DR. YANGA’S COLLEGES INC.

(Formerly Dr. Yanga’s Francisco Balagtas College)

Wakas, Bocaue, Bulacan

COLLEGE OF HEALTH SCIENCES

NURSING ┃MIDWIFERY ┃CAREGIVING NC II

BS Nursing Program

In Partial Fulfillment
Of the Requirement in
MCN 109 RLE

“Case Study”

Submitted by:
Pineda, kyla jane R.

BSN II-B

Submitted to:
Mrs. Pio, Gerlita

May 2023
 I. INTRODUCTION

Anemia is a condition in which blood has a lower-than-normal amount of red blood

cells or hemoglobin. Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or
hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in
pregnancy world-wide, conferring several health risks to mother and child. While anemia in
pregnancy may be pathologic, in normal pregnancies, the increase in RBC mass is smaller than
the increase in plasma volume, leading to a mild decrease in hemoglobin concentration referred
to as physiologic (or dilutional) anemia.

There are several kinds of anemia that pregnant woman can get during pregnancy these
are the cause or types that may pregnant woman have anemia, first is Anemia in pregnancy
During pregnancy, the volume of blood increases. This means more iron and vitamins are needed
to make more red blood cells. If you don't have enough iron, it can cause anemia. It's not
considered abnormal unless your red blood cell count falls too low. Iron- deficiency Women who
don't have enough iron stores can get iron-deficiency anemia. This is the most common type of
anemia in pregnancy. Good nutrition before getting pregnant is important to help build up these
stores. Vitamin B-12 deficiency Women who don't eat any foods that come from animals
(vegans) are most likely to get vitamin B-12 deficiency. Strict vegans often need to get vitamin
B-12 shots during pregnancy. And lastly Folate deficiency Folate (folic acid) is a B vitamin that
works with iron to help with cell growth. If you don't get enough folate during pregnancy, you
could get iron deficiency. Folic acid helps cut the risk of having a baby with certain birth defects
of the brain and spinal cord if it's taken before getting pregnant and in early pregnancy. The signs
and symptoms of anemia is having pale skin, lips, palms of hand or underside of the eyelids,
feeling of tired, weakness or fatigue, sensation of spinning (vertigo) or dizziness, and shortness
of breath and irregular heartbeats. Women who more likely to get anemia during pregnancy if
they Have two closely spaced pregnancies. Are pregnant with more than one baby, vomiting
frequently due to morning sickness, don't consume enough iron-rich foods, have a heavy pre-
pregnancy menstrual flow, Have a history of anemia before your pregnancy. And through Blood
test called CBC or Completed blood count that can diagnose anemia, this blood test is often
done at one of your first prenatal appointments. This used to analyze How many red blood cells
you have, their size and shape (which can indicate certain conditions like sickle cell anemia)
How much iron your body has stored. And if you are low in vitamins B12 and B9. For the
management in anemia, for medical is giving Nutritional supplements. Use of nutritional
supplements should be appropriately taught to the patient and the family because too much
intake cannot improve anemia. Blood transfusion. Patients with acute blood loss or severe
hemolysis may have decreased tissue perfusion from decreased blood volume or reduced
circulating erythrocytes, so transfusion of blood would be necessary. And Intravenous.
Intravenous fluids replace the lost volumes of blood or electrolytes to restore them to normal
levels. And for the nursing managements do the assessment taking the patient history and having
physical exam and some medical history then nutritional assessment.
 References:
Uscher, J. (2012, January 9). Anemia in Pregnancy. WebMD.
https://www.webmd.com/baby/guide/anemia-in-pregnancy

James, A. H. (2021). Iron Deficiency Anemia in Pregnancy. Obstetrics & Gynecology, 138(4),
663–674. https://doi.org/10.1097/aog.0000000000004559

Cafasso, J. (2022, March 10). Folate deficiency. Healthline. Retrieved April 26, 2023, from
https://www.healthline.com/health/folate-deficiency.

Mayo Foundation for Medical Education and Research. (2022, January 18). Vitamin deficiency
anemia. Mayo Clinic. Retrieved April 26, 2023, from
https://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/symptoms-
causes/syc-20355025
 II. OBJECTIVES
a. General Objectives

This case study aims to successfully apply the nursing process in conjunction with the
essential skills, knowledge, and attitude to construct optimal treatment for the patient with
anemia to achieve optimum health. Its purpose
 After 1 day of home visit, the family shall be able to:

 Maximize the use of resources as needed.

 Become self-reliant especially when it comes to health matters.
 Identify health problems that can be a threat in attaining optimum health.
 Apply some of the health teaching that the student nurse had imparted.

A. Entry, Climate of Acceptance, First Few Words,

Number of Home Visit
The student nurses were assigned to Taal, Bocaue Bulacan on November 23,
2022, Wednesday. They were supervised by Mrs. Gerlita J. Pio, their clinical instructor, and
Rural Health Workers from Barangay Taal, Bocaue Bulacan. Prior to conducting interviews,
their clinical instructor gives instructions and guidelines. Furthermore, the student nurses will
unite and be prepared to ensure that the evaluation and interview with the families are efficient
and easy to understand.

