COMMUNITY HEALTH NURSING 1 SEM 01 | CYC 02

LECTURE AUF-CON

NCM 0104 MODULE 06 – FAMILY NURSING PROCESS

● Process of identifying the needs and problems
OUTLINE based on the information gathered from different
I Family Health Assessment sources
A Tools ● Used in identifying and validating health and
II Initial Database
A Typology of Nursing Problems in Family Nursing nursing problems of the family based on the
Practice information gathered from different sources
B Family Nursing Diagnosis ○ Interviews, surveys, observations
C Family Health Task
III Family Data Analysis
● Weak assessment = everything will follow
A Socioeconomic and Cultural Characteristics
B Home Environment ACTIVITIES
C Family Health Status
D Family Values and Health Practices 1. ESTABLISHING A WORKING RELATIONSHIP

FAMILY HEALTH ● Family sees the nurse as a friend who is genuinely

concerned (mutual trust and confidence)
● Ways families communicate, cooperate, and ○ The client will be more open because of the
provide care for each other and maintain and established trust
sustain health routines ● POSITIVE OUTCOMES
○ Good quality of data
FAMILY HEALTH NURSING ○ Partnership in addressing identified health
needs and problems
● Level of CHN practice directed or focused on the ● The family must confirm the identified
family as the unit of care, with health as the goal data and diagnosis of the student
and nursing as the medium, channel of providing nurse
care ○ Satisfaction of the nurse and the client
○ Family is the center figure (input; our focus)
○ Health is the output (our goal) 2. ASSESSMENT

FAMILY NURSING PROCESS ● Process of collecting, organizing, and analyzing

data/information about the client
● Systematic guide to client-centered care with five
● CONSIDERATIONS
sequential steps
● Systematic way of processing information ○ What data needs to be collected?
gathered from different sources and translating ○ How will the data be collected?
intentions into meaningful actions or intervention ● Interviews, observation, survey, past
● CHARACTERISTICS records and/or documents
○ Dynamic: active and continuously ○ What are the sources of data?
moving/evolving ● Members of the family and/or anyone
○ Planned: organized method of critically related to the family
thinking about a family; not only done as you
○ Who will collect the data?
wish; there should be a clear procedure;
methodical
TYPOLOGY OF NURSING PROBLEMS IN FAMILY
○ Logical/rational: must be reasonable, NURSING PRACTICE
sensible, and valid
A. FIRST LEVEL ASSESSMENT
ASSESSMENT
● Determine the existing and potential health
● Systematic process of gathering and analyzing problems of the family
data

NCM 0104| Banaag, Cato, Diala, Mallari, Malonzo, Paras | 1

 MODULE 06 – FAMILY NURSING PROCESS
B. SECOND LEVEL ASSESSMENT
● Etiology or barriers from the family’s assumptions of
health tasks
3. DIAGNOSIS
● Identification of the client’s wellness status or
needs and problems based on the analysis of the
data/information gathered
● Family’s failure to perform health tasks to enhance
wellness state or to manage health problems
CASE SCENARIO
Nurse Jane is assigned to care for the Simpsons
family. Upon assessment, nurse Jane noted that the
3 children in the Simpsons family have long and dirty
fingernails, dirty clothes, walking barefooted, and
with body odor. She asked the children if they are
taking their bath and brush their teeth regularly and
they answered, “We just take a bath and brush our
teeth every other day, because we do not have
enough water to use.”
● Cues/Data
○ Subjective: “We just take a bath and brush
our teeth every other day, because we do
not have enough water to use”
○ Objective: 3 children in the family have
long dirty fingernails, dirty clothes, walking
barefooted, and with body odor
● Analysis and Diagnosis
○ HEALTH THREAT: Poor personal hygiene
● FAMILY NURSING CARE PLAN
○ Blueprint of the care that the nurse designs
○ Minimize/eliminate → identified health and
family nursing problems
○ Clear, comprehensive analysis of problems,
contributory cause of problems
○ Must be realistic = reasonable chance of
success
○ Prepared jointly with the family
● Working with, not for, the family
PLANNING
● Logical step-by-step process in designing a plan of
action to accomplish specific goals and objectives
○ GOAL: general in nature
○ OBJECTIVE: much more specific
● Includes a statement of objectives or desired
outcomes and specific nursing interventions
● Should be
NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 2
○ Appropriate
○ Responsive to the client’s problem
○ Contribute to the attainment of the desired
outcomes
○ Based on research and on nursing standards
● GOALS
○ General statement of condition / state to be
brought by course of action
○ Goals of CHN (Introductory phrases)
● To promote and preserve health
● To restore health when it is impaired
● To minimize suffering and distress
● To promote quality of living
● To develop self-care abilities
● OBJECTIVES
○ More specific statements of desired results
○ Short-term:
● Requires immediate action
● Results can be observed in short period
of time
● Few Family-nurse contacts (below 5
visits)
● Less resources
○ Long term:
● Behavior change (main object of
nursing care)
● 5 or more visits
● DESIRED OUTCOMES
○ Could be in terms of person’s health,
knowledge, attitudes and practices and
ability to cope with problems
○ Should be Specific, Measurable, Attainable
and Realistic, and have a specific Time frame
(SMART)
EXAMPLE
● Goal of Care
○ The children of the Simpsons family will be
able to maintain proper hygiene
● Objectives of Care
○ After 5 days of home visits, the children will
have short and clean fingernails, wears
clean clothes, walks with slippers, and no
body odor
POINTERS IN PLANNING
● Family must recognize and accept the existing
health needs / problems
● SMART (too high goals and failure can frustrate
both family and nurse)
● Accurate assessment and clear definition of
problem situation
○ Poor assessment = poor planning
 MODULE 06 – FAMILY NURSING PROCESS

