats in the materials
nature of the ds as their health used and the
problem. threa 2.Encourage the transportatio
t family to do some n of the
b. iden ways to prevent nurse
tify accidents such as
ways putting fence on
to the way as a
modi support
fy
envir
onm
ent
enumerate
some safety
measures
HEALTH FAMILY GOAL OF OBJECTIVES OF INTERVENTION PLAN

PROBLEMS NURSING CARE CARE NURSING METHOD RESOURCES
PROBLEMS INTERVENTIONS OF REQUIRED
NURSE
FAMILY
CONTACT
Health Inadequate to After nursing After nursing 1. Explain the
deficit ; provide nursing interventions intervention proper Time and
Cough and care to the sick , the family the family will; preparation of Home effort of the
colds member of the will able to a. acquire foods, good visit nurse and the
family due to eliminate the adequa nutrition’s and family
lack knowledge cough and te proper
about of extent cold and will inform management.
of nursing care able to ation 2. Provided some
needed. prevent re about information how
occurrence the to prevent and
of the disease the occurrence of
disease in , the disease.
the future. includi 3. Encourage the
ng the family to consult
signs the Doctors,
and midwives or other
sympto health
ms of professionals if
the the symptoms
disease persist.
s and
immedi
ate
preven
tion
b. Be
aware
of how
to
preven
t
spreadi
ng of
commu
nicable
disease
THE ‘BASITE’S’: A FAMILY CASE STUDY
LOPEZ, Jinky N.
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
This study has given me an opportunity to discover and learn new things in
the community, it’s environment and health status. But none of these would be possible
without the help of significant people that helped me to fulfill this study.
First and foremost, I would like to thank our Lord Almighty for giving me the
opportunity to be with the people in the community. For giving me the utmost guidance
and wisdom in fulfilling my tasks as a nurse learner. Thank you Lord for giving me the
strength to endure everything.
To our Clinical Facilitators, Mr. Jude L. Tayaben and Ms. Aprila Calasan, who were with us
all the way and never stopped on guiding and supporting us. I am truly grateful for their
presence, their understanding, patience and humor. You are truly a blessing to all of us.
To Mr. Basite for being the most kind, hospitable, and welcoming person I knew
in the community. Thank you Sir for trusting and sharing us your life.
To my parents for the unending support, guidance, patience, and funding of the
this study.
Lastly, to my co-nurse learners, especially our group in Sayangan for the
friendship, companionship and support. And for being one team throughout the
community immersion.
JINKY N. LOPEZ
CHAPTER 1
INTRODUCTION
Family is an open and developing system of interacting personalities with
structure and process enacted in relationships among the individual members
regulated by resources and stressors and existing within the larger community (Smith &
Maurer,1995).
Community health Nursing is the synthesis of nursing and public health practice applied
to promote and protect the health of population. It combines all the basic elements of
professional, clinical nursing with public health and community practice.
CHAPTER II
THIS CHAPTER SHOULD PRESENT THE GENERAL AND SPECIFIC OBJECTIVES OF THE
FAMILY CASE STUDY .
SETTING OBJECTIVES SERVES AS A ROAD MAP FOR THE PLANNING OF THE NURSING
INTERVENTIONS . OBJECTIVE
SETTING FACILITATES THE MOTIVATION FOR THE CLIENT AND THE NURSE BY PROVIDING A
SENSE OF
ACHIEVEMENT , ( KOZIER AND ERB, 2004)
GENERAL OBJECTIVES:
AT THE END OF THE NURSE LEARNER -FAMILY RELATIONSHIP , THE FAMILY SHOULD BE
ABLE TO DISPLAY
EXPECTED MEANS TO IMPROVE THE HEALTH STATUS AND BECOME COMPLIANT TO ALL THE
HEALTH TEACHING
TO IMPROVE THEIR WAY OF LIVING .
SPECIFIC OBJECTIVES:
AFTER A WEEK OF HOME VISITS AND WITH THE NURSE LEARNER AND FAMILY
INTERACTION , EACH OF
THE FAMILY MEMBERS SHOULD BE ABLE TO;
a. GIVE ADEQUATE AND TRUE INFORMATION DURING SURVEYS AND INTERVIEWS.

b. IDENTIFY PRACTICES AND BEHAVIORS THAT SUPPORT AND INHIBIT THE
INTERPERSONAL RELATIONSHIP
WITH IN THE FAMILY .
c. PARTICIPATE ACTIVELY DURING HOME VISITS .
d. SUGGEST ON HOW TO IMPROVE THEIR LIFESTYLE .
e. PERFORM VARIOUS HEALTH TEACHINGS GIVEN BY THE NURSE LEARNER .
CHAPTER III
INITIAL DATA BASE
THE INITIAL DATA BASE INCLUDES THE INFORMATION ABOUT THE FAMILY IN
VARIOUS
DIMENSIONS . IT INCLUDES THE FAMILY STRUCTURE , CHARACTERISTICS AND DYNAMICS , THE
SOCIO-
ECONOMIC AND CULTURAL CHARACTERISTICS , THE HOME AND ENVIRONMENT , THE HEALTH
ASSESSMENT OF EACH FAMILY MEMBER , AND THE VALUES, HABITS, PRACTICES ON HEALTH
PROMOTION , MAINTENANCE AND DISEASE PREVENTION .

A. FAMILY STRUCTURE , CHARACTERISTICS , AND DYNAMICS
(CODE (YEARS ) STATUS IN THE ATTAINMENT
NAMES ) FAMILY
KSB 88 FEMAL WIDOW MOTHER ---- ----
RB 56 MALE MARRIE FATHER/ FARMER ----
D SON
MB 52 FEMAL MARRIE WIFE HOUSE WIFE ELEM. GRAD
E D
MRB 11 FEMAL SINGLE ELDEST STUDENT GRADE 4
E CHILD (ONGOING )
MJB 9 FEMAL SINGLE SECOND STUDENT GRADE 3
E CHILD (ONGOING )
LB 7 MALE SINGLE THIRD STUDENT GRADE
CHILD 1(ONGOING )
THE BASITE FAMILY IS AN EXTENDED TYPE OF FAMILY . AS AN EXTENDED TYPE OF
FAMILY , IT IS
COMPOSED OF FATHER XY, MOTHER XZ, CHILDREN XA,XB AND XC PLUS FATHER XY’S
MOTHER , XS. THE
BASITE FAMILY RESIDES AT DIGWAY, LUBO, KIBUNGAN , BENGUET FOR ABOUT 4 YEARS
NOW . WHERE IN THE
CHILDREN GO TO SCHOOL AT GASAL BARRIO SCHOOL . SINCE THERE IS TOO FAR, THE
CHILDREN TOGETHER WITH
THEIR MOTHER RESIDE ON A DIFFERENT HOUSE DURING WEEKDAYS , WHICH IS NEARER TO
THEIR SCHOOL .
WHILE THE FATHER IS DOING THE FARMING , HIS MOTHER IS ONLY STAYING AT HOME
BECAUSE SHE CANNOT
WORK DUE TO OLD AGE . MEANWHILE, THE CHILDREN AND THEIR MOTHER GO DOWN TO
DIGWAY TO SPEND
THE WEEKENDS AS A WHOLE FAMILY .
B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS
THE FAMILY ’ S MAIN SOURCE OF INCOME COMES FROM MR. BASITE ’S WORK AS A
FARMER . HE CLAIMS
THAT HE DOES THE FARMING EARLY MORNING AND LATE IN THE AFTERNOON AND HARVESTS
IT TO SELL IN THE
MARKET . THEY DON ’T HAVE TO WORRY ABOUT PAYING THE ELECTRICAL AND WATER BILLS
BECAUSE THEY ONLY
USE CANDLES AND LAMPS DURING THE NIGHT AND THEIR WATER IS FREE FLOWING FROM THE
SPRING . THEY USE
WOOD FOR COOKING THEIR FOOD AND ONLY BUY THINGS WHEN IT IS NEEDED . MR. BASITE’S
ESTIMATED
MONTHLY INCOME IS P3,000.00. IT IS BUDGETED BY HIM AND HIS WIFE .
C. HOME AND ENVIRONMENT
BASITE FAMILY HAS TWO HOUSES . THE FIRST ONE IS MR. BASITE’S ROOM TOGETHER
WITH THE
CHILDREN AND HIS WIFE WHEN THEY ’ RE AROUND . THE SECOND ONE IS A NIPPA HUT WHERE
HIS MOTHER
SLEEPS AND AT THE SAME TIME WHERE THEY COOK THEIR FOOD THROUGH FIRE WOODS .
THEIR KITCHEN
UTENSILS ARE LOCATED OUTSIDE . THEY DON’ T HAVE A TOILET . THEY MAKE A PIT TO
DEFECATE AND COVER IT
WITH SOIL AFTERWARDS .
D. HEALTH ASSESSMENT OF THE FAMILY
THE FAMILY RECOUNTS HAVING A HISTORY OF ASTHMA , ANEMIA , GOITER AND
HYPERTENSION .
THOUGH MR. BASITE HAS MINIMAL KNOWLEDGE RECALLING WHO’S SIDE THESE ILLNESSES
GENERATED .
HISTORY OF PRESENT ILLNESS
MR. BASITE CLAIMS THAT HE HAS NO STOCK OF MEDICINE FOR HIS ASTHMA .
BACAUSE THE
MEDICATIONS ARE EXPENSIVE AND THE RHU’S ARE DISTANT TO THEIR PLACE , HE CHOSE TO
HAVE ONLY
ADEQUATE REST AND FLUIDS WHEN HIS ASTHMA ATTACKS . AND HER WIFE HAS GOITER.
THEY ONLY SEEK
MEDICAL ASSISTANCE WHEN IT ’S SEVERE .
1. HEALTH PERCEPTION-HEALTH MANAGEMENT PATTERNS
MR. BASITE IS SOMEWHAT KNOWLEDGEABLE ABOUT HIS HEALTH .
2. NUTRITIONAL AND METABOLIC PATTERN
THEIR DAILY FOOD INTAKE CONSISTS OF RICE, VEGETABLE , ROOT CROPS , MEAT AND
BREAD .
THE FAMILY CONSUMES MORE ON VEGETABLE AND ROOT CROPS BECAUSE MEAT IS QUITE
EXPENSIVE .
WHEN HAVING FLU, THEY CLAIMED TO TAKE SOME PAIN RELIEVER LIKE
PARACETAMOL AND ALAXAN .

FOR COUGH AND COLDS THEY BOIL OREGANO AND DRINK IT.
3. ELIMINATION PATTERN
THEY CLAIM TO DEFECATE EVERYDAY USUALLY IN THE MORNING AND URINATE ATLEAST
5-6 TIMES A DAY.
4. ACTIVITY-EXERCISE PATTERN
THE BASITE FAMILY CLAIMS TO HAVE EXERCISE DAILY BY WALKING UP AND DOWN
THE MOUNTAIN WHEN
GOING TO SCHOOL AND WORK . THOUGH MR. BASITE’S MOTHER IS ONLY CONFINED IN BED.
5. SLEEP AND REST PATTERN
THEY CLAIM THAT THEY SLEEP 6-7 HOURS EVERY NIGHT .
6. COGNITIVE -PERCEPTUAL PATTERN
BASITE FAMILY IS ORIENTED TO TIME , PLACE AND PERSON . AND ARE ABLE TO
RESPOND APPROPRIATELY TO QUESTIONS BEING ASKED . MR. BASITE IS AN OPEN TYPE OF
PERSON WHO TELLS A STORY DURING THE INTERVIEW .
7. SELF-PERCEPTION/SELF-CONCEPT
MR. BASITE SAID THAT HE IS CONTENTED AND HAPPY WITH THEIR SIMPLE LIFE .
ALTHOUGH HE IS
SADDENED BY HIS SHORTCOMINGS AS A FATHER TO HIS CHILDREN , A HUSBAND TO HIS WIFE
AND A SON TO HIS MOTHER .

8. ROLES AND RELATIONSHIPS
THEIR FAMILY DISPLAYS AN OPEN COMMUNICATION WHERE THEY UNDERSTAND AND
SUPPORT EACH OTHER.
9. SEXUAL /REPRODUCTIVE HEALTH
THE COUPLE REPORTS THAT THEY ARE NO LONGER ACTIVE TO SEX BECAUSE THEY
ALREADY HAVE THREE CHILDREN AND THEY CLAIM THAT THEY ARE VERY BUSY WITH THEIR
DAILY LIVING .
10. COPING STRESS
THE FAMILY CLAIMS TO HAVE STRENGTH AND MOTIVATION WITH EACH OTHER . WHEN
THEY HAVE PROBLEMS THEY MAKE SURE TO TALK TO EACH OTHER AND SOLVE IT.
11. VALUES/BELIEFS PATTERNS
THEIR FAMILY IS A RESILIENT FAMILY . THEIR CHILDREN ARE TAUGHT HOW TO PRAY AND
GO TO CHURCH . THEIR RELIGION IS CHRISTIANITY WHERE THEY GO TO CHURCH AT UCCP
WHEN THEY ARE COMPLETE .
12. VALUE, HABITS, PRACTICES ON HEALTH PROMOTION , MAINTENANCE AND DISEASE
PREVENTION DURING THE VISIT , THE FAMILY CLAIMED THAT THEY HAVE ENOUGH
FOOD FOR 3 DAYS AND THEY CAN

ALWAYS HARVEST VEGETABLE AND ROOT CROPS FROM THEIR GARDEN . WHEN THEY GET
SICK , THEY MAKE USE OF HERBAL PLANTS .
CHAPTER IV
FAMILY BACKGROUND
A. FAMILY HISTORY
BASITE FAMILY IS AN EXTENDED FAMILY . MR. BASITE IS A FARMER, HE CLAIMS THAT HE
DID
NOT ENTER SCHOOL . HIS WIFE , MRS. BASITE IS A HOUSE WIFE AND REACHED ELEMENTARY
LEVEL .
WHILE THEIR THREE CHILDREN ARE ON THE ELEMENTARY LEVEL . MR. BASITE ’S MOTHER IS
RESIDING
WITH THEM .
B. FAMILY TREE
FATHER MOTHER
(deceased)
SIBLING SIBLING SIBLING SIBLING SIBLING SIBLING SIBLING
MR. BASITE MRS. BASITE
ELDEST
CHILD
SECOND
CHILD
THIRD CHILD
CHAPTER V
Subjective Data: I. Infestation of lice as a health deficit
“ Idi paylang nga nagadu en ti kuto ken kilit A. Inability to give adequate nursing care
na, makabulan en.”as verbalized by Mr. Basite to the sick member of the family due to:
Objective Data: a. lack of time in performing hygienic
measures
-infestation of lice and ticks on every strand of
hair. b. lack of knowledge in performing wound
carer
-developed lesions and wounds on the scalp
c. financial problem
-scratching on the head every now and then
Subjective Data: II. Flu as a health threat
“ Mayat met ti bagbagi mi. Depende lang nu A. Inability to make decisions with respect
masubraan ti trabaho.” as verbalized by Mr. to taking appropriate health actions due
Basite to:
a. Low salience of the problem or
condition.
b. Lack of knowledge regarding the
problem.
Subjective Data: III. Goiter as a health deficit
“ Nabayagen ah diyay goiter ni asawak. Haan A. Inability to give adequate nursing care
mi nga maipadoctor ta awan kwarta mi” as to the sick member of the family due
verbalized by Mr. Basite to:
a. Financial problem
b. Lack of knowledge regarding the
illness.
c. Lack of salience in visiting the RHU’S
for check-up.
Subjective Data: IV. Asthma as a health deficit
“ Ada ti asthma idi kaubingan ko paylang, A. Inability to give adequate nursing care
ngem tatta ket awanen met.” As verbalized by to the sick member of the family
Mr. Basite due to:
a. Inadequate knowledge about the
nature, severity and complications
of asthma.
b. Inadequate knowledge about the
nature of extent of nursing care
needed.
CHAPTER XI
I. Infestation of lice as a health threat
1. Nature of the 3/3x1 1 This problem is a health
Problem threat.
2. Magnitude of the 3/3x2 2 One of the family
Problem member is severely
infested with lice.
the Problem moderately modifiable.
Appropriate
interventions are
somewhat available.
4. Preventive 2/4x1 0.5 The problem cannot be
Potential totally prevented.
5. Salience 1/3x1 0.33 The problem is seen as
serious this needing an

urgent attention.
Total Score 5.16
II. Flu as a health threat
2. Magnitude of 3/3x2 2 The adults can be
the Problem greatly affected.
3. Modifiability of 2/3x2 1.33 The problem is highly
Appropriate
available to manage
the problem.
4. Preventive 3/3x1 1 The problem can be
Potential totally preventive.
5. Salience 2/2x1 1 The problem does not
require immediate
attention according to
the family.
Total Score 5.99
III. Goiter as a health deficit
problem health deficit.
2. Magnitude of 3/3x2 2 Only one member of
the problem the family is affected.
3. Modifiability of 2/3x2 1.33 The problem is highly
the problem modifiable if the
family will seek
medical assistance.
4. Preventive 2/2x1 1 The problem is
potential moderately
preventable.
immediate attention
Total score 7.16

IV. Asthma as a health threat
2. Magnitude of 2/3x1 0.66 Only one member of
the problem the family is affected.
3. Modifiability of 3/3x1 1 The problem is highly
the problem modifiable.
Appropriate
available to manage
the problem.
4. Preventive 3/4x1 0.75 The problem cannot
potential be totally prevented
though there are
measures that the
family could do to
minimize the attacks

such as preventing
exposure or
minimizing the
triggering factors of
asthma.
5. Salience 4/4x2 2 The problem is seen
as serious that needs
immediate medical
attention.
Total score 5.41
PROBLEM SCORES
1. Infestation of lice as a health threat 5.16
2. Flu as a health threat 5.99
3. Goiter as a health deficit 7.16
4. Asthma as a health deficit 5.41
.
CHAPTER VIII
Risk Factors
-Exposure to secondhand smoke
-Having blood relative with asthma
-Exposure to occupational trigger such as

chemicals used in farming
Underlying Pathophysiology
-Avoid exposure to Presence of allergens, viruses, pollutants, and diet
allergens such as dust
and animals.
-Administering
nebulization or
inhaled
cortecosteroids. Constricted muscles
-rapid shallow respirations
-diminished breath sounds

Thick mucus and Shrunken air sacs
-Shortness of breath -frequent pausing to catch
-Wheezing the breath when talking
-Difficulty breathing
-Cough ASTHMA

Health Deficit: GOAL OF CARE:  Discuss with the  Goal met, the
After home visit, the family the family identify
Asthma family takes necessary causes, effect measures that
action to properly and the member
manage asthma. complications of could do to
asthma. minimize
 Provide adequate attacks such as
OBJECTIVES OF knowledge on avoiding
CARE: After 2 days the various ways exposure or
of nursing in maintaining minimizing the
interventions the cleanliness in the triggering
family will be able to surrounding. factors and
identify and avoid the  Listen to the knowledgeable
factors that cause family’s on action to
asthma and the concerns about properly manage
number of asthma asthma asthma.
attacks requiring management and
medical intervention respond with
is reduced. information to
correct any
misconceptions.
 Teach the family
skills
(assessment, use
of equipment,
and giving
medications) for
managing the
asthma attacks.
to monitor the
response to
medications.
Health Threat: GOAL OF CARE:  Discuss with the  Goal met, the
After home visit, the family the causes, family identify
Flu family takes effect and measures that
necessary precaution complications of the member
to prevent flu. could do to
occurrences of flu.  Demonstrate minimize
proper hand occurrences of
OBJECTIVES OF washing and hand flu such as
CARE: After 2 days hygiene. avoiding
of nursing  Reiterate exposure or
interventions the importance of a minimizing the
family will be able to clean environment. triggering
identify and avoid the  Advice to increase factors and
factors that cause flu. oral fluid intake up knowledgeable
to 2-3L/day or as on action to
tolerated. properly
 Suggest to the manage flu.
family the use of
herbal plants such
as oregano and
lagundi.
 Listen to the
family’s concerns
and question or
any
misconceptions.
Family Goals and Nursing Interventions Evaluation Plan
Nursing Objectives of Care
Problem
Health GOAL OF CARE:  Discuss with  Goal partially
Threat: After home visit, the the family the met, the
family takes causes, effect family identify
Infestation of necessary action to and measures that
lice. properly minimize complications the member
or if possible of having could do to
eradicate the infested with minimize
production of lice lice and ticks. severity of the
and ticks.  Provide health infestation of
teachings on lice.
OBJECTIVES OF how to prevent
CARE: After 2 days and treat lice
of nursing and ticks.
interventions the  Facilitate on
family will be able removing the
to identify and avoid lice and ticks by
the factors that performing
cause the infestation delousing and
of lice and facilitate or if possible
proper wound care. cut all the hair.
 Demonstrate to
the family how
to do wound
care and
delousing and
allow them to
do so.
 Instruct the
family to
practice hand
washing and
proper hygiene
to prevent the
spread of the
parasite.
 Listen to the
family’s
concerns and
queries.
CHAPTER IX
This section contains the planned nursing intervention to be carried out. In order to facilitate
health education to the family the nurse learner creates a brochure or pamphlet which can be
distributed to them for further reference if the family members experience attack. The content of
this brochure are the following: Asthma is a lung disease that makes it difficult to breathe.
Airways that carry air in and out of the lungs become swollen and tight. People who are having
an asthma attack often cough, wheeze and feel that they need to catch their breath. The cause of
asthma is not known, there is no cure. A serious asthma attack can even result in death. Asthma
triggers are chemicals or allergens that make you have an asthma attack. Strong chemical smells,
dust or pets can also trigger an asthma attack. Asthma triggers may be very different than other
people with asthma. Not all asthma triggers affect people the same way. Environmental asthma
triggers can be found both indoors and outdoors.

CHAPTER X
CONCLUSIONS
After a week of home visits and with the nurse learner and client interaction, Mr. Basite
can partially provide the needs and wants of his family. There are certain problems of the family
that should be solved and mostly are medical related problems. The family needs more
information dissemination for them to be able to: A.)Give adequate and true information during
surveys and interviews. B.) Identify practices and behaviors that support and inhibit the
interpersonal relationship within the family. C.) Participate actively during home visits. D.)
Suggest on how to improve their lifestyle. E.) Perform Various health teachings given by the
nurse learner.
RECOMMENDATIONS
Community health nursing has always been a part of a nurse learner’s life. It has always
been our duty to provide quality nursing care even in the farthest places where medical help is
out of reach. Promotion and preservation of a healthy lifestyle and disease prevention through
proper health teachings, appropriate and adequate application of health actions, community
nursing. In order for us to fulfill our objectives, full cooperation, compliance and collaboration is
needed not only in the different families but also with the barangay health officials and workers
of Barangay Lubo. I like to recommend:
To the Barangay Health Official and Workers
To be able to provide help in every household, they should come hand in hand in being role
models and good examples in the community. They should also make time to make programs
that would involve the community people. Lastly, they should be updated in the different
programs, researches and discoveries of the different departments in our government, example is
the DOH.
To the Basite Family
I would like to encourage them to be more active in participating in different programs in
their community and to seek medical assistance whenever needed to prevent any further
complications. It is nice also if they spend some time together as a family to reduce stress and
exhaustion from work and different activities in life, a picnic will do.
To my co-nurse learners
I am hoping that we are able to help these families until we graduate and to continue even if
we did graduate. Let us not get tired on lending a hand to improve the lives of our fellowmen. It
would be hard and tiring all throughout the journey, but it is not regretful to have helped and
nourished other people. Let us be thankful that we are given the opportunity to experience a
different life away from home and away from our comfort zone.
CHAPTER XI
REFERENCES
Barbara W. Judith A. Community Health Nursing concept & practice 4th edit. 1996
Freeman & Heinrich. Community Health Nursing Practice 2nd edi. 1998
(Smith & Maurer,1995)
“Tools and Guidelines for Nursing at the Family Level”. The Anphi Papers,22(1):13,1977.
Updated by AS Maglaya in 2003

THE DUMAPIO`S: A FAMILY CASE STUDY
MANGHI, Florinda B.
Benguet State University

COLLEGE OF NURSING
La Trinidad, Benguet

MAY 2017
ACKNOWLEDGMENT
I praise and thank Him ,the Creator of everything,Who made all things possible through
His guidance,wisdom and unrelenting blessings.
To our clinical facilitators, Sir Jude L. Tayaben and Ma’am Aprila T. Calasan,I am
indebted to them all because they have provided valuable feedbacks so that I can strive more
unconditional love and care in this study and to the community who welcomed us
wholeheartedly in their beloved houses.
To the University that gave us the opportunity for learning experiences through this
To the College of Nursing that contributed in the academics about health and taught us
the skills we need for house visit and health education.
Finally, to my beloved family for their unconditional love and care in this study ,for their
financial support and friends for their understanding and support on me in completing this
requirement. Without this helping hands ,I will not be able to finish study.
Sincerely Yours,
FlorindaB.Manghi
CHAPTER I
INTRODUCTION
which is contributory to the development, and progress of the community through active
involvement and self-responsibilities of each constituent.
structure, exhibits and creates norms, values, and social institution.
In Community health nursing, one of the two major fields of nursing in the Philippines,
nursing practice in the community means different to others. Its primary goal is the promotion
and preservation of health of its client that could be in the individual, family, population, group
and community. In community health nursing practice includes nursing directed to individuals,
families, groups; the dominant responsibility is the population as a whole. With these, the health
of the people is a reflection of the communities of which they live, play, work and learn.
Communities shape the lifestyle that people adopt in the livelihood of living safe, fulfilling and
productive lives. Family, basic social group united through bonds of kinship or marriage, present
in all communities. Ideally, the family provides its members with protection, companionship,
security, and socialization. The structure and the needs of that the family fulfills vary.
Community health nursing is a response to the health needs of the people. It does not
focus on a particular class or family. It is comprehensive and general in approach. Community
health service is not episodic as it requires continuous observation and monitoring of the
community as a whole.
My community experience did not only provide an avenue to apply what we have
acquired in the university but also provided an opportunity to serve our fellowmen. Because in
the being in the community is more than meeting the requirements in the Related Learning
Experiences (RLE), it is experiencing the real world, making real memories and rendering
service with competence, conscience, commitment and care.
It is in the community where I learned the nursing part from the hospital setting as I was
exposed to different level of orientation. It is in the community where the saying “Nursing is an
art” can be applied.
The family that I chose is a picture of the majority of the family here in our country: a
family living in a poor environmental condition without enough resources and lacks knowledge
on vital health information and experiences other socio-economic related problems. Though it is
tiring as it is, reaching out to this family and mingling with them made me feel the sense of
fulfillment as I shared my knowledge, skill and time to aid in uplifting the condition of the
family.

