DAVAO MEDICAL SCHOOL FOUNDATION INC.

Medical School Drive, Bajada, Davao City

College of Nursing

In Partial Fulfillment of the Requirements in NCM 104 Community Health Nursing

FNCP

Submitted to:

Concepcion, Karlo Gil D. RN, MN

Dela Cerna, Shirly May G. RN, MAN

Jamora, Kristine Carol C. RN, MN

Lydy Grace Segurola, RN, MAN

Nandy Padernilla, RN, MAN

Clinical Instructors

Submitted by:
Esperencilla, Lance
Magnaye, Carlou Jay V.
Romero, Dimple
Sahad, Raizza
Sango, Gracell
Sobrecarey, Gwyneth Gesler
Tan, Ezra
Tecson, Nicole Kate
Tinio, Neo Nico
Ubas, Ashley Ruth Ann T.
Villagonzalo, Ma. Larra Alea

BSN II B
December, 15 2022

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 Table of Contents

ACKNOWLEDGEMENT ..................................................................................... ii.

INTRODUCTION ................................................................................................. 4
OBJECTIVE OF THE CASE ............................................................................... 5
General Objectives ...................................................................................... 5
Specific Objectives ...................................................................................... 5

IDENTIFICATION OF CASE ............................................................................... 5

FAMILY BACKGROUND .................................................................................... 7
SOCIO-ECONOMIC ............................................................................................ 8
BACKGROUND ................................................................................................... 8
FAMILY MEDICAL AND HEALTH HISTORY ..................................................... 9
GENOGRAM .................................................................................................... 10
FAMILY APGAR ................................................................................................ 11

FAMILY COPING INDEX .................................................................................. 13

NURSING THEORY .......................................................................................... 16

Nightingale’s Environmental Theory ................................................... 16
Orem’s Self Care Model .......................................................................... 17
MANAGEMENT ................................................................................................ 19
Medical Management ................................................................................ 19
Nursing Management ............................................................................... 21
PROBLEM IDENTIFICATION ........................................................................... 23
Health Threats ........................................................................................... 23
Health Deficit ............................................................................................. 24
Foreseeable Crisis ..................................................................................... 24

FNCP ................................................................................................................ 31
HEALTH TEACHING ....................................................................................... 34
Primary Level of Prevention ...................................................................... 34
Secondary Level of Prevention ................................................................. 36
IMPLICATION ....................................................................................................37
HEALTH UPDATES .......................................................................................... 39
DOCUMENTATION ........................................................................................... 39
REFERENCES .................................................................................................. 41

i.
2
 ACKNOWLEDGEMENT

The students would like to express their heartfelt gratitude to the

following individuals who generously contributed to the completion of this
study.

To begin, we'd like to express our gratitude. We would like to express

our heartfelt gratitude to the Lord, our God, for granting us the ability to
assist our fellow humans. We'd like to thank him for blessing us along the
way and giving us the strength to persevere. This research would be
impossible without his directing grace. Our parents provided us with
continual assistance so that we could visit the community as needed.

Mrs. Visminda B. Batoy, RN, COHN, MN, Dean of the college of

nursing, for allowing us to embark on this life-altering voyage and for
educating us on what it means to be a proper community health nurse; To
the most loved and respected clinical instructor, Mr. Karlo Gil D.
Conception, RN, MN, for enlightening us all through this journey, always
recognizing our commitment, advancing us beyond our limits, and
constantly reminding us to strive for excellence and has always been
available and approachable whenever we needed assistance.

We thank all the family members for being kind enough to let us inside
their homes and assisting us in gathering all the data necessary to complete
this study. We have instilled in our minds, and particularly in our hearts, the
significance of assisting families in a specific community to achieve their
wellness, which is the primary goal of this study. We extend our deepest
gratitude to everyone who contributed to this investigation, including those
whose names have not been included here. With their help, we were able
to finish this study. This community exposure enhanced our capabilities in
giving care to the people who required the most of it.

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ii.
I. Introduction

According to research conducted by (Barnard, 2022), a family is

defined as a group of people who are connected to each other through
the bonds of marriage, blood, or adoption. These people live under the
same roof and interact with each other in their various social roles, which
are typically those of spouses, parents, children, and siblings. In order
to study the factors that surround them, such as their health, it is
necessary to identify both the family unit as a whole and the individual
members who comprise the family unit.

Moreover, (Antonio, 2022), defined community as a group of people

who live in the same location or who share a particular quality in
common. As a result of having similar perspectives, interests,
aspirations, and objectives, members of a community often experience
a sense of fellowship with one another. It emphasizes preventative care
as well as health education and preservation. This community
engagement utilizes what we learned in class while assisting our fellow
citizens. As student nurses, this is a chance for us to provide nursing
interventions that are suitable and feasible within community-based
health care.

This study discusses an extended family of seven (7) members

residing in Brgy. 19-B El rio Davao City. Our group was privileged to
interview family members and assess their homes and the health status
of each family member to obtain the health threats, health deficits, and
foreseeable crises and to be able to formulate a family nursing care plan.

