SNAMS Paper Template Group 2B

A Family Case Analysis
presented to
The Faculty of the School
of Nursing and Allied Medical Sciences
HOLY ANGEL UNIVERSITY
In partial fulfillment
Of the requirements for the degree
Bachelor of Science in Nursing
Briton, Ildee Marie B.
Ilagan, Jarah Maica A.
Llaneta, Allyssa G.
Pacis, Isabella Nicole R.
Soriano, Jean Nicole M.
October 18, 2023

Acknowledgement
Our group would like to express our deepest gratitude and appreciation to the Berry
Family, especially Mrs. Strawberry, for welcoming us in their home, allocating time for our visits
and cooperating with our requests for the completion of this paper. This endeavor would not have
been possible without their collaboration.
We are also extremely grateful to our instructor, Michelle Laxamana, RN for her patience
and understanding of the shortcomings and struggles we met during our exposure to the
community, as well as her guidance and feedback throughout the process of improving the
well-being of the Berry Family and in creating this family case analysis.
We would like to extend our sincere gratitude to our Associate Professor, Jose Henry
Lansangan, PhD, MAN, RN for motivating and directing us before every interaction with our
client, including his efforts in examining our paper for revisions. Additionally, to our Assistant
Professor, Lauro N. Linag, MAN, RN for teaching us how to do the different aspects of
community health nursing and giving us critiques regarding our outputs.
A special thanks also to our family and fellow nursing students for the moral support that
allowed us to have the energy and strength needed to power through the challenges of this
project and for their thoughtfulness in attending to our needs and concerns, may it be physical or
financial.
2
School of Nursing and Allied Medical Sciences
Lastly, our group would love to give honor and praise to our God for providing us with
protection to keep us and the people around us safe from harm during our exposure, knowledge
to give appropriate care to our clients, compassion to our fellow brother and sisters within the
community, endurance to face the problems we have encountered, motivation to perform our
individual and group responsibilities, and excellent support by surrounding us with outstanding
clinical instructors as well as caring family and friends to allow this journey to be successful.
3
Table of Contents
1. Include the following with pages
i. List of Tables
ii. List of figures
iii. List of Appendices
4
Objectives of the Study
LO1: Integrate relevant principles of social, physical, natural, and health sciences and
humanities in the provision of basic health care in terms of health promotion, disease prevention,
restoration, and maintenance and rehabilitation of individuals and families in a community
setting.
LO2: Discuss in a community health setting the appropriate basic individual and family health
nursing concepts and actions holistically and comprehensively.
LO3: Assess with the individuals and families in the community one’s status/competence in
terms of their current management and practices in health promotion, disease prevention,
restoration, maintenance, and rehabilitation.
LO4: Formulate with the individuals and their families in the community a plan of care that
addresses their current health conditions, needs, problems, and issues in health promotion,
disease prevention, rehabilitation, maintenance, and restoration based on priorities.
LO5: Implement safe and quality health interventions that address the health needs, problems,
and issues regarding health promotion, disease prevention, rehabilitation, maintenance, and
restoration of individuals and families in the community.
LO6: Provide health education that is concerned with health promotion, disease prevention,
restoration, maintenance, and rehabilitation using selected planning models to targeted
individuals and families in the community.
5
LO7: Evaluate with the individuals and families in the community their health
status/competence regarding health promotion, disease prevention, restoration, maintenance, and
rehabilitation after the administration of basic nursing health care.
LO8: Institute appropriate corrective actions to prevent or minimize harm arising from the
probable adverse effects of the individual and family nursing activities regarding health
promotion, disease prevention, restoration, maintenance, and rehabilitation in a community
setting.
LO9: Formulate a safe, appropriate, and evidence-based nursing interventions particular in the
health promotion, disease prevention, restoration, maintenance, and rehabilitation of individuals
and families in, a community setting.
LO10: Adhere to ethico – legal considerations when providing safe, quality, and professional
nursing care in addressing the need for health promotion, disease prevention, restoration,
maintenance and rehabilitation of individuals and families in the community.
