GORDON COLLEGE OLONGAPO CITY COLLEGE OF NURSING

FAMILY CASE ANALYSIS

SUBMITTED BY:

BALAJADIA, JESSIEFEL DE GUZMAN, STEFAN PRAISE ALVEZ, LUDELLE RENA CALIMBAS, MARICEL EBALO, GRACE LEE BSN II-C1B

DATE OF SUBMISSION: SEPTEMBER 18, 2010

II. FAMILY STRUCTURE AND CHARACTERISTIC A. GENERAL FAMILY STRUCTURE NAME AGE SEX CIVIL STATUS Married Married Single Single Single Single Single Single Single POSITION IN THE FAMILY Head Wife Eldest Child 2nd Child 3rd Child 4th Child 5th Child 6th Child 7th Child EDUCATIONAL OCCUPATION ATTAINMENT Undergraduate (Seaman) Highschool graduate Highschool graduate Highschool graduate Ongoing 3rd year Highschool Ongoing Grade 6 student Ongoing Grade 4 student Substitute driver None None Scavenger Student Student Student -

A B C D E F G H I

45 39 19 18 15 12 10 3 1

Male Female Male Male Female Female Female Female Female

INTERPRETATION: The Letter family is a nuclear family composing of nine members. Their family life cycle is in stage six which is the Launching Stage family. Letter C, the eldest child was the one who is separated from the family and began to form a family on his own. ANALYSIS: The traditional nuclear family structure is composed of a husband, wife, and children. An advantage of a nuclear family is its ability to provide support to family members; people know each other well and can feel genuine affection for each other. In a time of crisis, this same characteristics may become a challenge to a family as there are few family members to share the burden and offer support. As launching stage family, the stage at which children leaves to establish their own households is the most difficult stage because it appears to represent the breaking up of the family. Parental roles change from those of the mother or father to once removed support people or guideposts. (Maternal and Child Health Nursing; Adelle Pilliteri; 6th Edition, Volume 6; Chapter 3, pages 41-47)

Child abuse YES  NO    “Madalas kami magtalo lalo na pag patungkol sa pera at kapag walang makain. page 45). Open communication among family members b. Pag may problema lahat kami pinaguusapan iyon. This task includes opening an effective means of communication among family members. They quarrel on simple things like providing food for their daily needs.B1. Napapalo ko din mga anak ko para disiplinahin at hindi na ulitin ung maling ginawa nila. ANALYSIS: B2. simpleng patapik patapik lang na matututo sila. establishing values and enforcing common regulations for all family members. Kapag nagaaway naman kami ni misis. kinagabihan din noon nagbabati kami”. CHARACTERISTICS OF COMMUNICATION YES   NO a. Swearing or use of insult when talking to each other “Open naman kami dito sa isa’t isa. They sometimes use insult words when talking to each other especially when they are having fights. . No husband and wife beating and no child abuse present within the family. Wife/husband beating 3. 6th Edition. INTERPRETATION: There is an open communication within the family and all of then are verbal in showing their care towards each other. Frequent quarreling 4. maintenance of order is one of them. (Maternal and Child Health Nursing. Siyempre hindi umaabot ung palo ko na nagpapasa na. Hindi din maiiwasan talaga na minsan nakakapagmura at insultuhan kami”. Observable conflicts between family members 2. INTERPRETATION: There are observable conflicts between family members but it’s not very complicated. GENERAL FAMILY RELATIONSHIP CRITERIA 1. Volume 6. ANALYSIS: In the eight family tasks by Duvall and Miller (1990). Adelle Pilliteri. as verbalized by A. as verbalized by A.

. incorporate family values and develop skills to function in society. fulfill their assigned roles in the family. Volume 1.page 434). 8th Edition.The effectiveness of family communication determines the family’s ability to function as a cooperative. growth producing unit. The information transmitted influences how members work together. Kozier and Erb.(Fundamentals of Nursing.

.

He is accepting part time jobs and sidelines to earn extra income for their other expenses. there is justification. Volume 1. FAMILY HEALTH STATUS A. halos sakto lang pampagkain naming. Regular ko namang kita ay 200 pesos sa pagtritrike. determining which family needs will be met and their order of priority is allocation of resources.III. 6th Edition. SOCIO ECONOMIC EXPENSES ELECTRIC BILL WATER BILL MEDICATION DAILY SCHOOL ALLOWANCES (3 KIDS) FOODS AND OTHER EXPENSES Father regular income: 200 per day 6000 monthly The client verbalized that. consistency and fairness in distribution.  Obstetric history of G8P7T7P1A0L7  Seven children delivered via normal spontaneous delivery.  Still birth happened after the 3rd child and supposedly their 4th child. It was 35 weeks of AOG and a home delivery.” INTERPRETATION: The father is eager to provide all the needs of the family. page 45) IV. (Maternal and Child Health Nursing. In healthy family. minsan sumaside line din ako sa saklaan at kapag may nagpapabenta ng kung anu-anong gamit kapag nakabenta binibigyan ako ng komisyon. Minsan kapag may gusto magpadrive kumikita din ako ng 400 pesos. NOT MONITORED NO HEALTH HISTORY NO HEALTH HISTORY Cough and cold  Had fever for 3 days and given medication AMOUNT ( MONTHLY) 700 500 40 900 4500-6000 C D E F . Adelle Pilliteri. FAMILY HEALTH HISTORY NAME OF FAMILY MEMBERS A B HEALTH HISTORY Hospitalized for stomachache and diagnosed dyspepsia. “Nakadepende sa mga raket ko ang kita ko araw-araw. ANALYSIS: According to Duvall and Miller (1990).

kaso namatay iyong pang-apat pero premature na siya. They want it to be organized simple and clean also for their comfort. as verbalized by B. “Mahalaga para sa amin talaga e pera. 2. Money Food Clothing House Client A verbalized that. The wife delivered only once at the hospital and the rest was at home. 4. Pagkain din at bagong damit. The mother was taking them to the health center but not always. pero ung panganay namin sa ospitaldoon sa eskwelahan niyo ngayon. Tapos iyong mga anak ko hindi pa naman nagkakasakit na naospital sila. Mabibili mo na lahat kapag may pera. Kasi diba andoon na lahat. Lastly. Next are new clothes. The family is on self-medication like when they experiencing fever. It was ranked first for the family’s felt need.G H I of Paracetamol by her mother. Cough and cold  Not treated Cough and cold  Not treated NO HEALTH HISTORY “Lahat ng panganganak ko puro sa bahay lang. 3.” INTERPRETATION: The family simply believes that money is what they really needed. They think that they can buy and can fulfill all their needs if they have enough money. They want new. and the past prescriptions for the same illness were used again by them. Halimbawa iyong Tempra o Biogesic na pambata. INTERPRETATION: The head of the family was hospitalized because of stomachache but only in the Emergency Room and medication was given. Felt Family Needs 1. ANALYSIS: B. tas kapag nilalagnat sila pinapainom ko lang ng Paracetamol. Kadalasan puro ubo at sipon. lalo na para sa mga bata. comfortable and on the generation clothes especially for the children. Walo dapat anak ko. They need it for their family survival. Gusto ko din ipaayos itong bahay kahit mapapinturahan lang. None of their children was hospitalized and only cough. Second is food. ung syrup”. the family wants to redecorate their house. . Nung nilabas ko nga lang patay na siya. cold and fever were experienced by them. She had one still birth caused by cord compression.