The environment in which they reside is near a sewer and a river and
is prone to flooding; the ground is muddy, and garbage can be seen near

4
 their home; several animals live nearby, and numerous tires can serve
as mosquito breeding grounds.

II. Objective of the Case

General Objectives:
By the end of this study the student nurse will be able to provide Health
teachings to the family and establish a nursing care plan which would
be beneficial to the family, as well as to the community. This case study
aims to apply the notion of family-oriented nursing care using a
systematic approach to the nursing process. It aims to determine our
interviewed family's health concerns in the neighborhood.

Specific Objectives

After this community exposure, our group will be able to:

1. Determine the general health of the family
2. Identify household health problems and hazards.
3. Educate the family about the importance of maintaining a clean and
healthy environment.
4. Present facts and data about the family's health risk concerns.
5. Assess the functioning and potential areas of family strength and
resources by determining the family's APGAR score and family coping index

III. Identification of the Case

Code Relation to Sex/Age Educational Occupation Monthly Civil

Name Head Attainment Income Status

Mr. GC Head M/58 Secondary Driver 12-13k Married

level

Mrs. Wife F/44 Secondary Housewife N/A Married

TC level

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 Ms. RC Daughter F/22 Secondary Stay at home N/A Single
level mother

Mr. JS Son – in law M/21 Secondary Culvert Maker 12-13K Single

level

Mr. CC Son M/16 Secondary N/A N/A Single

level

Ms. FC Daughter F/7 Primary N/A N/A School

Level age

Baby Granddaughter F/3 mos. N/A N/A N/A Infant

NS

COVID 19 VACCINATION STATUS

Code 1st Brand 2nd Brand Booster Brand Booster Brand

name Dose Dose 1 2

Mr. GC N/A N/A N/A N/A N/A N/A N/A N/A

Mrs. ✓ Pfizer ✓ Pfizer N/A N/A N/A N/A

TC

Ms. ✓ Pfizer N/A N/A N/A N/A N/A N/A

RC

Mr. JS ✓ Pfizer ✓ Pfizer N/A N/A N/A N/A

Mr. CC ✓ Pfizer N/A N/A N/A N/A N/A N/A

Ms. FC N/A N/A N/A N/A N/A N/A N/A N/A

6
 Baby N/A N/A N/A N/A N/A N/A N/A N/A
NS

CHILDREN’S IMMUNIZATION (5years and below)

Name Age Sex BCG DPT OPV HEPA B MEASLES

Baby NS 3 mos. F ✓ ✓ ✓ ✓ ✓ ✓

Ms. FC 7 yo F ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Due to a lack of time, we weren't able to obtain Ms. FC's immunization dates.

IV. Family Background

Mr. GC and Mrs. TcC are married and belong to a type of extended
family that resides in the husband's home; there are two families living in
one household, making them an extended family with three generations and
seven members. Mrs. TC, 44 years old, is a housewife and helps care for
her family, while Mr. GC, 58 years old, is the family's breadwinner and works
as a driver. They both participate in the decision-making processes
regarding health and finances. Mrs. TC had three pregnancies in total. The
eldest child is a twenty-two-year-old woman who has a boyfriend that lives
with her and they have a three-month-old child; the middle child is a sixteen-
year-old boy, and the youngest child is a seven-year-old girl.

The household has no rooms, they only sleep in the living room where
the 2 beds are located. Mr. GC’s family had an average sleeping time of 7-
8 hours. Since the father works from early in the morning until late at night,
only the youngest and the infant were taking 2–3-hour naps. The family eats
three meals a day on average, combining their comfort foods of fish, meat,

7
 fruits, and vegetables. Commonly, canned goods make up the family’s main
food source. They go to church every Sunday as a Roman Catholic family.
The family uses tricycles and a jeep as their primary modes of
transportation.

It was found that the relationships within the family as well as the
communication that took place between the various members of the family
were in a healthy state. It was observed that the children have good
manners, with the youngest of them choosing to play like the majority of
children their age do. Because they responded very well to being called, it
can be deduced that a good example of responsible parenting has been
set. While the mother prefers to spend her free time caring for her
granddaughter and watching YouTube videos, the father is kept busy with
work but, when he does have free time, he tends to his roosters. As for the
eldest child, she prefers taking care of her child, while the middle child is
kept busy by his friends, and the youngest child enjoys playing with toys
and interacting with other children in the barangay. The family enjoys
coming together at the end of the day for a leisurely conversation and open
communication.

V. Socio-Economic Background

The family's primary earners are Mr. GC and his daughter's live-in
partner Mr. JS. Mr.JS works as a culvert maker and makes an average of
12-13K pesos per month, all of which goes toward supporting his family. Mr.
GC is a tanker driver who earns 12-13k, depending on how often he is
contracted. Mr. GC's wife, Mrs.TC, is a housewife taking care of their two
children.

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 As evidence, they typically consume three meals daily, have clothing,
and have a place to live. However, they can only afford some of their
monthly expenses, such as their bills. They are equalitarian in their
decision-making, which means that they both significantly contribute to
decisions about budget allocation and the state of their health. They
establish a budget and only purchase essential items when they receive
their pay.