LO11: Adhere to established norms on the Philippine Nursing Law and other legal, regulatory,
and institutional requirements relevant to safe nursing practice in rendering care to an individual
and family in a community setting.
LO12: Protect the individuals and families in the community their rights based on “Patient’s
Bill of Rights and Obligations” in providing basic care in terms of health promotion, disease
prevention, restoration, maintenance, and rehabilitation.
6
LO13: Implement strategies/policies related to informed consent as it applies in the contexts of
individual and family nursing practice in a community setting in the provision of basic care in
terms of health prevention, disease prevention, restoration, maintenance, and rehabilitation.
LO14: Ensure a working relationship in the provision of basic care in terms of health
promotion, disease prevention, restoration, maintenance and rehabilitation with individual and
family in the community that is based on trust, respect, and shared decision – making using
appropriate communication / interpersonal techniques/strategies.
LO15: Document individuals' and families’ responses to the basic nursing care services
rendered and processes/outcomes of the family nurse-client working relationship.
LO16: Ensure completeness, integrity, safety, accessibility, and security of information of
family nurse-client working relationship in the community.
LO17: Adhere to protocols and principles of confidentiality in safekeeping and releasing of
records and other information of the individuals and families in the community.
LO18: Ensure intra-agency, inter-agency, multidisciplinary, and sectoral collaboration in
addressing the need for health promotion, disease prevention, restoration, and maintenance and
rehabilitation of individuals and families in the community.
LO19: Implement strategies/approaches to enhance/support the capability of the individuals,
families, and care providers in the community to participate in decision making with the
inter-professional team.
7
LO20: Maintain a harmonious and collegial relationship among members of the health team for
effective, efficient, and safe individual and family nursing care in the community.
LO21: Coordinate the tasks/functions of other nursing personnel (midwife, BHW, and utility
workers) addressing the need for health promotion, disease prevention, restoration, and
maintenance and rehabilitation of individuals and families in the community.
LO22: Collaborate with other members of the health team in the implementation of health
programs and services to individuals and families in the community.
LO23: Apply principles of partnership and collaboration to improve delivery of individual and
family health nursing services in the community.
LO24: Collaborate with government organizations, non – government organizations, and other
socio-civic agencies to improve health care services, support environment protection policies and
strategies, and safety and security mechanisms in addressing the need for health promotion,
disease prevention, restoration and maintenance and rehabilitation of individuals and families in
the community.
LO25: Manage individual, family, and community resources efficiently and effectively.
LO26: Apply management and leadership principles in providing direction to manage an
individual and family health nursing program in a community setting.
LO27: Use appropriate strategies/approaches to plan individual and family health programs and
basic nursing services in a community setting.
8
LO28: Evaluate specific components of the individual and family health programs and nursing
services in the community based on parameters/criteria.
LO29: Maintain a positive practice environment in managing the basic health care needs of the
individuals and families in the community.
LO30: Participate in conducting a family case analysis as a member of a care team.
LO31: Assume responsibility for lifelong learning, own personal development, and
maintenance of competence through a reading of current evidence relating to individual and
family nursing care in a community setting.
LO32: Engage in community advocacy activities that influence individual and family health
and social care service policies and access to services.
LO33: Model professional behavior as a community health nurse.
LO34: Exemplify love for the country in rendering individual and family health nursing
services to the Filipinos and their families in the community.
LO35: Customize nursing interventions based on Philippine culture and values in addressing
the need for health promotion, disease prevention, restoration, and maintenance and
rehabilitation of individuals and families in the community.
LO36: Use appropriate technology to support the delivery of nursing care to individuals and
families in the community.
LO37: Demonstrate caring as the core of community health nursing, love of God, love of
country, and love of people.

9
LO38: Manifest Christ-centeredness, integrity, excellence, community, societal responsibility,
and professionalism in the provision of basic community health nursing care to individuals and
families.
LO39: Project the positive professional image of a Filipino community health nurse in
providing basic nursing care to individuals and families.
