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MINDANAO MEDICAL FOUNDATION COLLEGE

P. Villanueva St., Agdao, Davao City


Tel. No.: (082) 221-6225

In Partial Fulfillment for the Requirements in


Community Health Nursing (NCM 104)

IKP Road, Barangay Governor Vicente Duterte, Agdao, Davao City


A FAMILY CASE STUDY OF
N FAMILY

Presented by:

Abedejos, Ivan Jake B.


Aguilar, Princess Armel Y.
Aldiano, Jhulyan Faith
Andrada, Carl Adriane Y.

Presented to:

Ms. Jo-Ann Alcantara, RN, USRN


Mr. Jovon Rey Toriales, RN
Ms. Ana Lagdameo, RN
Ms. Ana Lee Pendon, RN, MAN

DECEMBER 2023
MINDANAO MEDICAL FOUNDATION COLLEGE
P. Villanueva St., Agdao, Davao City
Tel. No.: (082) 221-6225

TABLE OF CONTENTS

Acknowledgement 4
Introduction 5
Objective of the Study 7
CHAPTER 1: Initial Data Base 8
Genogram 9
Family Structure 10
Dominant Family Members 10
General Family Relationship 10
Activities of Daily Living 11
Sleeping Pattern 12
Eating Pattern 12
Leisure Time Activities 12
Family APGAR 13
Family Coping Index 14

CHAPTER 2: Socioeconomic & Cultural Characteristics


Socioeconomic Background 16
Family Expenses 17
Decision Maker in Terms of Financial Matters 18
Significant Others 19
Relationship of the family to the Larger Community 19

CHAPTER 3: Environmental Factors


Ecomap 20
Housing 21
Kind of Neighborhood 21
Social & Health Facilities Available 22
Communication & Transport Facilities 22
MINDANAO MEDICAL FOUNDATION COLLEGE
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Tel. No.: (082) 221-6225

CHAPTER 4: Health Assessment of Each Member


Present and Past Illnesses 23
Physical Assessment 25
Values, Habits, and Practices on Health Maintenance
and Disease Preventions 28

CHAPTER 5: Health Prioritization


Scaling Method 29
Prioritization of Family Health Problems 30
Prioritized Health Problems 35

CHAPTER 6: Family Nursing Care Plan


Family Nursing Care Plan for Fall Hazard 37
Family Nursing Care Plan for Diabetes Milletus 35
Family Nursing Care Plan for Inadequate Sleep 37
Family Nursing Care Plan for Fire Hazard 40
Family Nursing Care Plan for Unvaccinated Pet Animals 43
43
CHAPTER 7: Nursing Implications 45

CHAPTER 8:Summary, Recommendation, Evaluation 45

CHAPTER 9: Bibliography 48

CHAPTER 10: Appendices 49

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Tel. No.: (082) 221-6225

ACKNOWLEDGEMENT

This study enabled the 2nd-year Nursing Students in Group 1-A at


Mindanao Medical Foundation College to have the opportunities to recognize
the different problems and needs of the family allowing development to their
health and living condition. However, all of these could not be done without
the help of those significant people that help us throughout the study. The
Group 1-A of 2nd Year Student in Nursing would like to express gratitude to
the following:

To our Clinical Instructor, Ma’am JoAnn Alcantara, RN, we would like to


express our deep and sincere gratitude for the opportunity given to conduct
this study and for the ongoing patience and support that have guided us.

To our cherished Dean of Nursing, Ma'am Ana Lee Pendon, RN, MAN,
for granting us the opportunity to gain exposure in Barangay Vicente Duterte.
We appreciate her constant encouragement and unwavering support
throughout this experience.

Our heartfelt appreciation also goes to Barangay Vicente Duterte, led


by Barangay Captain Remedios A. Dela Luz and all its members. Their
cooperation and permission were instrumental in conducting our study on one
of their residents.

To our family, classmates, and friends for their warm, positive and
loving support and encouragement, because without these people, our study
would not be a successful one. And of course, praises and thanks to the God
Almighty, for he showers us blessings throughout our case study. For the daily
guidance and safety provided, and for imparting valuable insights that help us
understand the significance of a family.

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INTRODUCTION

Family is the fundamental unit of society that works as a strong


foundation providing support and care among family members. Family plays a
crucial role in shaping how our communities and society grow and thrive.
Each family is unique and different from one another which means a family
can be different based on cultural norms, structure, dynamics, and values.
These variations contribute to unique family experiences and relationships,
shaping each family's distinct identity.

In Filipino culture, family plays a crucial role and possesses unique


characteristics compared to families from diverse nationalities. Unlike many
other families that primarily consist of nuclear units, Filipino families have a
broader network that includes extended family members. Consequently, there
is a strong emphasis on fostering relationships with extended family
members, underscoring the significance of these connections similar with
those with parents.(Goyala, 2019).

In a community setting, families can differ based on their backgrounds,


lifestyles, and interactions within the community. Factors like cultural diversity,
socioeconomic status, and community involvement contribute to the varied
nature of families (Li and Qiu, 2018). Moreover, the uniqueness of every
family widely creates differences in strategies and methods on how they
communicate, solve problems, and adapt to challenges. In addition, education
backgrounds, religious beliefs, and traditions further contribute to the diversity
of families in a community.

Although every family is different and diverse, the well-being of every


family in the community generally affects the well-being of the community as a
whole. Barangay Vicente Duterte is a barangay community located near the

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coastal area of Agdao, Davao City. The community consists of houses that
are built near each other, pathways that are uneven and narrow, and polluted
shoreside water. These conditions pose challenges to the health and living
conditions of the families residing in the barangay including the N Family
which is the subject of this study. The Community Health Nursing works to
tackle these challenges, focusing on the well-being and health needs of the
community’s family residents.

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OBJECTIVES

GENERAL OBJECTIVE:

At the end of the student nurse-family relationship, the N family will be


able to improve their health status and achieve self-sufficiency in managing
their well-being within a specified time frame through appropriate
interventions.