The student nurses were able to interview and identify families with current health issues or
threats, as well as families that needed help and health education, with the help of their clinical
instructor and the rural health worker.

First Home Visit (November 23, 2022)

It was a sunny morning when the student nurse made her first visit. Ms. Orange
approaches the student nurse politely and welcomes her to take a seat. After the student nurse
introduces herself and explains the reason for her visit, Ms. Orange gives her permission to
conduct an interview. Before the interview starts, the student nurse and Ms. Orange have a brief
conversation to establish rapport, get to know the client, and become more comfortable with the
student nurse.

The student nurse was only able to meet Ms. Orange since her partner left for work and
isn't at home. Ms. Orange is only at their house most of the time because she is eight months
pregnant. So, the only one who was interviewed and assessed by the student nurse was Ms.
Orange.

Furthermore, the student nurse was able to establish a rapport with Ms. Orange and speak
with her about their socioeconomic status, nutritional and fluid status, and APGAR assessment to
determine the current state of their family relationship. The student nurse was able to learn a few
things and even developed lighthearted conversation with Ms. Orange. The vital signs of the
current member were also assessed and documented. After a few hours, the student nurse said
goodbye to Ms. Orange and advised to get an ultrasound to check on the condition of her child.
 III. FAMILY CONSTELLATION

Name Age Ordinal Sex Educational Present

position Status Health
Status
Ms. Orange 38 Wife Female Elementary Ms. Orange
is eight
months
pregnant, 148
cm tall, and
weighs 53.1
kg. She
frequently
feels pain in
her back and
her abdomen.
She also has
edema in her
lower
extremities.

The
following
are her vital
signs:

T: 36.6
BP: 110/80
PR: 70 bpm
RR: 18 bpm
OXY SAT:
98
Mr. EU 40 Husband Male Elementary Mr. Banana
was not
assessed by
the student
nurse because
he is working
the whole
day.
 IV. HEALTH ASSESSMENT (IPPA-CEPHALOCAUDAL)

a. Physical Assessment of Each Family Member

Client: Ms. Orange

Parts of the body Technique Normal Actual Findings REMARKS
(system) (IPPA) Findings
SKIN Inspection, Warm, Smooth, The patient’s The patient’s
Palpation No abnormal skin is warm, skin is not dry.
pigmentation, No presence of
Lesions, lesions, rashes
Bruises, and bruises.
Scratches, Cuts, Insect bites,
Insect bites, scars, and
Wounds stretchmarks are
noted.
HEAD Inspection, Normocephalic The shape of the The head does
Palpation in shape, No head is not show any
masses and no normocephalic, dandruffs and
involuntary No tenderness lice. There is no
movement during palpation unusual size and
of the skull. contour of the
head.
FACE Inspection, Face is Face is The patient’s
Palpation symmetric symmetrical, No facial expression
without facial signs of is appropriate.
drooping. abnormal skin
color such as
cyanosis, pallor,
jaundice, and
erythema.
EYES AND Inspection Sclera is in Black iris, No No presence of
VISION white color, signs of styes or ptosis.
Presence of red abnormalities in
reflex, Lens are the eye
free of opacity structure. There
and clouding is presence of
red reflex, no
signs of cataract.
With normal
vision. Pupils
 are equally
round.
EARS AND Inspection, Should be Normal size, No The patient is
HEARING Palpation smooth, pinkish, signs of able to hear
and shiny drainage and properly on both
redness. ears.
NOSE Inspection No swelling, No signs of There is no
Symmetric, and tenderness, the inflammation or
No excessive shape and skin excessive
drainage color is normal. drainage.
The patient is
able to breathe
using her nostril
for both sides.
MOUTH Inspection Not dehydrated, No signs of No presence of
Tongue should dehydration, the dry lips.
feel soft with oral structures
positive muscle are in good
tone and condition. No
nontender signs of
tenderness in
patient’s tongue.
NECK Inspection, Neck ROM No signs of The patient
Palpation should be enlarged lymph performs neck
smooth and nodes, no ROM smoothly
controlled tenderness and controlled.
during
palpation, and
the patient is
able to move the
neck, chin, and
tilt her head
back as far as
possible.
CHEST Inspection, Side to side No presence of No tenderness
Palpation, symmetric chest barrel chest, or any
Auscultation shape, No Normal breath abnormalities.
masses and sound
tenderness
ABDOMEN Inspection, Abdomen is No presence of Pain in abdomen
Palpation, soft, symmetric, lesions or scars. is also noted due
Auscultation and nontender Stretchmarks are to her
without noted. No pregnancy.
distention. No abnormal
visible lesions or pulsations.
scars, Without
 bruit or visible
pulsation
PERIPHERAL Inspection, Normal Range Patient have full Edema and
VASCULAR Palpation of Motion, range of motion varicosities are
Equal length of in both upper noted and there
UPPER AND both feet, No and lower are no any
LOWER deformity, extremities, abnormalities
EXTREMETIES Presence of Edema is are present.
varicose. present with 3-
4mm
depression.
Varicose are
present on both
legs.