CHAPTER II
GENERAL OBJECTIVE:
At the end of the student-family relationship, the adopted family will be able to improve
their health status and become self-reliant in maintaining their health through appropriate
interventions.
After the 3 day home visits and the student-family interaction, the family member will be
able to:
5. Express own perception and identify ways to improve interpersonal relationship within
their family and identify practices and behaviors that support and inhibit the interpersonal
relationship within the family.
6. Identify actual and potential problems which may be a hindrance in attaining optimum
health.
CHAPTER III
INITIAL DATA BASE
A. Family structure, characteristics and dynamics
NAME AGE(Years) SEX CIVIL POSITION OCCUPATIO EDUCATIONAL
STATUS IN THE N ATTAINMENT
FAMILY
Kim 27 Male Married Father Farming Elementary Level
Kin 21 Female Married Mother Farming High School
Graduate
Kit 4 Male Single Son -- --
Kiing 2 Male Single Son -- --
The AMOY family is a nuclear type of family. Nuclear type of family is a group of
people composed of mother, father,and two sons. A nuclear type of family is found in almost all
societies although the length of time in which the family remains in this form remains varies
even within the same society. The nuclear family can be a nurturing environment in which to
raise children as long as there is love, time spent with children, emotional support, low stress and
a stable economic environment. In nuclear families, both adults are the biological and adoptive
parents of their children, (Jay, 2004). The AMOY family is patriarchal in authority. Their house
is located at Salipang, Sayangan, Kibungan, Benguet. They are residing there for 3years in their
rented lot. The couple shares in decision making of the family. They consult each other in terms
of planning and budgeting for the family.
The family’s main source of income is in farming. Their monthly income ranges from
Php 2,000-3,000 monthly. They rent a lot where they are growing their Chayote near their
residence. Their income is being budget by Mrs. Kin for their daily food,medications, bills and
other expenses. According to the couple, their income is not enough for their daily expenses.
Their house is composed of wood and G.I. and it has oneroom where they can all sleep.
They use LPG in cooking and sometimes, they also use fire woods to reduce their expenses.
They have a radio that serves as their recreational activity. Their comfort room is located outside
the house and they have a pit toilet. Their water source is connected to a spring. They have an
individual pit for garbage disposal and drainage system. They have dogs and chicken that are
kept in their backyard.
According to Mrs. Kin, they are practicing family planning. She also claimed that they
consult to the clinic whenever they have concerns about their health. Fortunately, mother
articulated that there had not been any serious illness or injury that their family experienced
during their stay at Salipang but she identified some of the common health problems in the
community.
Mrs.Kin claims that no one in their family smokes nor drinks alcoholic beverages.
Generally, the family displays knowledge evident of being able to recognize the importance of
having a healthy well-being.Generally, the family displays less knowledge evident of being able
to recognize the importance of having a healthy well-being and maintaining a healthy lifestyle.
The family takes herbal medicines or products when they have cough and colds. When
suffering from pain like headache and muscle pains, they mentioned that they often take
paracetamol. Daily food intake consists of rice, eggs, meat and vegetables. Mrs.Kinsaid that they
usually have simple meal consisting of rice and a single viand. When out of budget, they resort
to instant noodles and canned goods andchickens.
Mrs. Kin claimed that they have regular bowel movement. She also added that they have
no problem or difficulty in defecating and urinating because they drink enough fluids especially
in the middle of the day when the heat rises.

Mrs.Kin emphasized they exercise regularly but also claimed that their work as a farmer,
serve as their exercise. She does the household chores and walking serve as her exercise.
The couple sleeps for 5-6 hours especially when they had to wake up early to work in the
garden. They often take naps in the afternoon.
During the interview, the Mrs.Kin is oriented to time, place and are able to respond
appropriately when asked. Mrs.Kin is confident in answering queries. Verbal patterns of
communication are noted to be spontaneous.
7. Self-perception
Mrs.Kin claims that she and her husband perceived some situations to be stressful but
remain optimistic about things and condition. He also added that when stressed, praying is a lot
helpful.Both are very concern of the welfare of their children and when someone gets sick.
8. Roles and relationships
It is observed in the family that they have an open communication. It is noted that the parents
imposed proper discipline and behavior in acceptable manner like respecting elders in
community. Their way of disciplining their children was way too acceptable.
9. Sexual reproductive
Mrs. Kin claimed that she is using depo and they are using withdrawal as their family
planning.
10. Coping stress
The family claims to gain strength and motivation from each other. They assure and
support their children.
11. Values-beliefs pattern
The family belongs to the Roman Catholic. They claimed that they are always praying
before they eat and when also before they sleep.
Kit and Kinghave completed their immunization. During illness, the mother claimed that
they sought consultation to their clinic.

CHAPTER IV
FAMILY BACKGROUND
A. Family History
The AMOY family is a nuclear type of family. As a nuclear family, the family is
composed of 4, the head of the family which is usually the husband, then the wife and their two
children. The husband is 29 years of age while the wife is 21 years old and is working as a
farmer. The nuclear family can be a nurturing environment in which to raise children as long as
there is love, time spent with children, emotional support, low stress and a stable economic
environment. In nuclear families, both adults are the biological and adoptive parents of their
children, (Jay, 2004).
The Amoyfamily is patriarchal in authority. Their house is situated along the mountain of
Salipang, Sayangan, Kibungan, Benguet. Mrs. Kin claimed that they rent the lot where they live
and he said that she stayed there for almost 5 years.
Mrs.Kin failed to mention any diagnosed genetic conditions that are present in their
family.
. Family Tree
AMOY FAMILY
KIM KIN
KIT
KING
LEGEND:
KIM-Blue
KIN-Pink
SONS-Gray
CHAPTER V
nursing diagnoses.
Subjective Data
“Man-uyuyekdin nay anakko,
manpupudotmetlangsisya,” as verbalized by the A. Inability to recognize the existence of a
parent problem due to ignorance of facts
Objective Data B. Inability to make decisions with respect to

-coughing episodes taking appropriate health actions due to:
-runny nose
-skin warm to touch 1. Failure to comprehend the nature, magnitude
or scope of the problem
2. Lack of knowledge as to alternative courses

of action open to them.
Subjective Data: Presence of possible breeding sites of insects,

“Jay drums adi ken pails a tipagtambakan mi
tidanum mi.“, as verbalized by Mrs.Kin mosquitoes and rodents as a foreseeable crisis
Objective Data:
Drums, plastic bottles and Car tires are directly Inability to provide a home environment
placed on the wet ground that can be breeding
sites of mosquitoes conducive to health maintenance and personal
development due to:
c. Lack of knowledge on the importance of
hygiene and sanitation.
d. Lack of knowledge regarding preventive
measures
Chapter VI
This part contains the foundation of the prioritization of the Nursing problems.
1. Cough and Colds as Health Deficit

1. Nature of the 3/3*1 1 This problem is a

Problem affected which may
affect other members
of the family.
3. Modifiability of 3/3*2 2 The problem is

the Problem highly modifiable.
Proper interventions
are available to
manage the problem.
4. Preventive 2/3*1 1.33 The problem can be

Potential highly prevented
maintenance and
lifestyle.
5. Salience 2/2*1 1 The problem is as

seen serious that
needs urgent action
since it is a concern
of all family
members.
Total Score 6.83
2. Presence of breeding sites, insects and rodents as Foreseeable Crisis

1. Nature of the 2/3*1 0.67 This is a foreseeable
Problem crisis.
2. Magnitude of the 3/4*3 2.25 Breeding sites of
Problem insects and rodents are
present.
3. Modifiability of the 2/3*2 1.33 The problem is highly
Problem modifiable. Proper
interventions are
available to manage
the problem.
4. Preventive Potential 3/3*1 1 The ability of the
family to minimize the
proliferation sites of
insects is high with the
utilization of existing
family resources.
5. Salience 1/2*1 0.5 It is not felt as a
problem by the couple.
Total Score 5.75
CHAPTER VII
Family Nursing Problem Goals and Objectives Nursing Interventions Evaluation Plan
of Care
Health Deficit Goals:
Cough and Colds 1. Discuss with the After the nursing
After the nursing family the causes and interventions, the
A. Inability to interventions, the effects of cough and family will be able
recognize the family will be able to colds. to:
existence of a minimize the
problem due to occurrence of cough 2. Provide adequate a. acquire adequate
ignorance of and colds in the knowledge on the knowledge about the
facts future. various ways of condition,
maintaining
B. Inability to make Objectives: cleanliness around b. utilize community
decisions with their home. resources available in
respect to taking After the nursing undertaking the
appropriate interventions, the 3. Explain the condition
health actions family will: importance of proper experienced
due to: food handling and
a. acquire adequate preparation, good
information about the nutrition, adequate
1. Failure to disease including rest and sleep and
comprehend the nature, causes, signs and strengthening each
magnitude or scope of symptoms and family member’s
the problem preventive measures. resistance to illness to
2. Lack of knowledge as prevent its
to alternative courses of b. Utilize community occurrence.
action open to them. resources available in
undertaking the 4. Promote proper
condition personal and
experienced environmental
hygiene among all
members of the
family.
FAMILY NURSING GOALS/OBJECTIVES NURSING EVALUATION

PROBLEM OF CARE INTERVENTION PLAN
Presence of breeding After nursing 1. Discuss the Goals and
sites, insects and intervention, the family importance objectives were
rodents as Foreseeable will be able to eradicate and purposes met if the family
Crisis: the presence of these of proper was able to clean
Inability to recognize unwanted sites of vectors sanitation. the house
the presence of the causing diseases and 2. Cite the especially the
threat due to lack therefore will maintain a causes and possible breeding
of/inadequate home environment effects of the sites and was able
knowledge. conducive to health. prevalence of to enumerate and
these observed teachings
Inability to make The family will be aware unwanted regarding
decisions to take and will be more insects around elimination of
appropriate actions knowledgeable about the and inside the breeding sites.
due to failure to importance of proper home.
comprehend the sanitation especially at 3. Suggest
nature of the home. methods that
condition. would
eliminate the
breeding sites
of vectors.
4. Explore with
the family the
ways of
improving
home
sanitations
considering its
limited
resources.
5. Emphasize to
the family the
proper storage
of food that
may attract
vectors.
CHAPTER VIII
GOALS OF CARE: After the nursing interventions, the family will be able to minimize the
occurrence of cough and colds in the future.
a. acquire adequate information about the disease including causes, signs and symptoms and
preventive measures.
b. Utilize community resources available in undertaking the condition experienced

Cough and colds 1. Discuss with the family the Pamphlets about the problem
A. Inability to recognize the and colds.
B. Inability to make decisions knowledge on the various
with respect to taking ways of maintaining
appropriate health actions due cleanliness around their
to: home.
1. Failure to comprehend the
nature, magnitude or scope of 3. Explain the importance of
the problem proper food handling and
2. Lack of knowledge as to preparation, good nutrition,
alternative courses of action adequate rest and sleep and
open to them. strengthening each family
family.
GOALS OF CARE: After nursing intervention, the family will be able to eradicate the
presence of these unwanted sites of vectors causing diseases and therefore will maintain a
home environment conducive to health.
OBJECTIVES OF CARE: The family will be aware and will be more knowledgeable about
the importance of proper sanitation especially at home.
Presence of breeding sites, 1. Discuss the Material Resources:
insects and rodents as importance and Visual Aids on health
Foreseeable Crisis: purposes of proper teaching.
Inability to recognize the sanitation.
presence of the threat due to 2. Cite the causes and Human Resources:
lack of/inadequate effects of the Time and effort of the nurse
knowledge. prevalence of these leaner and the family.
unwanted insects
Inability to make decisions to around and inside the
take appropriate actions due home.
to failure to comprehend the 3. Suggest methods that
nature of the condition. would eliminate the
breeding sites of
vectors.
4. Explore with the
family the ways of
improving home
sanitations
considering its limited
resources.
5. Emphasize to the
family the proper
storage of food that
may attract vectors.
CHAPTER IX
OVER-ALL WORK PLAN
Problems Solutions Identified Time Frame
Poor Sanitary Health Education November 2017
Environment
CHAPTER X
CONCLUSIONS AND RECOMMENDATION
CONCLUSIONS
a) Family participate actively during home visit and assessment interviews,
b) Gives pertinent and factual information during surveys and interviews,
c) The Amoy family is not risk with other genetic illnesses,
d) Amoy family is open to change and new health teachings in turn taking the proper

RECOMMENDATIONS
Community health nursing has been a part of every nurse learners’ life. It is a
nurse’s duty to provide immediate health care to the community people’s health problems
before going to the higher health care facilities. Promotion and preservation of healthy
lifestyle and disease prevention through proper health teachings, appropriate application
of health actions, community activities are some ways to build a stepping stone for the
certain aims of community health nursing. The cooperation and collaboration of not only
the assigned family, community but also with the barangay health officials and workers
of Barangay Lubo or Bobocco are needed to fulfill the certain objectives. To be able to
help and provide proper health care services, the workers of the Barangay Health centers
should continue portray being role models to the residents of the community. They
should be more open and accommodating in order to be effective health teachers. To
Family Amoy, in order to acquire more knowledge regarding health, they should engage
in certain different programs that can serve as a basis in handling health matters at home.
If they encounter a certain illness, they should go to the Barangay Health Center for
proper consultation and diagnosis. They should also be open to the suggestions and
introduction of health teachings for her to practice regularly at home to manage good
health conditions.
CHAPTER XI
REFERENCES
Irwin, R. S., 2006,
Jay 2004,
Nanda (2011)
THE “VENTURAS”: A FAMILY CASE STUDY
PAAC,SHANAYA ROSE T.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
Enormous gratitude is given to the “Ventura” Family who cordially welcomed us during the
conduction of our home visits and openly shared information and knowledge regarding health
and other things that led us to the success of our survey. Furthermore I would like to
acknowledge our Clinical Instructors Sir Jude L. Tayaben and Maam Aprila Calasan who
dynamically directed us till the termination of the said activity. We wouldn’t make it without
your supervision. To team Sayangan, to my comrades, we had made it to the Third immersion,
we have already built the bases of our tower, let’s ponder more. I would also like to convey
appreciation to Benguet State University College of Nursing for giving us this opportunity to
learn and broaden our horizons. This community immersion taught us a lot, not just about living
with the people but also to appreciate the struggles they’ve been facing.
SHANAYA TAGABAN PAAC

CHAPTER I
INTRODUCTION
“No other success can compensate for failure in the home.”
-David O. McKay
It’s no stretch to say that a person has a serious advantage in life if they come from, a
loving, supportive home. Many people still succeed though they come from less than ideal
family situations , but having our basic needs met , knowing that our parents love us ad learning
life lessons at home make all the challenges of day to day living that much easier to face. Likely,
as an adult you want a happy home for your family.
This is no coincidence. God organizes us into families so that we can grow up in
happiness and safety, and so that we can learn to love others selflessly- the key to true joy.
Within the family is the best place to learn love others the way Heavenly father loves each one of
us.
Family is the basic unit consisting of parents and their children, considered as a group,
whether dwelling together or not. Community health nursing is a response to the health needs of
the people. It does not focus in a particular class or family. It is comprehensive and general in
approach. Community health service is not episodic as it requires continuous observation and
monitoring of the community as a whole.
CHAPTER II
This chapter presents the general and specific objectives of the family case study. Setting
objectives serves as a road map for the planning of nursing interventions. Objective setting
facilitates the motivation for the client and the nurse by providing a sense of achievement,
( Kozier and Erb, 2004).
General Objectives:
At the end of the nurse learner-family relationship, the family should be able to display expected
means to improve the health status of every family member.
Specific objectives:
After a week of home visits and with the nurse learner and the family interaction, each of the

a. Establish rapport and maintain open communication between the nurse learner and the family
to facilitate achievement of pertinent and factual information during surveys and interviews.
b.Identify actual from potential problems to obtain optimum health.
c.Actively participate and express own perceptions and identify ways to improve or manage the
identified health problem.
d.Prioritize the identified health problems and plan for possible solutions or nursing
interventions.
e. Categorize the identified health problems as health threat, health deficit or foreseeable crisis
through the guidance of the knowledgeable nurse learner.
f. Take to action the plans made and openly give suggestions and comments regarding set
objectives.
CHAPTER III
INITIAL DATA BASE
includes the Family Structure, Characteristics and Dynamics, the socio-Economic and Cultural
Characteristics, the Home and Environment, the Health Assessment of each family member, and
the Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.
A. Family Structure, Characteristics, Dynamics
NAM AGE SEX CIVIL POSITIO OCCUPATIO EDUCATIONAL

E (years) STATU N IN THE N ATTAINMENT
(code S FAMILY
names)
Mr.V 64 Male Married Father Farming Elementary
Undergraduate
Mrs. V 60 Female Married Mother Farming Elementary
Undergraduate
AA 27 Male Married Son Farming Elementary
Undergraduate
BB 24 Male Married Son Farming Elementary
Undergraduate
CC 22 Male Single Son Farming Elementary
Undergraduate
The Ventura Family is a nuclear type of family. As a nuclear family is composed of
Father A, mother B and their four children AA, BB, and CC.A nuclear type family is found in
almost all societies although the length of time in which the family remains in this form remains
varied even within the same society. The nuclear family can be a nurturing environment in which
to raise children is always appropriate and achievable as long as there is love, exclusive family
time, and emotional support, low stress and stable economic status. In nuclear families, both
adults are the biological and adoptive parents of their children, (jay, 2004). The Ventura Family
resides in Tolmod, Sayangan, Lubo, Kibungan , Benguet. Tolmod is one of the farthest places in
Sayangan. They resolve to gardening as their primary source of income, they work from dawn
till sunset to support their daily needs, since none of them had graduated. They only depend on
farming as their source of living which makes them more vulnerable to diseases. As for their
shelter, it is made up of wood and galvanized iron. Their sleeping quarters were unorganized but
adequate.
Mr. and Mrs. Ventura both originated from Kankana-ey tribe, both were igorots. They
still practice the cultures and beliefs of igorots like, butchering animals to offer for those
departed souls.
The family’s main source of income is farming. Mr. and Mrs. Ventura together with their
two sons work on their farm and have estimated salary of 1000 per month. Mrs. Ventura admits
that it is not enough to suffice their daily needs that are why she says they sometimes work at
their neighbor’s farm in order to complement the inadequacy of budget and to gather vegetables
for consumption.
Even with the distance Ventura family’s house was built and equipped well. They use
stove for cooking their food and electricity as their lighting. Their work place lies near their
home, the house was well built, and it has good ventilation and space. As for recreational
facilities they have television and radio. In general, they live in a healthy home environment.
The family recounts no history of hypertension o both lineage but suddenly years ago
Mr. Ventura had been diagnosed with Diabetes Mellitus while Mrs. Ventura was diagnosed with
Hypertension. Mr. Ventura lost his eye due to complications of his DM.The three children deny
any of these illnesses.
During the home visit the Ventura family was not in any form of distress, at the
moment both Mr. and Mrs. Ventura takes maintenance medication given by the midwife at
Bobocco and says they were consulting regularly for check-ups. Mrs. Ventura says her children
were experiencing cough and colds and believes this was the effect of unpredictable changes of
weather.
1. Health Perception – health management patterns
The member of the family except Mr. Ventura and his two sons, AA and BB claims not to drink
any alcoholic beverages. Mr. Ventura claims to drink beer while his two sons AA and BB drink
gin and beer occasionally. Mr. Ventura drinks an estimate of 1-2 bottles while his sons estimates
5-6 glasses for gin and 2-3 bottles for beer. Though during his younger years, Mr. Ventura
claims to be able to drink a case of beer with his friends. He started to drink alcoholic beverages
at the age of 17.
The Ventura family admits that they gained knowledge mainly on the importance of having a
healthy lifestyle, through the efforts of BSU Nurse Learners, and through frequent check-up they
admit that due to old age, they would be more likely to be exposed to diseases.
2. Nutritional- Metabolic pattern
Ventura Family resolve to herbal medicines when it comes to illnesses like cough and
colds and are able to perform some interventions like Tepid sponge bath in terms of fever. As
serious illnesses arise, they consult the RHU to seek medical attention.
Daily food intake consists of rice, vegetable and sometimes meat. Mrs. Ventura further
elaborated that their meal would always be rice and a single viand, mainly vegetable that was
freshly harvested from their farm. They rarely eat meat and other cuisine because of poverty as
claimed by Mrs. Ventura.
The family claims to defecate everyday usually in the morning. Generally, the children
including them, parents have observed that they urinate an average of 6 times daily. Their urine
is generally observed to be colored light yellow except for Mr. Ventura wherein he claims that he
has darker colored urine but furthermore he doesn’t complain of the odor or some sort of pain
while urinating. They claim that they usually experience watery stools after occasions like”
Kanyao” which make them conclude that they acquire it because of the foods eaten.
4. Activity- Exercise Pattern
The family does not regularly exercise but claims that their work as farmers serves as
their exercise. They claim that they don’t have time to exercise, and if they do have
spare time they would rather sleep or rest.
5. Sleep- rest Pattern
As claimed by Mr. Ventura estimated time for sleeping was 7-10 hours. They work
hard on the field all day so they sleep uninterrupted because of tiredness. Mrs. Ventura as well
reports that she at times takes a nap during the afternoon.
6. Cognitive- Perceptual Pattern
Mr. and Mrs. Ventura are oriented to time, place and are able to respond appropriately
to questions. They are both shy during the interview but they can be able to rationalize when
asked to explain things. Verbal patterns of communications are noted to be spontaneous.
7. Self-perception / self-concept
Every member opens and discusses concerns, they all display openness and
acceptance. Living life is great challenges they’ve learn to deal with every day. They are always
optimistic and positive. They properly deal with issues, they decide as a family, they easily learn
to adopt and consider changes.
The family members are observed to have an open communication. The children
express their concerns and feelings to their parents openly. In like manner, the couple as well
displays openness and concerns of their children and to each other. Their parents strictly enforce
discipline; respect in terms of parent-child relationship can be distinguished.
9. Sexual/ Reproductive Health
Mr. and Mrs. Ventura are now in their old ages.
10. Coping Stress
The family claims to gain strength and motivation from each other. Assurance and
support are ensured by Mr. and Mrs. Ventura to their children especially to their son Chester who
still needs their support.
11. Values/ Belief Pattern
The Ventura Family belongs to the Lutheran church. Mrs. Ventura claims that they have
a strong fear in God, in what they call “inayan”. Though they do not always attend the mass, they
make it to a point to pray and offer a thanksgiving to Kabunian by butchering a chicken and set it
as an offering.
12. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.
The children in the family didn’t complete their immunizations. According to Mrs.
Ventura the access of medical services to Tolmod is very difficult. If wanted to, they could just
go to Bobocco RHU but the problem was the transportation. Travelling to Bobocco would take
them two hours which can be very tiring and at the same time dangerous. Mrs. Ventura is
cognizant of the importance of food preparation but claims that she at times is left no choice but
to resort to instant goods rather than preparing nothing to eat. They’re financially restrained that
is why Mrs. Ventura is guilty about not being able to prepare nutritious foods for her family.
During illness they use herbal plants as their remedy for the initial phase but if the illness still
won’t subside they have no choice but to travel and consult the nearest RHU which is situated in
Bobocco. On the other side the culture of being igorot is also practiced during illness, they
consult the mambuneng for the restoration of their health and follow whatever advice the
mambunong says.
Chapter IV
FAMILY BACKGROUND
The Ventura Family is a nuclear type of family. As a nuclear family is composed of
Father A, mother B and their three children AA, BB, and CC and .A nuclear type family is found
in almost all societies although the length of time in which the family remains in this form
remains varied even within the same society. Mr. and Mrs. Ventura were both elementary
undergraduate, because of poverty they were unable to finish their studies because they can’t
suffice their needs in going to school. They both engaged in farming which initially started in
their younger years, and then later it became their occupation. Their eldest child AA is now
married and is living with his child at Itogon, Benguet. The second child, BB has already stopped
his schooling and married, he is now at Madaymen, Kibungan. CC is the only one left with them.
Farming is the only way they can suffice with their daily needs. Working from dawn till sunset
while being exposed in the extreme heat they say, life is hard, but they have no choice but to live
it as it is.
A. Family Tree
Mr. Ventura Mrs. Ventura

Married to
CC
AA BB
PARENTS
MALE
FEMALE
CHILDREN
B. Family Genogram
Mr. Ventura Mrs. Ventura

(DiabetesMellitus) (Hypertension)
CC
AA BB
(Cough & colds)
Chapter V
Cues or data Family Nursing Problems

Subjective data:
- “Adi kami unay makalinis tan pag tan I. Presence of possible breeding sites
mamabay ai magapu isa salulungan of insects’ rodents and vectors as a
ya,narigat pay adi di danum sina health threat.
Tolmod isunga mentataya kami” as
expressed by Mrs. Ventura A. Inability to recognize the
Objective data: presence of threat due to
- House was not in order, not well kept. inadequate knowledge.
Presence of vectors such as flies and B. Inability to make decisions to
mosquitoes. take appropriate actions due to;
- Water for washing and at the same time a. Failure to comprehend the
used in cooking was stored in a dirty nature of the condition.
drum outside their house.
- Uncovered containers particularly filled
with water seen near the toilet facility
Subjective data: II. Poor Hygiene

- “Narigat pay adi di danum sina isunga C. Inability to provide a home
maminsan kami ay mansukat ya man environment conducive to
ames” health maintenance and
Objective data: personal development due to ;
- Used clothes were seen everywhere. a. Inadequate knowledge of
- Nails were dirty and untrimmed. importance of hygiene and
- They neither eat nor drink without sanitation.
properly washing their hands; they b. Lack of knowledge of
seldom wash the clothes they use. consequences of the
problem.
c. Inadequate knowledge of
preventive measures
d. Lack of resources mainly,
water.
Subjective data: III. Cough and Colds
- “kana ok-ok ngarud din iaudi ay sana, D. Inability to provide adequate
karkaru edwani ay panag uudan et, nursing care to the sick or
duwan man panateng pay, ngem vulnerable member of the
kasiana samet ad sin panagbaliw di family due to;
tiempo” as verbalized by Mrs. Ventura a. Lack of knowledge about
Objective data: the illness.
- Drinking water used for cooking and b. Inadequate knowledge of
washing are stored in containers found preventive measures
outside the house.
- They continue working even the rain
pours, CC after working, rests for a
while before taking shower.
Subjective data: IV. Health Threat: Presence of Accident
- “ madi garud di epekto na ay, hazards
manparigat ta et ay buma sin agdan tan E. Inability to provide a home
umeegyat ta” environment conducive to
As verbalized by Mr. Ventura health maintenance and
Objective data: personal development due to ;
- The house has two stairs, one going to a. Lack of knowledge of
the sleeping room and the other to the consequences of the
kitchen. problem.
- Mr. Ventura lost his left eye due to b. Inadequate knowledge of
complications of DM; he finds it hard preventive measures
to go down the stairs especially when
lights are off.
Chapter VI
I. Presence of possible breeding sites of insects, rodents and vectors as a health threat.