SPECIFIC OBJECTIVES:

After one month of home visits and student nurse interaction, the family
and student nurses will be able to:

1. Establish rapport, trust, and connection during home visit.


2. Provide accurate and relevant information during surveys and
interviews.
3. Create a family genogram, ecomap, and presentation of Family Coping
Index.
4. Perform head to toe assessment of the chosen client and family
members.
5. Recognize actual and potential problems to achieve optimal health.
6. Identify the nature of the problem such as wellness conditions, health
deficit, health threat, and foreseeable crisis.
7. Develop potential solutions or nursing actions for prioritized health
issues.
8. Formulate interventions considering the student nurse’s abilities,
community, and family resources.
9. Implement planned interventions in collaboration with the student
nurse.
10. Execute health teachings imparted by the student nurse.
11. Evaluate changes in condition after giving intervention.

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CHAPTER 1
INITIAL DATA BASE
1.1 GENOGRAM

Table 1. Shows the Genogram

The N family is an extended type of family consisting of seven


members. Mrs. N is the head of the family that has three children with his
deceased husband. Her children are all male and she has two grandchildren
from his eldest son living along with his wife in the same household.

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1.2.1 FAMILY STRUCTURE


NAME AGE SEX CIVIL POSITION IN RELATION TO PLACE OF ETHNIC
STATUS THE FAMILY THE HEAD OF RESIDENCE BACKGROUND
THE FAMILY

Mrs. N 54 F Widowed Mother Head of the Family IKP Road, Barangay Davaoeño
Gov. Vicente Duterte,
Agdao, Davao City

Mr. N 34 M Deceased Father Partner IKP Road, Barangay Surigaonon


Gov. Vicente Duterte,
Agdao, Davao City

V.N 26 M Married Son Son IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

J.N 22 M Single Son Son IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

N.N 21 M Single Son Son IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

B.N 23 F Married Daughter-in-law Daughter-in-law IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

Z.N 3 F - Granddaughter Granddaughter IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

X.N 1 M - Grandson Grandson IKP Road, Barangay Davaoeño


Gov. Vicente Duterte,
Agdao, Davao City

Table 1.2 Shows the Family Structure

Family structure refers to the composition, organization, and


relationships within a family unit. It encompasses the members of a family in
their positions, relations, interactions, and the overall framework that defines
their household (Pasley & Petren, 2019). The data above shows the age, sex,
civil status, position in the family, relation to the head of the family, residence,
and ethnic background. With the data shown, The N Family is characterized
as both a single-parent and extended family. The widowed mother resides
with her three sons, grandchildren, and a daughter-in-law in the same
household.

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1.2.2 DOMINANT FAMILY MEMBERS


In the N Family, Mrs. N holds a dominant role, particularly in
decision-making and managing family matters. However, when it comes to
financial matters and the allocation of monthly expenses, she discusses it with
her second son, J.N. making him dominant also in the decision-making in
terms of finance and expenses. In regards to family health decisions,
everyone can decide on their own except the children.

1.2.3 GENERAL FAMILY RELATIONSHIP


Each member of the N Family interacts and maintains a good
relationship with each other. They communicate effectively and learn how to
deal with problems very well. The family actively practices mutual care,
understanding, and support. Mrs. N welcomes her eldest son and his wife into
the household, knowing their need for support. Moreover, the relationship
among the three sons remains strong, and it has been supportive in
maintaining their mother's well-being and has been providing for the family’s
needs.

1.2.4 ACTIVITIES OF DAILY LIVING


As the head of the family, Mrs. N spends most of the time with her
grandchildren since her three sons and daughter-in-law are working. She
knows how to groom and take a bath herself, however, her grandchildren can
not do it themselves that is why she takes on the responsibilities to groom and
dress her grandchildren as well. She cooks and prepares foods for them and
does most of the household chores. She then feeds her cats that roam around
their house with leftover foods from their meals that they eat.

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1.2.4.1 SLEEPING PATTERN


Their two-storey house has one room on each floor and they sleep
using “banigs”. The eldest son, V.N, along with his wife and two children
sleeps on the first floor while Mrs. N and her two other sons sleep on the
second floor. Mrs. N mentions that everyone in the family gets sufficient rest
and sleep, averaging between 8 to 10 hours each night. The exception is her
second son, J.N, who works at a graveyard shift in a call center and sleeps
only every afternoon averaging from 4 to 6 hours of rest.

1.2.4.2 EATING PATTERN


The N family is able to eat three times a day. Every morning, the family
gathers for breakfast before starting their day at work and responsibilities.
Mrs. N is responsible for cooking their meals with the help of B.N, her
daughter-in-law. They have to cook meals that are good for her two sons and
her two grandchildren. The second son rarely eats with them in the morning
due to his graveyard shift work and can only eat with them in the morning
when it is his day-off. Mrs. N cooks fish, chicken, and vegetable dishes most
of the time because she said it is cheap and at the same time nutritious.
However, knowing her condition, she tends to forget to control and limit her
rice intake. On the other hand, if she does not have any time to cook for food,
she will buy their meals at “karenderia”.

1.2.4.3 LEISURE TIME ACTIVITIES


The N Family spends their leisure time in different ways. Mrs. N spends
her leisure time going out to their house and chatting with neighbors. Her
grandchildren enjoy playing outside with other children and also love to play
with their pet cats and dogs. Her sons enjoy playing online games, basketball,
and billiards. They also spend their time together watching television which
serves as relaxation to the whole family.

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1.5 FAMILY APGAR

Criteria Question Mrs. N Response

Almost Some of Hardly


always (2) the time (1) ever (0)

Adaptation "How have family members aided each ✔


other in times of need?"

Partnership "How do family members communicate


with each other about such matters as ✔
vacations, finances, medical care, large
purchases, and personal problems"?.

Growth "How have family members changed


during the past years?"

"In what ways have family members aided


each other in growing or developing ✔
independent life-styles?"

"How have family members reacted to your


desires for change?"

Affection "How have members of your family


responded to emotional expressions such ✔
as affection, love, sorrow, or anger?"

Resolve "How do members of your family share ✔


time, space and money?"

Total 10

Average Highly Functional


A score of 10 indicates high functionality, suggesting that the N Family excels in all
these areas. Each member likely feels supported, there's effective communication,
shared responsibilities, emotional connection, and the ability to address and solve
problems together. This overall positive assessment suggests a strong and healthy
family dynamic.

Table 1.3 Shows the Family APGAR

Interpretation of Family A.P.G.A.R. (average score of family members):

8-10 points: Highly Functional Family

4-7 points: Moderately Dysfunctional

0-3 points: Severely Dysfunctional

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1.6 FAMILY COPING INDEX

This chapter depicts the actual observation of the family behavior and
practices in contrast to the ideal family attitude and behavior. It includes an
assessment on how the family handles various stressors. The observations
are analyzed to see the occurrence of health problems or negative attitudes
and behavior.