b. FANCAP assessment of each member

Client: Ms. Orange

CRITERIA ASSESSMENT REMARKS
FLUID She drinks 6 to 8 cups of water She usually drinks
each day since she always feels plenty of water every
thirsty but doesn't show any day.
signs of dehydration. She
doesn't drink tea or coffee, but
every night she drinks milk.
The skin tone wasn't pale, and
the temperature was normal.
AERATION She experiences difficulty in Their house has a good
breathing when she lies flat on ventilation.
bed. Has a respiratory rate of
18 beat per minute and heart
rate is 70 beat per minute.
NUTRITION She has a diet restriction She is eating foods that
because she’s about to give are good and healthy
birth, but she preferred to eat for her and her baby.
fish and vegetables and wasn't
picky about what she ate. There
is no sign of malnourishment.
COMMUNICATION She was responsive, talkative, She is easy to talk to
and cooperative during the and willing to
procedure of the assessment. cooperate in any
She understands well and assessments.
speaks with no difficulty.
ACTIVITIES OF DAILY LIFE Ms. Orange is a housewife and Since she is always at
 often has nothing to do, she
often just sleeps and sometimes
comes to her neighbor to watch
TV. Sometimes she does the
laundry and dishes. She usually
sleeps around 11:00pm and
wakes up at 5:00am. Her hours
of sleep are usually 6 hours a
day.
PAIN She experiences minimal
contractions and lower back
pain due to her pregnancy, but
there are no other signs of
possible pain.
their house,
she lacks the daily
activities she should be
doing such as,
exercising.
Pain in abdomen is
noted but other than
that there is no any
other pain are reported.

Other members of the family were not assessed because they are not present in the household
during the visit.
V. SOCIO-ECONOMIC, CULTURAL, AND ENVIRONMENTAL ASSESSMENT

A. Type of the Family

The family fruit is considered to be a type of cohabiting family. They lived
together as an unmarried couple.

B. Dominant Family Member/s In Terms of Decision-Making Especially to

Health Care
When it comes to expenses and budgeting for their daily foods, Mr.
Banana makes decisions for their family. But Ms. Orange makes decisions
regarding their health because her partner is often at work.

C. Source of Income and Expenditures

The family fruit main source of income is from Mr. Banana earns from
being a tricycle driver and part time as a construction worker. Ms. Orange is a
housewife since she is pregnant and about to give birth. According to Ms. Orange,
Mr. Banana’s income is not enough because his income varies on how many
passengers he will have on a day. Mr. Banana earns 200 to 300 pesos a day
according to Ms. Orange. Their food budget is 200 a day and the other income of
Mr. Banana goes to their electricity and water bills, and for Ms. Orange’s check-
ups.

The total monthly income of Mr. Banana is around 6,000 to 9,000

depending on how many passengers he will have and whether a construction
project is ongoing that will call him. With these, family fruit is considered as
poor. Ms. Orange also verbalized that in case of emergency they borrow money
from their friends and neighbors.
D. Working Hours
According to Ms. Orange the work hours of Mr. Banana is from 5:00 am
to 8:00 pm.

E. Ethnic Background and Religious Affiliation

Mr. Banana resides in Taal Bocaue Bulacan for 19 years while Ms.
Orange move last December 2021. They are both Roman Catholic but they rarely
go to church.

F. Significant Other’s Roles in the Family Life

The most significant people that is involved in their lives are their friends
and neighbors because when they are in need anyone of them will help them since
their other relatives are far away from them.

G. Health Habits/Beliefs
The family fruit go immediately to the hospital or clinic to see the doctor;
they no longer visit manghihilots or mananawas because they feel more secure
and able to put their trust in the doctor when it comes to health-related issues.

H. Family’s Involvement in Community Activities

The family fruit takes part in community events like fiestas and other
activities that are offered by their community.

I. Family’s Utilization of Community Resources

The family fruit enjoy the facilities that available in their community like
barangay health center and clinic wherein they can take each other when they are
sick.

J. Housing Condition
The fruit family does not own the house and they just live there for free
which means that their house is shared. It is composed of mixed material which is
wood and hollow blocks. The ground floor is made of hollow blocks and the 2nd
floor is made of woods.

The surroundings had pieces of wood, clothes, and bottles. The family
does not have door. Also, there’s a presence of broken and unequal stairs tread.
There was a presence of poor lighting condition. Further, the student nurse
observed presence of vector disease such as rodents, cockroaches, mosquitoes and
flies.

ADEQUACY OF LIVING SPACE:

Formula:
TFA (in sqm) = Length of the House x Width of the House
TSR = Number of Household Members x Corresponding Space Required for that
Member
 Consider:
Adults (13 y/o and above) = 15sqm
Children (1 y/o to 12 y/o) = 8sqm
Infants (Below 12 months) = 0sqm

Compare the TFA (Total Floor Area) with the TSR (Total Space Requirement)

Crowded if: TFA < TSR

Not Crowded if: TFA > TSR

TFA = 81.84m2
TSR = 2 (15)
= 30
Interpretation: TFA > TSR (NOT CROWDED)

K. Food Sources, Storage, and Cooking Facilities

Mr. Banana goes to the market every day for their food and Ms. Orange is
the one who cooks their food. They use fire wood since they can’t afford to buy a
gas stove. The food they usually eat is eggs, sardines, vegetables, and fish. They
rarely eat meat since their food allowance every day is just enough for their
family. However, they only stored food in the pot.