Many of these over-the-counter preparations have ingredients that. Ways of meeting basic needs are considered healthy when they are not harmful to others or to self. Paracetamol naman o kaya iyong Tempra ang pinapainom ko kapag nilalagnat sila”. pages 274-275). Each culture has ideas about health and is often transmitted from parents to children. consulted at the health center once Self medication Self medication Self medication - “Hindi pa kami naoospital. happier. cold and fever TREATMENT Self medication Self medication NOT MONITORED Self medication Self medication. C. may cause undesirable side-effects or adverse reactions or may be contraindicated in the client’s condition. Kozier and Erb. conform to the individual’s sociocultural values and are within the law. HEALTH BELIEFS AND PRACTICES FAMILY MEMBERS A B C D E F G H I ILLNESS Cough and cold Cough and cold NOT MONITORED Cough Cough. Pinapainom ko sila ng Carbocestein o kaya Cephalexin pag may ubo. 8th Edition. Volume 1. cold and fever Cough. as verbalized by B. People meet their own needs relative to their own priorities. cold and fever Cough. It is known that over-the-counter medications are used by 75% of older adults to relieve symptoms. cold and fever Cough. People who satisfy their basic needs appropriately are healthier. ANALYSIS: Culture and social interactions influence how person perceives or experiences and copes with health and illness. each person’s needs and reactions to those needs are influenced by the culture with which the person identifies. page 302) Older adults often attempt to seek relief from the problems by using over-the-counter preparations. Tapos pag nauulit iyong sakit. Kozier and Erb. They only rely on the past prescriptions that were given at the health center or on the over-the-counter drugs for their illness. 8th Edition. INTERPRETATION: They don’t consult physicians for their health problem. (Fundamentals of Nursing.ANALYSIS: All people have the same basic needs. and more effective than those whose needs are frustrated. when used inappropriately. however. ginagamit nalang namin iyong dating reseta sa health canter. Volume 1. . isang beses ko lang din dinala sa health center iyong isang anak ko nung nagkaubo’t sipon saka lagnat siya. (Fundamentals of Nursing.

Maganda kasing kumpleto sa bakuna para protektado diba. NOT MONITORED 11:00pm – 8:30am 9 hours and 30 mins. Vaccination promotes health and protects children from disease causing agents. ANALYSIS: Immunization is the process by which vaccines are introduced into the body before infections set in. MAN. vaccine are administered to induced immunity thereby causing the recipients immune system to react to the vaccine that produces antibodies to fight infections. “Kumpleto naman ng bakuna mga anak ko kahit ako kahit sa bahay lang nanganak asawa ko. Tsaka sabi samin mahalaga iyon nung nagpupunta kami sa health center”. INTERPRETATION: The head of the family is aware that their family needed to complete all the vaccines. IMMUNIZATION STATUS MEMBERS OF THE FAMILY A B C D E F G H I IMMUNIZATION (with Tetanus Toxoid Vaccine 1-5)  Measles Vaccine  BCG  OPV (3 dose)  Hepa Vaccine (3 dose) The father verbalized that. 10:00pm – 6:00am 8 hours 10:00pm – 6:00am 8 hours 10:00pm – 6:00am 8 hours 10:00pm – 7:00am/ 2:30pm – 3:30 pm 10 hours 10:00pm – 6:30am/ 2:00 – 3:30pm 10 hours “Natutulog iyong mga anak kong nag-aaral. Cuevas RN. page 142) C2. mga alas-dies ng gabi kasi papasok pa kinabukasan. Gumigising naman sila mga ala-sais para makaligo at makakain pa. FAMILY DAILY ACTIVITIES FAMILY MEMBERS A B C D E F G H I HOURS OF SLEEP AT NIGHT/NAP 10:30pm – 5:30am 8 hours 10:30pm – 5:00am/ 2:00pm – 4:00pm 9 hours and 30 mins. He knew that it could promote health and protect them from any diseases. (Public Health Nursing in the Philippines: Prescilla L. Ung iba .C1.

(Fundamentals of Nursing. (Maternal and Child Health Nursing.v. page 925) C3. Kami mag-asawa mga ala-singko gumigising. 6th Edition. ANALYSIS: Normal sleep pattern and requirements is used to believe that maintaining a regular sleep-wake rhythm is more important than the number of hours actually slept. Frequent lack of sleep can lead to chronic fatigue or depression. H at ung bunso mga alas-otso na siguro”. Some of them spend their time drinking alcohols and smoking cigarettes. But in their case. some need more and others can adjust to considerably less. “Minsan gusto ko lang mapag-isa. Adele Pilliteri. Kozier and Erb. Volume 2. STRESS MANAGEMENT FAMILY MEMBER A B C D STRESS MANAGEMENT “Kapag may problema ako. as verbalized by B. “Nanunuod lang yan o kaya nakikipaglaro sa mga kapatid niya”. as verbalized by B. as verbalized by B.v”. the other members of the family are not coping with their stresses in a healthy manner. Volume 2. “Naglilinis lang ako ng bahay o kaya nanunuod ng t. INTERPRETATION: Each family member had an adequate sleeping pattern. o kaya nakikinig ng mga kanta sa radyo”. 8th Edition. . NOT MONITORED “Gumagala lang ako. “Binibigyan namin ng laruan para malibang o kaya pagkain”. “Nakikipaglaro ako sa mga kaibigan ko o kaya nanunuod minsan”. because they are constantly busy and because staying up late is a symbol of the adult status they long for. kasama mga tropa ko kung saan saan o kaya umiinom kami at naninigarilyo nalang”. Many attempt to get by with too little sleep. sina D. kasi nanunuod pa kami mga drama sa t. dinadaan ko sa paninigarilyo”. E F G H I INTERPRETATION: All the members of the family have their own stress management. however. page 1166) Sleep is widely believe that everyone needs eight hours of sleep at night.naman mga alas-onse siguro. They consume normal hours of sleep and it’s good for them that they have no difficulty in their sleeping pattern. “Nanunuod akong t.v. ayoko lang may naggugulo pag may iniisip ako”.

ANALYSIS: Oral contraceptives. Family may use coping pattern rather consistently over fine or may change their coping strategies when new demands are made on the family.38 GENDER: MALE NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing. Volume 1. Pero nabubuntis pa din ako kasi nakakalimutan ko uminom minsan eh”. Pills must be prescribed by a physician. are composed of varying amounts of synthetic estrogen combined with a small amount of synthetic progesterone. (Maternal and Child Health Nursing. page 106) HEAD TO TOE PHYSICAL ASSESSMENT: NAME: A AGE: 45 YEARS OLD A. Adele Pillitteri.5% effective in preventing conception. a nurse practitioner. the typical failure rate is around 3%. 4th Edition. When used correctly. The coping mechanisms families and individuals develop reflect their individual resourcefulness. they are 99. the reason why pregnancy occurs. Normal . commonly known as the pill or OCs. It became ineffective because the mother sometimes misses taking it. MEASUREMENTS FINDINGS Weight 53 kg. as verbalized by the mother. 7th edition. Because women occasionally forget to take them and there are individual differences in women’s physiology. INTERPRETATION: Oral contraception is the family planning method they are using. or nurse-midwife following a pelvic examination and a Papanicolaou (Pap) smear. FAMILY PLANNING METHOD “Pills lang ang ginamit ko simula nung nakadalawang anak na kami hanggang ngayon. C4. Coping mechanisms can be viewed as an active method of problem solving developed to meet life’s challenges. Height 162 cm BMI 20.ANALYSIS: Family coping mechanisms are the behaviors family use to deal with stress or changes imposed from either within or without.