Scaling:
1 - No Competence
3 - Moderately Competence
5 - Complete Competence

Coping Areas Definition Rating Justification

Physical Independence This category is concerned with the 5 The family is able to get out of
ability to move about, to get out of their bed, walk independently,
bed, to take care of daily grooming, and do their own work and
walking, etc. responsibilities. All the family
members can perform activities
of daily living such as grooming
and doing household chores.
The family is also able to attend
to the needs of other members,
especially to the needs of the
grandchildren. Each and every
one of the members is capable
of caring for themselves.

Therapeutic Competence This includes all the procedures or 3 The N family can demonstrate
treatments prescribed for the care of and carry out the prescribed
illness, such as giving medications, procedures safely and efficiently
using appliances, dressings, in a confident and willing
exercises and relaxation, special manner. They know how to use
diets, etc. a nebulizer in times of asthma
attack. She is compliant in taking
her insulin shot every morning
and knows how to inject it

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properly on her own. The family


even owns their own pulse
oximeter and glucometer to
monitor their conditions.
However, Mrs. N tends to forget
controlling her glucose intake
and sometimes eats too much
more than she should have,
especially in rice.

Knowledge of Health This system is concerned with the 5 The family was able to identify
Condition
particular health condition that is the their health condition. The
occasion for care. mother is aware of her asthma
including her son and
grandchild. They know the
preventive measures to follow in
times of attacks. Mrs. N is well
aware of her diabetes.

Application of Health This is concerned with family action 3 The inside of the house is clean,
Principles on General
in relation to maintaining family but on the outside there's
Hygiene
nutrition, securing adequate rest and excessive animal waste that can
relaxation for family members, lead to environmental pollution,
carrying out accepted preventive contamination of water sources
measures such as immunizations, which could pose risks to the
and medical appraisal, safe home health of the family. In addition,
making habits in relation to storing there is also no emphasis on
and preparing foods. hand washing on the children

Health Attitude This is concerned with the way the 4 The N family is well-prepared
family feels about health care in and informed about their health
general including preventive conditions, aware of the nearby
services, care of illness and public healthcare facilities. They avail
health measures. the resources coming from the
community center.

Emotional Competence This has to do with the maturity and 5 The N Family lives harmoniously
integrity with which the members of at home. Even though conflicts
the family are able to meet the usual arise, they really see to it that
stresses and problems of life, and to they would discuss each

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plan for happy and fruitful living. concern calmly.

Family Living Pattern This is concerned largely with the 5 The N family has a good and
interpersonal or group aspects of healthy relationship with one
family life how well the family another, they get along well.
members of the family get along with They do things together and
one another, the ways in which they each family member acts for the
make decisions affecting the family good of the family. The children
as a whole, the degree to which they and grandchildren respect their
support one another and do things parents and vice-versa, and the
as a family, the degree of respect family tasks are shared.
and affection they show for one
another, the ways in which they
manage the family budget, the kind
of discipline that prevails.

Physical Environment This is concerned with the home, the 2 The N Family’s home
community and the work environment is not fitted for
environment as it affects family them. Especially for the children
health. because of the presence of
accident hazards and cat feces
scattered around the house
acting as breeding grounds for
vectors.

Use of Community It has to do with the degree of the 5 The family is aware of the
Resources family's use and awareness of the available resources in the
available community facilities for community. They maximize the
health education and welfare. availability of the health center
such as free check-ups.

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CHAPTER 2
SOCIOECONOMIC AND CULTURAL PRACTICES

2.1 SOCIOECONOMIC BACKGROUND

NAME AGE OCCUPATION PLACE OF MONTHLY EDUCATIONAL RELIGION


WORK INCOME ATTAINMENT

F.N 54 None - - High School Mormons


Level

S.E 55 N/A - - Grade School Christian


Level

V.N 26 Pedicab Driver P. Villanueva St., Est: 4,000 High School Mormons
Agdao, Davao Level
City

J.N 22 BPO Agent IBEX, SM 16,000 High School Mormons


Lanang, J.P. Level
Laurel Avenue,
Davao City

N.N 21 Hardware Staff R. Castillo, 6,000 College Level Mormons


Agdao, Davao
City

B.N 23 Canteen Staff P. Villanueva St., 3,000 High School Roman


Agdao, Davao Level Catholic
City

X.N 3 N/A - - - Mormons

Z.N 1 N/A - - - Mormons

Table 2.1 Shows the Socioeconomic Background

Mrs. N is a 34 year old widowed woman residing at IKP Road,


Barangay Gov. Vicente Duterte, Agdao, Davao City. She currently does not
have any work and depends on the monthly income of her children for their
own consumption and daily expenses.

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Four out of five adult members of the family have work and have their
own sources of income. Mrs. N stated that her eldest son, V.N has an
estimated monthly income of 4,000 pesos as a Pedicab driver although she
said it varies depending on the numbers of passengers in a day while her wife
has a monthly income of 3,000 pesos. Her second son, J.N, who earns a
monthly income of 16,000 pesos as a BPO agent shoulders most of the
expenses of her mother’s maintenance as her mother stated while N.N, earns
a monthly income of 6,000 pesos. When totalled, the estimated monthly
income of the whole family is around 29,000 pesos.