VI. Family Medical and Health History

The C family is currently residing at El Rio Vista Village, Davao City

and is composed of 7 members; Mr. and Mrs. C with their 3 children.
The family gets enough sleep during sleeping hours. The family is also
free from any known disease or illness. The family is prone to common
colds and coughs, especially during the rainy season. They also
complained with common illnesses like headaches and stomachaches.

Mr. GC was prescribed amlodipine as a maintenance drug to deal

with his blood pressure because he has been diagnosed with
hypertension.

Despite the fact that the family are at risk for hypertension, since it is
inherited genetically, hunger is also a concern. Every time they detect
the drainage system has been stopped for a while, the family cleans it.
They also periodically clear the house. The family relies on the barangay
health clinic for all of their medical requirements, especially for the
father's medicine, and they are contented with the support provided by
the barangay health staff. The head of the family and the other members
of the family are not up to date with their immunizations.

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VII. Genogram

Interpretation

The above presentation depicts the structure of C family. The

diseases that the family members experienced are depicted in the
diagram. Mr. GC has hypertension

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 VIII. Family APGAR
Legend Total Score

0- Hardly even 0-3 Severely dysfunctional

family

1- Some of the 4-6 Moderately functional

time family

2-Almost 7-10 Suggest highly

always functional family

Components Score Definition Justification

The client’s daughter is still a

Adaptation 1 I am satisfied with three-month-old baby. Her mother
the help that I Ms. TC teaches her how to take
receive from my care of a newborn. Ms. TC takes
family when care of Baby NS if Ms. RC wants
something is to rest or do something. They also
troubling me help each other when there are
problems.

Mr. JS and Ms. RC practices an

Partnership 1 I am satisfied with equalitarian manner regarding
the way my family decision-making especially in
discusses items of terms of health matters. Both
common interest parents consider individual
and shares perspectives and opinions..
problem solving
with me.

The parents are supporting Ms.

Growth 1 I find that my RC towards her wishes some of
family accepts my the time, when it comes to her
wishes to take on decision in life if she wants to try
new activities or something new activities in her life-
make changes in
style.
my life-style.

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 According to the interview data, Ms.
Affection 1 I am satisfied with Tc has a great deal of compassion for
the way my family her children, and Ms. RC's family
expresses expresses strong support for her
affection and feelings, by having open ears when
responds to my
she is expressing her emotions
feelings such as
anger, sorrow and
love.

There are misunderstandings and

Resolve 1 I am satisfied with problems that occur in the family,
the amount of the and the family hardly even talks
time my family about them together due to
and I spent
different schedules, but there are
together
still where they talk and resolve
issues as a family.

Total 5 The total family APGAR score is 5 which means they are
a moderately functional family, but they still manage to
support, love, and care for one another. They give the
family members a sense of stability, but not a sense of
belonging; they hardly ever discuss issues because of
their conflicting schedules, but they still encourage open
communication; and they still give the family members a
sense of importance, value, respect, and reverence.

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 IX. Family Coping Index

FAMILY POINT ASSESSED PROBLEM JUSTIFICATION

COPING SCALE SYSTEM
AREAS

Physical 1 There is a newborn in the The infant, baby NS is

Independence family. still reliant on her
mother at the age of
three months. But the
rest of the family can
get out of bed, walk
independently without
assistance of a family
member, and carry
out their
responsibility.

Therapeutic 1 Difficulty to buy medicine The family is able to

Competence due to financial problems go to the health center
if they have health
issues but due to
financial problems,
they are not able to
buy all prescribed
medicine.

Knowledge of 1 Lack of inadequate The family can

Health knowledge and skill in
Condition carrying out the necessary
interventions/treatment/care.
determine if there is a
presence of disease
and its effect on their
health as a family.
Although he is the
head of the household
and a workaholic, Mr.
GC is unable to

13
 comprehend the
significance and
advantages of taking
his medications to
support or keep his
health level.

Application of 1 Improper waste disposal The parents are

Health competent in carrying
Principle of out simple hygiene
General procedures, however,
Hygiene the family has an
improper waste
disposal system in the
back of their home,
which may still cause
illnesses in the family.
Additionally, when a
flood happens, the
garbage will spread,
making the area
around the house
untidy.

Health 1 Knowledge deficit lack of The family is unaware

Attitudes knowledge of the COVID 19 of the advantages of
vaccines COVID-19
vaccinations and is
concerned that
vaccinations may hurt
them. They lack a
solid understanding of
immunizations,
particularly COVID-19
vaccines.

Emotional 3 none The family talks about

Competence their experiences and
tries to understand
each other’s
perspective and
opinions. The family
appears to get along
with each other.

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Family Living 1 Inadequate Income The family can afford
to pay their bills each
month, but with seven
people in the
household, Mr. GC's
and his daughter's
live-in partner's
income is insufficient
to cover their daily
expenses, needs and
for Mr. GC's
medications for his
health.