L. Water Supply
NAWASA is the family's source of water but they don’t have their own
water supply, they only get water from their neighbor and they pay 5 pesos for
each pail. They use a plastic container for their drinking water.

M. Toilet Facility
The family fruit has own comfort room that is located inside their house
beside the sink. They have a water-sealed latrine level II excreted disposal system.
The cleanliness of their comfort room is unsatisfactory because there are cluttered
clothes and empty shampoo sachet on the floor.

N. Drainage System
The family fruit has an open stagnant canal in front of their house. They
also built a bridge as a route to their home.

O. Social and Health Facilities Available

The family fruit benefits from the barangay health center and lying-in
clinic for Ms. Orange where she can go to for her check-ups.

P. Communication and Transportation Facilities

The fruit family owns a keypad phone and sometimes they borrow to their
neighbors to communicate with their other relatives. They do not own any vehicle
 but in their community, it is easy to access transportation since there is a near
terminal where many tricycles are lined up.

VI. PROBLEM IDENTIFICATION

CRITERIA IN IDENTIFYING THE PROBLEM

CRITERIA SCORE WEIGHT
I. Nature
 Health Deficit 3 1
 Health Threat 2
 Foreseeable Crisis 2
II. Modifiability
 Easily 2 2
 Intermediate 1
(Moderate)
 Not Modifiable (FC) 0
III. Preventive
Potential
 Highly 3 1
 Intermediate 2
 Not modifiable 1
IV. Salience
 Problem Needing 2 1
Urgent Attention 1
 Problem Needing Not
Urgent attention 0
 Not a Felt Problem

A. List of the Problem Identified

No. PROBLEMS IDENTIFIED SCORE RANK
1 Presence of Vector Disease 3.84 1
2 Absence of Door 3.34 3
3 Poor lighting condition 3.34 3
4 Risk for Broken Stairs 3.34 3
5 Cluttered Living Space 3.17 5
B. Priority Setting

Problem 1. Presence of Vector Disease

CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE
1. Nature of the Score: 2 This is considered as a
Problem Weight: 1 health threat because of
0.67 stagnant water in the
Health Threat Computation drum, presence of canal,
2/3 x 1 and feces.

2. Modifiability of The family’s problem

the Problem Score: 2 regarding presence of
Weight: 2 vector disease has an
Current / easily modifiable.
Knowledge Computation
Family / 2/2 x 2 2 The family has a current
Resources knowledge about the
SN / problem.
Resources “Maraming lamok dito
Community / minsan may mga ipis
Resources din na nasa pader” as
verbalized by Ms.
Orangeverbalized by Ms.
Orange

The family has physical

resources such as
broom, dust pan,
mosquito coil, fly net

The student nurse will

provide health education
to the family on how to
clean and organize the
things that can be the
breeding sites of vector
disease.

The barangay health

center is having an
 activity in the
community which is
called “pausok” to
minimize the presence
of vector disease such
as, mosquitoes, flies,
and cockroaches.
3. Preventive It shows that the
Potential Score: 2 problem has a moderate
Weight: 1 preventive potential.
Severity ▲
Duration ▼ Computation 0.67 The problem was not
Current ▲ 2/3 x 1 considered severe
Management because Ms. Orange
High-risk ▲ verbalized that no one in
Group the family acquired a
vector borne disease.

The problem of vector

disease breeding sites
was already there before
Ms. Orange moved from
Bicol last December
2021.

Ms. Orange stated that

their current
management is to use
“katol” to elicit the
presence of mosquitoes.
They use candles to
prevent flies coming
inside the house.

The family fruit were in

high-risk because the
house is infested with
vector borne disease.
4. Salience of the Score: 1 Prior to the student
Problem Weight: 1 nurse intervention, Ms.
0.5 Orange was aware of the
Computation problem but she thinks
1/2 x 1 that it does not require
much attention since she
and her family is not
being harm by the vector
 borne disease.
TOTAL SCORE 3.84

Problem 2. Absence of Door

CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE
1. Nature of the Score: 2 This is considered as a
Problem Weight: 1 health threat because of
0.67 the risk for fall.
Health Threat Computation
2/3 x 1
2. Modifiability of The family’s problem
the problem Score: 1 regarding absence of
Weight: 2 their door has a
Current / moderate modifiable.
Knowledge Computation
Family x 1.5 / 2 x 2 1.5 The family has a current
Resources knowledge about the
SN / problem.
Resources
Community / The family has no
Resources resources of money to
put a door in their house.

The student nurse will

provide health education
to the family that will
encourage them to make
a way for them to have a
door at their house to
avoid accidents.

The community
resources are available
such wood and nails
through help of
neighborhood.
3. Preventive It shows that the
Potential Score: 3 problem has a highly
Weight: 1 preventive potential.
Severity ▲
 Duration ▼ Computation 0.67 The problem was not
Current ▲ 2/3 x 1 considered severe
Management because the family does
High-risk ▲ not experience to get
Group rob

Since she moved into

their house last
December 2021, the
door hasn't been present.
“Nung tumira ako dito
wala na 'yang pinto
hindi naman namin
mapagawan kasi wala
naman kaming
pampagawa” as
verbalized by Ms.
Orange.. Orange

Ms. Orange stated that

their current
management is to use a
curtain to block their
door.