LO41: Apply strategic interventions to address health-related concerns of individuals and
families in a community health care setting.
10
Introduction
Community health nursing is a specialized branch of nursing dedicated to addressing the
health requirements of individuals, families, and communities (Community Health
Nursing-Definition, Aims, Objectives, Principles - Nursingenotes.com, 2023). This practice is
oriented towards the promotion and preservation of health, the prevention of illness and injury,
and the provision of care within community settings. In the context of this paper, the focus shifts
to family nursing practice, a subset of community health nursing. In contrast to patient-centered
care, family nursing practice prioritizes providing comprehensive care for the entire family
within the community.
Dorothea Orem's Self-Care Deficit Nursing Theory emphasizes an individual's ability to
engage in self-care activities to maintain their health and well-being (Gonzalo, 2023). When
applied to the role of a community health nurse working with families, the nurse plays a crucial
role in assessing and supporting the family's self-care capabilities. The nurse collaborates with
the family to establish achievable health goals, monitor progress, and intervene when self-care
deficits arise, ensuring the family's overall health and well-being are optimized.
11
Barangay Pampang was the chosen community within Angeles City due to certain areas
within this barangay that are in need of immediate attention concerning health, sanitation, and
environmental conditions. The Berry family consists of a pregnant mother, a father, and three
children - two daughters and one son. As the community duty progressed, the mother welcomed
a newborn baby girl into the family. Guided by Dorothea Orem's Self-Care Deficit Nursing
Theory, the student nurses aim to understand the family's health condition and its relationship to
the broader community. They will identify both actual and potential health issues within the
family, determine its level of importance, and develop nursing interventions as well as care
plans.
12
Nursing Theory
“ Individuals have the ability to care for themselves and that nursing should focus on
assisting individuals in their self-care efforts when they are unable to perform these activities on
their own” - Dorothea Orem’s Nursing theory
As we kept on engaging ourselves in every home visit from September 11 - October 2,
2023, we applied Dorothea Orem’s nursing theory. She was a prominent nursing theorist known
for her Self-Care Deficit Nursing Theory (see Appendix ___). This focuses on the idea that every
individual’s responsibility and right is to practice self-care in order to keep themselves well and
to maintain their health (Gonzalo, 2023). Orem's theory highlights primarily on the needs of the
individual, therefore it can be applied to those families that live in depressed or underprivileged
areas by recognizing the interconnectedness of the members and their environment, serving as a
guide for healthcare teams to better support families in improving their health and well-being.
13
The core categories of how the group applied these are as follows; (1) Care of the Family
Members: Orem's theory acknowledges that families may experience a variety of stressors and
difficulties in depressed locations, such as financial difficulty, poor access to healthcare, and
social isolation. In accordance with the limitations of their surroundings and resources, this
theory was modified to emphasize the significance of family members looking out for each
other's health and well-being. (2) Assessment of Family’s Self-Care Abilities: First step carried
out is by collecting data about the health status of the Berry Family, whether subjective or
objective, identified health goals within the context of life history, lifestyle and health status. The
group also gathered information about the family’s requirements and capacity to perform
self-care. Then on the second step, which is mainly about the nursing diagnosis and care plans,
the group designed a system that is wholly compensatory or supportive-educative. Two actions
they accomplished were by bringing out a good organization of the components of client’s
therapeutic self-care demands and by selecting a combination of helping methods which will be
effective and efficient in compensating on overcoming the client’s self-care deficits.