2.2 FAMILY EXPENSES

ITEMS CALCULATIONS WEEKLY MONTHLY TOTAL

Rice 78 546 2,340


1kl/day x 52.0 (1 kilo
and ½ consumed)

Food 150 1,050 4,500


3x/day x 50.0

Cooking Oil 60 60 240


60 per kilo (1 kilo in a
week)

Coffee 10 70 300
- Great Taste Stick
2.00 per stick x 5
sticks a day

Brown Sugar 15 15 60
¼ in a week

Coffee Creamer 4 28 120


- Cream All
2.00 per stick x 2
sticks a day

Laundry Soap 40 40 160


- Surf
8.00 x 5 sachet in a
week

Fabric Softener 24 24 96
- Downy
8.00 x 3 sachet in a

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week

Shampoo 42 42 168
- Palmolive
7.00 x 3 sachet in a
week
- Head & Shoulder
7.00 x 3 sachet in a
week

Bath Soap 20 20 80
- Safeguard
20.00 x 1 bar for a
week

Toothpaste 24 24 96
- Colgate
12.00 x 2 sachet per
week

Energy Bill 1,000 - 1,000


Est: 1,000

Water Bill 400 - 400


Est: 800 divided by 2
users

Fare 50 350 1,500

Maintenance: 1,800 - 1,800


Insulin Human
(Lupinsulin)
1,800 per bottle every
month

Needle 10 70 300
½ cc, Insulin Needle
10.00 per needle
1 needle per day

Total 15,060
Table 2.2 Shows the Family Expenses

2.3 DECISION MAKER IN TERMS OF FINANCIAL MATTERS


When it comes to financial matters and monthly expenses, Mrs. N
discusses it with her second son, J.N have him settle in the decision-making.
The second son shoulders most of the responsibility of providing the required
funds for the family's monthly needs, especially her mother’s maintenance.

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However, all of them discuss and decide to determine the allocation of


financial responsibilities like food, basic hygiene, and utility bills.

2.4 SIGNIFICANT OTHERS


The N Family’s neighbors and close family friends serve as their
significant others in the community. Though not blood relatives, some
individuals in their neighborhood offer emotional support, creating a sense of
a helpful community for the family. The bonds formed with them are
significant, establishing a framework of mutual assistance and cooperation as
neighbors.

2.5 RELATIONSHIP OF THE FAMILY TO THE LARGER COMMUNITY


The N Family is not active in the activities in the community.. They do
not participate in barangay elections and have not been able to vote.
However, the relationship with their neighbors in the community are on good
terms. We have observed that she has a lot of friends whom she chats with
and talks with in vacant time. She spends most of her time at home doing
household chores or sometimes she walks around the neighborhood and
bonds with her grandchildren. Generally, the family is not active in the
community but at least knows the leaders in their barangay and has close
relationships with neighbors.

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CHAPTER 3
ENVIRONMENTAL FACTORS
3.1 ECOMAP

Table 3.1 Shows the Ecomap

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3.2 HOUSING
The N family’s house is situated near the coastal area of Barangay
Duterte, R. Castillo, Agdao, Davao City. Leading to their house, a bridge
made of uneven woods needs to be crossed before stepping into their
household. Their house is a two-floored structure made of planks and wood
and it is elevated from the ground with woods as foundation. The roof is made
of metal, the walls are made from a mixture of wood, plywood, and metal
roofing, and the flooring in both floors are made of planks and plywood. Their
house is a studio type with no private room on each floor where the second
floor serves as their living room, kitchen, and bedroom with the use of an old
mattress and “banig”. The first floor serves as the bedroom of the eldest son
along with his wife and children.

The stairs going up to the second floor are very steep and there is a
long gap between each stair, which makes it difficult to enter into their second
floor. The bathroom is located next to the stairs below, and a bridge needs to
be crossed, which is made of wood that is placed irregularly and it has gaps
which could pose risk for fall. The second floor has two windows, but the first
floor has only one window. They cook their meals with a butane stove near a
sink that is not connected to any pipes and has no drainage system, leading
food scraps to fall directly onto the seashore. The main water source of the
family is from a faucet located outside their house and it is shared by another
neighbor near their household.

3.3 KIND OF NEIGHBORHOOD


The neighborhood of the N family is an area where houses are built
next to each other making it prone to fire hazard. The area has previously
suffered from a fire incident, leading to widespread damage to the people and
their homes. After the incident, the houses in the neighborhood still continue
to be built in close proximity to each other. In addition, the neighborhood is

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prone to flooding since it is situated near the coastal area. Also, various
animals like dogs, cats, and chickens freely roam around the neighborhood
where feces can be observed scattered around the area near their household.

3.4 SOCIAL & HEALTH FACILITIES AVAILABLE


The N family’s residence is located near Alterado General Hospital.
The available health facility Barangay Gov. Vicente Duterte Health Center is
located in Del Pilar Extension, Bangsi Street, Agdao, Davao City. The health
center is approximately nine-hundred meters away which is relatively far from
their home. The family also do their check-ups and health-related inquiries in
Southern Philippines Medical Center (SPMC) which is estimated to be 3
kilometers away from their house.

3.5 COMMUNICATION & TRANSPORT FACILITIES


The N Family has a tricycle owned by the eldest son. But they mostly
commute and ride jeepneys when traveling to other places since their son
also uses the tricycle for his work and the tricycle can only accommodate and
is limited only to two people. In terms of communication, Mrs. N. stated that
everyone in the family communicates in Bisaya (Cebuano) while the second
son can communicate both in Bisaya and English. In terms of their means of
communication, the N family utilizes cell phone devices. Mrs. N, however,
does not have her own cell phone and depends on her son's devices.

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CHAPTER 4
HEALTH ASSESSMENT OF EACH MEMBER

4.1 PRESENT AND PAST ILLNESSES

a. Mrs. N - Mrs. N stated that she is diagnosed with Type II Diabetes with
their physician. She is currently taking her maintenance such as Insulin
shots every morning daily and uses glucometer to monitor her blood
glucose level. Mrs. N is also asthmatic and she said that she got it from
her father's side of the family. The triggers of her asthma are dust and
shellfish, she also said that she uses a nebulizer during an attack. Mrs.
N has a history of pneumonia as she stated. She stands 4 feet and 11
inches and weighs about 54 kilograms with a normal BMI of 24.

b. V.N - He has no degenerative, chronic or infectious disease as of the


present time. He also has completed immunization. When he was still 5
years old, he experienced chicken pox as Mrs. N stated. She estimated
that he is 5 feet and 6 inches just like her brother, N.N. The mother said
that he has no complaints as of the present time and has not taken any
medication.

c. J.N- As of now, he is in good health without any degenerative, chronic,


or infectious diseases. He is also completely immunized, and he stands
at a height of 5 feet and 7 inches as the mother estimated since he is
slightly taller than his brothers. According to his mother, he has no
current health complaints and is not currently taking any medications.

d. N.N- He has no degenerative, chronic or infectious disease as of the


present time. He also has completed immunization. He is 5 feet and 6
inches and weighs 62 kilograms according to data from lab findings.
For his past illnesses, Mrs. N said that he was diagnosed with Urinary