● Goals and objectives must be set jointly with the ● Doing or carrying out the interventions specified in
family (commitment) the care plan in partnership with client-partners
○ Documentation and other members of the team
● Help the family recognize the problem
BARRIERS TO JOINT GOAL SETTING BETWEEN ○ Increase knowledge
NURSE AND FAMILY ○ Help see the consequences
○ Encourage positive attitudes
● Failure on the part of the family to perceive the
● Develop the family’s ability and commitment to
existence of the problem
provide nursing care to its members
● Family may realize existence of a health
○ HOW?
condition/problem but is too busy at the moment
● Demonstration and practice sessions
with other concerns
on procedures
● Sometimes the family perceives the existence of a
● Treatment or techniques utilizing,
problem but does not see it as serious enough to
readily available low-cost materials
warrant attention
and equipment
● Refuse to face and do something about the
● Enhance the capability of the family to provide a
situation
home environment conducive to health
○ Fear of consequences of taking action
maintenance and personal development
○ Respect for tradition
○ Environmental modification
○ Failure to perceive the benefits of action
○ Vector control measures
proposed
○ Failure to relate the proposed action to the
STEPS
family’s goals
● Failure to develop a working relationship ● Identify appropriate nursing actions (most
effective)
COMPONENTS IN PLANNING ○ Home visits (enables the nurse to see,
observe, and assess the family as a unit)
● Prioritizing problems
○ Visit in workplace
○ Determine which of the problems identified
○ Telephone call
demand priority attention
○ Clinic conference
● Setting goals and objectives
○ School visit
○ Long-term / short-term
○ Health classes
○ Clear, measurable, realistic (SMART)
● Include resources
○ Must be defined with the context of
○ Material: supplies, equipment, teaching aids,
professional standards
handouts, charts, visual materials
● Follow the typology of nursing
○ Human: other HCT, community leaders
problems
● NOTE: Necessary preparations, coordination, and
● Identifying nursing actions which will
collaboration are done before implementation
meet the objectives set
● EXAMPLES:
● Identifying nursing actions which will meet the
○ Educate the children regarding the
objectives set
importance of proper hygiene
○ Nurse considers alternative courses of action
○ Explain possible effects of poor hygiene
● Formulating a plan for evaluating care
○ Assist the children in taking a bath
○ Based on the objectives set and the planned
○ Teach the children how to cut their fingernails
nursing interventions, the nurse can make a
and toenails
tentative plan for evaluation
○ Demonstrate to them how to properly brush
their teeth
IMPLEMENTATION ○ Help the family find an adequate supply of
water
● Translate care plan into action
● “DOING” phase of the nursing process
EVALUATION
● Nurse and family perform what is required and
modify pattern of care
● Planned, ongoing, purposeful activity in which the
nurse and client-partner determine the client’s