14
On the last step which is implementation and evaluation, the student nurses executed this
on their termination phase. They have assisted the Berry Family in self-care matters to identify
and describe health and health-related results. This was done by collecting evidence in evaluation
of the results which were achieved against results specified in the nursing system design and
etiology of the prioritized problems directed the actions. This was used by student nurses to
evaluate the capacity for self-care of both the family as a whole and the individual family
members. They have created focused interventions and support plans by identifying areas where
the family may struggle to meet their self-care needs. (3) Education and Encouragement: This
approach emphasized the significance of education and encouragement in giving the family
members the ability to properly carry out self-care tasks. Such individuals might not be aware of
practices that promote health or have limited access to resources. Families can be helped in
learning about self-care techniques and connecting with neighborhood services. (4) Cultural
Sensitivity: It is critical to take cultural influences into account when dealing with families since
they may have different self-care routines and health views. Using Orem's approach,
interventions were modified as well so that they are respectful of the family's values and
traditions and be culturally sensitive. Lastly, (5) Community Collaboration: In depressed areas,
community organizations and support networks can be major sources of help for families. Orem's
theory encouraged the student nurses to collaborate with the community resources to ensure that
families are comprehensively supported to meet their self-care needs.
15
This theory is applicable to the Berry Family because it promotes the importance of the
ability of an individual or family to independently maintain a certain quality of self-care that is
therapeutic in sustaining good health (Orem, 2001, p.82). Nurse-client interactions are only
limited for a specific allotted time so it is a must to encourage the clients to be independent
through health education, disease preventions and interventions taught and made for them. Upon
coming across the community-based related learning experiences, these offer numerous
advantages to student nurses by bridging the gap between theoretical knowledge and practical
application. These placements enable students to apply their classroom learning to real-world
healthcare settings, fostering the development of essential clinical skills and enhancing their
confidence.
These experiences enabled this group to identify the different problems they encountered
which can be tied to the application of Orem’s theory. Since Mrs. Strawberry has difficulty not
only in maintaining the health and hygiene of all her family members, but also in the
non-compliance of her family, it is imperative for the student nurses to educate them, including
the children, on how to properly address and take action when it comes to potential or existing
health crises.
16
Identification of the Case
Every subgroup in the Community Health Nursing I should choose their own index
client. Qualifications considered in choosing are the following: first, currently she must be
pregnant and in legal age which ranges from eighteen years old to forty-four years old. Second,
she can either be married or single but with at least two living children.
Fortunately, the student nurses in this subgroup were able to acquire and gather the
necessary data such as the names of the members of the family of the index client, current
address, pieces of information about home and socio-environment, physical assessments, health
history from the health center’s family record, and both subjective and objective cues on their
existing problem and its nature. While walking on the streets of the barangay, with the guidance
of the respective clinical instructor, Ms. Michelle Laxamana, RN, the student nurses got the
applicable index client for this study. Luckily, Mrs. Strawberry was cooperative from the first
day of home visit until the termination phase.
17
Limitations of the Study
One of the limitations encountered was non-compliance of the eldest daughter,
Raspberry, with the interventions related to poor hygiene. She was not following and not doing
the procedures for maintaining proper hygiene, as the index client verbalized (mother) “Ang
tamad niya kasi talaga sa katawan.”. Also, she was inconsistently present because she was
attending classes during our home visits so it was not possible for the student nurses to fully
evaluate her.
Secondly, the group was not able to interact with the father, Mr. Blackberry, because
every weekday, he is working from 8:00 AM until 5:30 PM, the reason why he is not included in
the cephalocaudal assessments and interviews. Time constraints contributed slight hindrance
with the interventions and evaluations.So as a result, with the faced limitations, the student
nurses were able to meet only the short-term and medium-term objectives, not the long-term
objectives.
Assessment Database (ADB)
Family Background
The Berry Family consists of a mother, father, two daughters, one son and a month old
baby. They are a family with young children. The two daughters are named Raspberry and
Mulberry, a son named Blueberry and a month-old baby girl named Cranberry. This family is
classified as nuclear because they are a group of people who are united by ties of partnership,
18
parenthood and consist of a pair of adults and their socially recognized children. Considered as a
patrilocal, they reside in a compound shared with her husband's family located in Brgy.
Pampang, Angeles City, a house owned by Mr. Blackberry. Each house in this compound
belongs to one of her husband's siblings, fostering close ties with his side of the family in which
they were categorized as patrilineal. In contrast, Mrs. Strawberry's family and relatives reside in
Sta. Rita, Guagua, creating a geographical separation between her own roots and her married life.