6. Nature of the 2/3 x 1 0.66 This problem is a
7. Magnitude of 4/4 x 3 3 Almost all of the
the Problem family members
could be affected.
8. Modifiability of 2/3 x4 2.66 The problem is
the Problem modifiable. To solve
the problem, possible
breeding sites around
their house shall be
removed.
the family will be
to prevent or
formation of breeding
sites of the insects,
rodents and vectors.
10. Salience 4/2x 1 2 The problem needs
immediate attention
according to the
family.
Total 9.32
Score
II. Poor Hygiene

11. Nature of the 3/3 x 1 1
Problem
12. Magnitude of the 2/4x3 1.5 Almost all of the
Problem family members are
affected.
13. Modifiability of 4/3x 4 5.33 The problem is easily
the problem clothes and
any belongings should
be kept clean; body
should always be well
groomed.
14. Preventive 3/3x1 1 The problem could be
Potential highly prevented .This
could be done if the
family is educated on
the importance of
cleanliness and
sanitation to health and
its great impact to
health.
15. Salience 2/2x 1 1 The problem is a
serious matter because
it involves all.
Total 9.83
Score
III. Cough and Colds

11. Nature of the 2/3 x 1 0.66 This problem is a
12. Magnitude of 2/4 x 3 1.5 Almost all of the
could be affected.
the problem, A
review on healthy
diet should be
conducted, they have
lemon at their
background, the need
to discuss the benefits
and herbal potencies
of these resources
would be of great
help.
the family will be
to prevent or
causes of having
cough and colds.
15. Salience 2/2x 1 1 The problem doesn’t
need immediate
action.
Total 6.82
Score
IV. Presence of Environmental Hazards

17. Magnitude of 3/4 x 3 2.25 Almost all of the
could be affected.
the problem, A
review on healthy
diet should be
conducted, they have
lemon at their
background, the need
to discuss the benefits
and herbal potencies
of these resources
would be of great
help.
19. Preventive 2/3x 1 0.66 The problem could be
the family will be
to prevent or
causes of having
cough and colds.
20. Salience 2/2x 1 1 The problem doesn’t
need immediate
action.
Total 7.57
Score
PROBLEMS SCORES
1. Poor Hygiene 9.83
2. Presence of Possible breeding sites of insects, rodents and vectors. 9.32
3. Presence of Environmental Hazards 7.57
4. Cough and Colds 6.82
Chapter VII
Cough and Colds
Weak Resistance
Trigger Factor
Airway Inflammation
Mucus Production Airway muscle tightening Swollen Bronchial Membranes
Narrow Breathing Passages
Wheezing, Cough, Shortness of breath
Diabetes Mellitus
Insufficient insulin
Reduced tissue uptake of Glucose
Intracellular Extracellular
Hypoglycemia Hyperglycemia
Glucogenesis &
Gluconeogenesis Hyperosmotic plasma Blood glucose > renal
threshold
Breakdown of fats
Decreased protein
synthesis Dehydration of cells
Cachexia Glucosuria- urine has
Lethargy a high SG
High levels of ketones Polyphagia
Decreased gamma
globulin Hyperglycemic coma
Susceptibility to Osmotic diuresis
infection Polyuria
Impaired wound Polydipsia
Diabetic ketoacidosis healing Hypokalemia
Hypertension
Irritation of SNS within the Dura or PPL of the cervical spine

Sympathetic trunk and ganglia
SNS in the vertebral artery SNS in the blood vessel
Constriction of vertebral artery ad blood vessel
HYPERTENSION
Chapter VIII

PROBLEM NURSING CARE CARE NURSING METHOD RESOURC
S PROBLEMS INTERVENTIONS OF ES
NURSE REQUIRED
FAMILY
CONTACT
Poor 1. Inability to After After nursing Material
Hygiene recognize the nursing intervention the Resources
presence of the intervention family: Home :
condition or , the family visit
problem due to will take 1. Would be Provide adequate
lack of necessary able to state the knowledge Visual
knowledge. measures to effects of poor through aids
prevent hygiene discussing the
diseases practices to the effects of poor Time and
2. Inability to related to body. sanitation. effort of
make decisions poor the nurse
with respect to hygiene. 2. Would be and the
taking able to Broaden the family
appropriate enumerate the knowledge of the
health action health family about the Expenses
due to failure to risks/complicati health risk and for the
comprehend the ons of poor complications of materials
nature of the hygiene poor sanitation. used and
problem. practice. the
Explore the transport
3. Inability to 3. Would be family on how to ation of
provide able to lessen the bad the nurse
adequate enumerate ways effects of these.
nursing care to on how to
the sick or reduce
vulnerable complications
member of the brought by Discuss with the
family due to such. family the
lack of benefits of
knowledge 4. Would be stopping or
about the able to lessening the
possible illness enumerate the effects of
that poor benefits of improper
sanitation can practicing sanitation.
cause. proper hygiene.
4. Inability to 5. Would select

provide a home appropriate
environment action in
conducive to reducing
health complications of
maintenance improper
and personal hygiene.
development
due to lack of
knowledge to
preventive
measures.

PROBLEM NURSING CARE CARE NURSING METHOD RESOUR
S PROBLEMS INTERVENTION OF CES
NURSE- REQUIR
FAMILY ED
CONTACT
Presence 1. Inability to After After nursing Impart adequate Material
of possible recognize the nursing intervention the knowledge Resourc
breeding presence of the intervention family: through Home visit es:
sites of condition or , the family discussing the
insects, problem due to will take 1. Would be effects of poor
rodents lack of necessary able to state the sanitation. Visual
and knowledge. measures to effects of aids
vectors. eradicate presence of
breeding rodents and Diversify their Time
2. Inability to sites around insects to the knowledge about and
make decisions their house safety of the health risk effort of
with respect to and the individual and and the
taking family will family. complications nurse
appropriate be educated they can acquire. and the
health action on family
due to failure to measures to 2. Would be
comprehend the prevent or able to Expense
nature of the minimize enumerate the Explore the s for the
problem. the possible health family on how to material
formation of risks/complicati exercise pest s used
3. Inability to breeding ons brought by control. and the
provide sites of the insects, pests, transpor
adequate insects, and rodents. tation of
nursing care to rodents and the
the sick or vectors. Discuss with the nurse
vulnerable 3. Would be family the
member of the able to benefits of
family due to enumerate ways stopping or
lack of on how to lessening the
knowledge reduce effects of
about the complications improper
possible illness brought by sanitation.
that these pests such.
can transmit.
4. Would be
4. Inability to able to
provide a home enumerate the
environment benefits of
conducive to maintaining the
health environment
maintenance clean and
and personal conducive to
development development.
due to lack of
knowledge to
preventive 5. Would select
measures. appropriate
action in
reducing the
presence of
these breeding
sites.

PROBLEM NURSING CARE CARE NURSING METHOD RESOURCE
S PROBLEMS INTERVENTIO OF S
N NURSE- REQUIRED
FAMILY
CONTACT
Cough and a.Inability to After After nursing Impart Material
Colds provide nursing intervention the adequate Resources:
adequate intervention family: knowledge Home
nursing care to , the family through visit
the sick or will take discussing Time and
vulnerable necessary 1. Would be able nutrition. effort of
member of the measures to to enumerate the the nurse
family due to; prevent the health and the
b.Lack of occurrence risks/complicatio family
knowledge of cough ns brought
about the and cold / improper Expenses
illness. given the nutrition and for the
c.Inadequate knowledge intervention materials
knowledge of on nutrition. towards these used and
preventive illnesses. the
measures Diversify their transporta
3. Would be able knowledge tion of the
to enumerate about the nurse
ways on how to health risk and
boost immunity complications
against these they can
diseases. acquire.
4. Would be able
to enumerate the
benefits of
maintaining
immunity and Explore the
proper nutrition. family on the
5. Would select uses of herbal
appropriate plants found at
action in their
reducing the surroundings.
presence of
these illnesses.
Chapters IX
GOAL OF CARE: After nursing intervention, the family will take necessary measures to prevent
diseases related to poor hygiene.
OBJECTIVES OF CARE: After nursing intervention the family:
1. Would be able to state the effects of poor hygiene practices to the body.
2. Would be able to enumerate the health risks/complications of poor hygiene practice.
3. Would be able to enumerate ways on how to reduce complications brought by such.
4. Would be able to enumerate the benefits of practicing proper hygiene.
5. Would select appropriate action in reducing complications of improper hygiene.

Material Resources:
Poor Hygiene
1. Inability to recognize the Provide adequate knowledge
presence of the condition or through discussing the effects Visual aids
problem due to lack of of poor sanitation.
knowledge. Time and effort of the nurse
and the family
2. Inability to make decisions Expenses for the materials

with respect to taking Broaden the knowledge of the used and the transportation of
appropriate health action due family about the health risk the nurse
to failure to comprehend the and complications of poor
nature of the problem. sanitation.
3. Inability to provide
adequate nursing care to the Explore the family on how to
sick or vulnerable member of lessen the bad effects of these.
the family due to lack of
knowledge about the possible
illness that poor sanitation can
cause.
Discuss with the family the
4. Inability to provide a home benefits of stopping or
environment conducive to lessening the effects of
health maintenance and improper sanitation.
personal development due to
lack of knowledge to
EVALUATION OF INTERVENTIONS: Goal was met. The family verbalized understanding

about the disadvantages to health that poor hygiene can give.
GOAL OF CARE: After nursing intervention, the family will take necessary measures to
eradicate breeding sites around their house and the family will be educated on measures to
prevent or minimize the possible formation of breeding sites of the insects, rodents and vectors.
OBJECTIVES OF CARE: After nursing intervention the family:
1. Would be able to state the effects of presence of rodents and insects to the safety of individual
and family.
2. Would be able to enumerate the health risks/complications brought by insects, pests, and
rodents.
4. Would be able to enumerate the benefits of maintaining the environment clean and conducive
to development.
5. Would select appropriate action in reducing the presence of these breeding sites.
Presence of possible breeding Impart adequate knowledge Material Resources:

through discussing the effects
sites of insects, rodents and of poor sanitation.
Visual aids
vectors.
Time and effort of the nurse
and the family
Expenses for the materials
used and the transportation of

Diversify their knowledge the nurse
about the health risk and
complications they can
acquire.
Explore the family on how to

exercise pest control.
Discuss with the family the

benefits of stopping or
lessening the effects of
improper sanitation.
EVALUATION OF INTERVENTIONS: Goal was met. The families agreed to conduct general
cleaning to search and destroy for breeding sites; they also verbalized understanding of the health
risks and complications brought by pests.
GOAL OF CARE: After nursing intervention, the family will take necessary measures / action to
minimize the percentage of accidents. ex. Putting rails at the stairs.
OBJECTIVES OF CARE:
After nursing intervention the family:
1. Would be able to enumerate the health risks bought by these structural hazards.
3. Would select appropriate action in reducing accidents.
Health Threat: Presence of Material Resources:

Accident hazards Provide adequate knowledge
through discussing the
importance of safety even
inside the house. Time and effort of the nurse
and
the family
Explore the family on how to
lessen the bad effects of these. Expenses for the materials
used and
the transportation of the nurse
EVALUATION OF INTERVENTIONS: Goal was met. The family members identified the
hazards inside and outside the house and
GOAL OF CARE: After nursing intervention, the family will take necessary measures to prevent
the occurrence of cough and cold / given the knowledge on nutrition.
OBJECTIVES OF CARE:
After nursing intervention the family:
1. Would be able to enumerate the health risks/complications brought improper nutrition and
intervention towards these illnesses.
3. Would be able to enumerate ways on how to boost immunity against these diseases.
4. Would be able to enumerate the benefits of maintaining immunity and proper nutrition.
5. Would select appropriate action in reducing the presence of these illnesses.
Cough and Colds Impart adequate knowledge Material Resources:

through discussing nutrition.
Time and effort of the nurse
and
the family
Diversify their knowledge
about the health risk and Expenses for the materials
complications they can used and
acquire. the transportation of the nurse
Explore the family on the uses

of herbal plants found at their
surroundings.
EVALUATION OF INTERVENTIONS: Goal was met.
A. Environmental sanitation
- Discussion would be focused on the advantages and benefits of having a clean
environment. The risks and complications and its effects to health and on the physical,
mental, developmental, social aspects of the family.
B. Proper Hygiene
- Benefits and advantages of being well groomed( taking a bath daily, tooth brushing every
after meal, changing of soiled clothes etch.) would be highlighted. Proper hand washing
will be demonstrated followed by nail cutting.
Chapter X
CONCLUSION
I therefore deduce that conducting this family case study doesn’t focus on the survey but it
requires “digging” into the family’s life. It’s more than surveying.
The Ventura Family is a family with incomparable hospitality and ingenuity. They take advice
positively; they are open in making changes for the sake of their family. They are very attentive
and responsive during the interview. They openly share experiences to satisfy and complement
the data’s given in order for us to formulate our hypotheses and make appropriate actions. Main
causes of these identified problems were lack of knowledge and resources. We have identified
four health problems, the poor hygiene, presence of possible breeding sites of pests, Presence of
accident hazards and lastly cough and colds. By looking at the nature of the problem, percentage
of modifiability and preventive potential are high, meaning chances of finding solutions for
these problems were very achievable. With the eagerness of the Ventura family, things could be
changed and put to proper manner.
RECOMMENDATION
Evaluation of our actions would be after 4-6 months upon implementation therefore
monitoring should be done to ensure that positive results would be achieved. I am very pleased
with how the Ventura Family showed their enthusiasm and determination. I saw how they
struggle to work for living yet they take things positively. I have strong credence that Ventura
family would be able to achieve our goal within the time frame.
Chapter XI
REFERENCES
Batty GD, Kivimaki M, Smith GD, Marmot MG, Shipley MJ. Obesity and overweight in relation
to mortality in men with and without type 2 diabetes/impaired glucose tolerance: the original
Whitehall Study. Diabetes Care. 2007;30(9):2388-91.
Mosdol A, Witte DR, Frost G, Marmot MG, Brunner EJ. Dietary glycemic index and glycemic
load are associated with high-density-lipoprotein cholesterol at baseline but not with increased
risk of diabetes in the Whitehall II study. Am J Clin Nutr. 2007;86(4):988-94.

Steven D. Ehrlich, NMD, a private practice specializing in complementary and alternative
medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by
the A.D.A.M. Editorial team.
Handouts given by Ma’am Carol Ruth Valles on NCM 100.
Manual Of Nursing Diagnosis / Edition 13
by Marjory Gordon
SBN-10: 1284044432
ISBN-13: 9781284044430
Pub. Date: 11/13/2014
Publisher: Jones & Bartlett Learning
THE ‘CAYAT’S’: A FAMILY CASE STUDY
PAKILO, Kynahryl B.
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
This study has given me an opportunity to discover and learn new things in
the community, it’s environment and health status. But none of these would be possible
without the help of significant people that helped me to fulfill this study.
First and foremost, I would like to thank our Lord Almighty for giving me the
opportunity to be with the people in the community. For guiding me and giving me wisdom in
fulfilling my tasks as a nurse learner. Thank you Lord for giving me the strength to endure
everything.
To our Clinical Facilitators, Mr. Jude L. Tayaben and Mrs. Aprila who guide and support us
and who are with us all the way through. I am truly grateful for your presence, your
understanding, patience and humor. You are truly a blessing to all of us.
To Ms. Cayat for being for being approachable, cooperative and for spending their time in
answering all the questions being asked.
To my parents for the unending support, guidance, patience, and funding of the
this study.
Lastly, to my co-nurse learners, especially our group in Sayangan for the
friendship, companionship and support. And for being one team throughout the
KYNAHRYL B. PAKILO
CHAPTER 1
INTRODUCTION
Family is an open and developing system of interacting personalities with
structure and process enacted in relationships among the individual members
regulated by resources and stressors and existing within the larger community (Smith &
Maurer,1995).
Community health nursing defined as a collection of people who interact with one another
and whose common interest or characteristics gives them a sense of unity and belonging. A
community is a group of people in defined geographical area with common goal and objective. It
is defined as the synthesis of nursing and public health practice applied to promote and protect
the health of population. It is a specialized field of nursing that focuses on the health needs of
communities, aggregates, and in particular vulnerable populations. It is a practice that is
continuous and comprehensive directed towards all groups of community members. It combines
all the basic elements of professional clinical nursing with public health and community practice.
(Mengistus&Misganaw, 2006)
CHAPTER 2
This chapter should present the general and specific objectives of the family case study.
Setting objectives serves as a road map for the planning of the nursing interventions. Objective
setting facilitates the motivation for the client and the nurse by providing a sense of
achievement, ( Kozier and Erb, 2004)
General Objectives:
At the end of the nurse learner-family relationship, the family should be able to display
expected means to improve the health status. Help to improve the community as one of the ways
to deliver health promotion in the society. Understand the community and share health teachings
to the society can help elevate the condition of our society. Rendering health services to certain
individuals influences the neighborhood. Observing proper waste disposal to makes the
community aware of the health of their environment.
After a week of home visits and with the nurse learner and family interaction, each of
the family members should be able to;
f. Give adequate and true information during the surveys and interviews.
g. Participate actively and act interested during home visits.
h. Suggest on how to improve their lifestyle.
i. Determine the condition in which the family lives and identify the conditions that
affect their health and know how to manage it.
j. Perform various health teachings given by the nurse learner.

CHAPTER 3
INITIAL DATA BASE
The Initial Data Base includes the information about the family in various
dimensions. It includes the Family structure, Characteristics and Dynamics, the Socio-
Economic and Cultural Characteristics, the Home and Environment, the Health
Assessment of each family member, and the Values, Habits, Practices on Health
Promotion, Maintenance and Disease Prevention.
E. Family Structure, Characteristics, and Dynamics
(code (years) STATUS IN THE ATTAINMENT
names) FAMILY
JC 20 Female Single Mother ---- ELEMENTARY
JJC 5 months Male Son ----
The Cayat family is a nuclear type of family. As an nuclear type of family, it is
composed of Mother JV, child JJV. The Cayat Family resides at Panga, Lubo, Kibungan,
Benguet for about 10 years now. Meanwhile, the baby and his mother goes up every Sunday at
Sayangan proper to attend the mass.
F. Socio-Economic and Cultural Characteristics
The family’s main source of income comes from her parents who work as a farmer
They don’t pay the electrical and water bills because they use candles and lamps during the night
and their water is free flowing from the spring. They use wood for cooking their food and only
buy things when it is needed. Home and Environment
There is only one bedroom where they all sleep and a one story building owned by the
family. They sleep together in a wooden bed near the entrance door which also serves as the
receiving area. The house is made up of mainly wood and GI material with the woods on the
sides. The house is not well ventilated and there is inadequate lightning. Breeding sites of
mosquitos, flies are inevitable due to open drainage and poor environmental sanitation. Their
house was located nearly at the bottom of the mountain under chayote farm. They use wood and
cooking and also as a source of lighting because Ms. Cayat can’t afford to pay for the bills. They
doesn’t have any comfort room near their house they defecate anywhere she also said that they
burn their garbage’s.
G. Health Assessment of the Family
Mrs. Severino denies history of illnesses because they did not even go to hospital or to the clinic
to have a check-up because the health care facility is too far and they do not have enough money
for consultation.
13. Health perception-health management patterns

Ms. Cayat claims she doesn’t smoke and drink.
14. Nutritional and metabolic pattern
Their daily food intake consists of rice, vegetable, root crops, meat and bread.
The family consumes more on vegetable and root crops because meat is quite
expensive.
When having cough and colds, they claimed that they don’t take any medicine they only drink
plenty of water and have some rest.
She claimed that they defecate everyday usually in the morning and urinate atleast 5-6 times a
day.
The Cayat family claims not having exercise she only stays at home with his son.
17. Sleep and rest pattern
They claim that they sleep 6-7 hours every night.
The mother is somewhat dis oriented she doesn’t answer appropriately in some of the questions
asked she stays silent.
19. Self-perception/Self-concept
Mr. Cayat said that he is contented and happy with their simple life. Although she is
saddened by her shortcomings as a mother to her child.

Their family displays an open communication where they understand and support each
other.
No sexual reproductive since she doesn’t any husband.
22. Coping Stress
The mother claims that she gain strength and motivation from her son.
23. Values/beliefs patterns
The family is Born Again. She go to church every Sunday at sayangan proper church
24. Value, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
The children in the family have not yet completed their immunization. The mother is cognizant
in the importance of food preparation but reports that she cannot do anything to buy them some
meat and poultry because of her low income and status in life. Mother claimed self-medication
when they got sick.
CHAPTER 4
FAMILY BACKGROUND
C. Family History
Cayat family is a nuclear family. Ms. Cayat claims that she did finished highschool.
D. Family Tree
FATHER MOTHER
(unknown)
Son
CHAPTER 5
Subjective Data: I. Poor personal hygiene as a health threat
- “Haan ko kanayun amesen ta hanko A. Inability to make decisions with
amo” as verbalized by the mother. respect to taking appropriate health
action due to failure to comprehend

the presence of the problem.
Objective data:
- Dirty and untrimmed finger and toe
nails
- Child have dirty clothes and unchanged
blanket
Subjective data: II. Cough and cold as a health deficit
B. Inability to make decisions with respect
- “man muteg ya man uyek nu to taking appropriate health actions due
mamingsan” as verbalized by the to:
mother c. Low salience of the problem or
condition.
Objective data: d. Lack of knowledge regarding the
- Cold weather problem.
- Runny nose
Subjective data: IV. Risk for diarrhea to unsafe drinking water
- “ haan koi papa init jay danum nga in as a foreseeable crisis.
inumek” as verbalized by the mother. B. Inadequate knowledge in
preventive measures on diarrhea
or any disease that may cause
by intake of unsafe water.

CHAPTER 6
J. Cough and cold
7. Magnitude of the 3/3x2 2 Almost of all the
Problem family members are at
risk.

the Problem moderately
modifiable.
Appropriate
interventions are
somewhat available.
9. Preventive 2/4x1 0.5 The possibility of
Potential transferring infection
to other members of
the family is high and
should therefore be
given immediate
attention.
10. Salience 1/3x1 0.33 There is a possibility
that infection can be
transferred but it is not
life treathening.
Total Score 5.16
II. Poor personal hygiene as a health threat

deficit
7. Magnitude of the 4/4x3 3 The mother has lack of
problem
personal hygiene.
8. Modifiability of the 2/3x4 2 The problem is moderately
Problem
modifiable to solve the
problem.

highly preventive. This
could be done measures to
prevent or maximize
improper hygiene.
10. Salience 1/2x1 0.5 The problem does not

immediate attention
according to the mother.
Total score 7.16
III. Risk for diarrhea to unsafe drinking water as a health deficit

deficit
7. Magnitude of the 3/4x3 2.25 Anyone in the family can
problem be affected
Problem modifiable. Appropriate
available to manage the
problem.
prevented. This could be
done if the family will be
educated on measures to
prevent or minimize the
possible factors of having
diarrhea like proper hand
hygiene and boil their
water to drink.

immediate attention
Total score 6.4
PRIORITIZATION OF PROBLEM
PROBLEMS SCORES
5. Cough and colds as health deficit 5.16
6. Poor personal hygiene as a health threat 7.16
7. Risk for diarrhea to unsafe drinking water as a health 6.4

deficit
CHAPTER 7
VIRUS
passages
Inflammation
Infection of epithelial (Chemical mediators)
cells of nasal passages
Blood vessel permeability Edema
Mucus secretion

Bronco
constriction Cough
CHAPTER 9
This section contains the planned nursing intervention to be carried out. In order to facilitate
health education to the family the nurse learner creates a brochure or pamphlet which can be
distributed to them for further reference if the family members experience attack. The content of
this brochure are the following: Asthma is a lung disease that makes it difficult to breathe.
Airways that carry air in and out of the lungs become swollen and tight. People who are having
an asthma attack often cough, wheeze and feel that they need to catch their breath. The cause of
asthma is not known, there is no cure. A serious asthma attack can even result in death. Asthma
triggers are chemicals or allergens that make you have an asthma attack. Strong chemical smells,
dust or pets can also trigger an asthma attack. Asthma triggers may be very different than other
people with asthma. Not all asthma triggers affect people the same way. Environmental asthma
triggers can be found both indoors and outdoors.

Health Deficit: GOAL OF CARE:  Discuss with the  Goal met,
After home visit, the family the causes, the
Cough and Colds family takes effect and family
as health deficit necessary action to complications of identify
properly manage cough and colds. measures
Subjective: cough and cold.  Provide adequate that
“man muteg ya knowledge on the prevent
man uyek nu various ways in the
mamingsan” as OBJECTIVES OF maintaining occurrenc
verbalized by the CARE: After 2 days cleanliness in the e of
mother of nursing surrounding. cough
interventions the  Listen to the and colds
family will be able family’s concerns
to identify and avoid about cough and
the factors that colds
cause of cough and management and
colds respond with
information to
correct any
misconceptions.
skills (assessment,
use of equipment,
and giving
medications) for
managing the
cough and colds

HEALTH GOAL OF CARE: Establish rapport  Goal not met
THREAT: After home visit, the mother
Poor personal hygiene the family should be  Check if the still don’t
able to maintain family is aware practice
Subjective Data: hygienic practices on their health proper
- “Haan ko practices. hygienic
kanayun OBJECTIVES OF  Demonstrate the practice.
amesen ta CARE: proper hand
hanko amo” as After nursing washing and
verbalized by intervention the instruct them to
the mother. family will be able do so.
to identify,
Objective data: recognize and  Perform ear
- Dirty and perform the health cleaning and nail
untrimmed practices habitually clipping to the
finger and toe children.
nails
- Child have  Emphasize the
dirty clothes importance of
and proper hygiene in
unchanged preventing health
blanket problem such as
illnesses.
 Listen to the
concerns of the
family regarding
the hindrance to
practice such as
hygienic
practices.
 Encourage to
verbalize feelings
and concerns.

Poor health GOAL OF CARE:  Assess the level  After nursing
sanitation as a After home visit, the of understanding intervention,
foreseeable crisis: family takes regarding the the member
Improper waste necessary action to identified will be able to
disposal and open properly minimize problem. demonstrate
drainage system just or if possible  Assess proper ways
beside their house maintain clean surroundings. of garbage
that turns out to be a surrounding  Provide disposal and
favorable reservoir information about will be able to
for a certain vector; OBJECTIVES OF proper ways on segregate
- Uncovered CARE: After 2 days proper disposal of their garbage.
containers, of nursing biodegradable
cans, bottles, interventions the and non-
wheels, family will be able biodegradable.
wastes and to display clean  Monitor for
others that are environment places that are
not kept in prone to dirt and
proper soiling.
garbage  Emphasize the
receptacles. importance of
clean and healthy
environment.
CHAPTER 10
CONCLUSIONS
After a week of home visits and with the nurse learner and client interaction, Ms. Cayat cannot
provide her sons need she is depending on her parents. There are certain problems of the family
that should be solved specially the mother’s hygienic practices and how she will took good care
of her child. The family needs more information dissemination for them to be able to: A.)Give
adequate and true information during surveys and interviews. B.) Identify practices and
behaviors that support and inhibit the interpersonal relationship within the family. C.) Participate
actively during home visits. D.) Suggest on how to improve their lifestyle. E.) Perform Various
health teachings given by the nurse learner.
RECOMMENDATIONS
Community health nursing has always been a part of a nurse learner’s life for generaton. It
has been our duty to provide best quality nursing care even in the farthest places. Promotion and
preservation of a healthy lifestyle and disease prevention through proper health teachings,
appropriate and adequate application of health actions, community activities are some ways to
build a stepping stone for the certain aims of community health nursing. To fulfill our
objectives, full cooperation, compliance and collaboration in the different families and also with
the barangay health officials and workers of Barangay Lubo. I like to recommend:
To the Barangay Health Official and Workers

They should make time to make programs that would involve the community people. They
should be more open and accommodating in order to be effective health teachers. Lastly, they
should be updated in the different programs, researches and discoveries of the different
departments in our government, example is the DOH.
To the Cayat Family
I would like to encourage them to be more active in participating in different programs in
their community and to seek medical assistance whenever needed to prevent any further
complications.
To my co-nurse learners
I am hope that we can be able to help lots of families until we graduate and to continue after
we graduate. Let us not get tired on lending a hand to improve the lives of our fellowmen. It
would be hard and exhausting all throughout the journey, but it is not regretful to have helped
and nourished other people. Let us be thankful that we are given the opportunity to experience a
different life away from home and away from our comfort zone. Let’s have some fun and enjoy
rendering our best quality care to the community.
CHAPTER 11
REFERENCES
Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health,
and the Ethiopia Ministry of Education.
“Tools and Guidelines for Nursing at the Family Level”. The Anphi Papers,22(1):13,1977.
Updated by AS Maglaya in 2003

THE ‘PAKATIW’: A FAMILY CASE STUDY
PALEYAN, Vilma L.

COLLEGE OF NURSING
BACHELOR OF SCINECE IN NURSING
MAY 2017
ACKNOWLEDGEMENT
This is to say thank you to all the ones that made this case study possible. Who guided me in
making this case study.
First of all, I would like to thank God for His support and all the guidance and prayers answered
by Him. Without Him, I will not be able to do this case study. And if there are challenges and
obstacles, it happened for a reason.
To the Pakatiw Family for their willful participation in this case study, for lending their time
when I am interviewing them and allowing me to adopt them as a family and friend in the
community.
To Ma’am Aprila Calasan our ever supportive, kind, and patient instructor who went with us in
the community. Thank you for being there for us, when we don’t understand some concepts you
were there to help us.
To my fellow group mates whom I asked for help. Thank You.
VILMA L. PALEYAN
CHAPTER I
INTRODUCTION
A community is a collection of people who interact with one another and whose common interest
or characteristics gives them a sense of unity and belonging. A community is a group of people
in a defined geographical area with a common goal and objective and the potential for interacting
with one another (Dryer’s den). Community can also be identified by a common interest or goal.
A collection of people, although they are widely scattered geographically, can have an interest or
goal that binds the members together called common interest community.
In community health nursing, there are many opportunities and skills which can be obtained. The
skills needed for the community areas vary; nurses should have a bachelor’s degree and sound
clinical experience. Community or public health nurses may specialize in areas such as home
care; case management; clinical, school, or corporate nursing; or pharmaceutical sales
(Lippincott Williams & Wilkins Inc., 2009).
Public health nursing (PHN) practice is population-focused and requires unique knowledge,
competencies, and skills. Early public health nursing roles extended beyond sick care to
encompass advocacy, community organizing, health education, and political and social reform.
Likewise, contemporary public health nurses practice in collaboration with agencies and
community members. Community health nurses can also find opportunities in higher education
and clinical research.
Nurses who choose traditional public health or home care should have a broad understanding of
health issues and be comfortable with autonomy, change, and uncertainty (Lippincott Williams
&Wilkins Inc., 2009). Family health includes the member’s health status and the family’s wellbeing
itself.
CHAPTER II
OBJECTIVE OF THE STUDY
This chapter presents the general and specific objectives of the family case study. Setting
objectives serves as a road map for the planning of nursing interventions to be implemented.
Objective setting facilitates the motivation for the client and the nurse by providing a sense of
achievement (Kozier and Erb, 2004).
At the end of the Study, The Nurse Learner understands the overall status of the family and
devises appropriate interventions.
After three days of continuous home visits and interaction with the family by the nurse
learner. Each family member should be able to:
a. Express own perception of self, family, and the environment.
b. Identify practices and behaviors that supports and inhibit relationship with the family.
c. See alternatives as they see fit in a given situation.
d. Increase confidence in doing home management.
e. Carry out health education efficiently and with minimal errors.