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 3

 MODULE 06 – FAMILY NURSING PROCESS

progress toward achievement of goals and

outcomes FAMILIES AT RISK FOR HEALTH AND HEALTH-RELATED
● Collection of the objective and subjective data PROBLEMS
which indicate whether: ● Very poor families
○ If objectives are met or unmet ● Pregnant women, young children, and elderly
○ If problems are resolved or not ● Those diagnosed with communicable diseases
○ If unmet or unresolved → reassessment or ○ Families with members diagnosed with PTB,
revision of the plan AIDS, and STDs
○ Requires interventions to prevent further
DOCUMENTATION spread
● Diagnosed with a chronic/long term condition
● Means of communication, not only between
○ Hypertension, diabetes mellitus, heart
nurses, but to other members of HCT
disease, and cancer
● Should include the following:
○ Periodic follow-up and monitoring to
○ Client assessment and health
prevent complications and premature
needs/problems identified
death
○ Interventions carried out
● Affected with a physical, developmental, or
○ Client response to interventions
mental disability
○ Outcome of interventions
○ Stroke, autism, mental retardation, and
○ Future plan of care
Alzheimer’s disease
● FUNCTIONS
● Those who are in crisis situations such as:
○ Serves as a proof of thinking and decision
○ Sudden death of the head/breadwinner
making that nurses do
○ Legal separation
○ Could protect the nurse from a lawsuit (it is
○ Loss of job/home due to natural disasters
generally believed that what is not written
● Counseling and other interventions can forestall
was not done)
more problems from happening
○ Gives decision makers an idea of the
workload of nurses
○ Provides information that can be used in
research and quality assurance and for
training purposes

NCM 0104 MODULE 06.1 – TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE
● Initial database for family nursing
TYPOLOGY OF NURSING PROBLEMS ● Categorize health problems according to type or
nature
● Developed in 1978 to facilitate the process of
defining family nursing problems
1. WELLNESS STATE OR CONDITION
● Works as a classification system of family nursing
problems Stated as potential or readiness
●
● Used by nursing students, community health
○ Clinical or nursing judgment about a client in
nurses, and educators in creating a family nursing transition from a specific level of wellness or
care plan capability to a higher level
● FAMILY NURSING DIAGNOSIS WELLNESS POTENTIAL
●
○ First level assessment ○ A nursing judgment on wellness state or
● Define health problems, health threats, condition based on client’s performance,
foreseeable crisis or stress points current competencies or clinical data but
○ Second level assessment NO explicit expression of client desire
● Define the family nursing
● READINESS FOR ENHANCED WELLNESS STATE
problems/diagnoses as statements
○ A nursing judgment on wellness state or
condition based on client’s current
FIRST LEVEL ASSESSMENT competencies or performance, clinical data
and explicit expression of desire to
● Determine the existing and potential health
achieve a higher level of state or function in
problems of the family

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 4

 MODULE 06 – FAMILY NURSING PROCESS

a specific area of health promotion and ● ACCIDENT HAZARDS

maintenance Broken stairs Pointed/sharp objects
○ Verbalized readiness for positive change Poisons and medicines
Fire and fall hazards
improperly kept
EXAMPLES
● POOR HOME/ENVIRONMENT CONDITION OR
● POTENTIAL FOR ENHANCED CAPABILITY FOR: SANITATION
○ Healthy Lifestyle (e.g. nutrition/diet,
Lack of food storage
exercise/activity) Inadequate living space
facilities
○ Health Maintenance/Health Management
○ Parenting Presence of breeding or
resting sites of vectors of
○ Breastfeeding Polluted water supply
diseases (e.g. mosquitoes,
○ Spiritual Well-being flies, roaches, rodents, etc.)
● Process of a client’s developing/
Improper garbage
unfolding of mystery through Unsanitary waste disposal
disposal
harmonious interconnectedness that
comes from inner strength/sacred Improper drainage Poor lighting and
system ventilation
source/God
● READINESS FOR ENHANCED CAPABILITY FOR: Noise and air pollution
○ Healthy Lifestyle
○ Health Maintenance/Health Management ● FAULTY/UNHEALTHY NUTRITIONAL OR EATING
○ Parenting HABITS OR FEEDING TECHNIQUES/PRACTICES
○ Breastfeeding Inadequate food intake
Excessive intake of certain
○ Spiritual Well-being both in quality and
nutrients
quantity
2. HEALTH THREAT Faulty eating habits Ineffective breastfeeding