turgor: pinched up skin immediately return (-) edema (-) swelling Warm to touch (-) nodule Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms.4 C 81 bpm 17 cpm 120/80 mmHg 36.intact epidermis . with frontal.rounded( normocephalic and symmetrical.no infection or infestation Interpretation Normal HAIR NAILS Thick Hair Black in color (+) for dandruff Hair is evenly distributed (-)for lice intact epidermis Dirty nails Blanch test capillary refill Angle of nails are 160 degrees Presence of dandruff is due to poor hygiene . 1175) B.smooth texture . parietal and occipital prominence):smooth skull contour Dirty nails is due to poor hygiene HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal . angle of nail plate about 160 degree . rough and dry skin texture.when pinched skin spring back to previous state . VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 110/70 mmHg 36.evenly distributed hair . nail beds) in dark skin people -no edema -no nodule . pg.highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .convex curvature.lips.5-370C 60-100 bpm 16-20 cpm Normal Body parts SKIN Actual Findings Dark brown color.Barbara Kozier.thick hair .silky and resilient hair .prompt return of pink or usual color(generally less than 4 sec) .

no discoloration . absence of nodules and masses . skin color is same as face.. equal movement . uniform Consistency. no tenderness Ability to purse the lips Moves freely no tenderness Normal MOUTH AND THROAT Normal NECK Movement with no discomfort (-)masses and nodules Normal . no lesion -air moves freely as the client breaths through the nares .smooth with no palpable nodules .no discharge .uniform color .not tender. no tenderness . indicating that the trigeminal nerve is in intact Normal EARS . smooth movements with no discomfort -masses and nodules are not palpable Normal NOSE No lesion.firm symmetric and straight .smooth.moves freely.ability to purse the lips .color is same as facial skin .no edema or tearing .coordinated. no discharged eyebrow symmetrically aligned. Client breaths freely No discharge Lips is pink (-) nodules.symmetric facial movement EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Color is same as facial skin.symmetrically .no discharge .no tender . no discharge.auricles is aligned in outer cantus of the eye .no discharge or flaring . auricles is aligned in outer cantus of the eye.clients blinks when the cornea is touched. nasal septum intact and in midline.skin intact.pink gums(bluish or dark patches in dark skinned clients) .

nail beds) in dark skin people -no edema -no nodule .Spinal column is straight Left and right shoulder and hips are at the same height Normal NAME: B AGE: 39 YEARS OLD A. VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 110/70 mmHg 36. Height 165 cm BMI 18.chest symmetry .5 GENDER: MALE NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing. pg.CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height.spine vertically aligned . no masses .7 C 83 bpm 19 cpm Normal Body parts SKIN Actual Findings Light brown color. 1175) 120/80 mmHg 36. MEASUREMENTS FINDINGS Weight 110 lbs.5-370C 60-100 bpm 16-20 cpm Underweight B.lips. pinched up skin immediately return (-) edema (-) swelling Warm to touch (-) nodule Dry skin (+) scars in legs Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms. Barbara Kozier. no tenderness. 7th edition.when pinched skin spring back to previous state Interpretation Normal . equal chest symmetry .chest wall intact.

no infection or infestation Presence of dandruff is due to poor hygiene . angle of nail plate about 160 degree .intact epidermis . indicating that the trigeminal nerve is in intact . no discharge.symmetrically Normal HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Normal EARS Color is same as facial skin.evenly distributed hair . no discoloration .no discharge .smooth.smooth texture .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .HAIR NAILS Thick Hair Black in color (+) for dandruff Hair is evenly distributed (-)for lice intact epidermis Clean nails Blanch test capillary refill=2 sec. no discharged Normal .prompt return of pink or usual color(generally less than 4 sec) .silky and resilient hair .convex curvature.skin intact.thick hair .color is same as facial skin . equal movement .symmetric facial movement eyebrow symmetrically aligned. auricles is aligned in outer cantus of the eye. Angle of nails are 160 degrees . uniform Consistency. parietal and occipital prominence):smooth skull contour .rounded( normocephalic and symmetrical. with frontal. absence of nodules and masses .clients blinks when the cornea is touched.no edema or tearing .auricles is aligned in outer cantus of the eye .

nasal septum intact and in midline.chest symmetry . skin color is same as face.firm NOSE No lesion. Client breaths freely No discharge symmetric and straight .chest wall intact. 5’4’’ 16.coordinated. MEASUREMENTS Weight Height BMI GENDER: MALE FINDINGS 98 lbs..not tender. equal chest symmetry Normal NAME: D AGE:18 YEARS OLD A. smooth movements with no discomfort -masses and nodules are not palpable . no lesion -air moves freely as the client breaths through the nares .no discharge .no discharge or flaring . no masses .moves freely. no tenderness Ability to purse the lips Moves freely no tenderness Normal NECK Movement with no discomfort (-)masses and nodules Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height.smooth with no palpable nodules .uniform color . no tenderness.54 kg/m2 NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese Underweight . no tenderness .ability to purse the lips .Spinal column is straight Left and right shoulder and hips are at the same height Normal MOUTH AND THROAT Lips is pink (-) nodules.spine vertically aligned .pink gums(bluish or dark patches in dark skinned clients) .no tender .

(-) edema (-) swelling Warm to touch (-) nodule Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms. pg.5-370C 60-100 bpm 16-20 cpm Normal Body parts SKIN Actual Findings Dark brown color. VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 110/70 mmHg 36.highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .smooth texture .thick hair . 1175) B. Angle of nails are 160 degrees Presence of dandruff and lice are due to poor hygiene .(Fundamentals of Nursing. parietal and occipital Normal HEAD Rounded skull (-)nodules or masses Symmetric facial in Normal .no infection or infestation Interpretation Normal HAIR NAILS Thick Hair Black in color (+) for dandruff Hair is evenly distributed (+)for lice intact epidermis Clean nails Blanch test capillary refill=2 sec.when pinched skin spring back to previous state . nail beds) in dark skin people -no edema -no nodule .rounded( normocephalic and symmetrical.60C 71 bpm 18 cpm 120/80 mmHg 36. 7th edition. turgor: pinched up skin immediately return within 2-3 sec.prompt return of pink or usual color(generally less than 4 sec) .convex curvature. with frontal. rough and dry skin texture.intact epidermis . angle of nail plate about 160 degree .evenly distributed hair .silky and resilient hair .lips. Barbara Kozier.

absence of nodules and masses .no discharge or flaring .no edema or tearing .symmetric facial movement eyebrow symmetrically aligned.smooth.smooth with no palpable nodules . no tenderness .symmetrically .movement prominence):smooth skull contour . uniform Consistency.ability to purse the lips . smooth movements with no discomfort Normal NOSE No lesion. equal movement .skin intact. indicating that the trigeminal nerve is in intact Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Color is same as facial skin. Client breaths freely No discharge Normal MOUTH AND THROAT Lips is pink (-) nodules. no tenderness Ability to purse the lips Moves freely no tenderness Normal NECK Movement with no discomfort (-)masses and Normal .no discharge . no discoloration .auricles is aligned in outer cantus of the eye . no lesion -air moves freely as the client breaths through the nares . no discharge.moves freely.no tender . auricles is aligned in outer cantus of the eye.coordinated.no discharge .not tender.pink gums(bluish or dark patches in dark skinned clients) .clients blinks when the cornea is touched. no discharged EARS .color is same as facial skin .firm symmetric and straight . skin color is same as face. nasal septum intact and in midline.uniform color .

VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 110/60 mmHg 36.when pinched skin Interpretation Normal .33 GENDER: MALE NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing. Height 135 cm BMI 23.5-370C 60-100 bpm 16-20 cpm Normal B.chest symmetry .nodules -masses and nodules are not palpable . 7th edition. Barbara Kozier.Spinal column is straight Left and right shoulder and hips are at the same height Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height. (-) edema (-) swelling Warm to touch Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms. no tenderness. no masses .chest wall intact. 1175) 120/80 mmHg 36.spine vertically aligned .70C 75 bpm 19 cpm Normal Body parts SKIN Actual Findings Dark brown color. MEASUREMENTS Weight 98 lbs. nail beds) in dark skin people -no edema -no nodule . pg. equal chest symmetry NAME: E AGE: 15 YEARS OLD FINDINGS A.lips. rough and dry skin texture. turgor: pinched up skin immediately return within 2-3 sec.

symmetric facial movement eyebrow symmetrically aligned.skin intact.no edema or tearing .(-) nodule spring back to previous state .smooth texture . parietal and occipital prominence):smooth skull contour .clients blinks when the cornea is touched.convex curvature.smooth. Angle of nails are 160 degrees NAILS .evenly distributed hair .prompt return of pink or usual color(generally less than 4 sec) .no infection or infestation Presence of dandruff is due to poor hygiene HAIR Thick Hair Black in color (+) for dandruff Hair is evenly distributed intact epidermis Dirty nails Blanch test capillary refill=2 sec.thick hair .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks . no discoloration . with frontal. equal movement .rounded( normocephalic and symmetrical. uniform Consistency. no discharge.silky and resilient hair . angle of nail plate about 160 degree . absence of nodules and masses .intact epidermis . indicating that the trigeminal nerve is in intact Dirty nails is due to poor hygiene HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Normal .

coordinated. Client breaths freely No discharge Normal MOUTH AND THROAT Lips is pink (-) nodules. skin color is same as face. no discharged . no tenderness .pink gums(bluish or dark patches in dark skinned clients) . no lesion -air moves freely as the client breaths through the nares .ability to purse the lips .not tender.firm symmetric and straight . smooth movements with no discomfort -masses and nodules are not palpable .symmetrically .no discharge .chest wall intact.chest symmetry .auricles is aligned in outer cantus of the eye . equal chest symmetry Normal NAME: F AGE: 12 YEARS OLD FINDINGS A.color is same as facial skin . no masses .no discharge . Height 129 cm. BMI 11.Spinal column is straight Left and right shoulder and hips are at the same height Normal NOSE No lesion.no discharge or flaring .moves freely.smooth with no palpable nodules .no tender .uniform color . auricles is aligned in outer cantus of the eye. no tenderness Ability to purse the lips Moves freely no tenderness Normal NECK Movement with no discomfort (-)masses and nodules Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height.EARS Color is same as facial skin.25 GENDER: FEMALE NORMAL FINDINGS INTERPRETATION <16 malnutrition Underweight . MEASUREMENTS Weight 18 kg. nasal septum intact and in midline.spine vertically aligned . no tenderness.

smooth texture .evenly distributed hair .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .prompt return of pink or usual color(generally less than 4 sec) Normal Interpretation Normal HAIR NAILS Thin Hair Black in color Hair is evenly distributed (+)for lice intact epidermis Dirty nails (-)Blanch test capillary refill Angle of nails are 160 degrees Presence of lice is due to poor hygiene Dirty nails is due to poor hygiene . angle of nail plate about 160 degree .when pinched skin spring back to previous state . Barbara Kozier.no infection or infestation . VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate Body parts SKIN 34.lips.5-370C 60-100 bpm 16-20 cpm Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms.silky and resilient hair .intact epidermis . (-) edema (-) swelling Warm to touch (-) nodule 36. 1175) B. pg.convex curvature. nail beds) in dark skin people -no edema -no nodule .4 C 80 bpm 17 cpm Actual Findings brown color. pinched up skin immediately return within 2-3 sec. 7th edition.thick hair .16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing.

auricles is aligned in outer cantus of the eye. no tenderness . no discoloration .uniform color . no discharge.not tender.no discharge Normal NOSE No lesion. no lesion -air moves freely as the client breaths through the nares . with frontal. parietal and occipital prominence):smooth skull contour .smooth.HEAD Rounded skull (-)nodules or masses Symmetric facial in movement . uniform Consistency.rounded( normocephalic and symmetrical. skin color is same as face.no edema or tearing .color is same as facial skin .symmetric facial movement eyebrow symmetrically aligned. Client breaths freely (+) discharge Lips is pink (-) nodules.firm symmetric and straight . nasal serum intact and in midline.moves freely. (+) discharged Normal EARS .smooth with no palpable nodules .clients blinks when the cornea is touched. absence of nodules and masses .auricles is aligned in outer cantus of the eye .ability to purse the lips .no discharge .skin intact. no tenderness Ability to purse the lips Moves freely no tenderness incomplete teeth Normal MOUTH AND THROAT Normal . indicating that the trigeminal nerve is in intact Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Color is same as facial skin.no tender .pink gums(bluish or dark patches in dark skinned clients) . equal movement .no discharge or flaring .symmetrically .

equal chest symmetry Normal NAME: G AGE: 10 YEARS OLD FINDINGS A. MEASUREMENTS 16 kg.6 C 80 bpm 18 cpm Normal Body parts SKIN Actual Findings Light brown color. 7th edition. Weight 124 cm Height 10. Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms. turgor: pinched up skin immediately return within 2-3 sec.Spinal column is straight Left and right shoulder and hips are at the same height Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height. Barbara Kozier. rough and dry skin texture.coordinated. no masses . nail beds) in dark skin people Interpretation Normal .5-370C 60-100 bpm 16-20 cpm Malnutrition B.spine vertically aligned .chest symmetry . smooth movements with no discomfort -masses and nodules are not palpable . VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 36. no tenderness.chest wall intact.66 BMI GENDER: FEMALE NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing. pg.NECK Movement with no discomfort (-)masses and nodules . 1175) 120/80 mmHg 36.lips.

thick hair .when pinched skin spring back to previous state .skin intact. equal movement .rounded( normocephalic and symmetrical.no edema or tearing . indicating that the trigeminal nerve is in intact Presence of lice is due to poor hygiene NAILS Dirty nails is due to poor hygiene HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Normal . no discharge.prompt return of pink or usual color(generally less than 4 sec) .smooth.intact epidermis . no discoloration .(-) edema (-) swelling Warm to touch (-) nodule Scars HAIR Thin Hair Black in color Hair is evenly distributed (+)for lice intact epidermis Dirty nails Blanch test capillary refill Angle of nails are 160 degrees -no edema -no nodule . absence of nodules and masses . with frontal. uniform Consistency. angle of nail plate about 160 degree .convex curvature.smooth texture .evenly distributed hair .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .silky and resilient hair .symmetric facial movement eyebrow symmetrically aligned. parietal and occipital prominence):smooth skull contour .no infection or infestation .clients blinks when the cornea is touched.

skin color is same as face. (+) discharged .uniform color .Spinal column is straight Left and right shoulder and hips are at the same height Normal NOSE No lesion. Malnutrition .EARS Color is same as facial skin.no tender . Barbara Kozier. no tenderness.chest symmetry .chest wall intact.coordinated. pg.spine vertically aligned . auricles is aligned in outer cantus of the eye.88 kg/m2 NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing.symmetrically .color is same as facial skin .firm symmetric and straight . 85 cm 13. 7th edition. Client breaths freely (+) discharge Normal NECK Movement with no discomfort (-)masses and nodules Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height. nasal septum intact and in midline.auricles is aligned in outer cantus of the eye .no discharge or flaring . equal chest symmetry Normal NAME: H AGE: 3 YEARS OLD A.not tender. MEASUREMENTS Weight Height BMI GENDER: FEMALE FINDINGS 10 kg. no masses . smooth movements with no discomfort -masses and nodules are not palpable .no discharge . no lesion -air moves freely as the client breaths through the nares .