Physical 1 Inadequate living space for The current home

Environment the whole family they reside in is
inadequate for the
family of seven.

Use of 1 Inaccessibility of required Ms. TC and Baby NS

Community care/services due to one of frequently visit the
Response the family members being community health
unavailable center to receive
services like
vaccinations and
prescription drugs.
But Mr. GC rarely
goes to the health
center because his
work as a tank driver
requires him to stay
up late.

X. Nursing Theory
Florence Nightingale’s Environmental Theory
Florence Nightingale’s environmental theory is based on five
points, which she believed to be essential to obtain a healthy home, such
as clean water and air, basic sanitation, cleanliness and light, as she
believed that a healthy environment was fundamental for healing. In her

15
time, she reported that noise was harmful and disturbed the rest of
individuals, so the conversation of caregivers should be avoided, as well
as agitation, unnecessary questions. On the other hand, Florence
recommended nutritious food, beds and appropriate bedding and
personal hygiene for individuals. The environment paradigm in
Nightingale’s model is understandably the most important aspect. Her
observations taught her that unsanitary environments contribute greatly
to ill health, and that the environment can be altered in order to improve
conditions for a patient and allow healing to occur.
In comparing therapy with healing, nightingale notes that while therapy
may always be implemented, healing is not always achievable.
Removing an illness’s signs and symptoms merely addresses the
physical dimension of treatment, ignoring the spiritual component, and
does not heal the condition. In this sense, it is important to highlight on
what Nightingale introduced, in the context of care, colors, light, music,
pets, exercise, flowers as aspects to be emphasized in a favorable
environment in search of healing, reaffirming the bases of environmental
theory and the premise that the environment influences people’s health.

It is said that comprehending all the characteristics that patients

display during a healthcare encounter is necessary for a nurse to
become sensitive to holism. In addition, Florence Nightingale
Environmental theory states that unhygienic conditions affect the health
of people living in that environment. This is because the environment
contains pathogens, pests and bacteria that cause various diseases.
Nightingale concludes that unsanitary environmental conditions pose
health hazards to people. Emphasizes how important the quality
surroundings are for patient recovery.

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Orem's Self Care Model
Orem’s Theory of Self-Care Deficit holds that self-care is a learned
activity that is natural to adults. The main premise of the theory states
that promotion of self-care contributes to the individual’s self-
maintenance and promotes health-care well-being (Orem, 2003). Orem
holds that the state of normalcy (the 5 promotions of human functioning
and development within social groups in accord with human potential,
known limitations, and the innate desire to be normal) is founded on a
set of common human factors. Basic conditioning factors (age, gender,
health care systems availability, education, family systems elements,
and patterns of living) and universal self-care requites (need for air, food,
water, activity/rest, solitude/social interactions) influence an individual’s
self-care practices.
Quality of life is identified as one of the main indicators of
cardiovascular health. Additionally, it is considered as an important
measure of treatment outcome. Evidence shows that the quality of life
in patients with hypertension is poor and it is less than the normotensive
people. Therefore, in order to improve the health status and treatment
outcome in patients with hypertension, it is necessary to find appropriate
interventions to improve their quality of life
Furthermore, the Self Care Model is applicable to our case
study since we identified during our initial interview that the head of the
C family was diagnosed with hypertension and Diabetes Mellitus.
Additionally, client RC verbalizes that she and her family would like to
know enough knowledge about the forms of treatment and the risks
arterial hypertension can cause due to its chronic characteristics can be
genetically be passed on to her daughter in the near future since this is
a necessary for prevention and before her father’s condition would
worsen.
Improvement of the quality of life and self-efficacy of patients
with hypertension is essential. Based on Orem’s nursing theory, self-

17
 care is considered as activities that people engage in to maintain,
restore or improve their health. Nurses do not consider patients as
inactive and mere recipients of health services; rather, they consider
patients as strong, reliable, responsible, and capable of decision-making
who can take care of their health appropriately. Orem defined three
nursing systems including wholly compensatory, partially compensatory,
and supportive-educative systems. The nurse’s roles in the supportive
educational system are taken when the patient is ready to learn
something, but he/she cannot do it without help and guidance
(Khademian, Ara & Gholamzadeh, 2020).

XI. Management
Overview

Hypertension, is commonly known as high blood pressure that is

higher than normal and is called “silent killer”. According to the Philippine
Heart Association, Hypertension prevalence in the Philippines increased
to 37% in 2021, alerting a “progressive rise” of high blood pressure
among Filipinos. Adding to that, hypertension is the most important
modifiable risk factor for stroke and myocardial infarction. (Kearney et
al. 2005) Modifiable risk factors for hypertension are unhealthy diets
(excessive salt, consumption, a diet high in saturated fats and trans-fat,
low intake of fruits and vegetables) physical inactivity, consumption of
tobacco and alcohol, and being overweight. While the non-modifiable
risk factors include a family history of hypertension and with co-existing
disease of diabetes or kidney disease. (WHO, 2021) The only way to
detect hypertension is to have a health professional take measures of
blood pressure.

