University of San Agustin

College of Health and Allied Medical Professions Iloilo City

COMMUNITY HEALTH NURSING

The Family Case Study

Submitted In Partial Fulfillment of the Requirements for

NCM 109a Maternal and Child Health Nursing (RLE)

Submitted to:

Gervil Berco, RN

Submitted by:

Bito-on, Florence

Bonifacio, Honey Babes R.

Cambe, Juvy Shania Nicole

Dagunan, Christian Friday V.

Dinson, Red Angela O.

USA BSN 2-B A.Y 2022-2023

 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

March 2023

General Objective:

After the conduct of the Family Case Study, the participants will be able to specify how the
different health teachings and interventions can aid in a more thorough service for the formulation of
family care plans that will be able to provide the client with valuable information and definitive strategies
to manage or avoid health problems that may influence the child's development within the mother's
womb that can transpire at the client's home and community along with enhancing their living conditions
and overall well-being.

Specific Objectives:

Within 144 hours, the participants will be able to:

1. Explain the significance of conducting the Family Case Study in consolidating the skills and
learnings of the student nurses through application in real-world situations.
2. Acquire sufficient knowledge from the Family Case Study to be able to give optimized care for a
specific health problem within the family or community.
3. Integrate the knowledge acquired from the Family Case Study to be able to provide a much more
detailed and effective care plan that adheres to the client’s standards.
4. Adhere to the Core Agustinian Values; Unitas, Veritas, and Caritas throughout the conduction of
the activity while embodying professionalism and the core nursing values to promote a positive
experience for all the participants.
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

Name of Interviewer: Bito-on, Bonifacio, Cambe, Dagunan, Dinson Course & Year: BSN 2-B
C.I. Assigned:__Gervil Berco, RN
Date Conducted: March 13, 2023 Time Started: 3:00 P.m. Time Ended: 4:00 P.m.

Name of Respondent Position in the Family Age (18 & Above)

Sarah Therese P. Bito-on 1st Child 36
Zone / Sitio Barangay Municipality
Purok tres Sapaw Dumanggas
I. FAMILY STRUCTUREE, CHARACTERISTICS AND DYNAMICS

There are six members of the household, namely; S.B., R.B., T.B., R.B., J.C.B., and M.T.B... R.B. is a
male born August 4, 1986, whose current age is fifty-five, completed elementary as his highest completed
education and is married to T.B., and has the role of father of the family that works as a business manager
with a monthly income of 80k. T.B. is a female born December 29, 1961, currently, aged sixty-one,
completed elementary as her highest completed education and is married to R.B., and has the position of
mother of the family with the role of housewife. R.B. is the daughter of R.B. and T.B., a female born February
21, 1988, whose current age is thirty-five, who completed college as her highest completed education and
is married, and has the role of the younger sister of the family that works as an entrepreneur that has a
monthly income of 17k. J.C.B. the nephew of S.B., a male born December 21, 2017, currently, aged five,
completed preschool as his highest completed education during the time of the interview and is single,
and is currently a student. Lastly, M.T.B. the niece of S.B. is a female born August 8, 2019, completed
preschool as her highest completed education, and is currently a student. The family is considered to be
extended whereas the father, R.B., is dominant in terms of decision-making. The family has a harmonious
relationship and openly communicates with one another thus there is no presence of conflict.

II. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

The client’s father provides the majority of the family’s income, which is the highest monthly
income; however, the family is able to purchase food everyday as the mother decides how the money is
spent. The family's religious affiliation is Roman Catholic and they attend the holy Eucharist mass every
Sunday. In terms of medical tradition, the family trusts folk healers and alternative traditional medicine, such
as the use of ginger, garlic, bitter gourd, and other herbal plants in the treatment of their health. There are
no non-family members who play an important role in the family's life. The family is rarely seen participating
in community activities.

