University of the Philippines Manila

The Health Sciences Center

COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

N105: NURSING INTERVENTIONS I

Family Health Nursing Focus

PRIORITIZATION SETTING

Head of the Family (Initials): CDN

Address (Barangay/City or Municipality): 1901-K, Interior 53, Zamora St. Brgy. 843, Pandacan, Manila

Category Health Conditions and Problems

Wellness State

Health Deficit 1. Heart Failure of CDN as a Health Deficit

2. Liver Cirrhosis of CDN as a Health Deficit
3. Hypertension of RRN as a Health Deficit

Health Threats 1. Risk for Falls for RRN as a Health Threat

2. Disturbed Sleeping Patterns of CDN as a Health Threat
3. Inadequate Nutritional Intake of CDN as a Health Threat
4. Unhealthful Dietary Habits/practices of RRN as a Health
Threat

Foreseeable Crisis/ Stress Point

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 1

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

Heart Failure of CDN as a Health Deficit

WEIGHT
CRITERIA JUSTIFICATION
SCORE ACTUAL

Nature of the
CDN’s heart failure is classified as a health
condition or Health Deficit 3 1.00
deficit.
problem presented
The health problem is partially modifiable
because the gravity of the problem is
already severe. The progression and extent
of damage of the disease is already
extensive as evidenced by the clinical
manifestations of heart failure in the client
(e.g. severe bilateral pitting edema (Grade
4), massive ascites, dyspnea at rest).
Modifiability of
Resources of the family are also inadequate
the condition or Partially Modifiable 1 1.00
to afford cardiac medical treatments /
problem
interventions. Resources of the community
are also limited especially since the client
may be needing a heart transplant. Current
knowledge, technology, and interventions
related to heart transplant here in the
Philippines are extremely rare. In fact, there
has only been one heart transplant done in
the country which was dated back in 1994.
The health problem has high preventive
Preventive potential because addressing it can
High 3 1.00
potential significantly increase the client's chance of
survival.
The whole family of CDN perceives the
health problem as severe and serious. The
A condition or
health condition needs immediate attention
Salience problem needing 2 1.00
and urgency but the family is quite unready
immediate attention
to address it because of financial
constraints.
Total Score: 4.00

Liver Cirrhosis of CDN as a Health Deficit

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 2

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA JUSTIFICATION
SCORE ACTUAL
Nature of the
CDN’s liver cirrhosis is classified as a
condition or Health Deficit 3 1.00
health deficit.
problem presented
The health problem is partially modifiable
because the client's liver cirrhosis is
secondary to her heart failure. Unless the
latter is addressed first, the gravity of the
problem would only continue to progress.
Modifiability of The extent of damage of the health condition
the condition or Partially Modifiable 1 1.00 is also quite extensive already as evidenced
problem by the clinical manifestations of liver
cirrhosis in the client (e.g. massive ascites,
slightly yellowish integument, muscle
wasting). Resources of the family are also
inadequate to afford medical treatments /
interventions to address the health condition.
The health problem has high preventive
potential because addressing it, together
with heart failure, can significantly increase
the client's chance of survival. Treating the
Preventive problem would also mean increased
High 3 1.00
potential functionality of the liver to produce bile and
facilitate waste removal and fat breakdown;
to produce proteins for blood plasma; and to
produce cholesterol to carry fats to the other
parts of the body.
The whole family of CDN perceives the
A condition or health problem as severe and serious. The
Salience problem needing 2 1.00 health condition needs immediate attention
immediate attention and urgency but the family is quite unready
to address it because of financial constraints.
Total Score: 4.00

Hypertension of RRN as a Health Deficit

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 3

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA JUSTIFICATION
SCORE ACTUAL
Nature of the
RRN's hypertension is classified as a health
condition or Health Deficit 3 1.00
deficit.
problem presented
The health problem is partially modifiable
because the family has partial resources to
address the health problem. They have the
Modifiability of
capacity to buy the maintenance medications
the condition or Partially Modifiable 1 1.00
of RRN, although not all the time. The
problem
community also has its resources (i.e.
antihypertensive medications) to manage
hypertension, although limited.
The problem has moderate preventive
potential because it is already a chronic
disease. The length of time the problem has
Preventive
Moderate 2 0.67 been existing is quite a while now. Also,
potential
hypertension has its remissions and
exacerbations, and so is hard to be fully
addressed.
RRN's sense of urgency to address the
problem is not that high because his
hypertension is already a chronic condition.
He also mentioned that sometimes, he can’t
A condition or
take medications because there are no
Salience problem not needing 1 0.50
medications to take in the first place. Client
immediate attention
also does not visit the Bagong Barangay
Health Center for provision of medications
when he is running out of his Telmisartan
and Amlodipine.
Total Score: 3.17