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A. Medical Management
Ideal Medical Management
Hypertension
Do a blood and urine test to check cholesterol and blood sugar levels
that may cause or worsen high blood pressure. Echocardiogram, this
noninvasive exam uses sound waves to create detailed images of the
beating heart. It shows how blood moves through the heart and heart
valves. After the tests the physician will recommend to do ambulatory
monitoring/regularly check the blood pressure, self -monitoring can give
stronger sense of control over health. Adequate rest of 7 to 9 hours of
sleep daily so blood pressure goes down and doing regular physical
activity to make the heart stronger. Eating a heart-healthy diet with less
salt, cutting down on sodium can help lower blood pressure and can
keep heart healthy. Thus, Observing and maintaining a healthy weight
or losing weight, Limit drinking alcohol to avoid rise of blood pressure.
Restrict smoking, tobacco products contain nicotine which causes blood
vessels to constrict and heart to beat more quickly, raising blood
pressure.

Physicians will base on the data about the progress of the medication
and the recommendations in adjusting to the healthy lifestyle of the
patient and decide on what to do, what to continue, add or change in the
management.

Actual Medical Management

Hypertension
Their lifestyle has to do something with him, the father, in
having hypertension, as well as his work which is being a tanker driver.
However, he takes medicine for his hypertension namely: Amlodipine. It
19
 is said by the daughter that their common food intake is canned goods
and local noodles, which have high sodium levels.
According to the daughter, they advise his father not to
consume alcohol and not to overwork. Following that, they also
encourage him to eat nutritious food, do regular exercise and drink his
medicine on time as prescribed by his physician.

B. Nursing Management

B.1. Problem List (Maslow’s Hierarchy)

Maslow’s Hierarchy of Needs

The pyramid is an indication of a model for understanding

human behavior by representing a different human need namely:
Physiological needs, safety needs, love and belonging, and self-
actualization. The main focus of Psychologist Abraham Maslow in
creating this model is that he believed that people can not reach the
higher needs if they cannot achieve the needs in lower levels.

Physiological Needs

The family has a rented house to live in, and has appropriate
clothing. Tap water is their only access for everything. May it be for
drinking, taking a bath and other needs. On a daily basis, they eat
three times a day combining their comfort foods of fish, meat, fruits,
and vegetables. Commonly, canned goods make up the family’s
main food source. They sleep 7-8 hours a day, which is a giveaway
of sufficient sleep.

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Safety Needs

In terms of safety needs of financial security, the father and

daughter’s live-in partner have the same monthly salary of 12-13k.
The father is working as Tanker Driver and the said live-in partner is
working as a culvert maker, which basically leads them to be the
breadwinner of the family. Their area is also a prone site to flash
flood, and around them is unsanitary segregation of trash that can
lead to breeding sites of mosquitoes and that may cause health
threats such.

Because the Family C house is made of light wood with a hut

texture, it is prone to fire. For the sake of health and well-being,
seven out of seven family members are of normal weight, and the
family's lifestyle may have contributed to the head of the family being
diagnosed with hypertension. One of the family members had
already been diagnosed with hypertension and diabetes risk. On the
second visit, the 3-month-old infant has a cough, colds, and fever
from being exposed to classmates who have the same signs and
symptoms as her.

Their sewage is an open system that might be a breeding

ground for disease vectors, putting the family at danger of mosquito
bites and infections. The client and his family members also had
common diseases such as fever, colds, headache, cough, diarrhea,
and . In terms of the client's safety, there are insects and potentially
harmful items such as sharp objects that the child may readily reach.
The family visits the barangay health clinic for any medical
requirements, particularly medicine for the father, and they are
satisfied with the services provided by the barangay health
professionals.

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Love and Belonging

The interviewer noted no indicators of disagreement or

conflicts among the family members; in support of this observation.
One of the family members enjoys viewing YouTube videos on her
phone when she has free time. If they don't have class, the kids play
during their free time. At the end of the day, the family likes gathering
for leisurely talk and open communication. They also go to church as
a family every Sunday.

Esteem Needs

The family shows cooperation during the interview and

answers all questions well. However, Ms. RC was conscious of the
cleanliness of their household during the time we interviewed the
client and said to talk and do the interview outside the house.

Self-Actualization Needs

The family has a problem in terms of the father and the

daughter’s live-in partner since the client's family ineffectively obtains
adequate financial assistance from the father and live-in partner.
This represents the culmination of an individual's linear progress.
Maslow must first provide the other requirements for them to reach
this degree of fulfillment. Client GC's and her daughter's live-in
partner motive to work is simply to provide for his family, making sure
that despite their low wage, the children, the infant and close partner
may eat three meals a day. Yet, the family is also dissatisfied with
just completing secondary level. Though there is still a chance to
pursue their dream course, if they so desire.

22
B.2. Problem Identification

Health Threats

Fire Hazards - The usage of firewood and charcoal for cooking

posed a fire hazard. The structure of the client's home consists of
wood and mixed building materials, which could increase its
combustibility.

Poor Environmental Sanitation - The overall environment has bad

odor, no proper waste management, with empty liquor bottles and
old tires present that can contain stagnant water, which can be
breeding sites of mosquitoes and other parasites.