II. HOME AND ENVIRONMENT

The family owns a three-bedroom, two-story house that was constructed from strong and long-
lasting materials. It is a complex structure made of wood, masonry, concrete, or another material that is
equipped with electrical and plumbing facilities. Complete lights and other electrical appliances are
provided, as are a refrigerator for storing food and an electric stove for cooking. However, some outlets
have faulty wiring that causes them to ground out when plugs are placed.

The home provides enough rooms for each family member to feel comfortable and quiet. They
have a private supply of water that is powered by an electric motor. There is a flush-type toilet in the
bathroom, which is kept continuously sanitized and hygienic. To avoid dirt and other debris accumulating,
the common spaces and bedrooms are periodically dusted. Despite this, dust is still visible because the
property is next to an uncemented barangay road. Breeding sites of disease-carrying insects can be
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

observed, specifically in plant pots with stagnant water outside their house. The garbage is properly
disposed of, segregated into biodegradable and non-biodegradable materials, and collected by the
garbage truck.

The housing situation within the client’s area is uncongested, with spaces between neighboring
houses. The client claimed that the social facilities are regularly cleaned not only because of early-morning
street sweepers but also because the residents also contribute to maintaining the facilities' cleanliness and
preventing dengue cases.

The barangay hall, basketball court, chapel, primary school, and daycare center are among the
neighborhood's social facilities. Modern electronic gadgets like phones and other devices are utilized for
communication. Due to the area's proximity to a national highway, jeeps, buses, and tricycles are all viable
modes of transportation.

IV. HEALTH STATUS OF EACH FAMILY MEMBER

A. Medical History Assessment

Based on the medical history assessment, Mr. R.B. has been diagnosed with Parkinson’s Disease, high
blood, and Asthma. He takes medication namely Sinemet 1 tablet bid, Atorvastatin 1 tablet Foster Next
haler to regulate his health condition. The client reported no allergies, accidents, or injuries as well as
hospitalization records.

Moreover, Mrs. T.B. has been undiagnosed with pneumonia. She has never been hospitalized and has
never encountered any accidents or injuries. R.B. has been hospitalized at Dumangas District Hospital year
2012 due to dengue.

B. Nutritional Assessment

The nutritional assessment of the B. family indicated that the BMI of both Mr. R.B. and Mrs. T.B. are
25. 7 and 25.8 which is classified as overweight. The BMI of R.B. J.C.B. and M.T.B. are 20.2, 21.7, and 15.9
respectively which are determined as normal. All the family members consume 3 meals a day and have
their snacks at least once or twice a week.

Mrs. R.B. conducted a developmental evaluation of a preschooler. J.C.B. is said to be in his intuitive
perceptual stage, which is when he learns to adapt to new information and change his perceptions. J.C.B.
gradually becomes more conscious of his powers while maintaining a strong attention and focus span. Mrs.
R.B. stated that when J.C.B. was left off at the learning facility after returning from school, he demonstrated
a temperament of frequent outbursts. After evaluation, Mrs. R.B. declared the lack of important and
reversible risk factors associated with the specific lifestyle-influenced illness.

V. VALUES, HABITS, PRACTICES ON HEALTH PROMOTION, MAINTENANCE AND DISEASE PREVENTION.

Based on the illustration above, Mr. R.B., T.B. and R.B. are immunized by all vaccines except HIB
vaccine. On other hand, J.C. B. is not immunized by HIB, OPV, IPV and Covid-19 while M.T.B. is not also
vaccinated with HIB, OPV, IPV, PCV, MMR, and Covide-19.
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

The healthy lifestyle practices of the family are based on their dietary intake, S.T.B. limits food with
sugar contents, R.B and T.B. doesn’t have a proper diet, their dietary intake is not controlled but both of
them don’t drink sugary beverages. S.T.B., R.B and T.B. keep themselves hydrated and they drink their
medicine on time. On other hand, J.C.B and M.T.B. consume appropriate food for their body; they eat
nutritious foods that have a less sugar and salt content. Fruits and vegetables are their favorites.