5-370C 60-100 bpm 16-20 cpm 36.1175) B. rough and dry skin texture.evenly distributed hair . nail beds) in dark skin people -no edema -no nodule .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks . (-) edema (-) swelling Warm to touch (-) nodule Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms.no infection or infestation . turgor: pinched up skin immediately return within 2-3 sec.when pinched skin spring back to previous state . with frontal.prompt return of pink or usual color(generally less than 4 sec) .8 C 74 bpm 16 cpm Normal Body parts SKIN Actual Findings Dark brown color. absence of Interpretation Normal HAIR NAILS Thick Hair Black in color Hair is evenly distributed (+)for lice intact epidermis Dirty nails Blanch test capillary refill=2 sec.lips. parietal and occipital prominence):smooth skull contour .intact epidermis . VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate 120/80 mmHg 36. uniform Consistency.smooth texture .silky and resilient hair . angle of nail plate about 160 degree .smooth. Angle of nails are 160 degrees Presence of lice is due to poor hygiene Dirty nails is due to poor hygiene HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal .thick hair .rounded( normocephalic and symmetrical.convex curvature.

no tender . indicating that the trigeminal nerve is in intact Normal EARS .no discharge . no discoloration . no discharged eyebrow symmetrically aligned. auricles is aligned in outer cantus of the eye. no tenderness .pink gums(bluish or dark patches in dark skinned clients) . no lesion -air moves freely as the client breaths through the nares .chest symmetry .color is same as facial skin .clients blinks when the cornea is touched. smooth movements with no discomfort -masses and nodules are not palpable .not tender.no discharge . nasal septum intact and in midline. no tenderness Ability to purse the lips Moves freely no tenderness Normal NECK Movement with no discomfort (-)masses and nodules Normal CHEST No nodules or masses Normal .spine vertically aligned Normal NOSE No lesion.nodules and masses .symmetric facial movement EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Redness of conjunctiva Color is same as facial skin. skin color is same as face.no edema or tearing . no discharge.firm symmetric and straight . equal movement .skin intact.ability to purse the lips .moves freely.uniform color .coordinated.symmetrically . Client breaths freely No discharge Normal MOUTH AND THROAT Lips is pink (-) nodules.auricles is aligned in outer cantus of the eye .smooth with no palpable nodules .no discharge or flaring .

when pinched skin spring back to previous state .chest wall intact.Spinal column is straight Left and right shoulder and hips are at the same height NAME: I AGE: 1 YEAR OLD A.Spinal column is straight Left and right shoulder and hips are at the same height. 17. VITAL SIGNS Blood pressure Temperature Pulse rate Respiratory Rate Body parts SKIN Actual Findings Light brown color. 1175) 120/80 mmHg 36. pg.5-370C 60-100 bpm 16-20 cpm Underweight B.thick hair Interpretation Normal HAIR Thin Hair Black in color Normal .evenly distributed hair . nail beds) in dark skin people -no edema -no nodule .lips. 63 cm.5 NORMAL FINDINGS INTERPRETATION <16 malnutrition 16-19 underweight 20-25 normal 26-30 overweight 31-40 moderately to severely obese >40 morbidly obese (Fundamentals of Nursing. Barbara Kozier. 7th edition. equal chest symmetry . no masses . MEASUREMENTS Weight Height BMI GENDER: MALE FINDINGS 7 kg. pinched up skin immediately return (-) edema (-) swelling Warm to touch (-) nodule Normal Findings -Generally uniform except in the areas exposed to the sun: areas of lighter pigmentation(palms. no tenderness.

with frontal. auricles is aligned in outer cantus of the eye. equal movement .symmetric facial movement eyebrow symmetrically aligned.intact epidermis .no infection or infestation .color is same as facial skin .clients blinks when the cornea is touched. no discharge.no tender .prompt return of pink or usual color(generally less than 4 sec) .firm Normal HEAD Rounded skull (-)nodules or masses Symmetric facial in movement Normal EYES Eyebrows symmetrically Equal movement (-) edema and teary eyes Pupil is round and equal Blinking is symmetrically Normal EARS Color is same as facial skin. uniform Consistency. parietal and occipital prominence):smooth skull contour .auricles is aligned in outer cantus of the eye . no discharged Normal . indicating that the trigeminal nerve is in intact .skin intact.rounded( normocephalic and symmetrical. absence of nodules and masses .smooth texture . no discoloration .smooth.no edema or tearing .highly vascular and pink in light skinned clients: dark skinned clients may have brown or black pigmentation in longitudinal streaks .convex curvature.no discharge . angle of nail plate about 160 degree .symmetrically .silky and resilient hair .NAILS (-) for dandruff Hair is evenly distributed (-)for lice intact epidermis Clean nails Blanch test capillary refill Angle of nails are 160 degrees .

ipis at daga dito sa bahay.no discharge or flaring . no tenderness. They have their own water supply and electricity. tapos pipinturahan pa namin kapag may sapat na kaming pera para dito. The client verbalized that “Mas nakakamura kasi kami pag uling ang ginagamit kesa sa gas. nasal septum intact and in midline.moves freely. no masses . HOME AND ENVIRONMENT They live on their own house and it is enough for them to live in.uniform color .” They use plastic container for their drinking storage and it is place beside the kitchen.NOSE No lesion. The client verbalized that “Tatapusin nalang namin ang bahay.pink gums(bluish or dark patches in dark skinned clients) .not tender.smooth with no palpable nodules .” “Maraming insekto. . They use charcoal for their cooking. no tenderness Ability to purse the lips Moves freely no tenderness Normal NECK Movement with no discomfort (-)masses and nodules Normal CHEST No nodules or masses Spinal column is straight Left and right shoulder and hips are at the same height. The house is not yet finish and further development like painting is needed.chest wall intact. smooth movements with no discomfort -masses and nodules are not palpable .ability to purse the lips . the garbage collector collects the garbage in their barangay. It is made from wood and cement. skin color is same as face.coordinated.spine vertically aligned . The client verbalized that “ Kumukuha kami ng tubig sa poso sa tabi ng bahay namin para sa pang inom at panligo na rin. no lesion -air moves freely as the client breaths through the nares .” Every Tuesday and Thursday. Client breaths freely No discharge symmetric and straight . equal chest symmetry Normal V. no tenderness . They have no presence of hazard accident in the house. The family has no pet.chest symmetry .’ As verbalized by the client.no discharge . hindi naman kasi naiiwasan yang mga iyan dito sa lugar namen.Spinal column is straight Left and right shoulder and hips are at the same height Normal MOUTH AND THROAT Lips is pink (-) nodules.

Barbara Kozier. “Dito samin magkakasundo naman ang mga tao.Disease Agent-Environment link man by manipulating his environment is able to prevent contracting disease by blocking disease agent from entering his body. ANALYSIS: A few environmental factors that can influence growth and development include living conditions of the child. 6th Edition. 8th edition. In the Man. Potter . social worker. socio-economic status (e. Madali silang lapitan kapag kailangan namin ng tulong”. since the mosquito vector will be prevalent in the area.g. poor versus financial stability). provide developmental support versus exposes the child to hazards). Having no pet helps the family to reduce the risk of infection caused by pets inside or even outside the house.Perry. ANALYSIS: A client environment includes all of the many psychosocial factors that influence or affect the life and survival of the client. private doctors and official are present in their place. Safety in health care setting reduces the incidence of illness and injury.INTERPRETATION: The family was lucky for having a house of their own. But the areas of the house are prone to infection causing agent because pests and breeding sites of vectors are present. This broad definition of environment crosses the continuum of care for setting in which the nurse and client interact. and increases the client’s sense of well-being. If the community fails to clean its environment and the breeding sites for Aedes mosquitoes are found everywhere then the community will have a higher risk for contracting dengue fever. climate and community (e. Marunong naman makisama lahat ng kapitbahay. They have good water supply but drinking there is not a safe action because the water are not ideal for drinking. page 960-961) VII. improves or maintains a client’s functional status. may kakilala din naman kami hindi lang namin alam iyong mga . shortens the length of treatment and hospitalization. AWARENESS OF COMMUNITY ORGANIZATION “May mga alam din akong community organization. tulad nung mga aktibidad sa health center pati yung mga kagawad. INTERPRETATION: They have a good relationship with their neighborhood. page 309) VI. FAMILY ENVIRONMENT The head of the family verbalized that. (Fundamentals of Nursing. The health center. Volume 2. (Fundamentals of Nursing. They have garbage collecting unit assigned to their area that’s why there is a proper garbage disposal.g. Ginagawa naman ng mga namumuno dito mga tungkulin nila. They don’t have to pay any rental fees.