Inadequacy of living space - The family’s living room is also used

as the family’s bedroom. Containing only 2 beds, the space is too
small to accommodate the 7-member family. Due to this setup, there
would be an easier and faster spread of microorganisms within the
family.
Financial instability - Mr. GC, a tanker driver and Mr. JS, a culvert
maker, who only makes 12-13k depending on the work slot available,
provides just enough money to supply the family’s needs, however,
is not able to provide the family’s wants.

Health Deficit
Lifestyle - The family does not practice a healthy lifestyle. Having
canned goods as the main food source, not exercising regularly,
drinking alcohol, drinking prescribed medicines only when available,
and not being fully vaccinated resulted in poor health and acquiring
sickness, most especially to Mr. GC, the family head, who
manifested hypertension.

23
 Foreseeable Crisis
Parenthood - Ms. RC and Mr. JS, both young adults, are not married
to each other, have a 3-month-old child, and have inadequate
knowledge about family planning, how to take care of an infant, and
their responsibilities such as providing for the child’s needs and
preparing for the future, as parents of their child.

Health Threats

Fire Hazards

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 2/3 x 1 0.67 It is a health threat. It may cause
life threatening risks due to fire.

2.Modifiability of
the Problem 1/2 x 2 1 The family does not have
adequate resources, therefore, it
is partially modifiable.

3.Preventive
Potential 2/3 x 1 0.67 If financial resources are
adequate, the risks can be
prevented.

4.Salience of the
Problem 1/2 x 1 0.5 The family perceived this as a
problem, but it does not need to
take necessary action.

Total
2.84

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Poor Environmental Sanitation

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 2/3 x 1 0.67 It is a health threat. It can cause the
growth of microorganisms and
parasites which may cause harm to
the family’s health.

2.Modifiability of
the Problem 1/2 x 2 1 It is partially modifiable. It can be
modified due to the available
resources and interventions.

3.Preventive
Potential 2/3 x 1 0.67 Educating the family will help
prevent having waste in the
surroundings.

4.Salience of
the Problem 2/2 x 1 1 The family recognizes it as a
problem and it needs immediate
action.

Total
3.34

Inadequacy of living space

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 2/3 x 1 0.67 It is a health threat. Microorganisms
may easily spread or be passed on
to one another due to the poor

25
 ventilation caused by inadequate
space.

2.Modifiability of
the Problem 0/2 x 2 0 Due to inadequate financial
resources, it is not modifiable.

3.Preventive
Potential 1/3 x 1 0.33 Can be prevented if the family has
adequate resources for alteration.

4.Salience of
the Problem 1/2 x 1 0.5 The family has not perceived this as
a problem, but does not need
immediate action.

Total
1.40

Financial instability

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 2/3 x 1 0.67 It is a health threat. The family can
only buy prescribed medications
only when they have the budget for
it.

2.Modifiability of
the Problem 1/2 x 2 1 It is partially modifiable. Switching
to a job with higher salary of both
bread winners of the family can
help in the family’s financial
resources.

26
 3.Preventive
Potential 1/3 x 1 0.33 If both bread winners of the family
have jobs with higher salaries,
financial instability can be
prevented.

4.Salience of
the Problem 1/2 x 1 0.5 The family recognized it as a
problem, but it does not require
immediate action.

Total
2.5

Health Deficit

Lifestyle

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 3/3 x 1 1 It is a health deficit. Poor and
unhealthy lifestyle affects the
body’s nutrients and protection
from diseases.

2.Modifiability of
the Problem 1/2 x 2 1 It is partially modifiable. The family
has deficient knowledge about the
importance of health.

3.Preventive
Potential 2/3 x 1 0.67 It can be prevented by educating
the family about the importance
and prioritization of health.

27
4.Salience of the
Problem 2/2 x 1 1 The family does not recognize it as
a problem, and it needs immediate
action.

Total
3.67

Foreseeable Crisis

Parenthood

Criteria Computation Actual Justification

Score

1.Nature of the
Problem 1/3 x 1 0.33 It is a foreseeable crisis. Ms. RC
and Mr. JS became parents at an
early age.

2.Modifiability of
the Problem 1/2 x 2 1 The problem can be partially
modified by educating them about
the responsibilities of parents, and
family planning.

3.Preventive
Potential 1/3 x 1 0.33 Guidance by the parents must be
present in order to prevent the
problem from occurring.

4.Salience of the
Problem 1/2 x 1 0.5 The family does not recognize it as
a problem, but it needs immediate
action.