CHAPTER III
INITIAL DATA BASE
This chapter discusses the information of the Pakatiw Family. It is composed of the
demographic profile of each member of the family.
NAME AGE SEX CIVIL POSITIO OCCUPATION EDUCATIONAL

(years) STATUS N IN THE ATTAINMENT
FAMILY
PP 33 Male Married Father Farmer High school
Graduate
MP 27 Female Married Mother Farmer College
Undergraduate
MP 8 Female Single Child Student Grade 3
MP 6 Female Single Child Student Grade 1
The Pakatiw family is a typical nuclear type family. Their family is composed of a father,
mother, and 2 daughters. They are also an egalitarian family where a family is of the same
decision power between the father and the mother. The Pakatiw family resides at Banawa,
Kibungan, Benguet. They have been living there for almost 6 months.
The family’s main source of income is coming from their gain in their products like carrots,
potato, and cabbage. The family’s estimated monthly family income is ranging from P1, 000.00
– P2, 000.00. He and his wife are still equally deciding where will it be spent but mostly, it was
still spent on electricity and equipment for their farm.
The family is a mixed of Kankana-ey and Ibaloi. They are very hospitable and accommodating.
When they have visitors, they stop their work and give their full attention to their guests like us.
They are green thumb based from their surroundings because it is composed of many different
kinds of fruit bearing vegetables.
Their home and environment is quite clean and superb when in terms of organization. It is a
typical Filipino home which is composed of variety of plants that extends from the entrance of
their home to their backyard. Their house was made with wood and cement. They have 2 rooms
that is used for sleeping and a kitchen.
This section includes the comprehensive health assessment of each member of the family. It
starts with the 5 health status of the family then individual assessments. D. Health Assessment of
the Family.
Mrs. MP claimed that his husband drink alcoholic beverages occasionally and when they
have celebration. They have a really good understanding when in terms of health and they are
really careful in maintaining it. Aside from that they also do their work really fast and reiterated
that they need ample time of rest to avoid exhaustion.
Their daily meals consist of vegetables available on their garden and some livestock that are
being took care in the backyard. Sometime they verbalized that they sometime skip meals when
they are busy at farm and they said that coffee is one of their diets.
The family claims that they defecate regularly and didn’t experience and sign of constipation and
diarrhea. They also claimed that they normally urinate without any pain or incontinence.
The Pakatiw family’s work serves as their exercise. It is composed of lifting heavy objects
and hiking kilometers until they reach the highway for their product to be transported.
Based from the data gathered, the Pakatiw family sleeps at a regular pattern of 8 – 10 hours
of undisturbed sleep but when there is an unusual happening, they need to stay awake for at least
3 hours then go back to sleep again.
All the members of the family are oriented to time, place, person and date. They are able to
respond appropriately to question and are alert and assertive they seem to tongue tied at first but
are talking after a few minutes.
The family in general is optimistic and has a view in life. They are brave enough to face
their challenges and reiterated that being pessimistic will not help.
9. Reproductive Health
Mr. Pakatiw and Mrs. Pakatiw are still on their reproductive ages. Mrs. Pakatiw uses modern
family planning method which is pills. They have planned to add more children but they are
using modern family planning to give space to the next child.
10. Coping Stress
They cope up with stress when they talk to each other and stay together. They seem to just
plant plants in their backyard as a stress reliever for them.
The family is a Roman Catholic family. They claimed that they have faith in God and that He is
the only savior. They pray silently every day to thank Him.
The Pakatiw family is very eager to learn more about health. They take notes and ask
questions regarding health. They show signs of prevention such as planting some medicinal
plants and also having proper waste disposal. They seem to have a high level of knowledge
regarding insect breeding grounds.

Chapter IV
FAMILY BACKGROUND
A. Family History
The Pakatiw Family is a typical nuclear type family. Their family is composed of a father,
mother, and a 2 daughters. The Pakatiw family resides in Banawa, Kibungan, Benguet. They
have been living there for almost 6 months. They are also an egalitarian family where a family is
of the same decision power between the father and the mother.
B. Family Tree
P. Pakatiw M. Pakatiw
Father Mother
M. Pakatiw M. Pakatiw
Daughter Daughter
Chapter V
This section contains the assessed problems within the family utilizing appropriate nursing
diagnoses.

Subjective Data Cough and colds as health deficit
A. Inability to recognize the existence of a
- “mamigsan yan ulay man-arbis nu problem due to ignorance of facts
layden mi ay isambot din ubla mi ed B. Inability to make decisions with respect to
garden yan ulay maudanan kami yan taking appropriate health actions due to:
tuloy ladta isunga manpanateng kami
ay tulo” 1.Failure to comprehend the nature, magnitude
or scope of the problem
Subjective Data Poor Environmental Sanitation, such as

- “Maga di man ala sin basura mi isunga
ipagtay mi ed dontog adi.” 1.Improper / Unsanitary waste disposal
Subjective Data Distance of Rural Health Clinic as Foreseeable

- “Adawi din clinic ya isunga Crisis:
umipasadot ay mandan ka paylang yan The family members experience difficulties in
wada garud di rikriknaem.” going to the clinic.
Chapter VI
This section contains the basis of the prioritization of the Nursing problems.
2. Magnitude of the 2/4*3 1.5 One of them is
of the family.
are available to
manage the problem.
maintenance and
lifestyle.
seen serious that
needs urgent action
of all family
members.
Total Score 6.83

3. Poor Environmental Sanitation
1. Nature of the 2/3*1 0.66 This problem is a
2. Magnitude of the 3/4*3 2.25 All of the family
Problem members could be
affected.
3. Modifiability of 2/3*2 1.33 The problem is

the Problem moderately
modifiable. To be
able to solve the
problem, the family
must be aware on the
consequences if they
will not maintain
cleanliness.
4. Preventive 3/3*1 1 The problem can be

Potential prevented. This can
be done through
educating the family
on measures to
maintain and observe
proper food handling
and preparation.
5. Salience 2/2*1 1 The problem is seen

as serious that needs
an urgent action
for each family
member.
Total Score 6.24
3. Distance of Rural Health Clinic as Foreseeable Crisis
Problem crisis.
2. Magnitude of the 3/4*3 2.25 Distance of Rural
Problem Health Clinic is
visible.
3. Modifiability of 2/3*2 1.33 The problem is
4. Preventive 3/3*1 1 The Capability of the
Potential family to reach the
clinic is high with the
use of available
family resources.
5. Salience 1/2*1 0.5 The problem does not
require immediate
action according to
the family
Total Score 5.75
Chapter VII
Pathophysiology of Cough And Colds

Chapter VIII
I. Cough and Colds as Health Deficit
FAMILY GOALS/OBJECTIVES NURSING EVALUATION

NURSING OF CARE INTERVENTION PLAN
PROBLEM
Cough and After nursing 1.Discuss with the After the nursing
Colds as Health interventions, the family members the interventions, the
Deficit: following are expected importance of family will be able
to take place: knowing the to recite
Inability to necessary importance of
make decisions 1.The chances of information about treating cough and
with respect to spreading disease to the disease to cold earlier. The
taking family members will prevent spreading family will be able
appropriate be slim. them. to know remedies
actions due to: and management
2.The recurrence of 2.Provide adequate of the problem.
Failure to cough and colds among knowledge on
comprehend the family members will various ways of
nature, be prevented or maintaining
magnitude, or minimized. cleanliness in their
scope of the surroundings.
problem.
3.Explain the
Lack of importance of
knowledge as to proper food
alternative preparation,
courses of exercise, and rest in
action to open strengthening ones
them. against illness.
4.Provide
information on
health centers in the
vicinity for health
care assistance.
II.
FAMILY GOALS/ NURSING EVALUATIO
NURSING OBJECTIVES OF INTERVENTION N PLAN
PROBLEM CARE
Poor After nursing 1. Discuss with After the
Environmental intervention, the the family nursing
Sanitation, such as family will take the the interventions,
necessary actions to importance of the family will
1. Improper / improve and maintain environmental be able to do
Unsanitary the sanitation of their sanitation to their proper waste
waste immediate health. disposal and
disposal surroundings. The clean the
following should be 2. Explore with immediate
achieved: the family surroundings.
the ways of
1. The family improving There will be
should know home an available
the importance sanitation area in
of proper considering disposing the
waste disposal. its limited wastes.
resources.
2. Clean
surroundings a. Emphasize to
to prevent the family
breeding the
places of pests. advantages of
proper
3. Make a garbage
designated disposal.
place for
disposing the b. Instruct all
waste. the family
members to
prevent
breeding
places of
pests.
III. Distance of Rural Health Crisis as Foreseeable Crisis

FAMILY GOALS/ NURSING EVALUATION
NURSING OBJECTIVES OF INTERVENTION PLAN
PROBLEM CARE
Distance of Rural After nursing 1. Involve all After nursing
Health Clinic as interventions, the the family interventions, the
Foreseeable Crisis: family will be able members family will be
to encourage and about encouraged and
The family enhance their discussing visits the clinic
members knowledge about the meaning for at least once
experience the importance of of visiting or twice a
difficulties in going visiting the clinic. the clinic. month. The
to clinic. 2. Coordinate health care
with the practitioner will
health care be able to do
practitioners home visiting.
to do visiting
on every
house hold at
least once or
twice a
month.
3. Encourage
and motivate
the family to
visit the rural
health clinic
for at least
once or twice
a month.
4. Enhance the
knowledge of
the family
about the
disadvantage
s of visiting
the clinic.
Chapter IX

GOAL AND PROBLEM INTERVENTIONS EVALUATION RESOURCES
OBJECTIVE OF
OF CARE INTERVENTION
GOALS OF Cough and Discuss with the Goals met. After Brochures
CARE: After Colds as family members the home visits, the
the nursing Health importance of family was able to
interventions, Deficit: knowing the recite importance
necessary of treating cough.
The chances of Inability to information about The family was
spreading make the disease to able to know
disease to decisions with prevent spreading remedies and
family members respect to them. management of
will be slim. taking cough and colds.
appropriate Provide adequate
The recurrence actions due to: knowledge on
of cough and various ways of
colds among Failure to maintaining
family members comprehend cleanliness in their
will be the nature, surroundings.
prevented or magnitude, or
minimized. scope of the Explain the
problem. importance of
proper food
OBJECTIVES Lack of preparation,
OF CARE: knowledge as exercise, and rest in
After the to alternative strengthening ones
nursing courses of against illness.
interventions, action to open Provide information
the family will them. on health centers in
be able to: the vicinity for
health care
recite assistance.
importance of
treating cough
and cold earlier.
The family will
be able to know
remedies and
management of
the problem.
OBJECTIVE OF
GOAL OF Poor 3. Discuss with Goal met, the Booklet
CARE: Environmental the family the family
Sanitation, importance of demonstrated
After nursing such as: environmental knowledge on the
intervention, sanitation to their importance of
the family will Improper/ health. proper waste
take the Unsanitary disposal.
necessary waste disposal 4. Explore with
actions to the family the
improve and ways of
maintain the improving
sanitation of home
their immediate sanitation
surroundings. considering its
The following limited
should be resources.
achieved:
c. Emphasize to
The family the family the
should know advantages of
the importance proper
of proper waste garbage
disposal. disposal.
Clean
surroundings to
prevent
breeding places
of pests.
Make a
designated
place for
disposing the
waste
OBJECTIVES
OF CARE:
There will be
an available
area in
disposing the
wastes.

OBJECTIVE OF
GOALS OF Distance of Involve all the family Goals met. The Books
CARE: Rural Health members about family is
After nursing Clinic as discussing the encouraged to visit
interventions, Foreseeable meaning of visiting the clinic for at
the family will Crisis: the clinic. least once or twice
be able to a month.
encourage and The family Coordinate with the
enhance their members health care
knowledge experience practitioners to do
about the difficulties in visiting on every
importance of going to house hold at least
visiting the clinic. once or twice a
clinic. month.
OBJECTIVES
OF CARE: Encourage and
After nursing motivate the family
interventions, to visit the rural
the family will health clinic for at
be encouraged least once or twice a
and visits the month.
clinic for at
least once or Enhance the
twice a month. knowledge of the
The health care family about the
practitioner disadvantages of
will be able to visiting the clinic.
do home
visiting.
Chapter X

Conclusion:
This part is where the overall impression and the suggestion are given. It is where we form a
main thought that can finalize the study.
1. The Pakatiw family is mostly healthy and has a good perception on what is
going on in their community.
2. There is a need for further teaching regarding nutrition and importance of
having a good balance diet.
Recommendation:
This is based from data gathered and the lack of the study. This further understands
some concepts.
1. There is a need for further teaching regarding nutrition and importance of
having a good balance diet.
2. Needs in depth assessment of the health status of each family member.
Chapter XI
REFERENCES
Kozier, B. &Erb, W.H. (2004). Fundamentals of Nursing. 9th Edition
Stanhop, L. Community & Public Health Nursing, 5th edition, 2000
Sheila, T. Barhana, R. Sarah, A Community Health Nursing Principle, 2000
Stanhope, Knoll Mueller. Hand book of community base & home health nursing practice 3rd
edition, 2000
Judith Ann. Allender, Barbara Walton S. Community Health Nursing Concept and Practice 5th
edition 2001.5. Freeman & Heinrich. Community Health Nursing Practice 2ndedition, 1998
Maglaya, Arcelli, Community Health Nursing, 200 Educational Publishing House
OVERALL WORK PLAN
PROBLEMS SOLUTIONS IDENTIFIED TIME FRAME

Cough and Colds Health Education November 2017
Poor Environmental Sanitation Health Education November 2017
Distance of Rural Health Health Education November 2017
Clinic
THE ‘SAL-LEY’: A FAMILY CASE STUDY

PANICO, Marilou P.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
I would like to extend my deepest gratitude to Benguet State University-College of Nursing for
giving me a wonderful opportunity to conduct a family case study like this. Thanks al to Carimo
Family, for their active participation and for cooperating with me, answering all our questions
truthfully.
I also thank our facilitators, Mr. Jude L. Tayaben and Mrs. Aprila T. Calasan for their guidance
all throughout the community immersion, their patience, encouragement and support to this
study.
To our family, for their endless encouragements and truthful advices that inspired us to
finish the research which is a part of our endeavor in reaching our dreams. Thank you also for
the support in all aspects and for every understanding you made especially during the time when
they need to come home late and when they needed to take a higher priority on the study;
Above all, To Almighty Father, for bestowing the knowledge, skills and attitude with the
necessary compassion, endurance, wisdom and courage to face all the challenges and overcome
all the obstacle met during the whole course in making this study.
Marilou P. Panico
CHAPTER I
INTRODUCTION
Community and health care nursing provide health education, care management and primary
care to individuals and families who are members of vulnerable populations and high risk
groups. Health nurse integrate community involvement and knowledge about the entire
population with personal clinical understandings of the health and illness experiences of
individuals and families within the population. Community and nurses focus on the prevention of
illness, injury or disability, the promotion of health and maintenance of the health of the
populations, they work with communities, target health promotion and disease prevention, they
act as teachers, counselors and plays an important role in preventing wide spread illness and
disease. Community and public health nurses’ goal is to promote, preserve, and maintain the
health of populations through the delivery of personal health services to individuals, families,
and groups, and also the prevention of disease and disability, to promote and protect the
community as a whole. (Clayton, 2012)
Community health nursing is defined as a collection of people who interact with one another
and whose common interest or characteristics gives them a sense of unity and belonging. It is a
specialized field of nursing that focuses on the health needs of the communities, aggregates, and
in particular vulnerable populations. It is a practice that is continuous and comprehensive
directed towards all groups of community members. It combines all the basic elements of
professional, clinical nursing with public health and community practice. (Mengistu &
Misganaw, 2006)
The family is one of the most important social groups we belong to as we grow up and become
part of society. It is the place where we learn most of our values and find a belonging. Without
our families we would not be the same people we grow up to become. Throughout history, the
word family has carried many different meanings. Most people think of a family as a mother,
father, and several children, but a family could be almost any group with common
characteristics.
CHAPTER II
OBJECTIVE OF THE STUDY
This presents the general and specific objectives of the study. This aims to understand and
identify the problems within the family.
At the end the student nurse interaction, the family should be able to enumerate factors and
displays understanding to improve the health status of every family member.
After the home visit and the nurse learner and family, each of the family members should be
able to:
A. Identify ways to manage the disease or condition of every family member.
B. Identify importance of using available resources within the family.

CHAPTER III
INITIAL DATA BASE
includes the Family Structure, Characteristics, and dynamics, the Socio-economic and Cultural
characteristics, the Home and the Environment, the Health Assessment of each family member,
and the Values, Habits, Practices and Health Promotion, Maintenance and Disease Prevention.

STATUS IN THE ATTAINMENT
FAMILY
LB 31 Male Married Mother Farmer Elementary
Graduate
TB 26 Female Married Father Farmer College Graduate
LB 3 Female _______ First Child _______ ________
The Balao family is a nuclear type of family. Nuclear type of family is a group of people
composed of mother, father and children. A nuclear type of family is found almost all societies
although the length of time in which the family remains in this form remains varies even within
the same society. The nuclear family can be a nurturing environment in which to raise children
as long as there is love, time spent with children, emotional support, low stress and a stable
economic environment. In nuclear families, both adults are the biological and adoptive parents of
their children (Jay, 2004). Balao family resides in Gasal, Sayangan, Lubo, Kibungan, Benguet.
The family members resided there for 26 years. The couple had one child. Both LB and TB share
decision making in the family. They consult each other in terms of planning and budgeting for
the family. Both of them shares disciplining their children.

The family’s main source of income is both RC and FC’s monthly income in farming. Their
monthly income ranges from Php 7,000 monthly. They have their farm at Gasal and Tollebeng
where it is near their residence. Their income is being budget by TB for their daily expenses. For
them, their income is enough for their daily expenses.
They are living in a one story house made of concrete and wood. There are 1 room used for
sleeping where 3 people can sleep. The house is owned by the family. They use wood and LPG
in cooking. There source of lighting is electricity. Their comfort room is located outside the
house and it is a flush type. Their water source is connected to a spring and using rain-water.
They dispose there garbage through open dumping. They have dog that is tied in their backyard.
Mrs. TB claimed that they have no known family history of illness or diseases. They only got
cough and colds during cold weather.
E. History of Past Illnesses
Mrs. TB denies history of such illnesses.

The mother claims that no one in their family smokes nor drinks alcoholic beverages. Generally,
the family displays knowledge evident of being able to recognize the importance of having a
healthy well-being.
The parents take herbal medicines or products when they have cough and colds. They are taking
Paracetamol when they got headache.
Daily food intake consists of rice, eggs, meat and vegetables. Mrs. TB also mentioned that they
usually have eaten rice and a single viand.
The family claimed that they defecate every day and usually in the morning. Their urination
mostly is from 5-6 times daily. No difficulty in voiding.
The family claims that they consider farming as their daily exercise for they walk for meters
and carry their products going to waiting shed where they store their products.
The family claimed that they sleep for more than 7-8 hours in a day with their children also
sleeps for 9 hours of uninterrupted sleep. Mrs. TB wakes up early in the morning to prepare food
for her family. Mrs. TB claims that she at times sleeping with her child during the afternoon.
All the members of the family are oriented to time, place, person and they are responding
appropriately with the questions. Mrs. TB is confident in explaining things and she also justify
every questions asked. Verbal communication is spontaneous and comprehends to every
question.
The parents generally are optimistic and claimed that they had handled family problems with
each other’s presence. They are both helpful and supportive to each other in times of problems.
Both are very concern of the welfare of their children and when someone gets sick.
It is observed in the family that they have an open communication. As parents, they display
openness to the concern of their children. It is noted that the parents imposed proper discipline
and behavior in acceptable manner like respecting elders in community. Their way of
disciplining their children was way too acceptable.
Mrs.TB claimed that they do family planning as taught by the midwife.
10. Coping Stress
The family claims to gain strength to each other and motivation from each other. They
assure and support their children. They still allow their children to experience despair and
disappointments for them to be more prepared later in life.

The family belongs to the Roman Catholic. They claimed that they are always praying before
they eat and when also before they sleep.
The children are all completed their immunization. Parents are conscious on the importance
of proper preparation of foods. Mrs. TBFC claimed that they both budget the finances to be able
to serve healthy meals and she plant organic vegetables so that it save some money. They usually
visit the clinic when they got sick and taking self-medication.
CHAPTER IV
FAMILY BACKGROUND
A. Family History
The Balao family is a nuclear type of family. As a nuclear family, the family is composed of 3,
the head of the family which is usually the husband, then the wife and their child. The husband is
31 years of age while her wife is 26years old and they are working as a farmer. The first child is
4 years old. The nuclear family can be a nurturing environment in which to raise children as long
as there is love, time spent with children, emotional support, low stress and a stable economic
The Balao family is patriarchal in authority. Their house is situated along the mountain of Gasal,
Sayangan, Lubo, Kibungan, Benguet. Mrs. TB claimed that they owned the lot where they live
and she said that she stayed there for 26 years.
B. Family Tree
LEGEND:
LB- Father
LB TB TB- Mother
LBB – 1st child
LBBC
C. Genogram
Mrs. TB failed to mention any diagnosed genetic disorders in their family.
CHAPTER V

Subjective Data Cough and colds as health deficit
A. Inability to make decisions with respect to
- “man-uuyek da eman adi, asin marigatan taking appropriate health actions due to:
da ay maseyep nu malabi” 1. Lack of knowledge as to alternative courses of
action open to them.
Subjective Readiness for Enhanced Capability for Health
- “salamat ading ta wda kau ay mangisuro Management/Health Maintenance
si amagen mi”
Objective
Subjective Poor Home/Environmental

- “kaibasubasura kami ladtan sin basura Condition/Sanitation
mi” A. Improper waste disposal
Objective
- Presence of waste materials in front of
the house
CHAPTER VI
of the family.
are available to
manage the problem.
maintenance and
lifestyle.
seen serious that
needs urgent action
of all family
members.
Total Score 6.83
2. Readiness for Enhanced Capability for Health Management
1. Nature of the Problem 1/3*1 0.33 This is a wellness
state.
2. Magnitude of the 3/4*3 2.25 The parents are
Problem willing to maintain
their wellness state.
3. Modifiability of the 2/3*2 1.33 The problem is
Problem slightly modifiable.
are available to
maintain wellness
state.
4. Preventive Potential 3/3*1 1 Occurrence of disease
can be prevented
maintenance and
healthy lifestyle.
5. Salience 0/2*1 0 It is not a felt
problem.
Total Score 5.24
3. Poor Home/Environmental Condition/Sanitation
1. Nature of the Problem 1/3*1 0.33 This is a wellness
state.
2. Magnitude of the 3/4*3 2.25 The parents are
Problem willing to maintain
their wellness state.
3. Modifiability of the 2/3*2 1.33 The problem is
Problem slightly modifiable.
are available to
maintain wellness
state.
4. Preventive Potential 3/3*1 1 Occurrence of disease
can be prevented
maintenance and
healthy lifestyle.
5. Salience 0/2*1 0 It is not a felt
problem.
Total Score 5.24
CHAPTER VII
FAMILY NURSING GOALS AND NURSING EVALUATION

PROBLEM OBJECTIVES OF INTERVENTIONS PLAN
CARE
Health Deficit: Goals of Care: 1. Discuss the causes After the nursing
Cough and Colds After the nursing and effects of cough interventions, the
A. Inability to make interventions, the and colds. family will be able to:
decisions with respect family will be able to 2. Provide adequate A. Acquire adequate
to taking appropriate minimize the knowledge on the knowledge about the
health actions due to: occurrence of cough various ways of condition,
1. Lack of knowledge and colds in the maintaining B. Utilize community
as to alternative future. cleanliness around resources available in
courses of action open their home. undertaking the
to them. Objectives of Care: 3. Explain the condition experienced
After the nursing importance of proper
interventions, the food handling and
family will: preparation, good
A. Acquires adequate nutrition, adequate
information about the rest and sleep and
disease including strengthening each
causes, signs and family member’s
symptoms and resistance to illness to
preventive measures. prevent its
B. Utilize community occurrence.
resources available in 4. Promote proper
undertaking the personal and
condition experienced environmental
hygiene among all
members of the
family.
FAMILY GOALS/ OBJECTIVES INTERVENTIONS EVALUATION

NURSING OF CARE PLAN
PROBLEM
After the effective nursing 1. Identify with the family Goal/ Objectives
Wellness State: interventions and health the course of action and met if:
teachings, the family will the resources available a. The
Readiness for perceive benefits of and analyzing the family
enhanced proposed action. consequences for each demonstr
action. ates a
capability for After the nursing 2. Demonstrate proper hand home
health interventions the washing. conducive
management. following should be 3. Emphasize the to health;
achieved: importance of personal b. The
a. The family will hygiene and proper food family
demonstrate a handling. practices
home 4. Advice on minimizing good
environment health threats such as hygiene;
conducive to cigarette smoking and and
health; alcohol consumption to c. The
b. Practice good maintain health. family is
hygiene 5. Reiterate the importance able to
c. The family will of healthy lifestyle by take
be able to take eating available actions on
actions on nutritious resources and minimizin
minimizing daily exercise. g health
health threats 6. Reiterate the importance threats
and of follow up check-ups and
maintaining and taking maintenance maintaini
healthy of family members with ng
lifestyle. health problems healthy
7. Encourage positive lifestyles.
emotional attitude
toward problems by
affirming the family’s
capabilities and
providing information on
available resources.
FAMILY GOALS/OBJECTIVES OF NURSING EVALUATION