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Tract Infection (UTI) last month and was taking antibiotics prescripted
by the doctor. Currently. The mother stated that he has no illnesses
and complaints as of the present time and has not taken any
medication.

e. B.N- She has no degenerative, chronic or infectious disease as of the


present time according to Mrs. N. On the other hand, Mrs. N also does
not know about any past illnesses about her daughter-in-law.

f. Granddaughter Z.N - The granddaughter, along with her brother,


underwent immunization and received deworming treatment in
September, 2023. Both the granddaughter and her uncle and
grandmother share a common health condition, asthma, for which Mrs.
N assists her using a nebulizer during asthma attacks. Mrs. N
mentioned that Z.N was hospitalized last year due to an infection..
Presently, Z.N is in good health, without any ongoing illnesses, and is
not taking any medications.

g. Grandson X.N - The grandson has no present illnesses. He has also


completed immunization and was dewormed along with her sister. Mrs.
N mentioned that he has a past history of pneumonia after he was
given birth by her mother and was treated in the hospital. As of now, he
has no present condition and is not taking any medication.

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Physical Assessment: Mrs. N, Mother, 54-years old


Vital Signs

Blood Pressure 130/90 mmHg

Temperature 36.5 C

Pulse Rate 90 beats per minute

Respiratory Rate 19 beats per minute

Skin

Color The color of the skin is tan

Lesion No macule or papule noted

Vascularity There is no edema, vascular and purpuric lesions

Moisture Moisture accords to hot weather

Texture Dry and wrinkly

Temperature Warm

Mobility and Turgor Skin rapidly resumed to its original state

Nails The nails are clean and clipped short

Head

Hair Short and coarse with gray hairs

Scalp No lice and swelling found

Skull The size, contour and configuration is normal. There are no nodules

Face The face is square in shape

Forehead Visible wrinkle

Eyes Eyes are black and can move in six cardinal movements

Ears No odor or swelling and can hear properly

Nose No obstruction and inflammation

Mouth No swelling and inflammation noted

Neck Can flex easily

Shoulder and Arms Both symmetry

Elbow There are no swelling, nodules and deformities

Forearms Can extend and flex properly

Hands and Wrist No deformities or club foot noted

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Physical Assessment: Z.N, Grandchild, 3-years old


Vital Signs

Blood Pressure -

Temperature 36.6 C

Pulse Rate 90 beats per minute

Respiratory Rate 21 breaths per minute

Skin

Color The color of the skin is light and fair

Lesion No macule or papule noted

Vascularity There is no edema, vascular and purple lesions

Moisture Moisture accords to hot weather

Texture Smooth and warm

Temperature Warm

Mobility and Turgor Skin rapidly

Nails The nails are clean and clipped short

Head

Hair long and silky hair

Scalp No lice and swelling found

Skull The size, contour and configuration is normal There are no nodules found.

Face The face is round in shape

Forehead Smooth, no wrinkles

Eyes Eyes are black can move in six cardinal planes

Ears No odor or swelling and can hear properly

Nose No obstruction and inflammation

Mouth No swelling and inflammation noted

Neck Can flex easily, no tenderness

Shoulder and Arms Both symmetry

Elbow There are no swelling, nodules, and deformities noted

Forearms Can flex properly

Hands and Wrist There are no nodules and deformities noted

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Physical Assessment: X.N, Grandchild, 1-year old


Vital Signs

Blood Pressure -

Temperature 36.5 C

Pulse Rate 94 beats per minute

Respiratory Rate 22 beats per minute

Skin

Color The color of the skin is tan

Lesion No lesions noted

Vascularity There is no edema, vascular and purpuric lesions

Moisture Moisture accords to hot weather

Texture Smooth and firm.

Temperature Warm

Mobility and Turgor Skin rapidly resumed to its original state

Nails The nails are clean and clipped short

Head

Hair Short, thin and silky hair

Scalp No lice and swelling found

Skull The size, contour and configuration is normal

Face The face is round in shape

Forehead Smooth, no wrinkles

Eyes Eyes are black can move in six cardinal planes

Ears No odor or swelling and can hear properly

Nose No obstruction and inflammation

Mouth No swelling and inflammation noted

Neck Can flex easily, no tenderness

Shoulder and Arms Both symmetry

Elbow There are no swelling, nodules and deformities noted

Forearms Can extend and flex properly

Hands and Wrist No deformities or swelling found

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The other family members were not able to be physically assessed due
to their busy schedule. Only Mrs. N and her grandchildren are available during
our home visits.

VALUES, HABITS, AND PRACTICES ON HEALTH MAINTENANCE AND


DISEASE PREVENTIONS

According to Mrs. N, all the children in the family have completed their
immunization. The children were also dewormed last September, 2023.

The family is well-prepared and informed about their health conditions,


aware of the nearby healthcare facilities. They avail the resources coming
from the community health center and avail for their free check-ups. Mrs. N
consistently guides their family on proper medication intake. Moreover, they
use a nebulizer for treatment when experiencing asthma attacks. Mrs.N is
currently taking her maintenance such as Insulin shots every morning daily
and uses glucometer to monitor her blood glucose level due to her Type II
Diabetes.

According to Mrs. N, all members of the family have enough rest and
sleep. They usually do 8 to 10 hours of sleep at night excluding his second
son who works in a graveyard shift as a BPO agent. She stated that there is
no proper routine for their exercise and the only exercise that she can point
out is walking, and it only happens when she walks to their neighborhood and
stores. Watching television and listening to radio serves as relaxation to her
family.

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CHAPTER 5
HEALTH PRIORITIZATION
SCALING METHOD
Criteria Score Highest Weight
Possible
Score
Nature of the problem 3 1
Health Deficit 3
Health Threat 2
Foreseeable Crisis 1
Modifiability of the Problem 2 2
Easily Modifiable 2
Partially Modifiable 1
Not Modifiable 0
Preventive Potential 3 1
High 3
Moderate 2
Low 1
Salience 2 1
A serious problem, 2
immediate attention
needed
A problem, but not 1
needing immediate
attention
Not a felt need/problem 0

Scoring:

Decide on a score for each of the criteria.


Divide the score by the highest possible score and multiply by the
weight.