● Conditions that are conducive to disease and Faulty feeding techniques

accident, or may result in failure to maintain
wellness or realize health potential ● STRESS-PROVOKING FACTORS
Strained marital Strained parent-sibling
EXAMPLES relationship relationship
Interpersonal conflicts
● Family size beyond what family resources can between family Caregiving burden
members
adequately provide
● Presence of risk factors of specific diseases (e.g.
● UNHEALTHFUL LIFESTYLE AND PERSONAL
lifestyle diseases, metabolic syndrome, family
HABITS/PRACTICES
history of hereditary condition)
Cigarette/tobacco
● Threat of cross infection from a communicable Alcohol drinking
smoking
disease case Walking barefooted or
Eating raw meat or fish
● Unsanitary food handling and preparation inadequate footwear
● Inherent personal characteristics (e.g. poor impulse Self-medication or
Poor personal hygiene
control) substance abuse
Engaging in dangerous
● Health history which may participate/induce the Sexual promiscuity
sports
occurrence of a health deficit (e.g. previous history Inadequate rest or Non-use of self-protection
of difficult labor) sleep, exercise or measures (e.g. non-use of
● Inappropriate role assumption (e.g. child physical activity, and bednets in malaria and
assuming mother’s role, father not assuming his relaxation activities filariasis endemic areas)
role)
● Lack of immunization/inadequate immunization
3. HEALTH DEFICIT
status especially children
● Instances of failure in health maintenance
● Family disunity
○ Self-oriented behavior of member(s)
○ Unresolved conflicts of member(s)
○ Intolerable disagreement

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 5

 MODULE 06 – FAMILY NURSING PROCESS

EXAMPLES ● Nurse Marissa conducted her initial home visit to

one of the families. She noted the presence of
● Illness states, regardless of whether it is diagnosed matches, lighters, and candles improperly kept on
or undiagnosed by medical practitioner the house.
○ Cough and colds, malnutrition, fever, ANS:
parasitism, hypertension, tuberculosis,
dandruff, pediculosis, tooth decay Aling Nena’s daughters play outside their house
●
● Failure to thrive/develop according to normal rate without wearing slippers.
○ Delayed growth and development
ANS:
● DISABILITY
○ Whether congenital or arising from illness;
transient/temporary (e.g. aphasia or
SECOND LEVEL ASSESSMENT
● Temporary paralysis after a CVA
● Etiology or barriers from the family’s assumptions of
● Permanent (e.g. leg amputation
health tasks
secondary to diabetes; blindness from
● Statements of the family’s incapabilities in the
measles, lameness from polio)
assumption of the health tasks
● Family’s realities or perceptions about the attitudes
4. FORESEEABLE CRISIS/STRESS POINTS
related to assumptions of tasks on each condition
Anticipated periods of unusual demand on the identified during the 1st level assessment
●
individual or family in terms of ● Statement of factors which are maintaining the
adjustment/family resources undesirable response and preventing the desired
change
● RESULTS ARE REFLECTED AS:
Marriage Divorce or separation
○ Inability to recognize presence of the problem
Pregnancy, labor,
Menopause d/t
puerperium
○ Inability to make decisions with respect to
Parenthood Loss of a job
taking appropriate health action d/t
Additional member Hospitalization of a family
(e.g. newborn, lodger) member ○ Inability to provide nursing care to the sick,
disabled or dependent member of the family
abortion Death of a member
d/t
Resettlement in a new
Entrance at school ○ Inability to provide a home environment
community
which is conducive to health maintenance
Adolescence Illegitimacy
and personal development d/t
○ Failure to utilize community resources for
FAMILY HEALTH TASKS
health care d/t
● Recognize the presence of wellness states or health ● CATEGORIZATION OF PROBLEMS
condition problems ○ General to specific
● Make decisions about taking appropriate action to ● General: inability to utilize
maintain wellness or manage the health problem ● Specific: financial resources,
● Provide nursing care to the sick, disabled, manpower, and/or time
dependent, or at-risk members ○ Main category of problem (health task)
● Maintain a home environment conducive to health ○ Several more specific problems
maintenance and personal development ● Reflect contributory problems or
● Utilize community resources for health care explanations for the existence of the
problem
○ REMEMBER: The more specific the problem
PRACTICE | CASE SCENARIOS
definition, the more useful is the nursing
● One of the eight children of Aling Marie has been diagnosis
hospitalized. She stated that it is their first time to
experience such event. INABILITY TO RECOGNIZE THE PRESENCE OF THE
CONDITION OR PROBLEM DUE TO:
ANS:
● Lack or inadequate knowledge