NURSING CARE INTERVENTION PLAN
PROBLEMS
Poor After nursing interventions, 1. Reinforce the After nursing
environmental the schedule for the interventions, the
sanitation: family will be able cleaning family will be
Improper waste to: able to
activity w/c was
disposal 1. Demonstrate demonstrate
effective cleaning, if made during the effective cleaning
not sanitizing the last home visit. and the proper
different parts of 2. Emphasize the disposal of
both their house & importance of a garbage.
their environment. clean & healthy
2. Know the correct environment.
basis for cleanliness.
3. Discuss w/
3. Give the importance
of a clean techniques &
environment. methods used in
cleaning &
sanitizing such
as segregating
non-
biodegradable
and
biodegradable.
4. Monitor for
places that are
prone to soiling
and dirt.
5. Emphasize the
importance of
clean and
healthy
environment.
CHAPTER VIII
A cough is a common reflex action that clears the throat of mucus or foreign irritants. Coughing
to clear the throat is typically an infrequent action, although there are a number of conditions that
can cause more frequent bouts of coughing. (Irwin, R. S., 2006)
Cough and Colds
VIRUS
passages
Inflammation (Chemical mediators)
Infection of epithelial cells

of nasal passages Blood vessel permeability Edema
Mucus secretion
Bronco Cough
constriction
CHAPTER IX
GOALS/OBJECTIVE PROBLEM INTERVENTION EVALUATION RESOURCES
FOR CARE
Goals of Care: Health 1. Discuss the After the nursing Books, brochures
After the nursing Deficit: causes and effects interventions, and internet
interventions, the Cough and of cough and colds. the family will
family will be able to Colds 2. Provide adequate be able to:
minimize the A. Inability knowledge on the A. Acquire
occurrence of cough to make various ways of adequate
and colds in the future. decisions maintaining knowledge about
with respect cleanliness around the condition,
Objectives of Care: to taking their home. B. Utilize
After the nursing appropriate 3. Explain the community
interventions, the health importance of resources
family will: actions due proper food available in
A. Acquires adequate to: handling and undertaking the
information about the 1. Lack of preparation, good condition
disease including nutrition, adequate experienced
causes, signs and knowledge rest and sleep and
symptoms and strengthening each
preventive measures. as to family member’s
B. Utilize community resistance to illness
resources available in alternative to prevent its
undertaking the occurrence.
condition experienced courses of 4. Promote proper
action open personal and
to them. environmental
hygiene among all
members of the
family.
GOALS/ OBJECTIVE PROBLEM INTERVENTION EVALUATION RESOURCES

FOR CARE
After the effective Readiness 1. Identify with Goal/ Objectives Book, brochures
nursing interventions the family met if: and internet
and health teachings, the for enhanced the course of a. The family
family will perceive action and demonstrat
benefits of proposed capability the resources es a home
action. for health available and conducive
analyzing to health;
After the nursing management the d. The family
interventions the consequence practices
following should be s for each good
achieved: action. hygiene;
a. The family will 2. Demonstrate and
demonstrate a proper hand e. The family
home washing. is able to
environment 3. Emphasize take
conducive to the actions on
health; importance minimizin
b. Practice good of personal g health
hygiene hygiene and threats and
c. The family will proper food maintainin
be able to take handling. g healthy
actions on 4. Advice on lifestyles.
minimizing minimizing
health threats health
and maintaining threats such
healthy lifestyle. as cigarette
smoking and
alcohol
consumption
to maintain
health.
5. Reiterate the
importance
of healthy
lifestyle by
eating
available
nutritious
resources
and daily
exercise.
6. Reiterate the
importance
of follow up
check-ups
and taking
maintenance
of family
members
with health
problems
7. Encourage
positive
emotional
attitude
toward
problems by
affirming the
family’s
capabilities
and
providing
information
on available
resources.
GOALS/ PROBLEM INTERVENTION EVALUATIO RESOURCE

OBJECTIVE FOR
CARE N S
After nursing Poor 1. Reinforce the After nursing Books,

interventions, environmenta schedule for
The family will be able l the cleaning interventions, brochures and
to: sanitation:
activity w/c
a. Demonstrate Improper the family will internet
effective waste was made
cleaning, if not disposal during the last be able to
sanitizing the home visit.
different parts 2. Emphasize demonstrate
of both their the
house & their importance of effective
environment.
a clean &
b. Know the cleaning and the
correct basis for healthy
cleanliness. environment. proper disposal
c. Give the 3. Discuss w/
importance of a techniques & of garbage.
clean methods used
environment. in cleaning &
sanitizing
such as
segregating
non-
biodegradable
and
biodegradable
.
4. Monitor for
places that are
prone to
soiling and
dirt.
5. Emphasize
the
importance of
clean and
healthy
environment.
CHAPTER X
CONCLUSIONS AND RECOMMENDATION
CONCLUSIONS
e) Family participate actively during home visit and assessment interviews,
f) Gives pertinent and factual information during surveys and interviews,
g) The Balao family is not risk with other genetic illnesses,
h) Balao family is open to change and new health teachings in turn taking the proper
RECOMMENDATIONS
Community health nursing has been a part of every nurse learners’ life. It is a nurse’s duty to
provide immediate health care to the community people’s health problems before going to the
higher health care facilities. Promotion and preservation of healthy lifestyle and disease
prevention through proper health teachings, appropriate application of health actions, community
nursing. The cooperation and collaboration of not only the assigned family, community but also
with the barangay health officials and workers of Barangay Lubo or Bobocco are needed to
fulfill the certain objectives. To be able to help and provide proper health care services, the
workers of the Barangay Health centers should continue portray being role models to the
residents of the community. They should be more open and accommodating in order to be
effective health teachers.
To Family Balao, In order to acquire more knowledge regarding health, they should
engage in certain different programs that can serve as a basis in handling health matters at home.
If they encounter a certain illness, they should go to the Barangay Health Center for proper
consultation and diagnosis. They should also be open to the suggestions and introduction of
health teachings for her to practice regularly at home to manage good health conditions.
CHAPTER XI
REFERENCES
Irwin, R. S., 2006,
Jay 2004,
Nanda (2011)
THE ASISLO FAMILY: A CASE STUDY
PAR-OGAN, Rhealyn A.
Benguet State University
COLLEGE OF NURSING
La Trinidad, Benguet
MAY 2017
ACKNOWLEDGMENT
First of all, I would like to thank the Lord Almighty for the guidance and blessings He
had given me.
I would like to extend my genuine gratefulness to these people who made this study
possible.
To our clinical facilitators, Sir Jude L. Tayaben and Ma’am Aprila T. Calasan for their
valuable supervision and never-ending support.

To the family who gladly participated in this study and to the community who opened
their beloved houses to us.
To the University that gave us the opportunity for learning experiences through
To the College of Nursing that contributed most to our knowledge about health and
taught us the skills we need for house visit and health education.
Finally, an honorable mention goes to my family and friends for their understanding and
support on me in completing this requirement. Without helps of the particular that mentioned
above, I would face difficulties in doing this.
Sincerely Yours,
Rhealyn A. Par-ogan
BSN III
CHAPTER I
INTRODUCTION
which is contributory to the development, and progress of the community through active
involvement and self-responsibilities of each constituent.
structure, exhibits and creates norms, values, and social institution.

In Community health nursing, one of the two major fields of nursing in the Philippines,
nursing practice in the community means different to others. Its primary goal is the promotion
and preservation of health of its client that could be in the individual, family, population, group
and community. In community health nursing practice includes nursing directed to individuals,
families, groups; the dominant responsibility is the population as a whole. With these, the health
of the people is a reflection of the communities of which they live, play, work and learn.
Communities shape the lifestyle that people adopt in the livelihood of living safe, fulfilling and
productive lives. Family, basic social group united through bonds of kinship or marriage, present
in all communities. Ideally, the family provides its members with protection, companionship,
security, and socialization. The structure and the needs of that the family fulfills vary.
Community health nursing is a response to the health needs of the people. It does not
focus on a particular class or family. It is comprehensive and general in approach. Community
health service is not episodic as it requires continuous observation and monitoring of the
community as a whole.
My community experience did not only provide an avenue to apply what we have
acquired in the university but also provided an opportunity to serve our fellowmen. Because in
the being in the community is more than meeting the requirements in the Related Learning
Experiences (RLE), it is experiencing the real world, making real memories and rendering
service with competence, conscience, commitment and care.
It is in the community where I learned the nursing part from the hospital setting as I was
exposed to different level of orientation. It is in the community where the saying “Nursing is an
art” can be applied.

The family that I chose is a picture of the majority of the family here in our country: a
family living in a poor environmental condition without enough resources and lacks knowledge
on vital health information and experiences other socio-economic related problems. Though it is
tiring as it is, reaching out to this family and mingling with them made me feel the sense of
fulfillment as I shared my knowledge, skill and time to aid in uplifting the condition of the
family.
CHAPTER II
GENERAL OBJECTIVE:
At the end of the student-family relationship, the adopted family will be able to improve
their health status and become self-reliant in maintaining their health through appropriate
interventions.
After the 3 day home visits and the student-family interaction, the family member will be
able to:
8. Express own perception and identify ways to improve interpersonal relationship within
their family and identify practices and behaviors that support and inhibit the interpersonal
relationship within the family.
9. Identify actual and potential problems which may be a hindrance in attaining optimum
health.
CHAPTER III
INITIAL DATA BASE
A. Family structure, characteristics and dynamics
NAME AGE(Years) SEX CIVIL POSITION OCCUPATIO EDUCATIONAL
STATUS IN THE N ATTAINMENT
FAMILY
Yin 27 Male Married Father Farming Elementary Level
Yang 19 Female Married Mother Farming High School
Graduate
Yeng 3 Male Single Son -- --
The Asislo family is a nuclear type of family. Nuclear type of family is a group of people
composed of mother, father and a son. A nuclear type of family is found in almost all societies
although the length of time in which the family remains in this form remains varies even within
the same society. The nuclear family can be a nurturing environment in which to raise children
as long as there is love, time spent with children, emotional support, low stress and a stable
economic environment. In nuclear families, both adults are the biological and adoptive parents of
their children, (Jay, 2004). The Asislo family is patriarchal in authority. Their house is located at
Nagawa, Sayangan, Kibungan, Benguet. They are residing there for 3years in their rented lot.
The couple shares in decision making of the family. They consult each other in terms of planning
and budgeting for the family.
The family’s main source of income is in farming. Their monthly income ranges from
Php 2,000-3,000 monthly. They rent a lot where they are growing their Chayote, Potato and
Carrots near their residence. Their income is being budget by Mrs. Yang for their daily
food,medications, bills and other expenses. According to the couple, their income is not enough
for their daily expenses.
Their house is composed of wood and G.I. and it has one room where 2 persons can
sleep. They use LPG in cooking and sometimes, they also use fire woods to reduce their
expenses. They have a television and radio that serves as their recreational activity. Their
comfort room is located outside the house and they have a water sealed toilet. Their water source
is connected to a spring. They have an individual pit for garbage disposal and drainage system.
They have dogs, chicken and cat that are kept in their backyard.
According to Mrs. Yang, they are practicing family planning. She also claimed that they
consult to the clinic whenever they have concerns about their health. Fortunately, mother
articulated that there had not been any serious illness or injury that their family experienced
during their stay at Nagawa but she identified some of the common health problems in the
community.

Mr. Yin claims that he tried smoking and drinking alcohol but then stopped it recently.
He also mentioned about using herbal medicines for treatment of cough and colds. Generally, the
family displays less knowledge evident of being able to recognize the importance of having a
healthy well-being and maintaining a healthy lifestyle.
The couple takes herbal medicines or products when they have cough and colds. When
suffering from pain like headache and muscle pains, they mentioned that they often take
paracetamol. Daily food intake consists of rice, eggs, meat and vegetables. Mr. Yin elaborated
that they usually have simple meal consisting of rice and a single viand. When out of budget,
they resort to instant noodles and canned goods, chickens, hotdog and meat.
The couple claimed that they have regular bowel movement. They also added that they
have no problem or difficulty in defecating and urinating because they drink enough fluids
especially in the middle of the day when the heat rises.
The couple does exercise regularly but the husband claims that their work as a farmer,
serve as their exercise. The wife does the household chores and walking serve as her exercise.
The couple sleeps for 5-6 hours especially when they had to wake up early to work in the
garden. Mrs. Yin and Yeng often has naps in the afternoon.
During the interview, the couple is oriented to time, place and are able to respond
appropriately when asked. Both of them retaliate as soon as they can and were able to rationalize
when asked to explain things. Verbal patterns of communication are noted to be spontaneous.
7. Self-perception
Mr. Yin claims that he and his wife perceived some situations to be stressful but remain
optimistic about things and condition. He also added that when stressed, praying is a lot helpful.
The couple is observed to have an open communication. When asked, the mother answers
and the husband follows if he has something to add. They claim that they both display openness
to the concerns and needs of each other.

9. Sexual reproductive
Mrs. Yang claimed that she is taking pills and they are using withdrawal as their family
planning.
10. Coping stress
The family claims to gain strength and motivation from each other. When a situation
seems to be intolerable, Mr. Yin said that praying is the best solution.
11. Values-beliefs pattern
The couple Lutheran and they added that they have strong fear to God.
Yeng have completed their immunization. During illness, the mother claimed that they
sought consultation to their clinic or sometimes to private health centers.
CHAPTER IV
FAMILY BACKGROUND
B. Family History
The Asislo family is a nuclear type of family. As a nuclear family, the family is
composed of 3, the head of the family which is usually the husband, then the wife and their four
children. The husband is 27 years of age while the wife is 19 years old and is working as a
farmer. The nuclear family can be a nurturing environment in which to raise children as long as
there is love, time spent with children, emotional support, low stress and a stable economic
The Asislo family is patriarchal in authority. Their house is situated along the mountain
of Nagawa, Sayangan, Kibungan, Benguet. Mr. Yin claimed that they rent the lot where they live
and he said that she stayed there for almost 3 years.
Mr. Yin, failed to mention any diagnosed genetic conditions that are present in their
family.
. Family Tree
ASISLO FAMILY
YIN YANG
Yeng
Legend:
Father
Mother
Child
CHAPTER V
nursing diagnoses.
Subjective Data
“Manpanpanateng din nay anakko,
manpupudotmetlangsisya,” as verbalized by A. Inability to recognize the existence of a
the parent problem due to ignorance of facts
Objective Data B. Inability to make decisions with respect to

-coughing episodes taking appropriate health actions due to:
-runny nose
-skin warm to touch 1. Failure to comprehend the nature,
magnitude or scope of the problem

Subjective Data: Presence of possible breeding sites of insects,

“Ijay drums ken plastic bottles a
tipagtambakan mi tidanum mi.“, as verbalized mosquitoes and rodents as a foreseeable crisis
by Mr. Yin
Objective Data: Inability to provide a home environment

Drums, plastic bottles and Car tires are
directly placed on the wet ground that can be conducive to health maintenance and personal
breeding sites of mosquitoes
development due to:
e. Lack of knowledge on the importance
of hygiene and sanitation.
f. Lack of knowledge regarding
preventive measures
Chapter VI
This part contains the foundation of the prioritization of the Nursing problems.

of the family.

are available to
manage the problem.

maintenance and
lifestyle.

seen serious that
needs urgent action
of all family
members.
Total Score 6.83
4. Presence of breeding sites, insects and rodents as Foreseeable Crisis

Problem crisis.
2. Magnitude of the 3/4*3 2.25 Breeding sites of
Problem insects and rodents are

present.
3. Modifiability of the 2/3*2 1.33 The problem is highly
Problem modifiable. Proper
interventions are
available to manage
the problem.
4. Preventive Potential 3/3*1 1 The ability of the
family to minimize the
proliferation sites of
insects is high with the
utilization of existing
family resources.
5. Salience 1/2*1 0.5 It is not felt as a
problem by the couple.
Total Score 5.75
CHAPTER VII
Family Nursing Problem Goals and Objectives Nursing Interventions Evaluation Plan
of Care
Health Deficit Goals:
Cough and Colds 1. Discuss with the After the nursing
After the nursing family the causes and interventions, the
C. Inability to interventions, the effects of cough and family will be able
recognize the family will be able to colds. to:
existence of a minimize the 2. Provide adequate a. acquire adequate
problem due to occurrence of cough knowledge on the knowledge about the
ignorance of and colds in the various ways of condition,
facts future. maintaining
cleanliness around b. utilize community
D. Inability to make Objectives: their home. resources available in
decisions with undertaking the
respect to taking After the nursing 3. Explain the condition
appropriate interventions, the importance of proper experienced
health actions family will: food handling and
due to: preparation, good
a. acquire adequate nutrition, adequate
information about the rest and sleep and
1. Failure to disease including strengthening each
comprehend the nature, causes, signs and family member’s
magnitude or scope of symptoms and resistance to illness to
the problem preventive measures. prevent its
2. Lack of knowledge as occurrence.
to alternative courses of b. Utilize community
action open to them. resources available in 4. Promote proper
undertaking the personal and
condition environmental
experienced hygiene among all
members of the
family.
FAMILY NURSING GOALS/OBJECTIVES NURSING EVALUATION

PROBLEM OF CARE INTERVENTION PLAN
Presence of breeding After nursing 6. Discuss the Goals and
sites, insects and intervention, the family importance objectives were
rodents as Foreseeable will be able to eradicate and purposes met if the family
Crisis: the presence of these of proper was able to clean
Inability to recognize unwanted sites of vectors sanitation. the house
the presence of the causing diseases and 7. Cite the especially the
threat due to lack therefore will maintain a causes and possible breeding
of/inadequate home environment effects of the sites and was able
knowledge. conducive to health. prevalence of to enumerate and
these observed teachings
Inability to make The family will be aware unwanted regarding
decisions to take and will be more insects around elimination of
appropriate actions knowledgeable about the and inside the breeding sites.
due to failure to importance of proper home.
comprehend the sanitation especially at 8. Suggest
nature of the home. methods that
condition. would
eliminate the
breeding sites
of vectors.
9. Explore with
the family the
ways of
improving
home
sanitations
considering its
limited
resources.
10. Emphasize to
the family the
proper storage
of food that
may attract
vectors.
CHAPTER VIII
GOALS OF CARE: After the nursing interventions, the family will be able to minimize the
occurrence of cough and colds in the future.
a. acquire adequate information about the disease including causes, signs and symptoms and
b. Utilize community resources available in undertaking the condition experienced

Cough and colds 1. Discuss with the family the Brochures about the problem
A. Inability to recognize the and colds.
B. Inability to make decisions knowledge on the various
with respect to taking ways of maintaining
appropriate health actions due cleanliness around their
to: home.
1. Failure to comprehend the
nature, magnitude or scope of 3. Explain the importance of
the problem proper food handling and
2. Lack of knowledge as to preparation, good nutrition,
alternative courses of action adequate rest and sleep and
open to them. strengthening each family

family.
GOALS OF CARE: After nursing intervention, the family will be able to eradicate the
presence of these unwanted sites of vectors causing diseases and therefore will maintain a
home environment conducive to health.
OBJECTIVES OF CARE: The family will be aware and will be more knowledgeable about
the importance of proper sanitation especially at home.
Presence of breeding sites, 6. Discuss the Material Resources:
insects and rodents as importance and Visual Aids on health
Foreseeable Crisis: purposes of proper teaching.
Inability to recognize the sanitation.
presence of the threat due to 7. Cite the causes and Human Resources:
lack of/inadequate effects of the Time and effort of the nurse
knowledge. prevalence of these leaner and the family.
unwanted insects
Inability to make decisions to around and inside the
take appropriate actions due home.
to failure to comprehend the 8. Suggest methods that
nature of the condition. would eliminate the
breeding sites of
vectors.
9. Explore with the
family the ways of
improving home
sanitations
considering its limited
resources.
10. Emphasize to the
family the proper
storage of food that
may attract vectors.
CHAPTER IX
OVER-ALL WORK PLAN
Problems Solutions Identified Time Frame
Poor Sanitary Health Education November 2017
Environment
THE GRACE OF THE LILY: A FAMILY CASE STUDY
PITAS, Marykris L.
BENGUET STATE UNIVERSITY- COLLEGE OF NURSING

May 2017
ACKNOWLEDGEMENTS
The nurse-learner would like to sincerely express her profound gratitude and appreciation to
the following, who in one way or the other, made this study possible.
To Sir Jude Tayaben and Ma'am Aprila Calasan, our clinical facilitators, for their continuous
assistance and selfless efforts.
To the Tiongan family who warmly welcomed the nurse-learners during their home visit and
had gladly shared to their thoughts and knowledge to them.
Also, the nurse-learner would like to extend her deepest gratitude to her parents and
guardians for their unending guidance and support.
Foremost, to God Almighty, who made all things possible. The nurse-learner uplifts all her
praises and honor to Him alone.
Marykris L. Pitas
CHAPTER I
INTRODUCTION
Community health Nursing is the synthesis of nursing and public health practice as

applied to promote and protect the health of population. It combines all the basic
elements of professional and clinical nursing with public health and community practice.
(cartercenter.org)
A Community Health Nurse, therefore, acts as a partner in a health team who

provides nursing care, treatment to the sick, health counseling and does work in different
places such as home, school, and health center. (Cmai,2005)
As Community Health Nursing revolves on individuals, families, population

group or aggregates, and the community, according to Nurseslab.com, there are twelve
(12) principles that govern CHN. These are as follows: (1) The recognized need of
individuals, families and communities provides the basis for CHN practice; (2)
Knowledge and understanding of the objectives and policies of the agency facilities
goal achievement; (3) CHN considers the family as the unit of service; (4) Respect
for the values, customs and beliefs of the clients contribute to the effectiveness of care
to the client; and (5) CHN integrated health education and counseling as vital parts of
functions.
Moreover, (6) Collaborative work relationships with the co-workers and

members of the health team facilities accomplishments of goals; (7) Periodic and
continuing evaluation provides the means for assessing the degree to which CHN
goals and objectives are being attained; (8) Continuing staff education program
quality services to client and are essential to upgrade and maintain sound nursing
practices in their setting; (9) Utilization of indigenous and existing community
resources maximizing the success of the efforts of the Community Health Nurses;
and (10) Active participation of the individual, family and community in planning
and making decisions for their health care needs, determine, to a large extent, the
success of the CHN programs.
As well as, (11) Supervision of nursing services by qualified by CHN

personnel provides guidance and direction to the work to be done; and (12)
Accurate recording and reporting serve as the basis for evaluation of the progress of
planned programs and activities and as a guide for the future actions. With all of
these, nurses would certainly be guided and be led for the ultimate goal of Community
Health Nursing which is to promote community health. (Hitchcock, Schubert, Thomas,
2003)
159
CHAPTER II
General Objectives:
At the end of the nurse learner-family relationship, the family should be able to
display well-founded means to improve and sustain the health status of each family
member.
After a week of home visits and with nurse learner-family interaction, every family
member would be able to:
a) Identify ways to improve interpersonal relationship within their family.
b) Enumerate the importance of diseases and illnesses prevention.
c) Utilize available resources in solving their problems.
d) Develop and maintain good habits of personal hygiene and sanitation.
e) Understand health teachings to be rendered.

CHAPTER III
INITIAL DATABASE
The initial database includes the information about the family in various dimensions.
It includes the Family Structure, Characteristics and Dynamics, the Socio-economic and
Cultural Characteristics, the Home and Environment, the Health Assessment of each
family member, and the Values, Habits, Practices on Health Promotion, Maintenance and
Disease Prevention.
NAME AGE SEX CIVIL POSITIO OCCUPATIO EDUCATIONA

STATU N IN THE N L
(code (years) S FAMILY ATTAINMENT
names)
Tiger 33 Male Married Father Farming Elementary

Graduate
Easter 30 Femal Married Mother Farming High School

e Graduate
Candidu 10 Femal Single First Child Student Grade V

m e
Martagon 7 Femal Single Second Student Grade II

e Child
Regale 2 Femal Single Third --- ---

month e Child
s
Generally, a family is a group, which is made up of two parents and their kids
living jointly as a unit. It also consists of all the successors of a common precursor. In
general, a family is a social unit of two or more individuals, related by marriage, blood,
or adoption and having a common pledge to the mutual relationship
(importantindia.com).
Nuclear family, also known as conjugal, elementary, or traditional family,
consists of only a couple and their children. As every family type has its own pros and
cons, a nuclear family type has the following advantages: small families have small
financial needs; have less quarrels and personal vendetta, so less problems; make
members of family responsible; have more privacy than those with extended family type;
and are usually a well-maintained economical family (BIT-Journal).
The Lily family is a nuclear type of family. The household is composed of father
Tiger, 33 years old; mother Easter, 31 years old; and their 3 children: Candidum, 10 years
old; Martagon, 7 years old; and Regale, 2 months old.
Easter states that her husband, Tiger, is more dominant in terms of planning and
budgeting for their family while Easter claims to dominate in terms of the health of the
family. The couple also reported that the discipline and training of their children are
being shared by both of them.
The family's main source of income is from farming. Their product is sayote or
chayote. With an estimated monthly income of Php 5,000.00, MT reports that they are
trying their best to suffice their needs, fortunately, they are not renting their land and
house, and that only their food, schooling of the children and their personal stuffs are
being expensed with.
Tiger and Easter graduated elementary and high school, respectively. Their children
Candidum is currently on her fifth grade, while Martagon is on her second grade.
All of the members of the Lily family claim them as part of the protestant church.
The Lily Family resides in Gasal, Sayangan, Lubo, Kibungan, Benguet. They have
been living there for almost 10 years. They live in a housing unit made up of concrete
materials. There is only one wide bedroom in the unit and is claimed to have four persons
sleeping in the room. They use LPG in cooking, as well as wood.
The environment is generally in good condition; however, the house is surrounded by
tall grasses and old tires near the house as possible breeding sites of vectors of diseases.
During the home visit, Easter has no claims on history of present illnesses, except for
common cough and colds during the past 6 months. Natural remedies like water therapy
and rest were used as an intervention. Fever was also noted with remedies of sponge bath
with vinegar-water solution. Both remedies were said to be effective.