𝑆𝑐𝑜𝑟𝑒
𝐻𝑖𝑔ℎ𝑒𝑠𝑡 𝑆𝑐𝑜𝑟𝑒
× 𝑊𝑒𝑖𝑔ℎ𝑡

Sum up the score for all the criteria. The highest score is 5, equivalent
to the total weight.

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PRIORITIZATION OF FAMILY HEALTH PROBLEMS


I. Diabetes Mellitus as a Health Deficit

Criteria Weight Computation Actual Justification


score
Nature of the problem 1 3/3x1 1 Diabetes is classified
Scale: as a health deficit
Health deficit – 3 because it is an
Health threat – 2 existing problem that
Foreseeable crisis – 1 needs immediate
attention.
Complication could
occur if intervention
and proper
management is not
provided.
Modifiability of the 2 1/2x2 1 The problem can be
problem partially modified
Scale: because it depends
Easily modifiable – 2 on her whether she
Partially modifiable – 1 participates in the
Not modifiable – 0 interventions that will
be provided.
Preventive potential 1 3/3x1 1 The problem can be
Scale: highly prevented if
High – 3 interventions such as
Moderate – 2 proper eating
Low – 1 management and
controlled diet are
applied.
Salience 1 2/2x1 1 The family,
Scale: specifically, the
A serious problem, mother perceives it as
immediate attention needed a problem that needs
–2 immediate attention.
A problem, but not needing
immediate attention – 1
Not a felt need/problem – 0
TOTAL SCORE: 4

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II. Unvaccinated Pet Animals as a Health Threat


Criteria Weight Computation Actual Justification
score
Nature of the problem 1 2/3x1 0.66 It is considered as a
Scale: health threat as
Health deficit – 3 Unvaccinated pets
Health threat – 2 are a danger not just
Foreseeable crisis – 1
to other animals but
also to the humans
around them.
Modifiability of the 2 2/2x2 2 The problem can be
problem easily modified
Scale: because they only
Easily modifiable – 2 needed to have their
Partially modifiable – 1
pets vaccinated,
Not modifiable – 0
Preventive potential 1 3/3x1 1 The problem can be
Scale: highly prevented if
High – 3 vaccination of the
Moderate – 2 pets will be
Low – 1
administered.
Salience 1 0/3x1 0 The head of the
Scale: household does not
A serious problem, perceive it as a
immediate attention needed problem at all.
–2
A problem, but not needing
immediate attention – 1
Not a felt need/problem – 0
TOTAL SCORE: 3.66

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III. Accident hazard specifically fall hazard as health threat

Criteria Weight Computation Actu Justification


al
scor
e
Nature of the problem 1 2/3x1 0.66 It is a health threat
Scale: because it could be a
Health deficit – 3 huge problem to the family
Health threat – 2 especially to their children.
Foreseeable crisis – 1 Falls can lead to injuries,
ranging from minor bruises
to more severe
consequences, posing a
risk to the overall
well-being of family
members.
Modifiability of the 2 1/2x2 1 The problem is partially
problem modifiable since there is a
Scale: need for resources to
Easily modifiable – 2 improve the condition of
Partially modifiable – 1 their house. The family
Not modifiable – 0 resources are not
adequate for improving
their environment
considering other
problems, but through
proper health teachings
and family members, this
problem can partially be
minimized.
Preventive potential 1 2/3x1 0.66 If properly managed, the
Scale: problem will be moderately
High – 3 prevented.However, time
Moderate – 2 and money is required.
Low – 1
Salience 1 1/2x1 0.5 The family sees it as a
Scale: problem but does not need
A serious problem, immediate attention since
immediate attention needed it requires time and
–2 money.
A problem, but not needing
immediate attention – 1
Not a felt need/problem – 0
TOTAL SCORE: 2.82

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IV. Accident hazard specifically fire hazard as a health threat.

Criteria Weight Computation Actual Justification


score
Nature of the problem 1 2/3x1 0.66 It is a health threat as
Scale: it can lead to injuries,
Health deficit – 3 loss of life, and
Health threat – 2 damage to property.
Foreseeable crisis – 1
Modifiability of the 2 1/2x2 2 It is partially modifiable
problem because they can take
Scale: preventive actions,
Easily modifiable – 2 such as practicing fire
Partially modifiable – 1 drills, and ensuring
Not modifiable – 0 proper storage of
flammable materials.
Proactive measures
can significantly
reduce the risk and
impact of a fire in their
home.
Preventive potential 1 3/3x1 1 Fire hazards have high
Scale: preventive potential
High – 3 because implementing
Moderate – 2 safety measures, such
Low – 1 as proper storage of
flammable materials,
regular equipment
maintenance, and
adherence to fire
safety protocols, can
significantly reduce the
likelihood of fires.
Salience 1 0/2x1 0 The family didn’t feel a
Scale: need or problem
A serious problem, related to fire hazard
immediate attention needed either due to a lack of
–2 awareness, or
A problem, but not needing underestimating the
immediate attention – 1 potential risks
Not a felt need/problem – 0 associated with fire.
TOTAL SCORE: 3.66

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V. Inadequate sleep and rest as a health threat.


Criteria Weight Computation Actual Justification
score
Nature of the problem 1 2/3x1 0.66 It is a health threat
Scale: because it can lead to
Health deficit – 3 stress, impaired
Health threat – 2 cognition, weakened
Foreseeable crisis – 1 immunity, and higher
risks of chronic
conditions, affecting His
overall wellbeing.
Modifiability of the 2 1/2x2 1 It is partially modifiable
problem because while lifestyle
Scale: changes can improve
Easily modifiable – 2 sleep, external factors
Partially modifiable – 1 like job demands, such
Not modifiable – 0 as those in a call center,
may limit the ability to
establish consistent
sleep routines and
manage stress
effectively.
Preventive potential 3 1/3x1 0.33 The preventive potential
Scale: is low due to external
High – 3 factors like job demands
Moderate – 2 in a call center, which
Low – 1 may limit the ability to
implement effective
preventive measures
such as consistent sleep
routines.
Salience 2 2/2x1 1 The family recognizes
Scale: the sleep problem but
A serious problem, isn't urgently addressing
immediate attention needed it since they see it as a
–2 slow, non-immediate
A problem, but not needing issue, given that the call
immediate attention – 1 center worker is the main
Not a felt need/problem – 0 provider. Yet, taking
action sooner can
prevent future health
issues.
TOTAL: 2.99