In their family dynamic, despite Mr. Blackberry being the primary breadwinner, both spouses
follow an egalitarian authority as parents. They are united in ensuring that their children obey
both of them and jointly make decisions regarding their upbringing. They recognize their fair
right to discipline their children, even when faced with disobedience.
Mrs. Strawberry, a 39-year-old married mother, was born on September 27, 1984 in San
Fernando City. She finished elementary school and is currently doing a small time tailoring, a
part-time job. Her workplace is at home because she has her own sewing machine in which she is
able to earn ₱ 600 per month as an income. Her husband’s name is Mr. Blackberry, a 48-year-old
married father. He was born on June 8, 1975 in Angeles City. Mr. Blackberry finished high
school and is currently working as a labor worker in a construction firm. The site depends per
project on where it will be located. As an income, he receives ₱ 13,200 per month.
Raspberry, their first-born daughter, is an 11-year-old child who was born on September
22, 2012 in Angeles City. She is currently in sixth grade in Pampang Elementary School.
19
Blueberry, their middle child son who is at the age of 8 years old who was born on November 7,
2014 in Angeles City. He is currently in third grade in Pampang Elementary School. Mulberry,
their daughter who is also in the middle of the siblings, is a 3-year-old child who was born on
January 17, 2020 in Angeles City. As per the client’s verbalization, she will join the preschool
program by next year when she turns four. Lastly, their youngest daughter is Cranberry, who was
recently born on September 14, 2023 in Angeles City (See Table 1 below).
Table 1. Demographical Data
NAME B-DATE AGE GENDER CIVIL POSITIO PLACE EDUCATIO OCCUPATI- PLACE AVERAGE
STATUS -N IN OF NAL ON OF MONTHLY
THE BIRTH ATTAINME WORK INCOME
FAMILY NT
Mrs. September 39 Female Married Mother San Elementary Small time Home ₱ 600
Strawberry 27, 1984 Fernando tailoring
City (small
stitches)
Mr. June 8, 1975 48 Male Married Father Angeles High School Labor On site ₱ 13, 200
Blackberry City (construction depends
) per
project
(currently
in
Angeles
City)
Raspberry September 11 Female Child Daughter Angeles Currently in n/a n/a n/a
22, 2012 City Elementary
Blueberry November 7, 8 Male Child Son Angeles Currently in n/a n/al n/a
2014 City Elementary
Mulberry January 17, 3 Female Child Daughter Angeles n/a n/a n/a n/a
2020 City
20
Cranberry September 1 Female Child Daughter Angeles n/a n/a n/a n/a
14, 2023 mont City
-h
Exploring their family history through a genogram, the first generation: Mrs. Strawberry's
parents and her husband. Tragically, on her husband's side, both of his parents have passed away.
His father's demise was attributed to a stroke, specifically a heat stroke caused by excessive heat
exposure, while his mother succumbed to diabetes mellitus, a condition that raised concerns
about potential diabetes carriers within the subsequent generations. On Mrs. Strawberry's side,
her father succumbed to pneumonia, but her mother continues to play a vital role in supporting
the family. Moving to the next generation, Mrs. Strawberry's husband, being the youngest, has
one sister and one brother, while Mrs. Strawberry herself came from a larger family, including
five sisters and two brothers, and she is the 5th child. Sadly, one of her sisters lost her life due to
kidney failure, a condition believed to be triggered by certain medications or toxins that
disrupted normal kidney function. Despite varying family sizes, they all maintain a harmonious
relationship. Mr. Blackberry and Mrs. Strawberry, being married together, are parents to three
daughters and one son. The genogram illustrates that, despite the health challenges and losses
within their respective families, the bonds connecting these generations remain harmonious.
21
Figure 1. Family Genogram & Relationship Map
22
Socio-Economic and Cultural Differences
Information was gathered from Mrs. Strawberry to gain insight into the Berry Family's
socioeconomic background. Their monthly income, totaling ₱ 13,800, comprises the combined
earnings of Mrs. Strawberry (the index client) and Mr. Blackberry.