CHAPTER IV
FAMILY BACKGROUND
A. Family History
Tee family is a nuclear type of family which is composed of 4 members: the
couple Mrs. Easter and Mr. Tiger, their three children: Candidum, Martagon, and
Regale. Easter claims that her husband, Tiger, is the head of the family. They have
been living in Gasal for almost 10 years now. The family's source of income is
farming with an estimated income of Php 5,000.00 per month, depending on the prize
of their crops.
B. Family Tree
AT MT
αT nT ysT
LEGEND:
Black– male Red– female
Chapter V
The Lily family seeks consultation in Bobocco Clinic whenever they have concerns
about their health. However, they use natural or home remedies first before consulting
healthcare providers, if the concern was not solved, they sought for medical care. Tall
grasses and old tires near the housing unit were noted to be a possible breeding site of
insects.
Cues/Data Family Nursing Problem
Subjective Data: A. Presence of breeding sites of insects,

rodents and vectors as a Health threat
"Han mi maasikaso ngarud piman ya, karo
ada ti baby nga mabanbantayan en tadta," B. Inability to recognize the possible
said Easter. diseases that could be acquired
through the presence of mosquitoes.
Objective Data:
Old tires left outside the house
Tall grasses at the back of the house
Subjective Data: A. Unhealthful personal practices from

poor personal hygiene as a Health
"Awan ti nail cutter mi," claimed by threat
Martagon.
B. Inadequate knowledge of importance

of hygiene and sanitation, especially
Objective Data: to their children.
Long and dirty nails of both hands and feet
Candidum and Martagon both have head

lice
Subjective Data: A. Additional member- newborn as

presence of stress points
"Mayat met ngem siyempre ada gamin
manen ti baby nga mabanbantayan" claimed
B. Lack of family resources, specifically
by Easter.
manpower resources.
Objective Data:
Easter would always cuddle her baby even

during doing house chores
Chapter VI
This section contains the basis of the prioritization of the nursing problems.
I. Presence of breeding sites of vectors of diseases (mosquitoes, flies, etc.) as a

Health Threat

6. Magnitude of 2/2 x 2 2 The resources and interventions

the Problem needed to solve the problem are
available.
7. Preventive 3/3 x 1 1 Occurrence of Dengue, Malaria,

Potential and other communicable
diseases can be minimized.
Total Score: 4.67

II. Unhealthful personal practices from poor personal hygiene as a Health threat

Problem
available.
7. Preventive 3/3 x 1 1 Achievement of environment

Potential that is conducive for health of
the family.
8. Salience 1/2 x 1 0.5 The family understands the

consequences of the problem.
Total Score: 4.17
III. Additional member- newborn as presence of stress points
5. Nature of the 1/3 x 1 0.33 It is a Health Deficit that needed


available.
7. Preventive 2/3 x 1 0.67 Severity of the disease may be

Potential prevented through proper health
maintenance and understanding
of health teachings.
8. Salience 1/2 x 1 0.5 The family recognizes it as a

problem.
Total Score: 2.5

PROBLEMS SCORES
1. Presence of breeding sites of vectors of diseases (mosquitoes, 4.67

flies, etc.) as a Health Threat
2. Unhealthful personal practices from poor personal hygiene as a 4.17

Health threat
3. Additional member- newborn as presence of stress points 2.50

Chapter VII
A Family Nursing Care Plan is the set of actions the nurse decides to implement to
be able to resolve identified family health and nursing problems (Liego, 2012)
HOUSEHOLD: 1
SITIO: GASAL
Health Family Goal of care Objectives Interventio Method of Resourc

proble nursing of care n measures nurse- es
m problems family required
contact
Presenc Inability After an After an 1. Assess Home visit Human
e of to hour of hour of condition of resource
breedin recognize nursing nursing the house s: time
g sites the intervention intervention and level of and
of possible , the family , the family knowledge. effort of
insects, diseases will be able will be able 2. Discuss the nurse
rodents that could to to the possible learner
and be demonstrate demonstrate sources of and the
vectors acquired understandi understandi mosquitoes' family
as a through ng of the ng of the presence.
Health the health health 3. Explain
threat presence teaching teachings, to the
of regards to and family all
mosquitoe the possible breeding possible
s. causes and sites of harmful
effects of mosquitoes effects that
the presence will be mosquitoes
of these cleaned. can cause
vectors. to health of
the family.
4.
Encourage
on
maintaining
cleanliness
by regularly
cleaning the
surrounding
s.
Nurse Learner: Marykris L. Pitas Name of Client: Lily Family
HOUSEHOLD: 1
SITIO: GASAL
Health Family Goal of care Objectives Interventi Method of Resource

problem nursing of care on nurse- s
problems measures family required
contact
Unhealthf Inadequat After an After an 1. Assess Home visit 1.
ul e hour of hour of personal School Human
personal knowledg nursing nursing health Nursing resources
practices e of intervention interventio practices : time
from poor importan , the family n, the and and
personal ce of will be able family hygiene. effort of
hygiene as hygiene to specificall 2. Explain the nurse
a Health and demonstrate y the to the learner
threat sanitation understandi children family all and the
, ng of the will be possible family
especially health able to effects 2.
to their teaching improve that can Hygiene
children. regards to their cause Kits
proper personal harm to containin
personal hygiene as the health g nail
hygiene in evidenced of the cutter,
relation to by clean family suyod,
their general and short from poor etc.
health. nails, neat personal
clothes and hygiene.
minimal 3.
head lice. Encourage
on
maintainin
g
cleanlines
s and
orderlines
s,
especially
on
personal
hygiene
and
practices.
HOUSEHOLD: 1
SITIO: GASAL
Health Family Goal of Objectives Interventio Method of Resource

problem nursing care of care n measures nurse- s
problems family required
contact
Additiona Lack of Within Within the 1. Assess Home visit Human
l family the home home visit, the family's resources
member- resources, visit, the the family coping : time
specificall family will mechanism and effort
newborn
y will be demonstrat on their of the
as manpower able cope e and/or present nurse
presence resources up with enumerate situation. learner
of stress their ways on 2. Discuss and the
points current how to with the family
situation cope up family
of with their
additiona additional feelings
l family family about their
member. member. additional
family
member.
3. Explain
the
importance
of proper
coping
techniques
to avoid
stressful
points.
Chapter IX
I. Presence of breeding sites
GOAL OF CARE:
After an hour of nursing intervention, the family will be able to demonstrate understanding of the
health teaching regards to the possible causes and effects of the presence of these vectors.
OBJECTIVES OF CARE:
health teachings, and breeding sites of mosquitoes will be cleaned.
Inability to recognize the 5. Assess condition of the house Human resources: time
possible diseases that could be and level of knowledge. and effort of the nurse
acquired through the presence learner and the family
6. Discuss the possible sources of
of mosquitoes.
mosquitoes' presence.

mosquitoes can cause to health
of the family.
After the nursing interventions, the family made actions to avoid possible diseases that may be
due to the said problem.
II. Unhealthful personal practices from poor personal hygiene
GOAL OF CARE:
health teaching regards to proper personal hygiene in relation to their general health.
OBJECTIVES OF CARE:
Within the home visit, the family will demonstrate and/or enumerate ways on how to cope up
with additional family member.
Inadequate knowledge of 1. Assess personal health practices 1. Human resources: time

importance of hygiene and and hygiene. and effort of the nurse
sanitation, especially to their learner and the family
children.
possible effects that can cause harm 2. Hygiene Kits
to the health of the family from containing nail cutter,
poor personal hygiene. suyod, etc.
cleanliness and orderliness,
especially on personal hygiene and
practices.
After the nursing interventions, the family made actions to establish neat and proper personal
hygiene and practices, as well as maintaining cleanliness of the family members.
III. Additional member- newborn
GOAL OF CARE:
Within the home visit, the family will be able cope up with their current situation of additional
family member.
OBJECTIVES OF CARE:
Within the home visit, the family will demonstrate and/or enumerate ways on how to cope up
with additional family member.
Lack of family resources, 1. Assess the family's coping Human resources: time
specifically manpower mechanism on their present and effort of the nurse
resources situation. learner and the family
2. Discuss with the family their
feelings about their additional
family member.

proper coping techniques to avoid
stressful points.
After the nursing interventions, the family was able to figure out possible ways to cope up with
their current situation.
Chapter X
The community health nurse is charged with promoting the health of populations, not only the
individuals within populations. This requires advocacy on the part of the nurse, for entire communities
as well as for the individuals within (Clark, 2008).
With this, the nurse learners should remain to be community health nurses, not only for today but
should also extend for a lifetime, for them to continue upholding the true essence of being a nurse,
which is to promote health especially in our communities.
The nurse learners should also encourage the Lily family and other families in the community to
continue taking good care of their health, for we all know that "It is our Health that is our Wealth".
Continuous information dissemination should also be empowered in the community to reiterate having
a good lifestyle for health.

Chapter XI
REFERENCES
Dorothy Baldwin. All about Children: An introduction to Health development. 1983. page 10-11
Janice E. Hitchcock, Phyllis E. Schubert, Sue A. Thomas. Community Health Nursing: Caring in
Action, Volume I. 2003. page 346
Mary Jo Clark, Ph.D., RN. Community Health Nursing: Advocacy for Population Health, 5th edition.
©2008
www.nurseslab.com
THE “CAYAT`S”: A FAMILY CASE STUDY
POOTEN, Blessing Joyce

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENT
I would like to spend sincere gratitude to CAYAT family who generously shared their time and
experience for the purposes of this case study. Without them, the completion of this study would not
have been possible.
I wish to express my sincere thanks to Sir Jude L. Tayaben and Ma'am Aprila Calasan, facilitator,
for their unlimited guidance in order to finish this case study.
I am thankful to my family and friends who have shown me unconditional love and continouos support.
I am grateful to the God for the good health and wellbeing that were necessary to complete this case
study.
Blessing Joyce
Pooten
CHAPTER I
INTRODUCTION
Community health nursing and public health practices applied to promote and protect the health of
population. It combines all the basic element of professsional, clinical nursing with public health and
community practice. Community health nursing is essential particularly at this time because it
maximizes the health status of the individuals, families, groups and the community through direct
approach with them (Mengitsu, D., Misganaw, E. 2006).
Broadly defined, a community is a collection of people who interact with one another and whose
common interest or characteristics gives them a sense of belonging and shared identity, values, norms,
communication, and supporting behaviors.
Family health care nursing is “ The practical science of preventative and remedial support to the
family in order to help the family system unit independently and autonomously maintain and improve
its family function”.
The basis of modern community health nursing is to share responsibility of helping each other.
When it comes to considering an organization, equal participation of the people working through the
community groups/ people with the people, for the people for their mutual benefit, change in behaviour
and health pactices. Mutual respect and cooperation from both caregiver and receiver of care to help
empower the people.
Home environment is the most effective ways of increasing family's understanding and
involvement in health problems. At times, home visiting is the only way to obtain a comprehensive
picture of the family health status. Home visiting or home health service is that components of
continuum of a comprehensive health care in which health care services are provided to individuals,
and families in their place of residence for the purpose of promoting maintaining or restoring health or
of maximizing the level of independence while minimizing the effect of disability and illness, including
terminal illness. Home health service refers to all the services and products provided to clients in their
home, to maintain, restore, or promote their mental, physical and emotional health.
A nursing home visit is a family- nurse contact which allows the health worker to assess the home
and family situations in order to provide the necessary nursing care and health related Activities (Vera
2012). In performing home visits, it is essential to prepare a paln of visit to meet the needs of the
clientand achieve the best results of desired outcome.

CHAPTER II
Today community participation and involvement is getting a due attention before the occurrence of
illnesses as lifestyle changes to continue to play a significant role in morbidity and mortality. Chronic
illnesses, tobacco smoking, road traffic accident etc., and environmental playing a big role in the
community changes that affect health are steadilybecoming the major concerns influencing human
health is in our country.
General Objective:
At the end of the nurse learner family relationship, the family should be able to display expected
means to improve the heallth status of every family member.
Specific Objective:
After a week of visits and with the nurse learner and family interaction, each of the family member
should be able to;
a.) Express own percaption and identify ways to improve interpersonal relationship within their
family.
b.) Identify practices and behaviours that support and inhibit the interpesonal relationship within the
family.
c.) Make decision with respect to taking appropriate knowledge about prevention and home
remedies for hypertension and cough & colds.

CHAPTER III
INITIAL DATA BASE
Family Cayat is composed of 6 members. They are in nuclear type of family and at the same time
extended because their daughter who is married and have a son resides with them, patriarchal in
authority. As nuclear type family is composed of father, mother and children. A nuclear family is fund
in almost all societies although the length of time in which the family remains in this form remains
varies within the same society. The nuclear family can be nurturing environment in which to raise
children as long as there is love, time spent with children, emotional support, low stress, and a stable
economic environment. In nuclear families, both adults are the biological and adoptive parents of the
children, (Jay,2004). The Cayat family resides at Lubo, Nagawa, Kibungan. They have been leaving
there for 8 years and 11 months. Mrs. Cayat and Mr. Cayat share the decision making in their family.
They consult each other in terms of planning and budgeting for their family. In terms of the health of
the family. Mrs. Cayat claims that they also share their task when it comes to disciplining their child.
A. FamilyStructure, Characteristics and Dynamics
NAME AGE SEX CIVIL POSITION OCCUPATI EDUCATIO
STATUS IN THE ON NAL
FAMILY ATTAINME
NT
BC 46 M M HUSBAND FARMER ELEMENTA
RY
NC 39 F M WIFE FARMER ELEMENTA
RY
JPC 10 M S SON STUDENT STUDENT
JL 22 F M DAUGHTE STORE COLLEGE
R KEEPER STUDENT
WL 25 M M SON IN FARMER HIGH
LAW SCHOOL
AL 2 M S GRANDSO
The family's main source of income is from being farmer. They plant “sayote” in their garden and
cultivate then sell it where they are able to collect money at a range of 2,000. Mr. Cayat also claim that
he also help others when they are harvesting their plant and being paid of 350 with an 8 hour work in
the field. With the monthly salary of around Php 2,000, Mrs. Cayat budgets the money
handed/collected to buy for their foods in everyday life.

C.Home and Environment
The Family Cayat has a bungalow type of house and it is composed of wood and a galvanized iron
sheets that has one room and a bed where they sleep all together, also serves as their kitchen and dining
room.
The main source of their water supply is a spring that is located up the hills. There water is free
flowing and some are being stored on a basin. They burn some of their garbage and throw their garbage
on a pit located just below their house.
D.Health Assessment of the Family
The family does not have any history of any illnesses specifically on the lineage of Mr. and Mrs.
Cayat.
Father- Mr. Cayat does not have any illnesses like hypertension. He claims that he only had episodes
of nape pain with a BP of 130/70 mmHg but he said it is not caused by hypertension but it is cause by
tiredness. As he states” awan met ti ammuk nga sakit ti nanang ken tatang ko”
Mother- Mrs. Cayat does not have any hereditary illnesses. As she claims “awan met ti sakit da innak
ken ammak”
The Cayat during the home visit appears to be healthy, but one of the family member was sick and
hospitalize due to UTI.

CHAPTER IV
FAMILY BACKGROUND
A. FAMILY HISTORY
– Family Cayat is composed of 6 members. They are in nuclear type of family and at the same
time extended bacause their daughter who is married and have a son resides with them,
patriarchal in authority.
B. FAMILY TREE
BADAY NENITA
JOVELYN JIM PAUL

WENDER
ANTHONY
GUZRYX
Figure 1. Cayat's Family Tree

CHAPTER V
HEALTH DEFICIT
CUES OR DATA FAMILY NURSING PROBLEM
Subjective data: I. Cough and colds as a health deficit
“pasubli-subli ngay jay sakit nga uyek weno A. Inability to make decision with respect to
panateng” taking appropriate knowledge about prevention
and home remedies.
- lack of knowledge about the nature and
complications of coughand colds.
Subjective data: II. Hypertension as a health deficit
“ada ngay nu maminsan ket sumaksaket dyay B. Inability to recognize the presence of health
tengged ko, nangato gayam BP'k” problem due to lack of or in adequate knowledge
about hypertension.
- lack of knowledge about the signs and
symptoms of hypertension.
- lack of knowledge about the nature and
complications of hypertension.
HEALTH THREAT
CUES OR DATA FAMILY NURSING CARE PROBLEM
Subjective data: III. Presence of breeding places of mosquitoes and
“ ti problema ket dyay lamok, maparuwar ken flies as a health threat.
uneg ket ada lamok “ A. Inability to recognize the possible diseases
Objective data: that could be acquired through the presence of
- moldy drums are used for water storage. mosquitoes and flies.
- containers and plant pots accumulates water are B. Inability to make decisions to take
present. appropriate actions due to:
- failure to comprehend the nature/
magnitude of the problem/ condition.
Objective data: IV. Poor environmental sanitation as a health
- pieces of candy wrappers are present threat.
- garbage are not well segragated A. Inability to provide home environment which
- remains of cabbage leaves are present at their is conductive to health maintainance and
backyard and not disposed properly. development of personal hygiene.

CHAPTER VI
This section contains basis of the prioritization of the Nursing Problems.
I. Cough and Colds as a health deficit
Criteria Computation Actual Score Justification
1. Nature of problem 3/3x1 1 It is a health deficit that
requires immediate action
and adequate management
to reduce likelihood of
transmission and
complications.
2. Modifiability of the 2/2x2 2 Inadequacy of living space
problem and environment condition
are barriers to
achievement of good
personal hygiene.
3. Preventive potential 3/3x1 1 Transmission of cough and
colds may be reduced if
the problem is managed
adequately as soon as
possible.
4. Salience of the problem ½ x1 ½ The family recognizes it is
a problem. However, it
does not see the problem

as needing immediate
action.
Total Score: 4.5
II. Presence of breeding places for mosquitoes and insects as a health threat.
Criteria Computation Actual Score Justification
1. Nature of the problem 2/3x1 0.66 It is a health threat
2. Modifiability of the 1.5/2x2 1.5 Current knowledge,
problem interventions and
resources are available to
solve the problem.
3. Preventive potential .75/3x1 0.25 The possibility of
increasing family size is
reduced; the available
family resources can be
utilized to encourage
growth promoting
experiences for members.
4. Salience of the problem 0x1 0 The family recognizes the
problem as serious and
needing immediate
attention.
Total score: 2.41

PROBLEMS SCORE
1. Cough and Colds 4.5
2. Presence of Breeding sites for mosquitoes and insects 2.41

CHAPTER VIII
Health Family Goal of care Objectives of Interventions Method of Resources
Problems nursing care measures family requires
problem nursing
contact
Health Inability to Within the Within the 1. Assess the Home Visits 1. Human
deficit: cough make three home three home family status resources
and colds decision with visit the visits the on personal time and
respect to family: family: hygiene. effort of both
taking a. will be able a. will be able 2. discuss and nurse learner
appropriate to prevent to enumerate explain the and family.
knowledge recurrence of or signs and 2. Soap,
about the disease in demonstrate symptoms, Water and
prevention the future. some common towel.
and home b. able to gain preventive causes of
remedies. more measures cough and
knowledge regarding colds.
about cough cough and 3. Explain the
and colds. colds. importance of
b. utilizes proper food
resources preparations,
available in good
the nutrition,
community in hygiene and
resolving the in
problem. strengthening
one's immune
system or
resistant.
4. Instruct to
cover mouth
when
sneezing and
coughing.
Health Family Goal of care Objectives of Interventions Method of Resources
problems nursing care nurse family

plan care measure contact required
Presence of Inability to After three After nursing 1. assess Home visits Cleaning
breeding recognize the home visits care condition of material
places of possible the family interventions the house and Interview
mosquitoes disease that will be able the family level of method Simple visual
and flies could be to: will be able to knowledge. aids and
acquired a. demonstrate 2. Discuss the Observation materials
through the demonstrate understanding possible needed.
presence of understanding of the health sources of
mosquitoes. of the health teachings. presence of
teachings The breeding mosquitoes
with regards sites of the and insect.
to the mosquitoes 3. Explained
possible will be to the family
causes by the cleaned.. all the
presence of possible
these vectors. harmful
effects that
mosquitoes
can cause, the
different
diseases that
can be fatal to
the family
member
because of
the
mosquitoes.
4. Encourage
on
maintaining
cleanliness by
regularly
cleaning the
surrounding
or their
backyard and
the proper
disposal of
garbage.
CHAPTER IX

In this family nursing care plan, 2 problems are gathered. These are health deficit
which includes cough and colds followed by present of breeding sites. From the FNCP I
first implemented my nursing care paln by explaining to them about the illness which is
the cough and colds. In explaining to them about the different diseases that can be get
from the mosquitoes I used some of my knowledge learned in the school and planned to
make a brochure for the next immersion.
CHAPTER X
CONCLUSION
– The family was able to prevent the recurrence of the disease because
when we visited them they are somehow healthy and was also able to
enumerate some ways on how to avoid cough and colds.
RECOMMENDATIONs
– Health teaching for common cough and colds is highly recommended so
that they can prevent it from reoccuring again.
– Visiting the rural health clinic is highlyb recommended.

MS, A FAMILY CASE STUDY
PRESCO, Zoee B.
COLLEGE OF NURSING
LA TRINIDAD, BANGUET
MAY 2017
ACKNOWLEDGEMENTS
As a nurse learner, it is essential to be knowledgeable about dealing with problems
of families in the community. This case study has been given to me as an opportunity to
get an exposure to these kinds of problems, be able to give help to the families regarding
these problems, and be aware of their current health status. Although none of these
would be possible without the aid of significant people involved in this study.
First of all to the Almighty Lord our God, for leading me into this path, for giving
me strength and opportunity. For his guidance and protection that he bestows upon us
daily, and the blessings that he so generously showers upon us day by day.
To our Clinical Facilitator, Mr. Jude Tayaben, for his always positive and energetic
support in our day to day activities and providing help in the completion of this case
study. I am truly grateful for your patience, understanding, concern, and guidance you
gave.
To Mrs. MS, for accommodating, welcoming, and trust in sharing both basic and
personal information, which would make this study possible.
To my parents, who I am truly grateful for their unending support, whether
emotionally, physically, and financially, to support the making of this study.
Lastly to my classmates, especially for my group mates in Sayangan, for the
friendship and support that makes us a team, to work and perform the activities to make
this study all possible.
ZOEE B. PRESCO
Chapter 1
INTRODUCTION
A family is a group of people related by heredity, such as parents, children, and
siblings. The term is sometimes broadened to include related by marriage or those living
in the same household, who are emotionally attached, interact regularly, and share
concerns for growth and development of the group and its individual members. (Mosby’s
Dictionary, 2008).
A community is a term for groups of people living in somewhat close association,
and usually under common rules. (Random House Dictionary, 2016). Nurse Learners are
exposed, or immersed in these communities because this is where they can adapt, or
learn, to different kinds of people. Though they are exposed to their own communities
every day, it is still not enough because no two communities are alike. In Family Health
Nursing, the family is considered to be the basic unit of care. It is the main influence of
an individual wherein he learns his behaviors. Knowing this, it is essential for the family
to learn about health practices.
By means of this case study, a Nurse Learner will immerse himself to the
community, through a family which is the basic structure. Using a tool, in depth
assessments, and critical inspections, the Nurse Learner identifies possible health threats
and health problems. Once identified, he then gets an idea on where to intervene. With
the knowledge of the learner, he then shares information, techniques, and performs
nursing interventions for the improvement of the family. This study is also a key in
improving the health of the community itself.
The family chosen by the Nurse Learner is a picture of the majority of families in the
community. A family living in a poor environmental condition and lack of knowledge
regarding health. Though difficult and tiring, it gives the learner the sense of fulfilment,
success and content, as he shares information, skills, and performs interventions to aid in
the condition of the family.
CHAPTER 2

This chapter presents the general and specific objectives of this family case study.
Setting objectives provides direction for planning a family nursing intervention. It
facilitates motivation for the client and the nurse by providing a sense of achievement.
(Kozier and erb, 2004).
General Objectives:
At the end of the Nurse Learner- Family relationship, the family, should be able to
display expected means to improve their health status and become self-reliant in
maintaining their health.
After a week of home visits, and with the nurse learner and family interactions, each
of the family members should be able to:
a. Give factual information during surveys and interviews.
b. Participate during home visits.
c. Carry out planned interventions together with the nurse learner.
d. Perform health teachings taught by the nurse learner.
CHAPTER 3
INITIAL DATA BASE

The initial data base is the information about the family in various dimensions. It
includes the family structure, characteristics and dynamics, the socio-economic and
cultural characteristic, the home and environment, the health assessment of each family
member, and the values, habits, practices on health promotion, maintenance and disease
prevention.
This is summarized in a tabular format, it also contains further discussion on the
other characteristics of a healthy family like decision making and others.
Name Age Sex Civil Position in Occupation Educational
Status the Family Attainment
MS 50 Female Married Farmer Elementary
Level
Mrs. MS is the only member of the household. She resides in Digway, Sayangan, Lubo,
Kibungan since she was born. She is independent in making her decisions. Her husband
has passed away, and they have 2 children, but they do not live with her because they are
currently studying at La Trinidad, Benguet.
B. Socio- Economic and Cultural Characteristics

Mrs. MS has a salary that is not consistent. She said that it all depends on the market
of what she harvests. She is a very hard working person. She has been a farmer since she
was a kid. She invests her money in farming materials and electricity bills. She does not
pay for water because it is very much free, and she doesn’t pay for rent because she owns
her house.
Her house is a one-room house, made of wood and galvanized iron. There are two
windows, a door. For a restroom, she has a covered, shed like, with a closed pit toilet. As
for her kitchen, she uses firewood for her cooking.
History of the Past Illnesses
Mrs. MS recalls having times of high blood pressure, but only when she is tired from
work. Also, periodically, she gets flus and fevers.
Mrs. MS is not taking in any maintenance medications. When struck with flu or
fever, she claims that she doesn’t take medications because she does not have any. She
only rests and drinks lots of water. But in the case of severe pain, she goes to her
neighbor to ask for some medications if there are any.
Family assessment based and Functional Health Pattern

1. Health Perception- health management patters
Mrs. MS is knowledgeable about her health.
2. Nutritional- metabolic pattern.
If having flus and fevers, she usually just rests and drinks lots of water. In the case of
severe pain, she goes to her neighbor to ask for medications if there are any.
Her daily food intake mainly consists of vegetables like sayote and gabi. She also
gets carbohydrates from rice and root crops. Protein wise, she eats eggs. She doesn’t eat
meat because she has difficulty chewing them because she has no teeth.
She claims to defecate every day, and urinate regularly and does not hold it in.
4. Activity- exercise pattern
She does not perform exercise routines because she claims that her work serves as
exercise for her.
5. Sleep- Rest pattern
Mrs. MS claims that she sleeps about 5-6 hours. But during the afternoon, she sleeps
if there is nothing to do.
6. Cognitive- perceptual pattern.

She seems to be time oriented. She has a calendar to keep track of dates. During the
interview, she appeared shy at first, but open minded. She responds to our questions with
confidence. She loves to smile even if she has no teeth.
7. Self- perception/Self Concept
Even being a widow, she appears happy. She says that if it’s your time, it’s your
time. She has her children who visit from time to time.
Because she is living by herself, she is independent in making decisions for herself.
During the home visit, she was very welcoming.
Currently, she does not have a sexual life because she is a widow and is not at
reproductive age. But has been blessed with 2 children when her husband was still alive.
10. Coping Stress
During the interview, she claims to get motivation from her 2 children. She claims to
get stressed but not very often.
11. Values/ Belief Patterns
Mrs. MS was born and raised in Sayangan, Lubo, Kibunga. She goes to worship at
EROMI but not as often as before. Yet, she still prays on a regular basis.
12. Value, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
She watches her health by making sure that she eats every day, avoiding getting
soaked in rain, and making sure the water she drinks are clean.
CHAPETER 4
Cues or Data Family Nursing Problem
Subjective Data: 1. Hypertension as a health deficit
- “Mejo maulawak nu mabanugak ken A. inability to take in medication due to:
sumakit teltel ko” a. Lack of budget
Objective Data: b. Nowhere to buy
- Verbalized dizziness when exhausted c. distance from house to Clinic/ RHU
nape pain for daily check up
- BP taken as 130/90
Objective Data: 2. Flu and Fever as a health deficit
- Report of periodical flus and fevers A. Inability to make decisions with
respect to taking appropriate health actions
due to:
a. Lack of/ inadequate knowledge/
insight as to alternative courses of action
open to them.
CHAPTER 5
1. Hypertension as a health deficit
1. Nature of the Problem 3/3 x 1 1 Hypertension is a health
deficit in which will cause
complications that require
immediate attention and
adequate management of
one’s blood pressure.
2. Modifiability of the 2/2 x 1 1 Current knowledge,
Problem interventions and resources
are available to solve the
problem og high blood
pressure or hypertension
3. Preventive Potential 3/3 x 1 1 Increase BP can be
prevented through proper
health management of HPN
4. Salience 2/2 x 1 1 The family perceives HPN
as a serious problem needing
attention.
Total Score 4
2. Flu and Fever as a health deficit

1. Nature of the Problem 2/3 x 1 0.66 These two common diseases
is a health deficit that needs
immediate attention to avoid
worsening
2. Modifiability of the 1/2 x 1 0.5 The problem is modifiable
Problem but due to the unavailability
of health resources, they can
only depend on rest.
3. Preventive Potential 3/3 x 1 1 The problem is highly
preventive because common
illnesses can be easily
eliminated
4. Salience 1/2 x 1 0.5 The problem can be easily
modifiable if adequate
knowledge from the health
personnel is given.
Total Score 2.66
PROBLEMS SCORES
1. Hypertension as a health deficit 4
2. Flu and Fever as a health deficit 2.66
CHAPTER 6
From: http://pathoofhtn.blogspot.com/
CHAPTER 8
Nursing Interventions
Goal of care: after 1-2 hours of student nurse- client interaction, the family will be able to remind
herself in taking care of self, regarding hypertension.
Objective of care: after effective nursing intervention, the client will be able to:
1. Educate family members about importance of regular check ups
2. Explain importance of proper food intake
3. Enumerate diseases that might develop if hypertension is not prevented earlier.
4. Know about the Dos and Don’ts of hypertension
Hypertension as a health deficit Establishing rapport BP apparatus
Home Visit Time for Student Nurse- Client
Health teachings interaction
Encourage lifestyle modification
for their benefits
Educate them the proper way of
taking good care of their health
and food intake
Evaluation of interventions: Goal met after nursing interventions, the patient was able to:
Explain proper food intake
Enumerate diseases that might develop if HPN is not prevented earlier
Enumerate HPN Dos and Don’ts
References: Family Nursing Care Plan

Nursing Interventions
Goal of care: after 1-2 hours of student nurse- client interaction, the family will be able to
effectively promote and maintain health, regarding prevention of Flu and Fever.
Objectives of Care: After nursing intervention, the family will:
a. acquire adequate information about the diseases: including signs and symptoms, and
treatment
b. be aware on ways to prevent these illnesses
Flu and Fever as a health 1. Discuss with the family the Time and effort on the part
deficit causes, effects and of the nurse and the family
complications of Flu and
Fever
2. Provide information on
how to prevent these
illnesses.
3. Educate client on treatment
methods.
Evaluation of interview: after nursing intervention, goal was met, client was able to:
a. acquire information about the diseases: including signs and symptoms, and treatment
b. be aware on ways to prevent these illnesses
References: Family Nursing Care Plan
Chapter VIII
Family Nursing Goals and Nursing Evaluation Plan
Problem Objectives of Care Interventions
Hypertensio After the nu 1. Discuss wit After the nursing

n rsinginterv h the familyth interventions, the
ention thef e causes, effects and family will be able
amily, family complications
to:
member will be of hypertension.
able to have
I n a b i l i t y t o blood pressure 2. Provide
m a k e decisions within normal adequate a. acquire
with respectt o t a range knowledge
king appropriat ont h e v a r i o u s w adequate
ehealth actions a.) Acquire ade ays of maintain
due tol a c k o f quateinformatio i n g normal BP. knowledge
k n o w l e d g e r e n about hyperte
g a r d i n g n s i o n , including 3. Proper
about the
i t s management signsa n d intake of medic
symptoms, i m ines
condition
m e d i a t e health or a l t e r n a t i v
care assistancea es
b. gain blood
n d p r e v e a n d preventive me
n t i v e measure asures.
pressure
s.
within
normal
range
Family Nursing Goals and Nursing Evaluation Plan
Problem Objectives of Care Interventions
Flu and Fever After 1-2 hoursof 1. Asses vital Goals and
student nurse- signs
clientinteraction, 2. Lessen objectives were met
thefamily will clothing and
beable tohave place client if the family was
lowered temperature away from
within normal range direct heat able to have
3. Instructed
4)Show knowledge and temperature within
regarding proper demonstrate
interventions and d client normal range, and
prevention regarding
measures. tepid sponge demonstrate
5))Give bath
theimportance of 4. Educated interventions and
acleanenvironment client on
proper preventive measures
intake of
medications against the
5. Reiterated
importance disieases.
of diet and
rest on
clients
health
CHAPTER 9
Conclusion
After days of home visits and with the nurse learner and client interaction, Mrs. MS
cannot provide some of the materials that she needs for health maintenance, due to her
low income and the fact that she is living alone. She needs more information from nurse
learners for her to be able to: a.) make better decisions for herself regarding health
problems, b.) carry out planned interventions, c.) perform the health teachings taught by
the nurse learner.
Recommendations
In every Nurse Learner’s life, Community Health Nursing will be an important part
of the journey. As a Nurse Learner, it is his duty to provide immediate health care and
health teachings to the community people, before advancing to higher health facilities.
Promotion of a healthy lifestyle, preservation of good health, prevention of health
deficits and health threats through health teachings are some stepping stones in achieving
the goals of community health nursing. To fulfill our goals, collaboration and
cooperation with the barangay, all the families, and even officers and workers of Sitio
Sayangan, Barangay Lubo; I would like to recommend:

To the Barangay Officials and Workers:
Continue their journey towards health promotion. Also, consider doing reach-out
programs to far houses. Try to provide mini health centers in sub sitios. Lastly, try to
remain updated with the latest information about health and health preservation.
To Mrs. MS
In order to attain optimum health, please consider all the health teachings brought
about to you. Be open minded about different information and do not be afraid to go for
consultation in the nearest health care facility accessible to you.
To the Nurse Learners:
Exposure and immersion in these types of places may not be what we are used to.
But it is a milestone in our nursing journey. Take and embrace this opportunity to handle
real life situations, not just to help out others, but also to enhance your nursing skills with
limited resources. This would bring out the nurse in you that is patient, responsible, and
the other qualities of an EVERLASTING nurse. Obstacles are on our way, but with
patience and courage, we will be successful in the end.