For the amount of rest and sleep the family has a different sleeping schedule whereas, S.T.B., R.B
and T.B. sleep for more than 6 hours a day. J.C.B and M.T.B sleep for 8 hours or more than that. The family
are very active when it comes to their physical exercises/activities because they involve themselves in
any activities that are good for their endurance and for their health. R.B. and T.B. do brisk walking every
morning. R.B. cooked their meals everyday and does some household work/maintenance because this
is also her way to move her body. T.B. are the ones who organize and clean their house and she also
does gardening. J.C.B and M.T.B. enjoys playing outside, J.C.B. are fond of cycling while M.T.B. are into
dancing. While, S.T.B. doesn’t have an exercise routine at all.

The protective measure that the family do is to protect themselves in the current health pandemic
which is the Covid-19, they do social distancing and frequent hand washing because these are the ones
that we should practice in order for them to protect themselves in the transmission of viruses/microbes.
And S.T.B. always wear a face mask even before pandemic because of the environmental irritants that
could trigger her asthma.

The adequacy of relaxation and stress management of their family are unique and very suitable for
their age. S.T.B. is fond of watching Kdramas and reading books. R.B. loves to take naps after work and
do a little cleaning of their surroundings. T.B. are active in social media platforms, she reads, watches
vlogs, and listens to music in the social application. On other hand, J.C.B is fond of online games
because this reduces his stress while M.T.B loves literary pieces, she is fond of writing and reading books.
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

SCALE OF RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO PRIORITIES

Health Problem: Overweight as health threat related to obesity as evidenced by verbalization of the client
“gulpi lang galingin akon ulo kag ga hugot tangkugo kung mag kaon ako damo kapin pa matambuk nga
pagkaon.”

CRITERIA WEIGHT Scoring Justification

1. Nature of the Overweight is a Health

condition or threat in which will cause
complications that
problem
1 requires immediate
presented 3 (2/3)x
attention and adequate
Scale: 1
3 management of one’s
wellness state 1 blood pressure.
2
health deficit
health threat 1
foreseeable crisis
2. Modifiability of Current knowledge,
the condition or interventions and
resources are available to
problem
2 (2/2)x solve the problem of high
Scale: 2 2
easily modifiable 1 2 blood pressure or
Partially hypertension.
modifiable
0
not modifiable

3. Preventive Increase blood pressure

Potential can be prevented
Scale: 3 (2/3)x through proper health
high 1 teaching and proper
2 1 2/3 health management of
moderate
low overweight.
1

4. Salience The family perceives

Scale: overweight as a serious
2 problem needing
a condition or problem, attention
needing immediate attention
(2/2)x
1
a condition or problem, not 1 1
needing immediate attention

not perceived as a condition

or problem needing change
0 1

Problem’s
TOTAL SCORE: 5
Score 4
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

Health Problem: Asthma as health deficit (diagnosed) related to pneumonia as evidenced by coughing
with sputum and past medical records of asthma and verbalized "grabe nagid ubo ko pero dasun lang
ako mapa check up, luy a lang ni katapat kag nakulbaan ako mag pa hospital kapin pa ga busong ako”

CRITERIA WEIGHT Scoring Justification

1. Nature of the It is a health deficit

condition or because there are times
that he feels exhausted
problem
due to his work and R.B.
presented 3 himself doesn’t have the
Scale: 1 (3/3)x ability to recognize the
wellness state 3 1 1 presence of his condition
due to inadequacy of
health deficit 2 knowledge.
health threat 1
foreseeable crisis

2. Modifiability of The problem is partially

the condition or modifiable since R.B.
problem 2 himself chooses to rest
whenever he feels
Scale:
1 (2/2)x 0
2 exhausted.
easily modifiable 2
0
Partially modifiable

not modifiable

3. Preventive 3 Further complications will

Potential be avoided if this
(3/3)x
Scale: 2 1 problem will be
high 1 recognized and be given
moderate 1 1 a careful attention.
low
4. Salience The family recognize this
Scale: as a problem needing
2 immediate attention
a condition or problem, because it is not
needing immediate conducive to health.
attention
1 (2/2)x
1
a condition or problem, not 1
needing immediate
attention
0 1
not perceived as a
condition or problem
needing change