Total
2.16

28
Summary of Computation

Problem Total Score

Lifestyle
3.67

Poor environment sanitation 3.34

Fire hazard 2.84

Financial instability
2.5

Parenthood 2.16

Inadequacy of living space

1.40

29
B.3. FNCP

Lifestyle

Health Family Goal of Care Objectives of Nursing Method Resources

Problems Nursing Care Interventions of Nurse- Required
Problems Family
Contract

Unhealthy To raise the Short Term: 1. Establish -Home HUMAN

Lifestyle Inability to client’s After an hour of rapport visits RESOURCES:
and Personal recognize the awareness nursing -Interview
Habits/Practices presence of regarding interventions, the 2. Provide Method Time, effort
Specifically problems due to his unhealthy family will be adequate and
skills of the
eating canned to eating food intake and able to knowledge student nurses
goods, Alcohol canned alcohol verbalize through and family to
Drinking as goods as consumption. understanding discussing the finish the task
Health the main food on effects of effectively
Threat. source, To educate the the effects of excessive
drinking of family eating canned alcohol
alcohol on what are the foods. Consumption.
occasionally. possible health
problems that Long Term: 3. Broaden the
can After 2 to 3 days family’s
cause by of knowledge
excessive eating home visits, the about the
of canned client will be able health risks
goods. to and
demonstrate

30
changes and complications
how to of having
control the canned goods
alcohol as the main
drinking habits source of food

4. Discuss with
the family
the benefits of
stopping
or lessening
canned food
intake and
alcohol
consumption.

31
Poor environment sanitation
Health Family Nursing Goal of Care Objectives of Care Nursing Method of Resources
Problems Problems Interventions Nurse-Family Required
Contract

Poor The overall After the nursing 1.Establish rapport -Home visits HUMAN
environmental environment -To raise the intervention the -Observation RESOURCES:
sanitation, in has bad odor, family awareness family will be able 2.Discuss the -Interview
particularly no proper waste regarding the poor to: importance of having method Time, effort and
the presence management, environmental a good environmental skills of the
 Know the
of breeding or with empty condition in condition. student nurses
possible
resting sites liquor bottles and family to
presence of diseases it
for and old tires 3.Suggest methods finish the task
mosquitoes as present that can
vector. might that eliminates the effectively
health threat contain cause breeding site
stagnant water, -To inform the  Know how
which can be family of the to eliminate 4.Explore with the
breeding sites potential health the family the ways to
of mosquitoes issues brought on breeding improve home
and other by the existence of sites of sanitation
parasites. vector breeding mosquitoes -emphasize the
grounds  Know the
appropriate storage
that could attract
possible
-To inform people insects
effects of -instruct the family to
about the the
advantages of prevent any
breeding accumulation of
eliminating sites of of stagnant water.
unwelcome mosquitoes
breeding grounds.

32
 -To encourage the
creation of a
healthy
environment in the
household

Fire hazard
Health Family Nursing Goal of Objectives Nursing Method Resources
Problems Problems Care of Care Interventions of Nurse- Required
Family
Contract

Accident Usage of After the Specifically, 1. Establish HUMAN

hazards firewood and nursing the family rapport Home RESOURCES:
specifically charcoal for interventions will visit
fire hazard cooking posed a , the family be able to: 2.Discuss with Time, effort
as health threat fire hazard. The will be able the and
structure of the to decide on a) define family the skills of the
client's home proper and what presence of fire student nurses
consists of wood appropriate fire hazard hazards inside and family to
and mixed action(s) to is all about. their home. finish the task
building prevent the b) effectively
materials, which occurrence Recognize 3.Explain the
could increase of fire. the importance and
its presence of benefits of
combustibility. the existing eliminating fire
problem. hazards:

33
c) know the a) Prevent the
importance occurrence of
and unwanted fires.
benefits of b.) List
eliminating ways/methods
fire hazards to eliminate fire
present hazards within
inside the the family's
house available
resources:
c) Being alert
while cooking
d) Avoid
lighting
or cooking near
the materials
which are
vulnerable to
fire.

34
B.4. Health Teaching

Primary Level of Prevention

A. Environmental Sanitation

To eliminate breeding grounds for pests such as mosquitoes,

proper waste disposal must be allocated inside the home area where
it is accessible and covered, as well as water containers or anything
that might be prone to stagnant water. Stagnant wastewater can act
as a hatching habitat for mosquitoes. The family's excretions, such
as feces and other solid waste, should be kept away from the house,
water and food sources. Inform the family that water drainage is
necessary to minimize flooding in the area. Supplies for washing
one's hands and cleansing one's anal should be readily available.
Sanitation systems are designed to safeguard family C by creating a
healthy environment that lowers the likelihood of illness
transmission.

B. Food Sanitation, Safety and Hygiene

Instruct the family to keep the foods clean, covered, and away
from polluted areas. Before and after using the kitchen and cooking
facilities, they should be cleaned. Cooked food should not be
exposed after it has been served to avoid flies and other insects, and
should be thrown or discarded when exposed to air or polluted, which
is why it must be preserved correctly. Fresh vegetables and fruits
should be cleaned, and if cooked, they should be at the proper
temperature and kept in the refrigerator or other food storage

35
C. Personal Hygiene

Inform family C that hands should be cleansed with lukewarm

water if possible, and soap should be used. The toilet should also be
cleaned before and after use. Towels, undergarments, and
toothbrushes should all be kept separate. To avoid germs, used
towels should be cleaned and dried on a regular basis. Educate the
family about the dangers of going barefoot, and emphasize that this
should not be done in the home to prevent the spread of parasitic
infections. Encourage the family to wash their feet before going to
bed or before sleeping. Encourage the family to trim their nails since
longer nails can hold dirt and germs and contribute to the
development of various diseases.