indentifying problem areas. diagnosing causes and formulating solution. Minsan nakikita namin pag may mga programa sila tulad ng libreng pagkain at tuli”. It is concerned with programs aimed at social changed with primary reference to environmental conditions and social institution. as verbalized by A. They believe that it is not that important and will not help in their daily living.pangalan nila. group or organization to engage to plan collected action in order to deal with social problems within a democratic system of values. and developing the strategies and mobilizing the resources to effect action. INTERPRETATION: The family is aware of the community organizations within the area but their participation is not active. (Community Health Nursing in the Philippines. the process of working with an action system. Elisa V. Community organization refers to various methods of interventions whereby a professional change agent helps as community system composed of individuals. It involves to major and interrelated concern. Dizon) . which includes planning and organizing. ANALYSIS: It is important to be aware of community organization because it can help improve the lifestyle and socialization among family member and the community.

Nature of the problem COMPUTATION 2/3 x 1 ACTUAL SCORE 2/3 JUSTIFICATION The problem is health threat since walking barefooted can make the children acquire infection. But the problem is they are not wearing especially the children when going outside the house.PRIORITIZATION: A. They can avoid it if they can teach proper grooming. . Nature of the problem COMPUTATION 2/3 x1 ACTUAL SCORE 2/3 JUSTIFICATION It is a health threat since not all medicines over the counter drug have the same effect to every individual. Modifiability of the problem 2/2 x 2 2 3. they can prevent walking barefooted if the effect of doing so can be well explain to them. WALKING BAREFOOTED CRITERIA 1. Preventive potential 3/3 x 1 1 4. The family does not recognize the existence of the problem. 2. SELF MEDICATION CRITERIA 1. The problem is easily modifiable since the family has their footwear already. the nurse can encourage the family to use footwear and discuss the effect of not using it. Since the family has their footwear already. Salience of the problem 0/2 x 1 0 TOTAL 3 2/3 B.

The problem is partially modifiable because the family does not have the resources and budget to renovate or fix thee are to prevent vectors from multiplying. Preventive potential 2/3 x 1 2/3 . It is moderately preventive since it is not in the nature of the family to visit the health center for consultation. TOTAL 3 5/6 C. Salience of the problem ½ x1 ½ It is easily modifiable since the resources and facilities are available in the community like health center for the consultation of the family illnesses. Preventive potential 2/3 x 1 2/3 4. They consider it as a problem but not needing immediate attention because the medication they are using don’t cause allergic reaction to the family. Modifiability of the problem 2/2 x2 2 3. They rather self medicate that to spend time going in health center. It has a moderately preventive potential because it is time consuming in eliminating the pesting site of vectors 2. PRESCENCE OF BREEDING OR PESTING SITE OF VECTORS OF DISEASES CRITERIA 1. Nature of the problem COMPUTATION 2/3 x 1 ACTUAL SCORE 2/3 JUSTIFICATION It is a health threat because it can spread infection and can cause diseases. Modifiability of the problem ½ x2 1 3.2.

2. Salience of the problem 2/2 x 1 1 TOTAL 3 .4. Preventive potential 1/3 x 1 1/3 4. Modifiability of the problem ½x2 1 3. Salience of the problem 2/2 x 1 1 and family resources are unavailable. meaning he cannot supply the needed nutrient to prevent malnutrition in the family. It is a problem that needs immediate attention since inadequate food intake can lead to malnutrition. The problem is low in preventive potential because of the nature of work by the head of the family which is unstable. Nature of the problem COMPUTATION 2/3 x 1 ACTUAL SCORE 2/3 JUSTIFICATION The problem is a health threat since the family cannot provide properly for the family. The problem is partially modifiable because the family does not have enough money to sustain the desirable food requirement for all the remaining members of the family. TOTAL 3 1/3 D. INADEQUATE FOOD INTAKE BOTH IN QUALITY AND QUANTITY CRITERIA 1. The family recognized it as a problem needing immediate attention to prevent avoid illness and disease caused by these vectors.

. . .E. . . . . . . . . . . 3 2/3 SELF MEDICATION . . . . The problem is highly preventive since it is by choice of the head of the family. . . . . . . . . . . . . . . . 3 1/3 INADEQUATE FOOD INTAKE BOTH IN QUALITY AND QUANTITY . . Modifiability of the problem 3/3/ x 1 1 3. . . . . . . . . . . . . . . He will not easily prevent from doing it and will take quite sometimes to totally quit it. . . . . The problem is partially modifiable since the head of the family was smoking for quite years now and it had become his habit and stress management action. . . . . . . . . . 2 2/3 . . . . . . . . . . . . . . Salience of the problem TOTAL 0/2 x 1 0 2 2/3 WALKING BAREFOOTED . . . . . . . . . . . . . Preventive potential ½x1 1 4. . . . who was smoking if he will stop it when the after problem will explained and the effects are to be known. . . . . . . . 2. . . . . . . . . . . . . . . CIGARETTE OR TOBACCO SMOKING CRITERIA 1. . . . . . . . 3 CIGARETTE OR TOBACCO SMOKING . . . . . . Nature of the problem COMPUTATION 2/3 x 1 ACTUAL SCORE 2/3 JUSTIFICATION The problem is a health threat because it may result to disease caused by the chemicals acquired while smoking. . . . . . . . . . . . . . . . . . . . 3 5/6 PRESCENCE OF BREEDING OR PESTING SITE OF VECTORS OF DISEASES . The family does not perceived it as a problem at all.

020398934 /8..079.3/58.0704-080  247-/4-080 :3/.70 3495.3/7984:/07 .3/34/:08.089.39.9908.421479 2.3:97943  :3/0709  3472.2039.70..934 903/073088342.9094 80.20 09      #$   $&#%$ $ 09   09 .20 09 06:.3/ 34/:08 $% 434/:0847 2.421479 2.8808 $53.7.30/ .9 019. 24.2    #  #$   2.90/ 82449 472.8808.0709   24/07..9908.3/58 .-0  .841 :78390/943 .4:238897.089822097 472.70. 4..3/79 84:/07.   4.9 019.4:238 897.02039934 /8.7-.447/3.089 822097  ..8808 $53.5.8808.. 8530.4075      .

9:70 !:807.0/:583 220/.  472.28 58  3.9:. .3:97943  '%$$ 44/57088:70 %02507.3/38 9-743.-0/8 3/.805480/94 908:3.3/38 0307.70.447  74:.943 5.52    472.3//783 909:70 9:747 53.52 %#!#%%    .  .:314720. 22       -52   .059 390.798 $      -52 .783 50450 39075709.90709:73 93 80.90   4/5.943  472.90 #0857.841907 52039.947#.70.