The fruit family is high-

risk because they are all
living together
4. Salience of the Score: 1 Prior to the student
Problem Weight: 1 nurse intervention, Ms.
0.5 Orange was aware of the
Computation situation but she feels
1/2 x 1 that it does not require
much attention as she
and her family is not
having or experience to
get rob.
TOTAL SCORE 3.34

Problem 3. Risk for Broken Stairs

CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE
1. Nature of the Score: 2 This is considered as a
Problem Weight: 1 health threat because of
0.67 the risk for injury.
Health Threat Computation
2/3 x 1
2. Modifiability of The family’s problem
the problem Score: 1 regarding the risk for
Weight: 2 broken stairs has a
Current / moderate modifiable.
Knowledge Computation
Family / 1.5/2 x 2 1.5 The family has a current
Resources knowledge about the
SN / problem.
Resources
Community x The family has
Resources manpower resources
such as Mr. Banana has
capability to repair the
stair.

The student nurse

knowledge can help the
family by explaining the
risk of injury.

The barangay health

center has no resources
for the present problem.
3. Preventive It shows that the
Potential Score: 2 problem has a moderate
Weight: 1 preventive potential.
Severity ▲
Duration ▼ Computation 0.67 The problem was not
Current ▼ 2/3 x 1 considered severe
Management because Ms. Orange
High-risk ▲ verbalized that they not
Group experienced injury.

The problem existed

since she moved to their
house last December
2021.

Ms. Orange stated that

they don’t have current
management since they
 don’t have money to
repair their stairs.

The family fruit were in

high-risk since they are
the ones goes back and
forth at the broken
stairs.
4. Salience of the Score: 1 Prior to the student
Problem Weight: 1 nurse intervention, Ms.
0.5 Orange was aware of the
Computation situation but she feels
1/2 x 1 that it does not require
urgent attention.
TOTAL SCORE 3.34

Problem 4. Poor lighting condition

CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE
1. Nature of the Score: 2 This is considered as a
Problem Weight: 1 foreseeable crisis
0.67 because she might
Health threat Computation experience postpartum
2/3 x 1 hemorrhage.
2. Modifiability of The family’s problem
the problem Score: 0 regarding the unplanned
Weight: 2 pregnancy is not
Current / modifiable.
Knowledge Computation
Family x 1.5/2 x 2 1.5 The family has no idea
Resources about the problem.
SN /
Resources The family has no
Communit / budget to buy a light
y bulb.
Resources “Medyo mahina yung
ilaw namin, hindi kasi
mapalitan dahil walang
pera” as verbalized by
Ms. Orange." as
verbalized by Ms. Orange

The knowledge and skill

of student nurse aid the
family about the risk of
having poor lighting
 condition and its
management

The community
resources are available
such as cheap light bulb
in the hardware within
community.
3. Preventive It shows that the
Potential Score: 3 problem has a moderate
Weight: 1 preventive potential.
Severity ▼
Duration ▲ Computation .67 The problem is severe
Current ▼ 2/3 x 1 during the observation
Management of student the house was
High-risk ▲ dim and hard to see
Group anything in the house

The problem has existed

approximately a month

The family does not

have any current
manage on the problem
as evidence by limited
income

High-risk group are

present as evidence by
they are all living
together
4. Salience of the Score: 1 Prior to the student
Problem Weight: 1 nurse intervention, Ms.
0.5 Orange was aware of the
Computation situation but she feels
1/2 x 1 that it does not require
urgent attention.
TOTAL SCORE 3.34

Problem 5. Cluttered Living Space

CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE
1. Nature of the Score: 2 This is considered as a
Problem Weight: 1 health threat because of
 0.67 inadequate cleaning.
Health Threat Computation
2/3 x 1
2. Modifiability of The family’s problem
the Problem Score: 1 regarding the cluttered
Weight: 2 living space of their
Current / house has a moderate
Knowledge Computation modifiable.
Family / 1.5/2 x 2 1.5
Resources The family has a current
SN / knowledge about the
Resources problem.
Community x “Magulo ang bahay
Resources kasi wala akong oras
mag linis at saka palagi
kasi akong mag-isa” as
verbalized by Ms.
Orange

The family has

resources such as broom
and dustpan.

The student nurse

knowledge can help the
family to encourage
them to clean their
house and arrange
properly the cluttered
things.

The barangay health

center has no resources
for the present problem.
3. Preventive It shows that the
Potential Score: 3 problem has a highly
Weight: 1 preventive potential.
Severity ▲
Duration ▼ Computation 0.5 The problem was not
Current ▼ 1.5/3 x 1 considered severe
Management because Ms. Orange
High-risk ▲ verbalized that they are
Group not affected by the
problem.
 The problem started
when she was 3 months
pregnant which means
that the problem has
been existing for 5
months. The reason is
she needs to take a bed
rest and does not have a
time to clean their
house.