Problem’s 3
TOTAL SCORE: 5
Score
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

Health Problem: Unsanitary waste disposal as Health Threat related to waste air
pollutants and scattered garbage’s in front of their backyards. Subjective: “Grabe ang
baho, kakulbaan mahaklo sang amon bata nga gabusong”

CRITERIA WEIGHT Scoring Justification

1. Nature of the Unsanitary waste disposal

condition or can contribute to risks of
acquiring diseases that
problem
are bacterial/viral in
presented 3 origin.
Scale: 1 (2/3)x
wellness state 3 1 2/3

health deficit 2
health threat 1
foreseeable crisis

2. Modifiability of The resources needed to

the condition or modify the problem are
present in the family and
problem
with the help of nurse; the
Scale: (2/2)x
2 2 2 family can correctly
easily modifiable 2 apply simple measures to
1 solve the problem.
Partially modifiable
0
not modifiable

3. Preventive Possible diseases that will

Potential arise form the problem
Scale: 3 cannot be easily
(3/3)x prevented if proper waste
high 2 1 1 disposal will be imposed.
1
moderate 1
low

4. Salience
Scale:
Sanitary waste disposal
a condition or problem, needs immediate
needing immediate 2 attention because it can
attention (2/2)x contribute to risks of
1
1 acquiring diseases

a condition or problem, not

needing immediate 1 1
attention
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College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING
not perceived as a
condition or problem
needing change

Problem’s
TOTAL SCORE: 5
Score 4.7

Health Problem: Presence of breeding or resting sights of vectors of diseases as Health

threat related to dark unoccupied spaces as evidenced by presence of stagnant water
within plant pots outside their house and as verbalized by the client “sa gwa sang
amon balay damo kami mga gamit nga wla namon gina usar”.
CRITERIA WEIGHT Scoring Justification

1. Nature of the
condition or
problem Problem is perceived
presented as health threat as
3
Scale: vectors can cause
3 2/3 diseases
wellness state 1
(2 / 3 ) x 1
2
health deficit
1
health threat

foreseeable crisis

2. Modifiability of Case is easily

the condition or modifiable as many
problem 2
of the materials are
Scale: 1 2 already present.
(2/2)x
2
easily modifiable 2
0
Partially modifiable

not modifiable

3. Preventive It can be moderately

Potential preventive as the
Scale: (2/3)x family need health
1
high 3 1 2/3 teachings to use the
materials for vector
2
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College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

moderate 1 prevention.

low

4. Salience
Scale:

a condition or
2
problem, needing
immediate attention The family perceives
it as something that
a condition or
a condition or 1 (2/2)x 1 problem, needing
1
problem, not needing 1 immediate attention.
immediate attention

not perceived as a 0
condition or problem
needing change

Problem’s
TOTAL SCORE: 5
Score 4.3

Health Problem: Hypertension as Health Deficit

CRITERIA WEIGHT Scoring Justification

1. Nature of the
condition or
problem Hypertension is a health
presented threat due to the fact
3
Scale: that it increases the risk of
3 1 2/3 cancers of the uterus,
wellness state ( 2/ 3 ) x 1 pancreas, kidney, and
2 prostate. increases the
health deficit
1 risk of developing
health threat
heartburn, gallbladder
foreseeable crisis disease, liver problems,
and many other
complications if not
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

handled correctly.