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 6

 MODULE 06 – FAMILY NURSING PROCESS

● Denial about its existence or severity as a result INABILITY TO PROVIDE ADEQUATE NURSING CARE TO
of fear of consequences of diagnosis of problem, THE SICK, DISABLED, DEPENDENT OR
specifically: VULNERABLE/AT-RISK MEMBER OF THE FAMILY DUE TO:
○ Social-stigma, loss of respect of peer/ ● Lack of/inadequate knowledge about the
significant others disease/health condition (nature, severity,
○ Economic/cost implications complications, prognosis and management)
○ Physical consequences ● Lack of/inadequate knowledge about child
○ Emotional/psychological issues/ concerns development and care
● Attitude/philosophy in life which hinders ● Lack of/inadequate knowledge of the nature
recognition/acceptance of a problem and extent of nursing care needed
● Lack of the necessary facilities, equipment and
INABILITY TO MAKE DECISIONS WITH RESPECT TO supplies for care
TAKING APPROPRIATE HEALTH ACTION DUE TO:
● Lack or inadequate knowledge and skill in carrying
● Failure to comprehend the nature/magnitude of out the necessary
the problem/condition interventions/treatment/procedure/care (e.g.,
● Low salience of the problem/condition complex therapeutic regimen or healthy lifestyle
● Feeling of confusion, helplessness and/or program)
resignation brought about by perceived ● Inadequate family resources for care, specifically:
magnitude/severity of the situation or problem, i.e., ○ Absence of responsible member
failure to break down problems into manageable ○ Financial constraints
units of attack ○ Limitations/lack of physical resources (e.g.
● Lack of/or inadequate knowledge/insight as to isolation room)
alternative courses of action open to them ● Significant person’s unexpressed feelings (e.g.
● Inability to decide which action to take from among hostility/anger, guilt, fear/anxiety, despair,
a list of alternatives rejection) which disable his/her capacities to
● Conflicting opinions among family provide care.
members/significant others regarding action to ● Philosophy in life which negates/hinder caring for
take the sick, disabled, dependent, vulnerable/at-risk
● Lack of/inadequate knowledge of community member
resources for care ● Member’s preoccupation with own
● Fear of consequence of action, specifically: concerns/interests
○ Social consequences ● Prolonged disease or disability progression which
○ Economic consequences exhausts supportive capacity of family members
○ Physical consequences ● Altered role performance, specifically:
○ Emotional/psychological consequences ○ Role denial or ambivalence
● Negative attitude towards the health condition ○ Role strain
or problem ○ Role dissatisfaction
○ By negative attitude is meant one that ○ Role conflict
interferes with rational decision making ○ Role confusion
● Inaccessibility of appropriate resources for care, ○ Role overload
specifically:
○ Physical inaccessibility INABILITY TO PROVIDE A HOME ENVIRONMENT
CONDUCIVE TO HEALTH MAINTENANCE AND
○ Cost constraints or economic/financial
PERSONAL DEVELOPMENT DUE TO:
inaccessibility
● Lack of trust/confidence in the health ● Inadequate family resources, specifically:
personnel/agency ○ Financial constraints/limited financial
● Misconceptions or erroneous information about resources
proposed course(s) of action ○ Limited physical resources – e.g. lack of
space to construct facility
● Failure to see benefits (specifically long-term
ones) of investment in home environment
improvement