Ms. Orange stated that

they just clean the house
when they have time.

The family fruit were in

high-risk because they
live in a cluttered house.
4. Salience of the Score: 1 Prior to the student
Problem Weight: 1 nurse intervention, Ms.
0.5 Orange was aware of the
Computation situation but she feels
1/2 x 1 that it does not require
urgent attention.
TOTAL SCORE 3.17

VII. FAMILY NURSING CARE PLAN (In order of Priority)

PROBLEM #1: PRESENCE OF VECTOR DISEASE

CUES ANALYSIS OF OBJECTIVES INTERVENTIONS METHO RESOURCES EXPECTED
THE F OF REQUIRED OUTCOME
PROBLEM FAMILY
CONTAC
T

Subjective: Inability to > Short Term > Explain to > > Family After 1
“Maramin recognize the family the Home- resources: hour of
g lamok the After 1 hour harmful effects visit Manpowe health
dito presence of of health for having r such as teaching,
minsan the teaching, the vector borne complianc the family
may mga problem family will diseases at e identified 4
ipis din na due to be able to home such as Physical method
nasa inadequate identify at risk for resources used to
pader” as knowledge least 3 dengue, such as minimize
verbalized . method used leptospirosis, broom, the
by Ms. to minimize dysentery, dust pan, proliferatio
Orange the cholera. mosquito n of vector
Inability to proliferation coil, borne
Objective: provide a of vector mosquito diseases
Presence home borne > Provide net, food (i.e.,
of vector environme diseases (i.e., health teaching net. mosquito,
disease nt mosquito, that would rodents,
such as conducive rodents, flies, enlighten the > Student flies,
rodents, to health cockroaches) family nurse: cockroache
cockroach maintenanc as evidence regarding the Knowledg s) as
es, e and by Ms. prevention of e, skills, evidence
mosquitoe personal Orange vector disease time, and by Ms.
s and flies developme restate the such as use of effort Orange
nt due to: given health cleaning restated the
a. teachings. articles i.e., given
Inadequate broom, dust health
knowledge > Long Term pan, consistent teachings.
of After 1 day use of
importance of health mosquito coil, After 1 day
of hygiene teaching and of nursing
and mosquito
and encourageme interventio
net, and do not
sanitation. nt, the family n, the
leave food
b. is persuaded family
Inadequate to reduce the without demonstrat
knowledge presence of covering. ed the
of vector health
preventive disease like > Utilization of teaching
measures. rodents, community given by
c. Lack cockroaches, resources such student
of skill in flies and as "pausok" or nurse as
carrying mosquitoes fogging/sprayi evidence
out to prevent ng. by Ms.
measures transmission themselves to Orange
to improve of pathogens elicit the used
home that might presence of cleaning
environme cause vector disease. articles
nt. infection. such as
broom,
dust pan,
consistent
use of
mosquito
coil,
mosquito
net, and do
not leave
food
 without
cover.

PROBLEM #2: CLUTTERED LIVING SPACE

CUES ANALYSIS OF OBJECTIVES INTERVENTIO METHOF RESOURCES EXPECTED
THE PROBLEM NS OF REQUIRED OUTCOME
FAMILY
CONTAC
T

S> > > Short > Provide > > Family The family
“magulo Inability to Term health Home- resources: will be able
ang bahay provide a teaching visit Manpower to verbalize
kasi wala home After 1 hour about the such as the After 1
akong oras environmen of health advantages time and hour of
mag linis att conducive teaching, of a clean effort health
saka palagi to health the family environment teaching,
kasi akong maintenanc will able to such as free Student the family
mag-isa” as e and recognize from miss- nurse: recognized
verbalized personal the risk of step, slip, Knowledg the risk of
by Ms. developmen cluttered and stumble. e, skills, cluttered
Orange t due to: environment time, and environmen
a. Failure such as > Encourage effort t such as
O > Pieces to see miss-step, Ms. Orange miss-step,
of wood, benefits slip, or to ask for slip, or
clothes, (specifically stumble as help to her stumble as
bottles in long-term evidence by husband to evidence by
the ones of Ms. Orange keep the Ms. Orange
surrounding investment recall the things that recall the
s in health obstruct health
home teaching their way teaching
environmen presented. such as presented.
t pieces of
improveme > Long wood, After 1 day
nt Term bottles, and of nursing
b. Lack clothes intervention
 of skill in After 1 day , the family
carrying out of nursing showed
measures to intervention, improveme
improve the family nt as
home will be able evidence by
environmen to show absence of
t improvemen pieces of
c. t as wood,
Inadequate evidence by clothes,
family absence of bottles in
resources, pieces of the
specifically wood, surrounding
manpower clothes, s
resources bottles in
the
surrounding
s.