D. Proper Diet and Nutrition

Nutrition is important to one's health, growth, and

development. Excessive alcohol intake would be more dangerous for
the client because he has hypertension. As a result, the client is
much more motivated to exercise and consume nutritious meals like
vegetables and fruits. The food pyramid would serve as a guide for
such situations of sudden hospitalization, and the client with
hypertension should follow a low-fat diet. Educate the family member
on the dangers of alcohol consumption, avoiding identifying signs
and symptoms of disease, and missing meals or failing to follow the
diet prescribed by the health care practitioner.

F. Promote Sleep/Rest Pattern

Instruct the family about the necessity of getting a full hour of
sleep and having a decent body clock to help the body function

36
correctly. It can also reduce drowsiness, exhaustion, and stress, as
well as the chance of developing predisposing factors such as
hypertension and cardiovascular disease.

Secondary Level of Prevention

A. Hypertension
a. Reducing salt or sodium intake, because a healthy adult must
not have more than 2,300 mg of sodium a day.
b. Eating healthy foods such as fruits, vegetables, whole grains,
and low-fat dairy foods. Eat less fat or saturated fat.
c. Avoiding or limiting alcohol because alcohol can raise blood
pressure.
d. Avoid smoking or secondhand smoking
e. Managing weight because too much body weight is a risk
factor for high blood pressure.
f. Exercising regularly helps lower blood pressure and manage
weight.

Tertiary Level of Prevention

a. Diet and exercise can help you lose weight.

b. No smoking or excessive alcohol consumption.
c. Take daily or weekly blood pressure readings to monitor
improvement.
d. Pharmacological methods to reduce blood pressure, such as
prescription drugs or hypertension management, such as
amlodipine.

37
XII. Implication

The family required immediate attention; hence, the student nurses

analyzed, evaluated, and considered the difficulties and worries of the
family. In order to provide the family with the finest nursing care possible
in accordance with their needs, the student nurses have also prepared
a family nursing care plan. The following guidelines were agreed upon
by family nurses and student nurses:

For the Family

The student nurses were able to educate the family and give them
tips on how to deal with their issues. They also made it possible to
implement simple interventions, such as addressing the problem with
the home environment and the presence of young children and infants
who may be more susceptible to illness. In a community health nursing
context, it is hard to eliminate the common health hazards and existing
health issues without follow-up visits by nurses or other health care
workers to assess the community or individual family in achieving the
health care goal objectives, also without the follow-up visits of the family
itself in the barangay health center for follow-up checkup. Regardless of
these challenges, all nurses can increase the framework for dealing with
and monitoring illness and improve health outcomes. This would help
nurses and other healthcare professionals in the private and non-private
sectors raise awareness of the family's case study and encourage them
to maintain and develop community health initiatives in order to identify
the requirements of a single family.

For the Barangay 19-B

In order to lower the frequency of diseases and fatalities, community

health nurses instruct the population on how to preserve their health.
Being able to get quality healthcare is a huge benefit of living

38
somewhere, not only for an individual but also for families who may not
be aware of all the resources their barangay may provide. Before
delivering primary health care, the healthcare professionals at the
barangay health clinics underwent an introductory training program.
They offer medical assistance in an emergency, maternity, neonatal,
and pediatric care, as well as neighborhood-based programs like
barangay vaccination clinics that target young children and newborns in
particular. The barangay currently offers free services, most notably free
pharmaceuticals, but it should also promote its free services, medicines,
and vaccines across the area. To make families aware of the free
services the barangay could provide to families that are unable to pay
for their daily prescriptions.

For Student Nurses

By adopting appropriate nurse interventions for disease prevention

and health maintenance during the two home visits, nursing students
may sustain the family's health management practice in terms of the
three levels of health promotion and preventive interviews. As a result,
the nursing students will be prepared with the knowledge and abilities
needed to carry out the Community Health Nursing Family Case Study
and the Family Nursing Care Plan. They will be able to use their
capability as nursing students not just in the hospital environment but
also in the community thanks to the educational skills they are continuing
to build, which will help them develop their future professional expertise.

For Future Researchers

Future researchers might utilize this case study as a starting point to

better understand and encourage correct evaluation and enhance
community optimal health. To make people aware of the problem and
provide them the skills to understand it, the Barangay 19-B has to be
checked and updated, and health education should be gradually

39
 expanded. Because they will largely be interacting with various types of
families, the student nurses will effectively employ the information and
comprehension supplied by the abovementioned.

XIII. Health Updates

There are no unusual symptoms about Mr. GC's health or the health of
his family. From the first to the second visit, Ms. RC, the daughter, stated that
his father, Mr. GC, is doing well and showing no indications of illness. Mr. GC
still needs to return to the barangay health facility for a checkup and his
hypertension medication/maintenance.
XIV. Documentation

40
41
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