THE “POCTE`S”: A FAMILY CASE STUDY
TODYOG, Myryl M.
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENT
I would like to expound my sincere gratitude to POCTE Family who generously
shared their time and experience for the purpose of this case study.Without them, the
completion of this study would not have been possible.
I want to express my sincere thanks to my facilatator Sir Jude Tayaben and Ma’am
Aprila Calasan for their guidance in order to accomplish this case study.
I'm thankful to have my groupmates for their support and concerns. Special thanks to
Gemmarie Bangyod , Trisha Anne Wacas, Vilma Paleyan and Marilou Panico who
helped me gather data that we need to comply.
I'm thankful to my Family and friends who have shown their unconditional love,
concern and continuous support.
I'm grateful to God for the good health and wellbeing that he gave throughout the
completion of this case study.
MYRYL M.TODYOG
INTRODUCTION
Community health Nursing is the synthesis of nursing and public health practice
applied to promote and protect the health of population. It combines all the basic
elements of professional, clinical nursing with public health and community
practice.Community health nursing is essential particularly at this point in time because
it maximizes the health status of individuals, families, groups and the community
through direct approach with them.(Mengistu, D. AndMisganaw, E. 2006)
Family health care nursing is "The practical science of preventative and remedial
support to the family in order to help the family system unit independently and
autonomously maintain and improve its family functions." Family support seeks, for all
family system units, from those in a state of well-being to those in a state of ill-being, to
realize well being for the family system unit in all segments of growth and development.
CHAPTER II
Nowadays community participation and involvement is getting a due attention
before the occurrence of illnesses as life style changes and as to environment sanitation
continue to play significant morbidity and mortality. Environment has a big role in the
community that affects health are steadily becoming a major concern influencing human
health in our country.
General Objectives:
display expected means to improve lifestyle and environmental sanitations.
After couple of days of visits and with the nurse learner and family interaction,
parents should be able to;
a. Express own perception and identify ways to improve lifestyle and sanitation.
b. Understand importance of good hygiene and environment in relation to health.
c. To have an idea on herbal medicine that can helped manage health problems.
CHAPTER III
INITIAL DATA BASE
POCTE Family is composed of 5 members. They are in nuclear type of family and
patriarchal in authority. As a nuclear family it is composed of a father, a mother and
children. A nuclear family is found in almost all societies although the length of time in
which the family remains in this form varies within the same society.
The Pocte family resides at Tollibeng, Sayangan, Lubo, Kibungan .Mrs. And Mr. Pocte
share the decision making in their family. In terms of health of the family they make sure
that they have extra savings to buy the medicine that they needed. Mrs. Pocte also claims
that they share task when it comes to disciplining their children.
NAME AGE SEX CIVIL POSITION IN OCCUPATION EDUCATIONAL
STATUS THE FAMILY ATTAINMENT
JJP 35 M M HUSBAND FARMER ELEMENTARY
NP 30 F M WIFE FARMER ELEMENTARY
TP 10 F S DAUGHTER STUDENT
JP 9 M S SON STUDENT
TJP 5 M S SON
B. Socio- Economic and Cultural Characteristics
The family's main source of income is farming where in they where able to earn
money at a range of 4,000.They helped each other in the farm to have a good harvest and
to be able to earn more money.With the monthly salary of around Php 4,000, Mrs. Pocte
budgets the money handed to buy all the things they needed in everyday life.
The Pocte Family has a 2 bungalow house and its composed of wood and a
galvanized iron sheets. The one bungalow was their kitchen and the other one is the they
used for sleeping.
The main source of their water supply is a spring. They collect their water through
drums and plastic containers. They burn some of their garbage’s.
The family does not have any severe illnesses specifically on the lineage of Mr and
Mrs. Pocte.
Father- Mr. Pocte
Mrs. Pocte claims that her husband does not have any illnesses like hypertension.
Mother- Mrs. Pocte
Mrs. Pocte claims that she does not have any hereditary illnesses.
`The Pocte family during the home visit Mrs. Pocte was having cough and colds while
her five years old son was having colds.
1. Health Perception-Health Management Pattern
The mother claimed that her husband does not smoke however, he drinks alcohol
occasionally. The family does not use any herbal medicines when illness occurs within
the family members due to the reason that they lack knowledge on the uses of herbal
medicines. Thus, they just buy medicines like paracetamol at the store to take when they
feel something.
2. Nutritional-Metabolic Pattern
The parents takes warm water when they have cough and/ or colds also they are
buying medicines at the storesuch as (Paracetamol, etc.) to relieve their illnesses as
claimed by the mother.
The mother claims that they defecate regularly, and urinate regularly and does
not hold it in.
The children on the other hand takes paracetamol when they are having fever,
however they are not taking any supplemental vitamins but they take their vitamins
through eating vegetables.

Daily food intake consist of rice, fish/ meat and vegetables.When Mrs. Pocte run out
of budget they resort to canned goods added with vegetables they harvest in their
farm.The children sometimes eat junk foods and sweets.
4. Activity- Exercise Pattern
The family does not regularly exercise but the parents claim that their work as a
farmer and walking from their house to the store that is 2 kilometers serves as there
exercise also for their children they walk from their home going to their school for 45
minutes.
The children as claimed by the mother have time of 7-8 hours uninteruted sleep.Mr
and Mrs. Pocte on the other hand has around 5-6 hours of sleep especially being a farmer
you need to wake up early to work in the morning and they were also going home late in
the afternoon. Mrs. Pocte also considered 5-6 hours of sleep because she has to stay up
late waiting for her husband and wake up early in the morning to for the family's needs.
Both Parents are oriented to time, place, date and were able to respond appropriately
with all the question.They were to answer and were able to rationalize when asked to
explain things.Verbal patterns of communication are noted spontaneously.

7. Self-perception/ Self Concept
The parents generally get along together because they were able to consult one
another before doing a decisions. Mrs. Pocte also claims that their concern heightens
with the welfare especially their children education.
The family have a open communication. The couple show concern to their children
and to each other. It was noted that parents enforce discipline to their children in a
acceptable manner. Mrs. Pocte talked in a nice way to his 5 year old son who was shy to
talked and play with us during the home visits.
9. Sexual/ reproductive Health
Both parents are within the reproductive age. When asked about family planning,
Mrs.Pocte said that she and her husband stop using contraceptives recently because they
would like to have another child.
10. Coping stress
Mrs. Pocte claims that their family gain strength and motivation from each
other.Support are ensured by her and her husband to their children.Mrs. Pocte shares that
they always find time to bond with their children and able to show comfort to their
children when they have problems with their playmates or at school.

The Pocte Family was Assembly of God, Mrs Pocte claims that they have strong
faith to God. Though they don't always go to Church on Sunday's, they never forget to
put God first in all the thing that they do and they always remind their children to have
faith in God.
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease
Prevention
The children in the family have all completed their immunizations. The mother has
nowledge about the importance of healthy foods but because of restrained finances
sometimes she resort to canned goods and instant noodles but she also add vegetables
that they get from their farm like “ Ugsa kn sayote”.During illnesses, especially the
children if they get sick and it’s not alarming they just give medicine that they bought
from the store because the nearest health center is 1 hour travel by car from their home.
CHAPTER IV
FAMILY BACKGROUND
A. FAMILY HISTORY
Family Pocte is composed of 5 members. They are in nuclear type of family,

patriarchal in authority.
B. FAMILY TREE
JUN JUN NETITA
THIA
JUNREY
TEE-JAY
C. Genogram
HUSBAN WIFE
D COUGH &COLDS
FIRST
CHILD SECOND
CHILD
HEAD THIRD
LOUSE CHILD
COUGH
&COLDS
Head of the family has no known health condition or complaints during the visit,
while the mother was suffering from cough and cold during the home visit. The first
child was assessed having head lies and during the visit the second child has no
complaints of illness, while the third child was also suffering from cough and cold and
observed having long and dirty finger nails.
CHAPTER V
HEALTH DEFICIT

Subjective data: 4. Cough and Colds as Health Deficit
“ pa subli- subli t sakit nga uyek kn
panateng” A. Inability to make decision with respect to
taking appropriate knowledge about prevention
and home remedies.
a. Lack of knowledge about the nature
and complications of cough and colds.
HEALTH THREATS

Objective data: II. Poor environmental sanitation and hygiene
* Pieces of candy wrappers are present as health threat.
* Dirty clothes are just being hanged and
stored A. Inability to provide home environment
* Childs clothing was dirty, scars and dirt which is conducive to health maintenance and
are on the face. development due to ignorance of personal
hygiene.
CHAPTER VI
PRIORITIZATION OT THE NURSING PROBLEMS
Cough and Colds as a health deficit
Criteria Computation Actual score Justification

1.Nature of the 2/3x 1 0.67 It is a health deficit that
Problem requires immediate
action and adequate
management to reduce
likelihood of
transmission and
complications.
2.Modifiability of 2/2x2 2 Inadequacy of living
problem space and
environmental condition
are barriers to
achievement of good
personal hygiene
3.Preventive potential 3/3 1 1 Transmission of cough
and colds may be
reduced if the problem
is managed adequately
as soon as possible.
4.Salience of the 0.5x1 0.5 The family recognizes it

problem as a problem. However,
they does not see the
problem as a needing
immediate action.
TOTAL SCORE 4.17
Poor environmental sanitation and hygiene as health threat

Criteria Computation Actual score Justification
1.Nature of the 2/3x 1 0.67 It is a health deficit
Problem that requires
immediate action
and adequate
management to
reduce likelihood of
transmission and
complications.
2.Modifiability of 1/2x2 1 It is partially
problem modifiable, because
if adequate
knowledge from the
health personnel is
given, it can lead the
family to be aware
of the existing
problem, which in
turn will take
immediate action.
3.Preventive 3/3 1 1 If the family is
potential given adequate
knowledge, there
will be lesser risks
for the children to
acquire diseases.
4.Salience of the 0/2x1 0 The family does not
problem recognizes it as a
problem.
TOTAL SCORE 2.67
PRIOROTIZATION OF PROBLEMS
PROBLEMS SCORE
1.COUGH AND COLDS 4.17
2.POOR ENVIRONMENT AND HYGIENE AS HEALTH THREAT 2.67
CHAPTER VII
VIRUS
INFECTION OF EPITHELIAL CELLS OF NASAL

PASSAGES
SNEEZES
IRRITATION OF AIRWAY RECEPTOR
SORE THROAT
CHOLINERGIC STIMULATION
BRONCHOCONSTRICTION
COUGH
Simple cough starts with a virus that infects the epithelial cells of the nasal
passages. Once these cells are infected, it irritates tthe airway receptors. The infection of
these epithelial cells can also lead to sneezing and sore throat. Cholinergic stimulation
then takes place. Cholinergic stimulation is the response of the somatic motor neurons
when a stimulus is present. It reacts by releasing acetylcholine from the synaptic vesicles
found in the neurons. The chemical neurotransmitter is crucial for the propagation of
nerve impulse. The bronchi in the lungs now constricts and it directly causes coughing.
CHAPTER VIII
Health Family Nursing Goal of care Objectives of Intervention Method of Resources

Problems Problems Care Measures Nurse- requires
Family
Contact
Health Inability to Within the home Within the home 1. Assess the Home visits 1.human
deficits: make decision visits the family: visits the family:
family status on resources, time
cough and with respect to personal and effort of both
colds taking a. Will be able a. Will be able to hygiene. nurse learner and
appropriate to prevent enumerate or 2. Discuss and family
knowledge recurrence of demonstrate some explain the signs
about prevention the disease in preventive and symptoms,
and home the future. measures common causes
remedies regarding cough of cough and
b. Able to gain and colds. colds.
more knowledge 3. Explain the
about cough and b. Utilizes importance of
colds. resources proper food
available in the preparation,
community such good nutrition,
as herbal plants in hygiene and rest
resolving the in strengthening
problem. one’s resistance.
4. Reiterate the
importance of
good
environment
sanitation in the
prevention of
illnesses.
5. Instruct to
cover mouth in
sneezing and
coughing
HEALTH FAMILY GOAL OBJECTIVES
PROBLEM NURSING OF OF CARE NURSING METHOD RESOURCES
PROBLEMS CARE INTERVEN- OF NURSE- NEEDED
TIONS FAMILY
CONTACT
Poor Inability to - After Within 3 hours -Establish rapport Home visit -Nurse-learner’s
personal decide with two home of home visit and health sufficient
hygiene as respect to visits, the each day, -Assess the family education. evidence-base
a health taking family family will be health status knowledge
threat appropriate will be able to realize
action due able to the benefits of -Assess -Time and effort
Objective to failure to perform hand washing, knowledge and from nurse and
Data: recognize various enumerate understanding on client.
the presence procedur factors that hygiene
-Family of problem. es on corresponds to techniques.
members how to unhygienic,
with sustain and exhibit -Discuss the risk
untrimmed personal desire to alter of unhygienic
fingernails hygiene. unhygienic lifestyle.
practices.
-Family -Perform
members procedure of hand
with head washing
louse aseptically.
-Emphasize
importance of
hand washing to
children.
-Listen to family’s
concerns and
encourage them to
verbalize feelings
and concerns.
CHAPTER IX
The family’s knowledge on health maintenance and the existing conditions plays
an essential role in the preservation of the good health of each member. It is therefore the
nurse learner’s plan to provide enough information regarding the identified nursing
problems of the family.
Herbal medicines for minor health conditions (such as cough, colds, and fever)
will be introduced. The knowledge on the DoH – approved herbal medicines and its
preparation and concentration will also be imparted. The importance of seeking
professional health care will as well be emphasized.
Lastly, it shall be reiterated that it is essential to maintain a good health, not only
the physical aspect but as well as emotional, mental and spiritual aspect.
CHAPTER X
CONCLUSIONS
 FNCP that have been done will be properly implemented on the following visits
for the family to gain more knowledge about cough and colds and also how to
prepare home remedies medication.
RECOMMENDATION
 Health teaching for common cough and colds is highly recommended. It is also
recommended to reiterate the importance of good environment sanitation and
hygiene in preventing the reoccurrence of illnesses.
 BHW present in the neighborhood may visit their neighbors house to check
cleanliness and hygiene of the family members
 Visiting the Rural Health Unit is highly recommended.
 Information on the available herbal plants that can be an alternative in treating
common health problems such as cough and colds.

CHAPTER XI
REFERENCES:
 Mengistu, Daniel; Misganaw, Equilinet (2006): COMMUNITY HEALTH

NURSING
 Hohashi, Naohiro: Family Health Care Nursing
 Genericlook.com. (n.d.). Cholinergic Stimulation. Retrieved August 7, 2016,
from Genericlook.com Medical Encyclopedia:
http://medicalterms.info/anatomy/Cholinergic-Stimulation/
THE CAYAT: A FAMILY CASE STUDY
WACAS, Trisha Anne M.

COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
The completion of this study will never have been possible without the guidance and
support of the following who generously gave their time, efforts and valuable
suggestions for
the improvement of this output.
I wish to express my sincere thanks to the Benguet State University- College of

Nursing
administration, who provided the means for me to further study with a vision of
widening
my horizon for the satisfaction of knowledge to obtain a quality nursing care. I am also
very
grateful to Sir Jude L. Tayaben and Ma’am Aprila Calasan for their patience and support
in
guiding us during the duration of the community immersion.
To the Cayat family for their generous and active participation which led to
comprehensive nursing care plan for the family.
To the researcher’s family and friends who showed their moral, financial and
emotional
support for the completion of this study.
Finally, to God who is the source of knowledge, strength and everything, for giving
us
what is vital and essential which made us firm from beginning to end.
TRISHA ANNE M. WACAS

CHAPTER I
INTRODUCTION
Humans have always tended to live in groups of families, but the type of families
formed and family goals established have changed as technology has changed and life
has become more complicated (Lavoie- Tremblay, Bonin, Bonneville-Roussy, et al.,
2012). For example, when families lived on farms, they were extended or have a wealth
of relatives and friends close by to provide both physical and psychological support. As
more people moved into cities, families became typically nuclear with only two parents
and children present. Less support in terms of family members was available. A family is
defined by the U.S Census Bureau (USCB, 2010) as a group of people related by blood,
marriage, or adoption living together. Furthermore, Allender (2013) defines the family in
a much broader context as two or more people who live in the same household (usually),
share a common emotional bond, and perform certain interrelated tasks.How well a
family works together when times are good and how well it can organize itself against
potential threats depends on both its structure (who its members are) and its function (the
activities or roles family members carry out). Thus, the family health nurse is responsible
to identify structures and functions of each family member and make us of them to either
build a harmonious problem-solving approach in response to stressor or to strengthen and
sustain stability within the family.
The community is a group of people sharing common geographic boundaries and/or
values and interests (Maglaya, 2004). A community is also referred to as the place or a
geographic area where in group of people with common values and interest reside. It is a
social unit composed of individuals, families and population groups. Nevertheless, a
community has boundaries whether it is man-made or natural (Maureen and Smith).
There are four identified attributes of a community: people, place, interaction and
common characteristics, interests and goals.
Community health nursing is one of the major fields of nursing in the Philippines,
the other is hospital nursing. It is defined by Ruth B. Freeman as a service rendered by a
professional nurse with communities, groups, families, individuals at home, in health
centers, in clinics, in schools, in places of work for the promotion of health, prevention
of illness, care of the sick at home and rehabilitation. Hence, the primary goal of
community health nursing is health promotion.
In community health nursing, the family is the unit of care and the community is the
patient and there are four levels of clientele to be considered. Moreover, the goal of
improving community health is realized through multidisciplinary approach. Hence, the
community health nurse must work with and not for the individual, family, group and
community. The latter are active participants, not passive recipients of care. The practice
of CHN is affected by changes in society in general and by developments in the field of
nursing in particular. CHN is a part of a community health system, which in turn is a part
of a larger human services system (Maglaya, 2004).

The family that was chosen by the nurse-learner is a mirror of the most families not
only nationally but more internationally. Hence, reaching out to this family which has
evidently poor environmental sanitation and deficient knowledge on vital health
information and evidence-based interventions could be a stepping stone to address
specific problems arising from the latter concerns. Hiking is indeed tiring but the
fulfillment comes when a variation is made from the efforts and collaboration of both the
nurse-learner and members of the family.

CHAPTER II
This chapter presents the general and specific objectives of the family case study. As
nurse-learners we are obliged to be dutiful and responsible to maintain equilibrium
despite the retrogressive changes and increasing demands in health.
General Objectives:
At the end of the nurse- family interaction, the family will be able to identify
interventions necessary to address concerns and utilize them to maintain and sustain
wellbeing.
After two home visits the family will be able to display the following:
a. Identify specific intervention to specific concern.
b. Demonstrate practices that maintain and sustain wellbeing within the

family.
c. Utilize teachings to improve lifestyle for the prevention of diseases.

CHAPTER III
INITIAL DATA BASE
This chapter contains the family structure, characteristics and dynamics, the socio-
economic and cultural characteristics, home and environment, health assessment of each
member of Cayat family, values, habits, practices on health promotion, maintenance and
disease
prevention.
NAM AGE SE CIVIL POSITIO OCCUPATI EDUCATIO

E (Year X STAT N IN ON NAL
(Code s) US THE ATTAINME
Name FAMILY NT
s)
A 33 M Marrie HH Head Farmer College
d Graduate
B 24 F Marrie Wife Farmer HS Graduate
d
C 5 M Single Son N/A N/A
D 65 F Marrie Grandmot Senior Elem Level
d her Citizen
The Cayat family is an extended family composing of father A, mother B, their son
C and
grandmother. An extended type of family is found in almost all societies although the
length of
time in which the family remains in this form remains varies even with the same society.
The
extended family can be a nurturing environment in which to raise children as long as

there is
love, compassion, time spent with children, emotional support, low stress, and a stable
economic environment. In extended families, both adults are the biological and adoptive
parents of their children, (jay, 2004). The Cayat residence is found in Gasal, Sayangan,
Kibungan. The head, his wife and their son had been living there since the day they were
born
while their grandmother just stayed at the house since the day she was diagnosed with
Diabetes Mellitus. Nevertheless, their length of residency in their home is 4 year since
they
lived together as married couple last 2013. Mr. A has the authority in decision-making.
Nevertheless, Mrs. B is free of her opinions on the decision. She also was tasked for
nurturing
their child. They have equal rights in disciplining their child.
The family’s main source of income is from farming. The estimated monthly income
since their income depends on the quantity and quality of harvest is P3,000. Large
portion of
their money is spent on various needs such as food, fertilizers, insecticides and
pesticides.
According to Mrs. B, money is not a major problem within their family since their
supply to
food is adequate with their availability all around. Furthermore, they said that life in rural
area
is simple thus, it does not demand too much of everything.
The house that is owned by the Cayat’s family is made from wood and galvanized iron.
Nevertheless, the floor of the kitchen is hardened soil, itself. It has one room for the
family and
everyone sleeps in the same area they eat. They have radio for entertainment. There is a
source of lighting. The house has adequate ventilation Breeding sites of mosquitoes and
flies
are inevitable because of the open drainage and poor environmental sanitation. Their
house is
located beside the farm of their folks which makes it exposed to fertilizer, insecticide and
pesticide use. The animal manure from the pigs and chicken also attracts flies and adds to
the
risk for increase mosquito breeding. Furthermore, they have a comfort room which is
approximately 15 meters away from the house. Their water supply both for drinking,
cooking
and bathing is from rain water and spring and is situated around farms using pesticides
and
insecticides.
Mrs. MM is not knowledgeable of the illnesses encountered by the family members in
the past years since their consultation is limited to the “hilot” of the community. She
claimed
they did not seek consultation because of the distance from Gasal to the health care
center.
Nontheless, her mother-in-law was diagnosed with DM Type II last September, 2016.
Father A had not experienced any serious condition except for common colds.
Mother-in-law C is diagnosed with DM Type II last September 2016 at Benguet
General
Hospital and had undergone debridement last April 2017 because of an impacted wound.
Mother B claimed to have completed the tetanus vaccine. She is jolly and open to
queries during the visitation.
The couple’s son as claimed by Mrs. B is healthy. Moreover, the child is
not properly groomed and is untidy.
1. Family Perception, Health-management Patterns
The members of the family Cayat claimed not to engage in cigarette smoking
but Mr. A engages to alcohol drinking. Father A as claim by Mrs. B occasionally
drinks gin, beer, and rice wine. He began drinking when he was teenager.
2. Nutritional- Metabolic Pattern
Mrs. B claimed to utilize herbal medicines such as guava leaves for wound
healing and diarrhea. They also use antibiotic and paracetamol to treat such conditions.
Furthermore, knowledge on other herbal medicines is minimal.
Daily food intake includes rice and vegetables and most of the time, one kind in a
week meal. Meat, egg and canned goods are consumed occasionally. Mrs. B claimed
that their child eat what is being served and often consumes the food served for the
meal. They drink from the rainwater caught from a certain pit they made. According to
them, it tested negative last January.

Each member of the family claims to defecate regularly, everyday usually at
noon. Mother B claims that diarrhea and constipation is not a concern of the family
members. The family has a range of 3-6 times of urination a day with dark yellow
colored urine depending on the intake of water.
4. Activity- exercise Pattern
The family does not exercise a regular exercise pattern. Nevertheless, they
considered walking to and fro their farm as a form of exercise. Moreover, they see
household chores as another form of exercise.
Mother B claims that the family does not encounter difficulty in sleeping such
that they sleep at 7:30 in the evening and wakes up at 8:00 in the morning. Mrs. B on
the other hand claims that she wakes up earlier to prepare breakfast for the family. At
1:00 pm, they usually take a nap and wakes at 2:00 pm. Father A then goes back to the
farm. Mother B then cooks the food of their pigs. Then the usual routine follows.
6. Cognitive- perceptual Pattern
Mrs. B, Mr. A, Grandmother D child C are oriented to time, place and are able to
respond to the questions with minimal confidence. Nonetheless, conversations are
spontaneous.
7. Self-perception/ Self Concept
Mrs. B claims that they have positive outlook in life. If there are problem and
concerns encountered, they talk with one another to identify possible solutions on the
problem. In cases where in they cannot solve health problem due to financial issues,
they tend to ask help from their parents. Sibling rivalry is not common since they only
have one child.
As for their children’s schooling, they hope that all their children will finish until
college and land on good jobs.
8. Roles and Relationships
The family members observe an open communication. They express feelings and
concerns to each other openly. The couple also observe an openness by being vocal of
their day to day encounters.
Mrs. B, being currently using depo injectable for contraception while
Grandmother D has menopaused.
10. Coping Stress
The family exhibits stress coping mechanism through interaction. They claimed
that they gain strength from each other. The presence of stressor is common to them
but they believe that a family who solves the problem together will get through any
form of stress.
The family’s members are born and raised in Lubo, Kibungan and are members
of the Lutheran church. Mrs. B claims that they do not attend mass regularly, they are
God-fearing. They believe that going to church every Sunday does not test the faith of a
person but living a Christian life do.
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease

Prevention
The child in the family are all fully immunized children. Mrs. B also claimed
that she had completed the tetanus toxoid vaccine. Mrs. B recognizes hygiene and
sanitation and its impact on health but the environment is negatively hygienic. She
recognizes the need to integrate go, glow and grow foods but being financially
marginalized limits her to prepare foods in accordance to food group nutrition. In
response to illness, they self medicate most of the time and consult to physicians in
severe cases.
CHAPTER IV
FAMILY BACKGROUND
A. Family History
The Cayat family is composed of a mother, father, a child and a grandmother. Mr. B is a
College graduate and is 33 years old. Mrs. B is a highschool graduate and is currently
24 years old. Both are in farming which is the source of their income. Child C is not yet
attending school. The family claimed that cough and colds and the diagnosed Dm of their
grandmother are their major concern in the past months.