7 701 30413..7 008 !:5874:3/.1.:7.8808 $22097.73 .:..729494:.02039 8339.24..0 824498: .05.8970.3/708039..447..3/ 06:.8808 822097..780.8.88/:094 5447030 472.03/897-:90/.59. ..43:3.709. 803 . 24.447 ..041. 6:.990 97023. #0/308841 .088 9.94570.4:8 89.. 5.. 52039.9.0398 /.30 413.78 # %3.4730.. .4790..   74:3/0/ 34724.70 34/8.4394:7 82449 :31472 4388903.-803.9434731089.0-74347-..380.3.041 34/:08...08 /:0945447030 793.0/  3/.943  . 9 17439.905/0728 574259709:73415347 :8:.3/90.  340/02.905/0728 793. ..3 24.307..939. 0/02.5.3/ 4.03982.083 39.24.9  !70803.02039 0/02.8 39.7. 472..447 0307.9:70.934/8...3/53 398330/. 338 822097.43.78330/.02039  00-74822097.8 . 34/:0 $.894:.-4:9  /0700 82449909:70 ..0398-380390 ..90  0.0. .7 34310..7 .5.9089..02039  $ 0-748 822097..7 8.03 /897-:90/ 147...90.9433 439:/3.8. 3434/:0 0353.70  /07008 $  #4:3/0/8: 34/:0847 2.3..3/822097.1.0 39.3/2.0/83 8573-.. 5742303.7 9.943 340/02.30/06:..

 472.39:8419000 34/8.-0  .4:238897..8808 $53..3/79 84:/07.3/58 .73 :31472. 472.8.70.934 903/073088342.3/34/:08.30/34:907 .708  . 83 .3/897.:7.2   .081700.8808.8059:239...81.9 019..9 34/8.447/3.20 09 06:....39..0  3.088.3/32/30  039-70..447 88.81..8808 $53.981700 /8.089.3/58. 472.3/7984:/07 .9908.02039934 /8.70  4.70471.089 822097  .90/ 82449 24.70..20..447 349903/07340843 .70 822097.8 1..20 09  472..8808.#$ 44788.30/ ..   #$   $&#%$ $ 09    09 .70/   $ 40843 83.039-70. 34903/07 172  822097.30/3 4:907.20.079.70 3495.089822097 8530.421479 2.9908.44788.39:8419000  /8.4:238 897.724..83 .020398934 /8..9 019.9 ..08 8.421479 2.3/ 34/:08  $% 434/:0847 2.890 ..98974:90 3.:7.20.5.

7.2039.3:97943 .0704-080  247-/4-080 :3/.3:97943  :3/0709  3472.4075  .0709   24/07.7-.841 :78390/943 .2 #  #$ %#!#%%      2.   4.9094 80.

947#. '%$$ 44/57088:70 %02507.9:70 !:807.90   4/5.90 #0857.798 $     -52 .52     .

 3434/:0 0353.:. 5742303.3/38 ...:314720.94570.30 413..  30413. 9 17439..0-74347-.709.3//783 909:70 9:747 53.05.70  /07008 !70803.:7..90  0.03982.-803.90. .3/53 398330/.3..7 8.041 39075709.0/:583 220/.905/0728 793.447 .7-743.8.7 .4:8 89.905/0728 574259709:73415347 :8:. 22       -52   .9:70.0.9433 439:/3.90709:73 93 80.7 70180..805480/94 908:3.-4:9  /0700 82449909:70 .28 58  3.5.780..380.943 5.-0/8 3/..8.7 34310.0 824498: .3..041. .70.059 390.02039  472.3 24.9434731089.943  .3/708039. .  0/02.8970..08 /:0945447030 793.3/ 4.783 50450 340/02.8 .0398 /.0/83 8573-.03/897-:90/.7 9.9089. 52039... 803 .88/:094 5447030  #4:3/0/8: 34/:0847 2.1.70..43.447 0307.0 39..729494:.8 39.  . 5.8808 $22097.3/822097.4394:7 82449 :31472 4388903..59.5.52    472. # $ %.841907 52039..   74:3/0/ 34724.7.03 /897-:90/ 147.9:.088 9...447  74:.78330/.3/38 0307.943  472. 34/:0 472.

.20. #0/308841 .  $ 40843 83.447/3.20.943 340/02.4730.421479 2.78330/ .98974:90 3.30/ 472.30/06:.-0  .894:..447 349903/07340843 ...-0 34/:08 .39:8419000 34/8.1.3/90.8.8808.447 88. .0398  24. 338 822097.$ #$ 0-748 822097.5. 6:.24.0  3.43:3.  &% %# % 472..3/ 34/:08 472.. 83 ..0/  3/.934/8.08 8....981700 4/8.9..02039  00-74822097..70/  34/:08. 34903/07 172  822097.3/32/30  039-70.990 97023.083/.939.8059:239.9  .73 .  472..447.3/ 06:.. $% 434/:0847 2.90/ 82449 24.079.9.  44788.0398-380390 ..890 ..7 5...39:8419000  34/8.3/2.70 3495..83 .421479 2.:7.9 34/8.02039 0/02.30/34:907 .708  53:28 -:847/.039-70.73 :31472.3/897.70 822097.02039 8339. 472.9 .4790.088...:7.7 008 !:5874:3/.08170034 903/073088 824499345.083 39..44788.24.81..3/34/:08.70 ...8808 472.8808.20.70  58853 34/:08 34 903/073088 -9945:78090 58 4.081700 34903/073088  4.307.020398934 /8.70471.81. 24.8 1. .70 34/8..724.5.8808 822097..081700.02039934 /8..089822097 8530.-9945:7809058 34/8.30/3 4:907.

089 822097     #   $&#%$ $ 09   09 .3:97943  :3/0709  3472.089.934 903/073088342.70.8808 $53.9908.20 09 06:.4075      .7.2039..841 :78390/943 .$53.9094 80.20 09  #  #$   2.3/79 84:/07..4:238897.3/7984:/07 .4:238 897...0709   24/07.2     .0704-080  247-/4-080 :3/.3/58.70.39.   4.3/58 .9 019.9 019.7-.9908.

947#.943 5.70.9:.7 9.841907 52039.0/83 8573-. 803 .:314720.7 39075709.70.9:70 !:807.447  53. 22       -52   .4:8 89. 3434/:0 0353.90709:73 0/02.059 390..447 472.94570.729494:.3.03/897-:90/.3/38 9-743.943  472..7 . # %3..805480/94 908:3.52 %#!#%%    &3/0709  '%$$ 44/57088:70 %02507. .90 #0857.28 58  3.798 $           .3/38 0307.90   4/5.-0/8 3/.90  0. 34/:0 472.783 50450 340/02.0/:583 220/.

7 701 30413.0398 /.8808 822097.905/0728 574259709:73415347 :8:.4790.0..8..307. .08 8.934/8. 5742303.083 39.9433 439:/3.0-74347-.8808 $22097.39:8419000 34/8.02039  472.380.8 .9:70.3/822097. .088 9.:7.30/34:907 ... 52039.709..447.041 34/:08.:7.4394:7 82449 :31472 4388903.02039  00-74822097...447 0307.0 39..02039 8339. 34903/07 172 472...30/06:.939.3/53 398330/.03982.8.3/90.3 24..   74:3/0/ 34724.30/3 4:907...-4:9  /0700 82449909:70 .9089..70/  472..088.:7...05.5.44788..7 008 !:5874:3/..1..59.943  .8970. .894:..7.9  .5.3/ 06:.3/ 4..:.8 1. 5.905/0728 0.03 /897-:90/ 147.8 39..943 340/02.3/7:11 .70 822097.73 .78330/..  #4:3/0/8: 34/:0847 2.02039 0/02. 338 822097.39:8419000  34/8. #$ 44788.-803..$ 147/..0 824498: ..70 34/8.1.24..780. ..81.3/708039.20. 83 .24.90...83 . 24.3..990 97023.33. $ 0-748 822097.0/  3/.7 34310. 9 17439. 472.43.30 413. 6:.3/2..20.0398-380390 .4730..70  /07008 8.9434731089.