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CHAPTER 6

FAMILY NURSING CARE PLAN

FAMILY PROBLEM NURSING GOAL AND INTERVENTIONS RATIONALE EVALUATION


DIAGNOSIS OBJECTIVES

Diabetes Mellitus as a Inability to make Goal: a. Discuss the a. Proper eating After rendering the
health deficit. decisions with respect At the end of the importance of habits play a crucial nursing interventions,
to taking appropriate nursing intervention, maintaining proper role in overall health, the patient was able
Vital Signs: health action due to the family member will eating habits and the influencing energy to:
BP: 130/90 mmHg failure to control be able to understand effect associated with levels, weight
glucose intake. the importance of Diabetes if not management, and • Understand the
maintaining proper maintained. disease prevention importance of proper
eating habits and diet. (Mozaffarian et al., eating habits.
2011).
Objectives: • Recognize the risks
After 4 hours of b.Discuss the b. A balanced diet, associated with
nursing intervention, benefits of a balanced portion control, and improper glucose
the family member will diet, portion control, mindful food choices intake and the
be able to: and the impact of food contribute to stable benefits of having a
choices on blood blood sugar levels. balanced diet.
• Understand the sugar levels. (American Diabetes
importance and Association, 2019). • Understand the
benefits of importance of
maintaining proper c. Emphasize the c. To provide controlling white rice
eating habits. importance of limiting understanding of the in the diet.
and controlling, impact of consuming
• Recognize the risk specifically, white rice too much white rice Goal is partially met.
associated with in glucose intake. which can lead to
immoderate glucose rapid spikes and
intake. crashes in blood
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glucose (Hu et al.,


2012; Bhupathiraju et
• Identify alternative al., 2014).
and substitute for
white rice. d.Educate the family d. Educating on
member regarding healthier alternatives
substitutes such as to white rice, such as
brown rice as an brown rice, or sweet
alternative for eating potatoes, ensures a
white rice to a more nutrient-rich diet with
healthier option. lower impact on blood
sugar levels (Seal &
Brownlee, 2015).
11/15/2023

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FAMILY PROBLEM NURSING DIAGNOSIS GOAL AND INTERVENTIONS RATIONALE EVALUATION


OBJECTIVES

Unvaccinated pet Inability to recognize Goal: a. Discuss with the To raise awareness The Goal was not met.
animals as a health the presence of the At the end of our family the risk that and identify the
threat. condition or problem nursing intervention, comes with taking animals that may The nursing
due to lack or the family will be able care of unvaccinated pose risk to the Interventions were not
Objective Cues: inadequate to understand the risk pets to the childrens. childrens (Gavin, given and provided to
> Most of the pets knowledge. that comes with taking 2022) the family.
around the house are care of unvaccinated
not vaccinated. pet animals
b. Explain the
Objectives: importance of To safeguard their
After 4 hours of vaccinating the pet family from animal
nursing intervention, animals to avoid transmitted disease
the family will be able diseases like rabies especially to
to: childrens. (Brennan,
2021)
• Understand the risk
of disease c. Provide instructions
transmission through as to how they could
unvaccinated pet access free To help the family
animals. vaccinations for pet have knowledge as to
animals through the where they could
• Recognize the risk of Local Government access vaccination for
disease to the Unit. their pet animals.
children due to the still (Moaje, 2021)
developing immune
system of children.

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FAMILY NURSING CARE PLAN

FAMILY PROBLEM NURSING GOAL AND INTERVENTIONS RATIONALE EVALUATION


DIAGNOSIS OBJECTIVES

Accident hazard Inability to provide a Goal: a. Discuss to the a. To create After rendering
specifically fall hazard home environment After nursing family about the awareness, identify nursing intervention,
as a health threat. conducive to health intervention, the potential risks specific hazards, and the family was able to:
maintenance and family will be able to associated with the prompt proactive
Objective Cues: personal development recognize the hazard current pathway measures to help • Recognize the risks
due to: that their pathway structure and stairs. prevent accidents associated with the
> Bridge-like structure could cause. among vulnerable current pathway
that leads to their • failure to see individuals such as structure and stairs.
house is made of benefits of Objectives: children (Smith, 2022)
wood that is placed investments in home After 4 hours of • Understand the
irregularly and it has environment nursing intervention, b. Explain options for b. To minimize the risk importance of having
gaps and holes. improvement. the family will be able modifying the pathway of accidents while a safe pathway and
to: and stairs considering applying safety stairs to avoid
• lack of knowledge of more cost-efficient but considerations with accidents as
> The stairs going up preventive measures. • Recognize the risks stable and secure practicality and evidenced by
to their second floor associated with the materials to sustainability (Davis, verbalization of a
are steep and have current pathway minimize the risk of 2019). possible renovation of
large gaps between structure. accident. the pathway and
each step of the stairs in the future.
stairs. • Understand the 11/15/2023
importance of having Goal met.
a safe pathway to
avoid accidents.

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FAMILY NURSING CARE PLAN

FAMILY PROBLEM NURSING DIAGNOSIS GOAL AND INTERVENTIONS RATIONALE EVALUATION


OBJECTIVES

Accident hazard Inability to provide a Goal: a. Discuss with the To raise awareness The Goal was not met.
specifically fire hazard home environment At the end of our family the presence of and identify areas that
as a health threat. conducive to health nursing intervention, fire hazard inside their may pose risks of The nursing
maintenance and the family will be able home. getting caught in fire, Interventions were not
Objective Cues: personal development to understand the fostering a proactive given and provided to
> Cooking area is due to inadequate importance of taking approach to safety the family.
located near the wall knowledge of proper and (Farifi, 2023).
in their house made of preventive measures. appropriate action to
plywood. prevent occurrence of b. Explain the To safeguard their
fire. importance and property from fire
benefits of preventing hazard, ensuring a
Objectives: fire hazard secure and conducive
After 4 hours of emphasizing their living environment
nursing intervention, cooking area. (Doherty, 2020).
the family will be able
to:

• Understand the c. Demonstrate To physically show the


benefits of preventing methods to prevent family simple actions
fire hazards. hazards such as that can significantly
moving the butane reduce the risk of fire,
• Recognize the risks stove away from the translating awareness
associated with their wall that is vulnerable into safety practices
cooking area. to fire. (Doherty, 2020).