(Mayo Clinic, 2021)

2. Modifiability of It is partially modifiable

the condition or with the help of the
problem nurse's knowledge, nurse
Scale: 2 1 health education, and
(1/2)x the assistance and
easily modifiable 2
1 2 cooperation of the
Partially modifiable
not modifiable 0 family, as well as the
client's family's food
resources, to help modify
its conditions.
3. Preventive The preventive potential
Potential in this problem is high
Scale: 3
because the client has
2 1 not manifested major
high
complications thus far.
moderate 1 Hypertension can be
(3/3)x treated by eating a
low 1
1 balanced, calorie-
controlled diet, joining a
local weight loss group,
and increasing activities
such as fast walking and
exercise. (Nhsinform,
March 10, 2023)

4. Salience Families view

Scale: hypertension a problem
that requires immediate
a condition or
2 attention because they
problem, needing
are aware that it can
immediate attention 1 1
(2/2)x lead to a variety of
a condition or 1
0 1 complications, including
problem, not needing
health risks, if not treated
immediate attention
promptly.
not perceived as a
condition or problem
needing change
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College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

Problem’s
TOTAL SCORE: 5
Score 3.7

FAMILY CARE PLAN

Unsanitary waste disposal as Health Threat related to waste air pollutants and scattered
garbage’s in front of their backyards. Subjective “Grabe ang baho, kakulbaan
mahaklo sang amon bata nga gabusong”

Health Problem Goal of Care Health teachings Evaluation

Unsanitary Waste After 1 day of After 1 day of

Disposal as Health Threat nursing intervention, nursing
related to waste air the family will able intervention, the
pollutants and scattered to understand the goal was met;
garbages infront of their importance of the family was
backyards. home/environment able to
cleanliness to understand the
promote the safety importance
Subjective: of the pregnant home/personal
mother. cleanliness and
“Grabe ang baho, the
kakulbaan mahaklo environmental
sang amon bata nga factors that
gabusong” contribute to
the risk of
Objectives: acquiring
Family Nursing Problem: diseases of
Within 4 hours of newborn. They
1. Inability to provide a health education also verbalized
home environment and nursing care
conducive to health that “Nami gali
the family will be tanawon nga
maintenance and able to:
personal development naka plastar sa
due to: insakto nga
bulutangan ang
mga basura,
a1. Teach the mas madali
a. Inadequate a. Acquire
family the pagid ini e
knowledge of adequate
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

importance of hygiene information about significance of 3 segregate kag

and sanitation waste segregation. R’s. indi mag
balingaso ang
baho nga maka
a2. Explain how haklo sa amon
environmental bata nga ga
factors affect the busong”.
unborn child in the
womb.

b. Lack of skill in carrying b. Provide

out measures to improve appropriate actions b1. Teach family
home environment to improve how to separate
segregation plastic, metals, and
techniques or glass substances.
measures.

b2. Organize trash

bins based on their
used and waste
particles.

Overweight as health threat related to obesity as evidenced by verbalization of the

client “gulpi lang galingin akon ulo kag ga hugot tangkugo kung mag kaon ako damo
kapin pa matambuk nga pagkaon.”

Health Problem Goal of Care Health Teachings Health

Evaluation
Overweight as health After 3 days of
threat related to obesity After 2 days of the effective
as evidenced by nursing nursing
verbalization of the client intervention, the intervention, the
family will be able
“gulpi lang galingin akon Goal was met
to provide
ulo kag ga hugot the family was
appropriate
tangkugo kung mag able to provide
actions to control
kaon ako damo kapin and minimize their appropriate
pa matambuk nga eating habits that actions to
pagkaon.” can possibly lead enable them
to preeclampsia in control and
pregnancy. minimize the
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

unhealthy
eating habits
and they
verbalized
“Makapekto
Objectives:
gid ang
papawala sa
Family Nursing Problem: pagkaon sa
After the 2 hours of
amon bata kag
nursing education,
sa ginadala ya
1. Inability makes the family will be
nga apo
decisions with respect to able:
namon, muna
taking appropriate ma e planohan
health action due to:
gid namon ang
dapat yalang
kan on”.