In terms of expenses, the Berry Family shares certain bills with their compound
members. They each contribute ₱ 700 for the electric bill and ₱ 500 for the water bill every
month. Additionally, they allocate approximately ₱ 300 for laundry and bath essentials. For food,
they spend ₱ 9,000 each month, as they allocate ₱ 300 per day. They also budget ₱ 450 monthly
for potable water and ₱ 1,000 for Baby's essentials, including diapers and Wilkins.
Furthermore, the Strawberry household has two members attending school who receive a
daily allowance of ₱ 55 each, totaling ₱ 110 per day and ₱ 2,200 for twenty school days in a
month. When all these expenses are combined, the household's average monthly expenditure
amounts to ₱ 14,150. Consequently, they face a monthly deficit of ₱ 350 to cover their essential
needs.
Table 2. Income and Expenditures
Summary of Household Income and Expenditures of the Berry Family
23
Description Average Per
month
Income Mrs. Strawberry’s monthly ₱ 600
income
Mr. Blackberry’s monthly

₱ 13, 200 = ₱ 13, 800
income
24
Expenditures Electric Bill ₱ 700
Shared Bill
Water Bill ₱ 500
Shared Bill
Laudry and Bath Essentials ₱ 300
Food ₱ 9,000
₱ 300 x 30 days
School Allowance ₱ 2, 200
55/ day x 20 days = 1, 100
₱ 1,100 x 2 children = ₱
2,200
₱ 450
Potable Water
₱ 1000
Baby’s Essentials
Diaper and Wilkins

= ₱ 14, 150
Deficit = - ₱ 350
25
Home and Environment
Structure and its Environment
The Berry family’s home is not too far from the barangay health care center of Pampang.
The walk starts on the first street to the left of the health care center where the tricycles for
commuting are parked. With only a few steps, take the first turn to the left on a one-way narrow
road that can only accommodate small vehicles. One must be careful because there are unleashed
dogs roaming around the area. From here, it only takes a few seconds to reach an even narrow
path of dirt between two houses on the right side of the road which leads to a compound where
the Berry family lives (see Appendix F.1.1.).
Upon arrival, the immediate ground surrounding the compound is also dirt which makes
it hard to maintain the cleanliness of shoes while walking. The abundant clothes surrounding the
Berry family’s house that were left hanging to dry were also impossible to miss. There are also
two bathrooms and a sink to the right of the entrance to the compound, separate from the house
as well as garbage containers to the left of the entrance for communal use which are sometimes
unkempt or unsanitized. With further inspection, a sewing machine can be seen next to the door,
along with a few other belongings, which the index client, Mrs. Strawberry, uses to pass time and
make some money. Pigeon coops can also be seen near the house and the roofs of the bathrooms
(see Appendix F.1.2.).
The house that they live in is approximately 11.83 square meters in size and has two
windows. However, one of them is usually blocked by a curtain and is rarely used. There is no
26
ceiling and the roof is only made up of metal panels supported by wood. The walls are made of
hollow blocks put together by cement and are unsmoothed, making its inhabitants prone to
scratches. On the other hand, the floor is smooth and made of only cement.
Upon entry, one would immediately notice that the bedroom and kitchen are merged into
one room. Additionally, all of their belongings are arranged next to the walls so there is room for
the Berry family to move about in the center. However, their belongings look unkempt and the
corners and roof have accumulated dust (see Appendix F.1.3.). The north side of the bedroom
consists of three large cabinets for their clothes and personal belongings as well as an additional
cabinet for utensils and ingredients for cooking. Next to them is a small table to place
tupperwares and sewing necessities. Above the table is a plastic bag for food waste, full and
infested with small red ants, hanging on the wall (see Appendix F.1.4.a and F.1.5.). On the south
side, there is an old TV, piles of laundry, a small statue of Mary, a small electric fan, pillows and
folded blankets, wires, and other belongings (see Appendix F.1.4.b.). On the west side there are
three stacks of damaged twin sized foam used for sleeping that is placed on the floor right below
an open window with a curtain (see Appendix F.1.4.a. And F.1.4.b.). The kitchen, on the other
hand, is on the east side of the room. It has a small stove, kitchen wares, large jugs and
containers for water and rice, a gas tank, toiletries, rack of footwear, trash bin, and more laundry
(see Appendix F.1.4.c.).