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FAMILY NURSING CARE PLAN

FAMILY PROBLEM NURSING DIAGNOSIS GOAL AND INTERVENTIONS RATIONALE EVALUATION


OBJECTIVES

Inadequate sleep and Inability to make Goal: a. Discuss the a. To determine the The Goal was not met.
rest as a health threat. decisions with respect At the end of the importance and benefits of sleep
to taking appropriate nursing intervention, benefits of having which is essential for The nursing
Subjective Cues: health action due to the family member will adequate sleep to the maintaining physical Interventions were not
failure to comprehend be able to understand health and body. and mental health, given and provided to
> The second son has the nature/magnitude the importance of supporting cognitive the family.
an average of 4-6 of getting inadequate having adequate function, reducing
hours of sleep as sleep. sleep. stress, and promoting
stated by the mother. overall well-being
Objectives: (Pacheco & Singh,
“Makatulog ra tawon After 4 hours of 2023).
siyag mga upat nursing intervention,
hantod unom ka oras the family member will b. Discuss the risks b. To educate the risk
inig hapon” be able to: and possible effects of associated with lack
having inadequate of sleep which
• Understand the sleep to the health of compromised immune
effect on the health of the family. function, impaired
having inadequate cognitive abilities, and
sleep. increased health
concerns within the
• Recognize ways to family (Pacheco &
improve sleeping Singh, 2023).
patterns.
c. Educate methods c. To improve sleeping
and strategies to patterns include
improve sleeping maintaining a

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patterns. consistent sleep


schedule, creating a
conducive sleep
environment,
practicing relaxation
techniques, limiting
screen time before
bedtime, and seeking
professional help
when necessary.
(Suni & Cotliar, 2023).

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CHAPTER 7

NURSING IMPLICATIONS

Community Health Nursing is a specialized field of nursing that focuses


on the healthcare needs of individuals, families, and communities within a
specific geographic area. According to the American Public Health
Association (2013), Community Health Nursing is the practice of promoting
and protecting the health of populations using knowledge from nursing, social,
and public health sciences.

Nurses engaged in Community Health Nursing play a pivotal role in


health promotion and education, imparting valuable information to individuals
and communities. Community Health Nursing holds significant implications for
nursing education, practice, and research emphasizing proactive healthcare
strategies within communities.

9.1 NURSING EDUCATION


The study provides a practical application of theoretical knowledge. It
serves as an effective teaching tool, allowing health care educators to utilize
the study as a basis during community health teaching discussions. The study
could help nursing students develop and enhance critical thinking skills,
problem-solving abilities, and the capacity to apply theoretical concepts to
clinical practice within the community. It could facilitate deeper understanding
to the nursing students and prepare them to have a valuable foundation in
their education for their future roles in public health.

9.2 NURSING PRACTICE


The study provides a bridge between theoretical knowledge acquired in
educational settings and the practical challenges encountered in community
settings. It provides a real-world context to apply theoretical concepts and
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enhance the decision-making skills of nurses including nursing students. The


study could serve as a continuous learning tool, allowing professionals to
enhance their skills, stay updated on best practices, and adapt to evolving
healthcare situations, significantly contributing to the delivery of patient care
within community settings.

9.3 NURSING RESEARCH


The study provides detailed information and health-related
scenarios. It provides a unique opportunity to gain an in-depth understanding
of the complex dynamic between social, cultural, economic, and
environmental factors of the family. Researchers could utilize the study as a
source for evidenced-based practices, interventions, and as a guide to
formulate effective strategies aiming to address the specific needs and
challenges of diverse communities.

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CHAPTER 8

SUMMARY

The N Family is a single parent and extended type of family extending to


having the wife of the son and grandchildren living with them in the same
household. The family are residents of Barangay Gov. Vicente Duterte,
Agdao, Davao City situated near the coastal area. They have a small
two-storey house which has no private room on each floor and it is made of
wood and light materials.

The mother and her grandchildren stay at home while her three sons
and daughter-in-law are working. The first son is working as a Pedicab driver,
the second is a BPO Agent, the third is working as a Hardware staff, and her
daughter-in-law is working as a Canteen staff. The four of them divide their
financial responsibilities in the household but the second son spends the most
money in terms of maintenance that the mother is taking everyday.

RECOMMENDATIONS

The student nurses put up a recommendation to provide assistance for


the family. For them to have knowledge about health and environmental
problems within the family and in the community.

In order to know the health threats and prioritizations, the group


recommends doing follow-up visits. This is to identify and understand the
health needs of each family member.

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EVALUATION

The family case study was done after four home visits which spanned for
almost a month of interaction between student nurses and the family. This
timeframe provided us, student nurses, with sufficient opportunity to plan and
implement nursing interventions for the N family. The assessment process
was conducted with efficiency and a systematic approach, involving the
collection and interpretation of data to identify and validate the health and
nursing issues within the family.

Collecting information, building a positive nurse-family relationship, and


ensuring the family's active involvement are crucial. The N family, especially
Mrs. N, have actively participated in achieving the desired outcomes and
activities during the assessment, providing essential information for nursing
history and health needs evaluation. The assessment helped us student
nurses plan for planned activities to promote the family's health. We
conducted home visits, urged the family to maintain a clean environment,
helped the family to understand the impact of health threats in their
surroundings, and the presence of breeding sites that carry vectors. We
helped the family understand and recognize the risks associated with their
health and learned how to properly manage their waste and garbage.

As student nurses, we not only contributed to the immediate well-being


of the N family but also gained valuable hands-on experience in community
nursing and health promotion. This case study exemplifies the significance of
proactive engagement, education, and collaboration in promoting holistic
health within the context of family-centered care.

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Tel. No.: (082) 221-6225

CHAPTER 9

BIBLIOGRAPHY
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P. Villanueva St., Agdao, Davao City
Tel. No.: (082) 221-6225

Faridi, G. (2023). Fire safety in the workplace. Retrieved from


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P. Villanueva St., Agdao, Davao City
Tel. No.: (082) 221-6225

Proceedings of the Nutrition Society. 1-7.


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Tel. No.: (082) 221-6225

APPENDICES

Photo 1. Health Teaching

Photo 2. Health Assessment

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MINDANAO MEDICAL FOUNDATION COLLEGE
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Tel. No.: (082) 221-6225

Photo 3, 4, 5, 6, 7, 8. Structure of their House

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Tel. No.: (082) 221-6225

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