Risk for Falls for RRN as a Health Threat

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 4

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA ACTUA JUSTIFICATION
SCORE
L
Nature of the 2 0.67
RRN's hypertension is classified as a
condition or
health threat.
problem presented Health Threat
Partially Modifiable 1 1.00 The problem is partially modifiable
because it is related to the client's brain
aneurysm, for which he doesn't have plans
to address at the moment. The family does
not have the resources to address the
etiology of the health problem itself, and so
reducing its modifiability. In fact, two of
Modifiability of RRN's older brothers actually died of brain
the condition or aneurysm without undergoing any
problem treatment to address it.
Moderate 2 0.67 The health threat has moderate preventive
potential because the problem itself is not
Preventive severe. The client also reduces his risk for
potential falls by walking slower and cautiously.
Not perceived as a 0 0.00 RRN does not perceive the problem as
problem or condition needing change because he fails to see the
needing change magnitude and severity of the health
condition. He also does not utilize other
precautionary measures that can
Salience significantly reduce his risk for falls.
Total Score: 2.33

Disturbed Sleeping Patterns of CDN as a Health Threat

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 5

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA JUSTIFICATION
SCORE ACTUAL
Nature of the 2 0.67
CDN's disturbed sleeping pattern is classified as
condition or
a health threat.
problem presented Health Threat
Partially Modifiable 1 1.00 The health problem is partially modifiable
because it is related to the client's intake of
diuretics for her heart failure. The client cannot
just stop her medications because he cannot
sleep through the night. Her medications are
Modifiability of important for they are first-line diuretics for
the condition or heart failure and also because it facilitates the
problem reduction of her massively edematous legs.
Low 1 0.33 The preventive potential of the health problem is
low because the client has naturally disturbed
sleeping patterns secondary to her heart failure.
CDN no longer tolerates sleeping supine. She
usually sleeps in a sitting position near the edge
of the bed with 4 pillows under her back to
reduce venous return to and congestion in the
heart, and relieve her dyspnea. It is also hard to
Preventive prevent the health problem itself due to the
potential severity of the client's heart failure.
A condition or problem 1 0.50 Client has moderate salience towards the health
not needing immediate problem because she knows that it is hard for her
attention to actually resolve it. Unless the etiology will be
addressed, the client's disturbed sleeping
Salience patterns remain.
2.50

Inadequate Nutritional Intake of CDN as a Health Threat

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 6

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA JUSTIFICATION
SCORE ACTUAL
Nature of the 2 0.67
CDN's inadequate nutritional intake is classified
condition or
as a health threat.
problem presented Health Threat
Partially Modifiable 1 1.00 Client's health problem is only partially
modifiable because its etiology heavily relies on
her heart condition. CDN no longer has a good
appetite and can no longer tolerate eating large
amounts of food because of her heart failure and
massive ascites. Just eating a few spoons of rice
Modifiability of already makes her feel extremely full and
the condition or bloated. Client also revealed that she is easily
problem nauseated by oily and fatty foods.
Moderate 2 0.67 The health problem's preventive potential is only
Preventive moderate as it is decreased by the gravity and
potential severity of CDN's heart failure.
A condition or problem 1 0.50 Client has moderate salience towards the health
not needing immediate problem because she knows that it is hard for her
attention to actually resolve it. Unless the etiology will be
addressed, the client's inadequate nutritional
Salience intake remains.
2.83

Unhealthful dietary habits/ practices of RRN as a Health Threat

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 7

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

WEIGHT
CRITERIA SCOR ACTUA JUSTIFICATION
E L
Nature of the 2 0.67
RRN's unhealthful dietary habits/ practices are
condition or
classified as a health threat.
problem presented Health Threat
Partially Modifiable 1 1.00 The health problem is partially modifiable
because RRN lacks basic knowledge about
nutrition (e.g. 10 Kumainments, Pinggang Pinoy),
and its relationship with overall health and
Modifiability of well-being. In addition, the family does not have
the condition or the adequate financial resources to invest on
problem healthy food ingredients.
High 3 1.00 Addressing the unhealthy dietary habits/ practices
of RRN has high preventive potential for it can
significantly reduce the risk of acquiring diseases
especially for RRN who has hypertension and is
nearing the old age spectrum. A healthy diet can
Preventive significantly facilitate the proper control of his
potential fluctuating blood pressure.
A condition or problem 1 0.50 The salience or sense of urgency of RRN to
not needing immediate address the problem is not excellent because the
attention family has inadequate knowledge about the
negative implications of unhealthy dietary
patterns to one’s health. RRN also does not
present serious clinical manifestations associated
with unhealthy dietary patterns that interfere with
their daily activities and functioning, thereby
failing to recognize the magnitude of the problem
Salience , leading to low salience.
3.17

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 8

 University of the Philippines Manila
The Health Sciences Center
COLLEGE OF NURSING
WHO Collaborating Center for Leadership in Nursing Development
Sotejo Hall, Pedro Gil St., Ermita, Manila
Tel.: (632)523-1472 / Telefax: (632)523-1485

SUMMARY OF IDENTIFIED HEALTH PROBLEMS/CONDITIONS

ACCORDING TO PRIORITIES
Health problem Prioritization Score
1. Heart Failure of CDN as a Health Deficit 4.00

1. Liver Cirrhosis of CDN as a Health Deficit 4.00

2. Hypertension of RRN as a Health Deficit 3.17

2. Unhealthful dietary habits/practices of RRN as a 3.17

Health Threat
3. Inadequate Nutritional Intake of CDN as a Health 2.83
Threat
4. Disturbed Sleeping Patterns of CDN as a Health 2.50
Threat
5. Risk for Falls for RRN as a Health Threat 2.33

GUTIERREZ, AKL | 2019-00658 | Group 5 | 10/2022 9