COLLEGIO SAN AGUSTIN BACOLOD

College of Health and Allied

Professions
Nursing Program

Community Health Nursing

Home Visit Record # 4

Name of Student: Maricel de la Cruz Year & Sec: BSN 2B

Name of Client: C. B._____________
Date and time of visit: August 31, 2021 6am – 2pm_
Address: Purok 1, Barangay Estafania, Bacolod City_

OBJECTIVES ACTIVITY EVALUATION

After two (2) hours of
nurse-client interaction,
my client will be able to:

1. Say my name and 1. Introduce self and laying 1. Goal met. Client was
purpose of visit of purpose of visit to client able to state my name and
called me “Maricel”; She
further said “Maayong aga,
Maricel. Salamat kay
nakakadto kamo di.”

2. Respond to background 2. Interview client and 2. Goal met. Client was

information regarding the family members as well as able to provide important
family observe client’s home and information for the
physical environment Community Health Profile.
CB was very cooperative.

3. Identify community 3. Interview client to 3. Goal met. Client was

resources and services obtain information about able to identify resources
availed in the community the community resources and services that are
and services availed in the available in the community
community like:
A) Vollyball court – CB’s
children are able to play in
the volleyball court.

B) BHS – CB sends her 9

month old baby for
immunization in the BHS
 OBJECTIVES ACTIVITY
4. state about the present 4. Take physical and health 4. Goal met.
health status of their family assessment (vital signs) of
the client and family CB/S – 48 y/o Vital signs are
members
5. Participate during the 5. Explain the importance
Health Teaching of eating nutritious foods;
Show pictures of food rich
in carbohydrates, proteins,
fats
6. State the next date of 6. Establish the time of my
my home visit next home visit which will
be on September 6 next
week, Wednesday at 9am.
EVALUATION
the ff:
BP 110/80
Temp 37.1
Pulse 76
RR 20
Children’s Vital signs:
“FB”- 16 y/o
BP -120/70
Temp 36.8
Pulse 71
RR 19
“SB” – 9 month old
BP 110/80
Temp – 36.7
Pulse 78
RR 24
5. Goal met. Client was
able to listen carefully and
was able to ask questions
about food particularly rich
in protein since CB wants to
cook simple protein-rich
food for her children.in
relation to hygiene. CB was
able to give example of
food rich in carbohydrates,
fats and proteins.
6. Goal met.
CB was able to say the date
of my next visit. She said “
Sige, Maricel, salamat gid
sa tanan nga gintudlo mo sa
amon. Kit-anay kita liwat sa
Miyerkules, dason semana
September 6.”
 My fourth home visit was
well- accomplished and
went smoothly.
My adopted family was
very cooperative during my
home visit and they are also
accommodating.
My objectives for this home
visit were all met.

Proper asepsis techniques

were observed during my
home visit.

My journal (ARAS) will be

submitted today to our
Clinical Instructor.

________________________ ________________________
Student’s Signature Client’s Signature
Date and Time Date and Time