5.7 5.90/ 82449 24.724.8808.439.07-..../0174244/ .7/ .8.045203905.. 2.83..23.039-70.-..8059:239.443 %0...33.2.-0 34/:08 .043907434:80..421479 2.2.70  .07-. 472.3/34/:08.07-.239:-8. 3/3..97.147907.421479 2.30/ .934 903/073088342.3/32/30  039-70..7-.39.343.8..3/1:7907/0.8..079.7.70 3495.:3..8.447/3.40.89.9890.3938300/0/ %0 .3-.981700 4/8.03907-.73 %0:805..039.7-..7.95.2908.8   ..-3-.447 349903/07340843 .5:833..9 %.2338094 58.02039934 /8.3/79 84:/07.9/.5.3/897./94 .0/9.708  53:28 -:847/.70471.3.02039 %04:80834909138./0393904:80 %01.0/9..9 .-0  .0  3..3/98034:14790294.9.35.090743..8808.-9945:7809058 34/8.041. 472.089 822097 822097.73.307147907/7338947.0.81.9078:55.3.5.039.5.07%:08/.78330/ .089822097 8530..70.3.4..8808 $53.3/%:78/.235. %0.20.73 :31472.20 09  472.9 :2::.. $ 40843 83.23.8.33.0/9.03 %0:80.7.:.0398  24.23507.3/948.    '  '# %   %0.3/985.0 -08/0909...5. 9.9 .9908..890 ..3.834509  .8 3. .25.9.9 019.3/7984:/07 .8808 $53.3.034570803.3/58 ..3/ 34/:08 $% 434/:0847 2.039 %0.020398934 /8.203 8. 90..20 09 06:.081700.0.9 019.081700 34903/073088   &% %# %  4.9.40.3/58.947 .0/-90. 472./948.54848.2:7.7.08170034 903/073088 824499345.4:238897.4:238 897.70.7.5485539:7.9 34/8.03 982.9908.3/00.8.93..3 342.9 %0 .5.039..447 88.98974:90 3.089..07-...32.70  58853 34/:08 34 903/073088 -9945:78090 58 4.3/.083/.

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

:809.33..8 74:54747.5747.8.77010703.2.07-.3/ 84.574108843.7041.2.33 3/03913574-02.40.43...3483 ..3/84.3/47.9983499.9:..3/24-3907084:7.3 .3899:943 93.2431.943....3..47.0894 0110.9.3/90..8/.30/9572.039058.3..30.39.43/9438.943  422:390.79.7432039.4..045390897.3/349053907/.039438070-. 38..9439403.943347/0794/0..94389390.8.2.425480/413/.422:39 422:3947.3   $$   9825479.943-0.3.33.28.235.5.3052574.0730/ 95747./024.3./:.3.9008.90/.-:99075.8890241.088414739.5.3.704190....3.:08 98.3994-0.9.:/085.3.70.984..090 10890.0945.574-02893.7.70.28.:808.422:3988902.0 %0-00.9 9: ...07390574.984.9.3.9:783390!553088.2202-07.333.943 8349.9.925479.90/ .3//0..8 .74:82094/8413907.' 43                                .09403..422:3947.3/1472:.0/-      %#!#%%    %01.20/../3-7035.422:3947.09..9384:943.943 70107894.08942.3/390770.43.94388902 .

!# #%%     #  #%#  .9:704190 574-02 %  !&%%  .

 %&$ # .

039 ../ :9 90574-02890 . 57450774423  %01.-083.2.3 -./  90..2.090 1.390.394 902 %0.703490.3-..0901. &$%%  %0574-0280.04190 574-02    4/1.090 1.6:70 310.8907 14490..943  %0574-0280.3-0005.7014490/.-941 90574-02 .7 .7..3.303.9 41349:839  $3.73 0850..70./703.:88900110.2/408349 70./703 03434:98/0 904:80 903:780 .294:8014490.0 90...32.4/ 9190.70.7.7014490/1 900110.983.0.4:7..8 24/1.3570.941/4384 .9 970.90.3//8.8 90714490.43090 08903..

0 549039. .039.   !70.

03.04190 574-02 .   $.

9:704190 .  % %     $%   #%#  !&%%   .

 574-02 .

 %&$ # .

07 3/.200110.9 83./:.0349.0. &$%%  98.090 8..3084.0790 .9970. 20/.4:3907/7:.  .9940.

 4/1.-941 90574-02 .

 .   !70.0 549039.039.

 .

  $.03.04190 574-02   % % .

     !#$ # #!$%$% '% #$ $$$  #%#  !&%%  %&$ # &$%%   .9:704190 .

 .

0..0.79.2 /408349.:80901.808   4/1.090 7084:7.38570.:809.9478 17422:953   !70..943.:80/80...3 .9 574-02 -0.24/1.-0 -0.9970./ 310...039. 98.08.039.7094570.3/-:/09 947034..0 .90471900 .3/.-941   %0574-028 90574-02 5.

 .

098 3493903.908. 570.438/079.8990 0. 574-02-:9349 300/3220/.2308808  9824/07.8.:8090 20/.0549039.-0390 .9948503/920 4330.422:3900. -0.039.438:9.90 549039.0390714790 .3/1.9439490 1.90780120/.438:233 023.90 570.824/1.70..9903943-0.0...:8098920 ..94390.03907  %0.294.8.70 ..039.9434190 1.90 9.9 . 9.9:7041 901.-0 83..90 .9.03907147 .07..9478 980.24/07.943 %0 7.08 ..9390 5089389041..2   .0907084:7.70 :83/43 9.438:9..9.083.:80 .

03.04190 574-02 . $.

9:704190 574-02 .  % %     "&%  #%#  .

3/ /80.574-02 300/3220/.8.990394394570.9478   % %"&%"&%%  !&%%  .4/3088.-0  %01.80.3/1.27084:7.0.....08 .430/ 9.:80/- 9080.90 .039 ..270. .70:3.

 %&$ # .

 0.-0144/ 706:702039147./94 2..24/1.:80901.0392.2  %0574-028 5.039.3:97943    4/1.090 1.-0 -0./41 901.2 /408349.79.90 702.0549039.30.9 300/8220/.2.990394383..90 .../0 574507147901. -0.574-029.0 3.0. &$%%  %0574-028.3349574.0 549039.-941 90574-02    !70.3:979433 901.2  %0574-02843 570.33202-078 41901./06:.2.. .0034: 2430948:89.90144/ 39.:8041903.-0 20.983.330 .390 /087.039..9970.2  98.8 :389.9:70 4147-900.33498:5590 300/0/3:9703994 570.

 .

04190 574-02 .  $.03.

  % %      .

 #%% #%  $   #%#  !&%%   .9:704190 .

 574-02 %&$ # .

-941 90574-02 .  4/1.

.

039.0 549039.04190 574-02 .03.    $.   !70.

  % % .

    # %                                            .

  $%                                                   .

  !#$ # #!$%$% '% #$ $$$  .

  "&% % %"&%"&%%               #%% #%  $                                    .

0900..0391742/439 .708:994 /80.-9.79.0/9.9-0.943  03490.3/9. 574-02.3/9. 0.6:70/0 8243  %0574-028 570.-0 83.3/900110.1907 574-0205.8 .3/897088 2.06:90 8420920894949.0.039.   ./4190 1.7834 .:80/- 90.041900.2/408349 507.2 4..098 -.98.083./-0.7094 -0343  %0574-028 5.2..9.02.4.8 570./ 41901.8.80.  &$%%  %0574-028.8 8243108945 90390.9970.3.4208 .:80 92.. 6:99  %01.88243 1476:900.30/ ..24/1.02039.

Sign up to vote on this title
UsefulNot useful