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 7

 MODULE 06 – FAMILY NURSING PROCESS
● Lack of/inadequate knowledge of importance of
hygiene and sanitation
● Lack of/inadequate knowledge of preventive
measures
● Lack of skill in carrying out measures to improve
home environment
● Ineffective communication patterns within the
family
● Lack of supportive relationship among family
members
● Negative attitude/philosophy in life which is not
conducive to health maintenance and personal
development
● Lack of/inadequate competencies in relating to
each other for mutual growth and maturation
(e.g. reduced ability to meet the physical and
psychological needs of other members as a
result of family’s preoccupation with current
problem or condition)
FAILURE TO UTILIZE COMMUNITY RESOURCES FOR
HEALTH CARE DUE TO:
● Lack of/inadequate knowledge of community
resources for health care
● Failure to perceive the benefits of health
care/services
NCM 0104 MODULE 06.2 – INITIAL ASSESSMENT/DATABASE FOR FAMILY NURSING PRACTICE
FAMILY STRUCTURE (Characteristics and
Dynamics)
● Members of the household and relationship to the
head of the family
● Demographic data (age, sex, civil status, position in
the family)
● Place of residence of each member (whether living
with the family or elsewhere)
● Type of family structure (matriarchal/patriarchal,
nuclear/extended)
● Dominant family member in terms
decision-making especially in matters of health
care (M/F/SO)
● General family relationship (presence of any
obvious observable conflict between members;
characteristics communication or interaction
patterns among members)
SOCIOECONOMIC AND CULTURAL
CHARACTERISTICS
● Income and expenses
○ Occupation and place of work of each
working member
○ Who makes the decision
● Lack of trust/confidence in the agency/personnel
● Previous unpleasant experience with health worker
● Fear of consequences of action (preventive,
diagnostic, therapeutic rehabilitative), specifically:
○ Physical/psychological consequences
○ Financial consequences
○ Social consequences (e.g. loss of esteem of
peer/significant others)
● Unavailability of required care/service
● Inaccessibility of required care/service due to:
○ Cost constraints
○ Physical inaccessibility, i.e. location of facility
● Lack of or inadequate family resources, specifically:
○ Manpower resources (e.g. babysitter)
○ Financial resources (e.g. cost of medicine
prescribed)
● Feeling of alienation to/lack of support from the
community (e.g., stigma due to mental illness, AIDS,
etc.)
● Negative attitude/philosophy in life which hinders
effective/maximum utilization of community
resources for health care
● Educational attainment of each member
● Ethnic background and religious affiliations
● Family traditions, events or practices affecting
members’ health or family functioning
● Significant others and other roles they play in the
family’s life
● Relationship of the family to the larger community
○ Nature and extent of participation of the
family in the community activities
HOME AND ENVIRONMENT
of
● Housing
● Kind of neighborhood
● Social and health facilities available (social, health,
communication, and transportation facilities)
● Communication and transportation facilities
available
● Presence of accident hazards in the home and
immediate surroundings
● State of cleanliness and order in the home and
yard/surroundings
HOUSING
● Adequacy of living space
NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 8
 MODULE 06 – FAMILY NURSING PROCESS

● Sleeping arrangement EXAMPLE

● Presence of breeding or resting sites of vectors of ● TOTAL FLOOR AREA
diseases (e.g. mosquitoes, rodents, flies, etc.)
○ Length: 3.67 m
● Food storage (plate, casserole, bowls, refrigerator)
○ Width: 4.99 m
and cooking facilities
● Water supply ○ TFA: 18.31 sq meters
○ Source (pitcher, pump, AWD, jetmatic) ● TOTAL SPACE REQUIREMENT
○ Ownership ○ 6 adults (3 square meters)
○ Potability ○ 2 children (1.5 square meters)
● Toilet facility (type, ownership, sanitary condition)
○ 1 infant (0 square meters)
● Garbage disposal (burning, dumping, burying,
collection)
○ TSA: 21 sq meters
● Drainage system (type and sanitary condition) ● TSA > TFA = OVERCROWDED

HOUSING CONDITION ADEQUACY OF VENTILATION

● Concrete: made up of hollow blocks, cement, some
wood for the structure of the house
● Wood: the structure, foundation, and walls of the
house is made up of lumber and timber
● Concrete wood: a house is a combination of
cement blocks, sand, gravel lumber and timber
● Light: made up of galvanized iron, carton, and/or
sawali
● Determine the total floor area
● Get the area of the window or the window opening
in meters to get the total window opening
○ TWO = length x width
● Apply the formula for ventilation
○ TWO / TFA x 100
● Results must be 20% to be considered satisfactory,
while 18–19% is fair/below poor