a) Recognize the a1. Inform the client

a. Failure to
different risk that normal blood
comprehend the
magnitude of the factors of pressure is 120/80
condition overweight in and that high blood
pregnancy. pressure is defined
as having a systolic
pressure of at least
130 or a diastolic
pressure of at least
80, which include
an increased risk of
heart failure, heart
attack, and
cognitive decline.

b.1 teaches the

client to eat a
healthy, reduced-
calorie diet and
exercise regularly.

b. Inadequate b) Will be able to b.2 encourage

knowledge to alternative learn how to client to eat Whole
courses of action open manage the foods include whole
to them condition grains, fruits,
appropriately vegetables, whole
 University of San Agustin
College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

grains, nuts, fish,

poultry, beans, and
healthy plant oils.
These foods aid in
maintaining healthy
blood pressure,
weight, and
cholesterol levels.
Additionally, these
foods help reduce
the risk of diabetes,
heart disease, and
other illnesses.

c1. Instruct the

client the value of
healthy movement,
which can be
achieved through
walking, sports,
c. Be able to
dancing, yoga, or
practice healthy
running. More blood
lifestyle
can be pumped
more efficiently with
a stronger heart.
The pressure on the
arteries lessens as a
result. Blood
pressure drops as a
result.

Presence of breeding or resting sites of vectors of diseases as Health threat related to

dark unoccupied spaces as evidenced by presence of stagnant water within plant
pots outside their house.

Health Problem Goal of Care Health Teachings Health Evaluation

Presence of breeding or After 1 and a half After 1 and a half
resting sights of vectors days of nursing days of
of diseases as Health intervention, the successful nursing
threat related to dark family will be able interventions, the
unoccupied spaces as to get rid of goal was met;
evidenced by presence potential vector The family was
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College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING

of stagnant water within sites and be able to rid their

plant pots outside their knowledgeable on house of
house and as verbalized how to prevent potential vector
by the client “sa gwa vectors and the sites, identify the
sang amon balay damo harm they bring to dangers of
kami mga gamit nga the family, vector-related
wla namon gina usar”. especially to the illnesses as well as
pregnant mother what types of
and child. environments
vectors like to
inhabit for the
benefit of the
pregnant mother
and unborn
Objectives: child, recognize
Family Nursing Problem: the benefit of
investments for
1. Inability to provide a After 4 hours of home
home environment health education improvement to
conducive to health and nursing care, avoid vector
maintenance and the family will be infestation, list
personal development able to: different
due to: preventive
a1. Teach the measures to
family about the avoid vectors
a) Recognize the
a. Failure to see benefits different ways they and the
benefit of
(specifically can improve their importance of
investments for
home in order to vector
long term ones) of improving home to
avoid the vectors prevention and
investments in avoid vector
from entering. proper hygiene.
infestation.
home environment
improvement
b.1 Teach the
family the different
b. Lack of/inadequate b) List different ways they can use
knowledge of preventive to prevent vectors
preventive measures measures to avoid from entering.
vectors.
b.2 Assess the
family’s
understanding with
regards to the
different measures

College of Health and Allied Medical Professions Iloilo City
COMMUNITY HEALTH NURSING
c. Lack of knowledge of
importance of hygiene
and sanitation
Health Problems
Presence of breeding or
resting sights of vectors of
diseases
Unsanitary Waste Disposal
Asthma
Overweight
Hypertension
University of San Agustin
to be taken for
vector prevention
for the safety of
the pregnant
mother.
c.1 Teach the
c) Recognize the family the dangers
health concerns of vector related
posed by unclean illnesses as well as
environments that what types of
serve as disease- environments
carrying breeding vectors like to
grounds. inhabit.
c.2 Assess the
family’s level of
knowledge with
regards to the
types of diseases
that vectors carry
and what specific
vector carry them
that can affect the
condition of the
unborn child.
Scoring Priority
4.7 2nd
5 1st
4 4th
4.3 3rd
3.7 5th