PROBLEM #3: RISK FOR BROKEN STAIRS

CUES ANALYSIS OF THE OBJECTIVES INTERVENTIO METHOF RESOURCES EXPECTED
PROBLEM NS OF REQUIRED OUTCOME
FAMILY
CONTAC
T

S > “wala > Inability to > Short > Explain to > After 1
kasi provide a home Term the family Home- hour of
kaming environment the possible visit > Family health
pera kaya conducive to After 1 accident of teaching,
hindi health hour of having the family
namin maintenance health broken resources restated
mapagaw and personal teaching, stairs such possible
a” as development the family as risk for Manpower accident for
verbalized due to: will able to fall and such as having a
by Ms. a. restate injury time and broken stair
Orange Inadequate possible effort such as risk
family accident for > for fall and
O> resources, having a Student injury as
Utilization
Broken specifically broken stair nurse: evidence
of Mr.
and financial such as risk Knowledg by Ms.
Banana
unequal constraints/ for fall as e, skills, Orange
ability to
stair tread limited financial evidence time, and recall the
repair the
resources by Ms. effort health
stair
b. Inadequate Orange teaching
knowledge of recall the
 preventive health presented.
measures. teaching
presented. After 1 day
of nursing
> Long interventio
Term n, the
After 1 day family will
of nursing show
interventio improveme
n, the nt on their
family will broken
show stairs as
improveme evidence
nt on their by Mr. Eu
broken repair the
stairs as stair
evidence
by Mr.
Banana
repair the
stair

PROBLEM #4: ABSENCE OF DOOR

CUES ANALYSIS OF THE OBJECTIVES INTERVENTIO METHO RESOURCES EXPECTED
PROBLEM NS F OF REQUIRED OUTCOME
FAMILY
CONTAC
T

S > “nung > Inability to > Short > Explain > > Family After 1
tumira ako provide a home Term to the Home- resources: hour of
dito wala environment family the visit health
na 'yang conducive to After 1 about Manpowe teaching,
pinto hindi health hour of possible r such as the family
naman maintenance health risk of capability determined
namin and personal teaching, absence of to build of at least 2
mapagawa development the family door such Mr. risks of not
n kasi wala due to: will able to as Banana having a
naman determine trespassing door as
kaming a. at least 2 of unknown evidence
pampagaw Inadequate risks of not person and Student by Ms.
a” as family having a robbery. nurse: Orange
verbalized resources, door as repeat the
specifically Knowledg
by Ms. evidence e, skills, health
Orange: financial by Ms. teaching
constraints/limit > Utilize time, and
 ed financial Orange Mr. effort presented
O> resources repeat the Banana's
Absence of b. health ability to
door Inadequate teaching build a door Communit After 1 day
knowledge of presented y of nursing
preventive >
Encourage resources: interventio
measures. > Long n, the
Term to ask for Physical family
physical resources showed
resources such as improveme
After 1 day from their wood nt on
of nursing neighbor. absence of
interventio door as
n, the evidence
family will by Mr.
be able to Banana
show build a
improveme door
nt on
absence of
door as
evidence
by Mr.
Banana
build a
door

PROBLEM #5: POOR LIGHTING CONDITION AS A HEALTH THREAT

CUES ANALYSIS OF THE OBJECTIVES INTERVENTIO METHOF RESOURCES EXPECTED
PROBLEM NS OF REQUIRED OUTCOME
FAMILY
CONTAC
T

S > > Inability to > Short > Explain to > > Family After 1
"Medyo make decisions Term the family Home- resources: hour health
mahina with respect to the visit Manpower teaching,
yung taking After 1 consequenc such as the family
ilaw appropriate hour health es of having complianc identified at
namin, health action teaching, poor e, time 2 health
hindi due to Low the family lighting and effort risk of poor
kasi salience of the will be able condition lighting
mapalita problem/conditi to identify such as risk Student condition
n dahil on at least 3 for eye nurse: as evidence
walang health risk strain, miss- Knowledg Ms. Orange
pera." as > Inability to of poor step, slip, or e, skills, recalled the
verbalize provide a home lighting stumble time, and health
d by Ms. environment condition effort teaching
Orange conducive to as evidence > presented
health Ms. Orange Utilization Communit
O > The maintenance recall the of Mr. y After 1 day
student and personal health Banana resources: of nursing
nurse development teaching capabilty to Cheap intervention
have due to Limited presented change the bulb , the family
observed financial light within the showed
the constraints/limit > Long communit improveme
followin ed financial Term > Inform y nt as
g: resources about the evidence by
After 1 day community Mr. Banana
>Dim of nursing resources changed the
light interventio such as bulb
n, the cheap bulb
family within the
show community
improveme
nt as
evidence by
Mr. Banana
change the
bulb.

VIII. FAMILY COPING INDEX

Category Initial Justification

1 3 5
1. PHYSICAL
INDEPENDENCE

This category is Ms. Orange was able to move

concerned with the ability 
to move about to get out
of bed, take care of daily
grooming, walking, and
other things which
involves the daily
activities. Note that it is
the family’s competence
that is measured even
though an individual is
around properly, but was unable
to provide the necessary personal
care. Their house condition is
very poor since there is a lot of
unorganized things inside and
outside of their house.
independent, if the family
is able to compensate for
this. The family is
important hence, if the
focus of care is poor, for
instance, if the mother is
giving care to a
handicapped child that she
shared with other
members of the family,
the independence might
be considered incomplete.
The causes of
independence may vary
however. Lack of
independence in the
family may be due to
actual physical incapacity,
the inability of “know-
how”, the willingness of
fear of doing necessary
tasks.
2. THERAPEUTIC
COMPETENCE
 Ms. Orange is eight months
This category includes all  pregnant but she is not taking any
the procedures or h medication and vitamins. She’s
treatment prescribed for not exercising but sometimes have
the care of ill, such as  the time to relax.
giving medication, ••
dressings, exercise and
relaxation, special diets.