TOILET FACILITY EXAMPLE

● TFA: 18.31 sq meters
● Toilet facility with/without water carriage ● TOTAL WINDOW OPENING
○ Refers to a toilet facility, which has a septic
○ There are 2 windows each measuring 1.405
tank and could be manually or mechanically
m in length and 1.214 meters in width
flushed
● Balot system (wrap and throw) ○ TWO: 3.412 sq meters
○ Utilizes materials such as old newspapers or ● VENTILATION
plastic bags to collect human waste ○ (3.412 / 18.31) x 100
● Cat-hole method ● 18.63% = FAIR AND BELOW POOR
○ Digging a hole in the ground
HEALTH STATUS OF EACH FAMILY MEMBER
ADEQUACY OF LIVING SPACE
● Medical and nursing history indicating:
● Determine the size of the living space or the total ○ Current/past significant health
floor area (TFA) condition/illness
○ TFA = length x width ○ Beliefs/practices conducive to health and
● Determine the total space requirements (TSR) of illness
the family
○ Adult: 3 sq. m. COMPONENTS
○ Children: 1.5 sq. m.
○ Infant: 0 sq. m. ● Nutritional Assessment
● Compare the TFA with TSR ○ Anthropometric data (BMI and waist-hip
○ TFA > TSR = not overcrowded/adequate living ratio)
space ○ Dietary history specifying quality and quantity
○ TSR > TFA = overcrowded/inadequate living of food or nutrient intake per day
space ○ Eating/feeding habits/practices
● Developmental status
● Physical assessment findings
● Risk factors assessment

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 9

 MODULE 06 – FAMILY NURSING PROCESS

○ Hypertension, physical inactivity, obesity, DM, VALUES, HABITS, AND PRACTICES

inadequate fiber intake, alcohol drinking,
cigarette smoking, increased cholesterol, ● Center on health promotion and maintenance and
stress, and substance abuse on disease prevention
● Significant results of laboratory/diagnostic
tests/screening procedures COMPONENTS

ANTHROPOMETRIC DATA ● Immunization status

● Healthy lifestyle and practices
𝑤𝑎𝑖𝑠𝑡 𝑐𝑖𝑟𝑐𝑢𝑚𝑓𝑒𝑟𝑒𝑛𝑐𝑒 (𝑐𝑚) ● Adequacy of rest and sleep, exercise/activities, use
● Waist-Hip Ratio =
ℎ𝑖𝑝 𝑐𝑖𝑟𝑐𝑢𝑚𝑓𝑒𝑟𝑒𝑛𝑐𝑒 (𝑐𝑚) of protective measures, and relaxation/stress
○ NORMAL: < 1.0 (men) and < 0.85 (women) management activities
○ ANDROID/CENTRAL OBESITY: =/> 1.0 (men) ● Use of promotive-preventive health services
and =/> 0.85 (women)

REFERENCES
𝑤𝑒𝑖𝑔ℎ𝑡 𝑖𝑛 𝑘𝑖𝑙𝑜𝑔𝑟𝑎𝑚 (𝑘𝑔)
● BMI = Synchronous Lecture: 08 Nov 2022 (CI: Sir Doroteo
2
[𝐻𝑡 𝑖𝑛 𝑚𝑒𝑡𝑒𝑟𝑠] Dizon)

GUIDELINES FOR ADULTS

Underweight <18.5
Healthy Weight 18.6—22.9
Overweight >23.0
At Risk 23.1—24.9
Obese I 25.0—29.9
Obese II >30.0

WEIGHT (kg) FOR AGE OF BOYS AND GIRLS (0–72

MONTHS)
BELOW NORMAL ABOVE
AGE
NORMAL RANGE NORMAL
0 2.3 2.4–4.3 4.4
1 2.8 2.9–5.6 5.7
2 3.4 3.5–6.8 6.9
3 4 4.1–7.7 7.8
4 4.6 4.7–8.5 8.6
5 5.2 5.3–9.2 9.3

WEIGHT (kg) FOR AGE OF BOYS AND GIRLS (0–72

MONTHS)
UNDER OVER
MILD NORMAL
WEIGHT WEIGHT
YR
from to from
< 5th <85th >85th
5th 15th 15th
9 13.86 13.87 14.65 14.66 19.19 19.2
10 14.22 14.23 15.08 15.09 20.19 20.2
11 14.59 14.6 15.52 15.53 21.18 21.19
12 14.97 14.98 15.97 15.98 22.17 22.18
13 15.35 15.36 16.42 16.43 23.08 23.09
14 15.66 15.57 16.78 16.79 23.88 23.89

NCM 0104 | Banaag, Cato, Diala, Mallari, Malonzo, Paras| 10