B. Family Tree
Grandmother D
Mrs. B
Mr. A
C. Family Genogram
Diabetes Mellitus Type II
Cough and Colds
Cough and Colds
Married
Married
Male
CHAPTER V
Subjective Data: I. Cough and colds as health deficit
“Ag-uy-uyek kami amin kar karu ta A. Inability to provide adequate

pnaglalammin”, as verbalized by nursing intervention to the sick
mother. members of the family due to:
Objective Data: a. Knowledge deficit related

to the management of
-cold weather illness.
b. Inadequate resources for the
-productive cough treatment of illness.
Subjective Data: II. Poor personal hygiene as a health

threat
“Nalammin gamin isunga haan mi
isuda madigus ken awan py ti adu nga A. Inability to decide with respect
danum”, as verbalized by mother. to taking appropriate action due
to failure to recognize the
Objective Data: presence of problem.
-Child without footwear while inside

and outside the house.
-Family members with untrimmed

fingernails.
-Family members with untidy clothing.

Subjective Data: III. Inadequate Living Space
“Nasiksik kami lang dituy nu adda jy A. Inability to provide resources

duwa nga agisiskwela ijy Trinidad” for improvement of living
space.
Objective Data:
-Crowding Index of 4
CHAPTER VI

This chapter contains the basis on the prioritization of nursing problems.
I. Persistent cough and colds as a health deficit
CRITERIA COMPUTATION SCORE JUSTIFICATION

2. Magnitude of 2/4x3 1.5 All of the family
the problem members are
experiencing cough
and colds.
the problem highly modifiable.
are readily available
to manage the
problem.
potential highly preventable.
Measures can be
observed to avoid
prevalence.
5. Salience 1/2x1 0.5 This problem
requires immediate
attention according
to the family.
Total score 8.5
II. Improper hygiene as a health threat

problem health threat.
problem members do not
observe proper
hygiene.
the problem moderately
modifiable. It
requires further
reiteration and health
teaching.
potential highly preventable.
Measures can be
observed to minimize
improper hygiene.
5. Salience 1/2x1 0.5 This problem does
not require
immediate attention
according to the
family.
Total score 6.82
III. Inadequate Living Space

problem health threat.
problem members are
affected.
the problem hardly modifiable. It
requires financial
issues
potential less preventable.
Measures can be
observed to
maximize space.
10. Salience 1/2x1 0.5 This problem does
not require
immediate attention
according to the
family.
Total score 4.05
PROBLEMS SCORE
1. Persistent cough and colds as a health deficit 8.5
2. Improper hygiene as a health threat 6.82
3. Inadequate living space 4.05
CHAPTER VII
A cough is a common reflex action that clears the throat of mucus or foreign
irritants. Coughing to clear the throat is typically an infrequent action, although there are
a number of conditions that can cause more frequents bouts of coughing (Irwin, R.S.,
2006).
COUGH AND COLDS
VIRUS
Obstruction
Inflamation of nasal
(chemical passages
mediators)
Blood vessel
permeability Edema
Exudation of Rhinorrhea
serum
Infection of
ephitelial cells of
nasal passages
Mucus secretion
Airway
receptor
Cough
irritation
Sore Broncho
throat, constriction
sneezes
CHAPTER VIII

PROBLEM NURSING OF OF CARE NURSING METHO RESOURCE
PROBLEMS CARE INTERVENTIO D OF S NEEDED
NS NURSE-
FAMILY
CONTA
CT
Persistent 1.Inability to - After After 3 hours -Establish rapport Home -Nurse-
cough and provide two each day of visit and learner’s
colds as health adequate home home visit, -Assess the family health sufficient
deficit nursing visits, family will be health status education. evidence-base
intervention to the able to knowledge
Subjective the sick family enumerate -Gauge
Data: members of the will be management of understanding on -Time and
family due to: able to cough and cough and colds. effort from
“Ag-uy-uyek show colds such as nurse and
kami amin kar -Knowledge complia the utilization -Discuss the client.
karu ta deficit related nce on of herbal nature, risk and
pnaglalammin” to the the medicines causative factors -Herbal
, as verbalized management of manage available of cough and medications
by mother. illness. ment within the colds.
identifie community like
Objective -Inadequate d and oregano and --Perform
Data: resources for agreed lagundi. procedure of
the treatment of upon by effective coughing.
-cold weather illness. the
member
-Perform
s for the
-productive preparation of
preventi
cough herbal medicines
on and
and health teaches
cure of
on the use,
cough
frequency and
and
dosage of herbal
colds.
medicine.
-Reiterated to
increase intake of
citrus fruits like
calamansi, suha,
lemon, and guava.
-Instruct members
of the family to
increase fluid
intake as tolerated.
HEALTH FAMILY GOAL OBJECTIVE
PROBLE NURSIN OF S OF CARE NURSING METHOD RESOURC
M G CARE INTERVENTI OF NURSE- ES
PROBLE ONS FAMILY NEEDED
MS CONTACT
Poor Inability to - After Within 3 -Establish Home visit -Nurse-
personal decide two hours of home rapport and health learner’s
hygiene as a with home visit each day, education. sufficient
health threat respect to visits, family will be -Assess the evidence-
taking the able to realize family health base
Subjective appropriate family the benefits of status knowledge
Data: action due will be hand washing,
to failure able to enumerate -Gauge -Time and
“Nalammin to perform factors that knowledge and effort from
gamin recognize various corresponds to understanding nurse and
isunga haan the procedur unhygienic, on hygiene client.
mi isuda presence es on and exhibit techniques.
madigus of how to desire to alter
ken awan problem. sustain unhygienic -Discuss the risk
py ti adu personal practices. of unhygienic
nga hygiene. lifestyle.
danum”, as
verbalized -Perform
by mother. procedure of
hand washing
Objective aseptically.
Data:
-Emphasize
-Child importance of
without hand washing to
footwear children.
while inside
and outside -Listen to
the house. family’s
concerns and
-Family encourage them
members to verbalize
with feelings and
untrimmed concerns.
fingernails.
-Family
members
with untidy
clothing.
-productive
cough
PROBLEM NURSING OF OF CARE NURSING METHOD RESOURCES
PROBLE CARE INTERVENTI OF NEEDED
MS ONS NURSE-
FAMILY
CONTAC
T
Inadequat Inability - Within 3 -Establish Home -Nurse-
e Living to After hours of rapport visit and learner’s
Space provide two home visit health sufficient
resources home each day, -Assess the education evidence-base
Subjective for visits, family will family health . knowledge
Data: improve the be able to status
ment of family realize the -Time and
“Nasiksik living will benefits of -Gauge effort from
kami lang space. be adequate understanding nurse and
dituy nu able living space on the effects client.
adda jy to and of adequate
duwa nga devel demonstrate living space.
agisiskwel op a ways to
a ijy plan maximize -Suggest ways
Trinidad” on space. on hoe to
how maximize
Objective to living space.
Data: expan
d -Helps family
- space to store
Crowding occup unused
Index of 4 ied materials.
for
living -Discuss the
and advantages
appro and
priate disadvantages
to of crowded
numb household.
er of
-Helps the
house
family to
hold
prepare a plan
memb
for
ers.
maximizing
living space.
CHAPTER IX
COMPREHENSIVE FILE OF THE FAMILY INTERVENTIONS
This section contains the process of nursing intervention carried out.
I. Cough an colds
NURSING INTERVENTION
GOAL OF CARE: After two home visits, the family will be able to show compliance on
the management identified and agreed upon by the members for the prevention and cure of
cough and colds.
OBJECTIVES OF CARE: After 3 hours each day of home visit, family will be able to
enumerate management of cough and colds such as the utilization of herbal medicines
available within the community like oregano and lagundi.
Persistent cough an colds -Established rapport -Nurse-learner’s sufficient
evidence-base knowledge
-Assessed the family health
status -Time and effort from nurse
and client.
-Gauged understanding on
cough and colds.
-Discussed the nature, risk

and causative factors of
cough and colds.
--Performed procedure of
effective coughing.
-Performed preparation of
herbal medicines and health
teaches on the use,
frequency and dosage of
herbal medicine.
-Reiterated to increase
intake of citrus fruits like
calamansi, suha, lemon, and
guava.
-Instructed members of the

family to increase fluid
intake as tolerated.
EVALUATION OF INTERVENTIONS: After 5 hours of intervention for two days, the
family is able to identify ways on how to prevent and cure cough and colds.
I. Poor personal hygiene
GOAL OF CARE: After two home visits, the family will be able to perform various
procedures on how to sustain personal hygiene.
OBJECTIVES OF CARE: Within 3 hours of home visit each day, family will be
able to realize the benefits of hand washing, enumerate factors that corresponds to
unhygienic, and exhibit desire to alter unhygienic practices.
Poor personal hygiene -Established rapport -Nurse-learner’s sufficient
status -Time and effort from
nurse and client.
-Gauged knowledge and
understanding on hygiene
techniques.
-Discussed the risk of

unhygienic lifestyle.
-Performed procedure of
hand washing aseptically.
-Emphasized importance of
hand washing to children.
-Listened to family’s
concerns and encouraged
to verbalize concerns.
EVALUATION OF INTERVENTIONS: After 5 hours of intervention for two
days, the family is able to enumerate reason for having to observe personal hygiene.
II. Inadequate living space

GOAL OF CARE: After two home visits, the family will be able to develop a plan
on how to expand space occupied for living and appropriate to number of household
members
OBJECTIVES OF CARE: Within 3 hours of home visit each day, family will be
able to realize the benefits of adequate living space and demonstrate ways to
maximize space.
Inadequate living space -Established rapport -Nurse-learner’s sufficient
status -Time and effort from
nurse and client.
-Gauged understanding on
the effects of adequate
living space.
-Suggested ways on hoe to

maximize living space.
-Helped family to store

unused materials.
-Discussed the advantages

and disadvantages of
crowded household.
-Helped the family to

prepare a plan for
maximizing living space.
EVALUATION OF INTERVENTIONS: After 5 hours of intervention for two
days, the family is able to enumerate reason for having to observe normal crowding
index.
CHAPTER X
CONCLUSION AND RECOMMENDATIONS

Community Health Nurses are vital roles in the progress of the nation. They are the
stakeholders towards ending poverty because a healthy family builds a healthy

community and
a healthy community builds a progressive nation.
An ounce of prevention is better than a pound of cure, as they say. To provide
immediate healthcare to address the community’s health problem is the first step towards
empowerment. It is because if people see that somebody is willing to help the, it will
send a
message of empowerment among them. Prevention is our primary task so it is our duty to
give
our best shot to educate the people. Thus, a community health nurse should be equipped
with
abundant knowledge on how to improve or modify the lifestyles of the community for
the
betterment.
Nevertheless, there will always be barriers in immersing with the people and here is
mine to share. One important moral which I had gain from the immersion is to be more
sensitive to the need of others. For instance, the non- cooperative feedback of a member
of the
community rooted from that language barrier from which the people, if not all, some
cannot
comprehend to Ilocano dialect. This, sensitivity is highly recommended to maintain an

open
communication. Moreover, sensitivity also applies to my group mates. Hence, if one is in

need,
one is ready to give.

CHAPTER XI
REFERENCES
Irwin, R.S. (2006, January). Chronic cough due to gastroesophageal reflux disease.
Chest, 129(1_suppl), 80-94
AncyKurian, Father Muller Medical College Hospital

Published on Mar 4, 2013 Published in:Health and Medicine
Maglaya, 2004
Maternal and Child Care Pilliteri

THE 'DANGLAY’S ': A FAMILY CASE STUDY
WAKAT, Narjolyn P.
COLLEGE OF NURSING
MAY 2017
ACKNOWLEDGEMENTS
The nurse-learner would like to thank and extend appreciation to the following, who
in one way or the other, made this study possible.
To Mr. Jude L. Tayaben and Ms. Aprila Calasan, our clinical facilitators, for their
continuous assistance and selfless efforts during our activity.
To the Danglay family who warmly welcomed us during our home visit and had
gladly shared to us their thoughts and knowledge.
Also, the nurse-learner would like to extend her deepest gratitude to her parents and
guardians for their unending guidance and support.
Foremost, to God Almighty, who made all things possible. The nurse-learner uplifts
all her praises and honor to Him alone.
Wakat, Narjolyn P.
CHAPTER I
INTRODUCTION
The synthesis of nursing and public health practice as applied to promote and protect
the health of population known as Community health Nursing combines all the basic
elements of professional and clinical nursing with public health and community practice,
cartercenter.org.
Therefore a Community Health Nurse should act as a partner in a health team who
provides nursing care, treatment to the sick, health counseling and does work in different
places such as home, school, and health center. (Cmai,2005)
This revolves on individuals, families, population group or aggregates, and the
community, according to Nurseslab.com, there is twelve (12) principles that govern
CHN. These are as follows: (1) The recognized need of individuals, families and
communities provides the basis for CHN practice; (2) Knowledge and understanding of
the objectives and policies of the agency facilities goal achievement; (3) CHN considers
the family as the unit of service; (4) Respect for the values, customs and beliefs of the
clients contribute to the effectiveness of care to the client; (5) CHN integrated health
education and counseling as vital parts of functions; (6) Collaborative work relationships
with the co-workers and members of the health team facilities accomplishments of goals;
(7) Periodic and continuing evaluation provides the means for assessing the degree to
which CHN goals and objectives are being attained; (8) Continuing staff education
program quality services to client and are essential to upgrade and maintain sound
nursing practices in their setting; (9) Utilization of indigenous and existing community
resources maximizing the success of the efforts of the Community Health Nurses; (10)
Active participation of the individual, family and community in planning and making
decisions for their health care needs, determine, to a large extent, the success of the CHN
programs; (11) Supervision of nursing services by qualified by CHN personnel provides
guidance and direction to the work to be done; and (12) Accurate recording and reporting
serve as the basis for evaluation of the progress of planned programs and activities and as
a guide for the future actions. With all of these, nurses would certainly be guided and be
led for the ultimate goal of Community Health Nursing which is to promote community
health. (Hitchcock, Schubert, Thomas, 2003)
CHAPTER II

General Objectives:
display well-founded means to improve and sustain the health status of each family
member.
After a week of home visits and with nurse learner-family interaction, every family
member would be able to:
f) Identify ways to improve interpersonal relationship within their family.
g) Enumerate the importance of diseases and illnesses prevention.
h) Utilize available resources in solving their problems.
i) Develop and maintain good habits of personal hygiene and sanitation.
j) Understand health teachings to be rendered.
CHAPTER III
INITIAL DATABASE
The initial database includes the information about the family in various dimensions.
It includes the Family Structure, Characteristics and Dynamics, the Socio-economic and
Cultural Characteristics, the Home and Environment, the Health Assessment of each
family member, and the Values, Habits, Practices on Health Promotion, Maintenance and
Disease Prevention.
E. Family Structure, Characteristics, and Dynamics
NAM AGE SEX CIVIL POSITIO OCCUPATIO EDUCATIONA

E (years STATU N IN THE N L
(code ) S FAMILY ATTAINMENT
names)
LD 25 Male Married Father Farming Elementary Grad
JM 24 Femal Married Mother Farming High School
e level
LUD 5 Femal Single First Child --- Kindergarten

e
LGD 3 Femal Single Second --- ---
e Child
LFD 1 Femal Single Third --- ---
e Child
The Danglay family is a nuclear type of family. As a nuclear family, the household
is composed of five (5) members: father LD, 25 years old, mother JM, 24 years old with
their children LUD, LGD, and LFD.
A nuclear family, also called a conjugal, elementary, or traditional family, typically
consists of two married or legally-bound parents and their biological or adopted children
all living in the same residence and sharing the values, duties, and responsibilities of the
family unit. There can be any number of children in the family, and one or both parents
may work outside the home. (family.lovetoknow.com)

The Danglay Family resides in Gasal Sayangan, Lubo, Kibungan, Benguet. They
have been living there since 2015. JM states that her husband, LD, is more dominant in
terms of planning and budgeting for their family while JM claims to dominate in terms of
the health of the family. The couple also reported that the discipline and training of their
children are being shared by both of them.
F. Socio-Economic and Cultural Characteristics
The family's main source of income is from farming. Their products are chayote,
cabbage, corn, and sweet pea. With an estimated monthly income of Php 5,500.00, JM
reports that they are trying their best to suffice their needs, fortunately, they are not
renting their land and house, and that only their food, schooling of the children and their
personal stuffs are being expensed with.
G. Home and Environment
The house is located just beside a private road. The house is a bungalow type house
made up of concrete and GI sheets. There are two separate structures that can be seen.
The first one was their main house and the other is their comfort room. Just below the
house is their cabbage plantation and beside it is their sweet pea plantation. They use
LPG in cooking, as well as wood. There is one bedroom in the unit and is claimed to
have four persons sleeping in it.
The environment is generally in good condition. There is no problem with breeding
site since JM is fun of planting so the house is surrounded with plants that use plastic
containers as pots. However, the house is near a very steep area which could be
hazardous especially for her children.
H. Health Assessment of the Family
JM claims that she and her husband have no present illnesses that are experiencing
or even medicines that are being taken. However, JM states that her last child LFD is
having cough and is only being breastfed and given water as management for the cough.
CHAPTER IV
FAMILY BACKGROUND
C. Family History
Danlay family is a nuclear type of family. Which compose of five (5) members.
The father LD, mother JM and their three (3) kids, LUD, LGD, LFD. The father is
the one who primarily leads and handles the family. The family's source of income is
farming with an estimated income of Php 5,500.00 per month, depending on the prize
of their crops.
D. Family Tree
LD JM
LEGEND:
LUD LGD LFD
EE– male
EE– female
Chapter V
The Danglay family seeks consultation at Lubo Clinic in Lubo Proper, Lubo,
Kibunagn, Benguet whenever they have concerns about their health. Mrs. JM, as the
informant, mentioned of no diseases or illnesses that the family had acquired for the past
6 months, except of LGD the last child who had cough and colds.
Cues/Data Family Nursing Problem

Subjective Data:
“ kanayun nga ag riri dytoy ubing ko C. Inability to maintain personal
nganagatel ti ima kn saka na” hygiene which is conducive to
health maintenance and personal
Objective Data: development due to lack of
Children are not properly groomed adequate knowledge of the
The front yard where the children plays importance of hygiene and
is messy sanitation secondary to ignorance of
facts about the possible effects of
poor hygiene that may cause
probable disease condition.
Subjective Data: A. Improper (open) drainage system as

"Ay ag-ayus ladtan a dita jay danum nu a Health threat
ag-ugas kami"
B. Inability to provide home
Objective Data: environment which is conducive to
There is visible greenish and slimy health maintenance and
water flowing on the open drainage development.
Unclean front yard
Subjective Data: A. Inability to recognize the possible

“adu garud ti rumrumwar nga lamok dita diseases that could be acquired
igigid” through the presence of mosquitoes
Objective Data:
Presence of grassy and dark area at the
back of the house
Presence of open drainage
Chapter VI

This section contains the basis of the prioritization of the nursing problems.
IV. Personal Hygiene due to un neat environment

1. Nature of the 2/3 x 1 0.67 It is a Health threat that demand
available.
3. Preventive 2/3 x 1 0.67 Possible accidents can be
Potential avoided.
4. Salience 2/2 x 1 1 The family acknowledged the
said problem.
Total Score: 4.34
V. Presence of breeding sites of vectors of diseases (mosquitoes, flies, etc.) as a

Health Threat

available.
11. Preventive 3/3 x 1 1 Occurrence of Dengue, Malaria,
Potential and other communicable
diseases can be minimized.
Total Score: 4.67
VI. Improper (open) Drainage System as a Health Threat

Problem
available.
11. Preventive 1/3 x 1 0.33 Achievement of environment
Potential that is conducive for health of
the family.
12. Salience 1/2 x 1 0.5 The family understands the
consequences of the problem.
Total Score: 2.50
PROBLEMS SCORES
1. Personal Hygiene due to un neat environment 4.67
2. Presence of breeding sites of vectors of diseases (mosquitoes, 4.34
flies, etc.) as a Health Threat
3. Accident Hazards from under constructed house as a Health 3.17
Threat
4. Improper (open) Drainage System as a Health Threat 2.50
Chapter VII

According to Liego, 2012, a Family Nursing Care Plan is the set of actions the nurse
decides to implement to be able to resolve identified family health and nursing problems.
Chapter IX
IV.
GOAL OF CARE: After an hour of nursing intervention, the family will be able to
demonstrate understanding of the health teaching regards to importance of maintaining
proper hygiene.
OBJECTIVES OF CARE: After an hour of nursing intervention, the family will be
able to demonstrate understanding of the health teachings, and the cleanliness of the
surroundings.
Inability to maintain 9. Assess the hygiene practice Human resources: time
personal hygiene which is of each of the family and effort of the nurse
conducive to health member. learner and the family
maintenance and personal
development due to lack of 10. Provide health teaching
adequate knowledge of the about the importance of good
importance of hygiene and hygiene
sanitation.
11. Provide health teaching

about the importance of good
hygiene

After the nursing interventions, the family made actions to avoid possible diseases that
may be due to the said problem.
V. Presence of breeding sites
demonstrate understanding of the health teaching regards to the possible causes and
effects of the presence of these vectors.
able to demonstrate understanding of the health teachings, and breeding sites of
mosquitoes will be cleaned.
Inability to recognize the 13. Assess condition of the Human resources: time
possible diseases that could house and level of and effort of the nurse
be acquired through the knowledge. learner and the family
presence of mosquitoes.
14. Discuss the possible sources
of mosquitoes' presence.

mosquitoes can cause to
health of the family.

After the nursing interventions, the family made actions to avoid possible diseases that
VI. Accident Hazards

demonstrate understanding of the health teaching regards to the possible effects of debris
and materials left from under construction of house.
able to demonstrate understanding of the health teachings, and the construction site will
be cleaned and in order.
Inability to recognize the 1. Assess condition of the Human resources: time
possible hazards or threats house and level of and effort of the nurse
from debris and materials knowledge. learner and the family
left from under
construction of their 2. Explain to the family all
nearby house. possible effects that can
cause harm to the health of
the family from the
construction site.
cleanliness and orderliness
on the construction site.
After the nursing interventions, the family made actions to avoid possible hazards that
VII. Improper drainage system
understand the importance of proper drainage system in relation to health and sanitation.
able to demonstrate understanding of the health teachings, and the drainage system will
be fixed.
Inability to provide home 3. Discuss the importance of Human resources:
environment which is proper drainage system in time and effort of the
conducive to health relation to the family's health. nurse learner and the
maintenance and family
development. 4. Encourage the family to
maintain good sanitation.
After the nursing interventions, the family made actions to keep their environment clean
and conducive for health of their family.
Chapter X
The community health nurse according to Clark, 2008is charged with promoting the
health of populations, not only the individuals within populations. This requires
advocacy on the part of the nurse, for entire communities as well as for the individuals
within.
With this, the nurse learners should remain to be community health nurses, not
only for today but should also extend for a lifetime, for them to continue upholding the
true essence of being a nurse, which is to promote health especially in our communities.
The nurse learners should also encourage the Danglay family and other families
in the community to continue taking good care of their health, for we all know that "It is
our Health that is our Wealth". Continuous information dissemination should also be
empowered in the community to reiterate having a good lifestyle for health.

Chapter XI
REFERENCES
Janice E. Hitchcock, Phyllis E. Schubert, Sue A. Thomas. Community Health Nursing:
Caring in Action, Volume I. 2003. page 346
www.nurseslab.com
Dorothy Baldwin. All about Children: An introduction to Health development. 1983.
page 10-11
Mary Jo Clark, Ph.D., RN. Community Health Nursing: Advocacy for Population
Health, 5th edition. ©2008

FFamily Case Study Compilation 2

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

FFamily Case Study Compilation 2

Uploaded by

Copyright:

Available Formats

THE “BAY-AN`S”: A FAMILY CASE STUDY

BENGUET STATE UNIVERSITY

“Thankfulness creates gratitude which generates contentment”(Todd Stocker).

unselfishly contributed in this case study.

immersion and the making of this case study.

civilizations to carry their culture to the next generation.

Community is the original and first abode of human civilization.

OBJECTIVES OF THE STUDY

appropriate interventions and available resources.

participate during home visits and assessment interviews.

optimum health of each of the family members.

A. Family Structure, Characteristics and Dynamics

NAME AGE SEX CIVIL POSITION OCCUPATI EDUCATION

Sunday 43 Female Married Mother Farming and High School

White 22 Male Single Son Laborer ALS

Blue 18 Male Single Son Laborer Elem. Grad.

Yellow 16 Female Single Daughter Grade 10

Pink 12 Female Single Daughter Grade 5

Green 10 Female Single Daughter Grade 4

Violet 5 Female Single Daughter

Red 2 Male Single Son

Orange 11months Male Single Son

terms of decision making such as budgeting.

B. Socio-economic and Cultural Characteristics

their family needs.

C. Home and Environment

chicken that are kept in their backyard.

hospital depending in the severity of the illness.

FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

1. Health Perception-Health Management Pattern

difficulty and abnormality in defecation and urination.

difficulty in sleeping or insomia.

6. Cognitive- Perceptual Pattern

respond appropriately when asked. Verbal patterns of communication are noted to be

order to solve thy problems.

8. Roles and Relationships

and lactate amenorrhea

and they divert their attention.

11. Values- beliefs Pattern

All of the family members are a member of the CSPI religion.

E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

were not dewormed for the last 6 months.

is 43 years old and they are both working as a farmer.

WHITE BLUE YELLOW PINK GREEN VIOLET RED ORANGE

Husband and Wife

TYPOLOGY OF NURSING PROBLEM

CUES/DATA FAMILY NURSING PROBLEMS

Subjective Data: Presence of possible breeding sites of

PRIORITIZATION OF THE NURSING PROBLEMS

1.Health Deficit: Cough and Colds

Criteria Computation Score Justification

1. Nature of the Problem 3/3*1 1 This problem is a health

2. Magnitude of the 2/4*3 1.5 One of the children is

3. Modifiability of the 3/3*2 2 The problem is highly

4. Preventive Potential 2/3*1 1.33 The problem can be

5. Salience 2/2*1 1 The problem is as seen

Total Score 6.83

2. Foreseeable Crisis:Presence of breeding sites,and poor sanitation.

1. Nature of the 2/3*1 0.67 This is a foreseeable crisis.

2. Magnitude of the 3/4*3 2.25 Breeding sites of insects and

3. Modifiability of 2/3*2 1.33 The problem is highly modifiable.

4. Preventive 3/3*1 1 The ability of the family to

5. Salience 1/2*1 0.5 It is not felt as a problem by the

1. Cough and Colds 6. 83