3. KNOWLEDGE ON
HEALTH CONDITION

This category is Ms. Orange has only limited

concerned with the  understanding about different
particular health condition diseases. But when someone is
that is the occasion of sick to their family, they
care, knowledge of the immediately seek attention with
disease or disability, the doctor.
understanding of
communicability of
diseases and mode of
transmission,
understanding of general
patterns of development
of a new born baby and
the basic needs of infants
for physical care and
tender loving care.

4. APPLICATION OF
PRINCIPLES OF
GENERAL HYGIENE
Ms. Orange is a housewife so she
This is concerned with  gets an adequate rest since she has
family action in relation to nothing to do in their house, she
maintaining family sometimes sleeps at noon for half
nutrition, securing an hour and she is fully
adequate rest and vaccinated with booster.
relaxation for family
members and carrying out
accepted preventive
measures such as
immunizations, medical
appraisal, and safe
homemaking habits in
relation to storing and
preparing food.
5. HEALTH
ATTITUDES Ms. Orange benefits from the
services provided by Barangay
This category is Health Center. She always
concerned with the way consults to the doctor whenever
the family feels about needed, especially that she is
health care in general, pregnant.
including preventive
services, care of illness,
and public health
measures.

6. EMOTIONAL
COMPETENCE

This category has to do In times of family crisis, the

with maturity and
integrity with which the
members of the family are
able to meet the usual
stresses and problems of
 family fruit offer emotional
support to each other. Sometimes
the problem cannot be solved
immediately when it comes to
finances.
life, and to plan for happy
and fruitful living. This
involves the degree to
which individuals accept
the necessary disciplines
imposed by one’s family
and culture; the
development and
maintenance of individual
responsibility and
decision; and willingness
to meet reasonable
obligations, to accept
adversity with fortitude,
and to consider the needs
of others as well as one’s
own.

7. FAMILY LIVING

This category is
concerned largely with the They don’t always get along
interpersonal or group because they were the only two at
aspects of family life-how their house. And Mr. Banana is
well the members of the  always working that’s why Ms.
family get along with one Orange is always alone at their
another, the ways in house. Sometimes they fight
which they make over simple things but manage to
decisions affecting the resolve it immediately.
family as a whole, the
degree to which they
support one another and
do things as a family. The
degree of respect and
affection the show for one
another, the ways in
which the manage the
family budget, the kind of
discipline that prevails.

8. PHYSICAL
ENVIRONMENT

This category is The house condition of family

concerned with the home fruit is poor, because there is
 and community or work some presence of accidental
environment as it affects  hazards and their clothes are
family health. This hanging everywhere and very
includes the conditions for unorganized. Flies, mosquitoes,
housing, presence of cockroaches and rats are also
accident hazards, noted which can threaten their
screening, plumbing, health.
facilities of cooking and
for privacy, level of
community (deteriorated)
or modern, presence of
social hazards such as
bars, street gangs,
delinquency, pest such as
rats, etc.), availability and
conditions of schools and
transportation.

9. USE OF
COMMUNITY
FACILITIES
This category has to do
with the degree to which
family members know
about and the wisdom
with which they use
available community
resources for health,
education, and welfare.
The coping ability does
not indicate the level of
the need for services, but
rather the degree to which
they can cope when they
must seek such aid.
Ms. Orange is aware of the
programs offered by the Barangay
 Health Center, but sometimes
does not participate or does not
comply with them. They also
attend or participate in some
community activities such as town
festivals and others. Even though
they are aware, they still lack
knowledge about other free
benefits they can have.

IX. LEARNING DERIVED

Community health nursing involves a holistic approach to patient care.

Interventions target individuals, families, and communities within a geographic area.
 Nursing care focuses on the management and prevention of disease as well as
educating the community about maintaining health.

Through this study, the student nurse was able to better understand how to
interact, socialize, communicate, and respond to a lot of different people. I'm happy to
participate in the community exposure as a nursing student. With the opportunity
provided, the student nurse was able to establish a rapport with the assigned families.
This resulted in a two-way relationship between the student nurses and families, and I
learned the value of being a community student nurse in improving our community.

X. SPOT MAP AND DOCUMENTATION

 SPOT MAP
 FLOOR PLAN

 DOCUMENTATION
XI. BIBLIOGRAPHY

Taterway. (2020). Introduction of Family. Retrieved December 10, 2022,

from https://magadhmahilacollege.org/wp-content/uploads/2020/08/Family-Introduction-
and-definition.pdf

Thressiamma, P. M. (2010). JaypeeDigital | eBook

Reader. https://www.jaypeedigital.com/eReader/chapter/9789380704395/ch1

De Jesus, R., Learning Module: Community Health Nursing I, Bocaue, Bulacan, 2022