Kind of Neighborhood
To reach the compound where the Berry family resides, one must pass through a path of
dirt between the two houses seen from the street. Near the entrance on the right are the
bathrooms and the sink which they share with others who reside in the same compound. On the
27
left are smelly sacks or containers full of garbage and discarded food infested with flies and
maggots which are collected once a week every Tuesday morning (see Appendix F.1.6.). There
are also bird cages for pigeons near their home next to the garbage and above the bathroom that
are unsanitary but our client said that it is cleaned by the owner depending on what day it needs
to be cleaned (see Appendix F.1.2. and F.1.7.).
Adequacy of Living Space / Floor Area
The room has 11.83 square meters of floor space which is extremely inadequate for 2
adults and 3 children. Their area does not meet the recommended space requirement of 15 square
meters for one adult person, especially because the area occupied by their personal belongings is
also calculated within the total floor space of 11.83 square meters.
Solution for actual floor space
Solution for recommended floor space
1x0m2
Adequacy of Ventilation
The family mainly uses the door and the big window on the west side of the house,
receiving a 25.83% of ventilation which is adequate for the floor area they occupy. It
significantly reduces the heat trapped inside the house and may help prevent accumulation of too
much dust.
Food Sources, Storage & Cooking Facilities

28
In their household, the index client is responsible for buying food which they get from
stores near their home, but when the family has the ability to spare more money, the index client
goes to Pampang’s palengke. The family also grows a papaya tree behind the house and uses its
fruits for cooking. Although the family does not usually prepare their own food, they have the
basic cooking utensils stored in a cabinet and under the stove including metal pots and spatulas
which appear to be clean. However, the kids occasionally place objects inside the cabinet such as
super glue or trash that may contaminate the clean utensils. The family also has knives which
appear to have small spots of rusting, stored on a blocked window sill located above the stove
that is rusty and stained. On occasions in which they do have food to store, they place it among
the food seasonings they have on the top most section of the same cabinet as the cooking
utensils. In their case, since they usually do not have left over food, a refrigerator is unnecessary,
but the index client may ask her sister in-law a favor in case she is in need of it.
The family’s main water source comes from the communal sink and toilet facilities which
is safe so long as they acquire it directly from the faucet. Any water that is left in the pale should
be considered contaminated because it is exposed to an open environment accessible to
irresponsible users, outsiders, animals, flies, and dirt. For potable water, they purchase those blue
5-gallon jugs of mineral water for the whole family as well as 1 liter bottles of Wilkins for the
index client and her baby which are always secured with covers.
Toilet Facilities
The Toilet facility is found outside the compound in one of the bathrooms. They use a
toilet bowl without flush in which they compensate with a pail of water and tabo. The walls and
the corners on the compound where water usually stays after a shower are covered in moss or
29
lumot and since the surrounding area is made of dirt instead of concrete, the floor is sometimes
muddy. It usually depends on the users whether the toilet facility remains sanitary because
everyone is responsible for cleaning after use. In some cases, a user is too lazy to clean the area,
leaving it dirty. Aside from the facility’s general appearance, the water that comes out of the
faucet is clean. But after it reaches the pail, it is exposed to multiple contaminants as the door is
usually left wide open, making it accessible to non-residents of the compound, animals, dirt, and
other environmental factors. The residents themselves may even leave used or contaminated
water in the pail.
Social and Health Facilities
Based on the records, the family is identified and acknowledged as a permanent resident
of barangay Pampang. The community presents a variety of facilities available at walking or
short travel distances such as the health center, pharmacies, elementary and high schools,
hospital, barangay hall, public market, sari-sari stores, playground and basketball courts which
are well utilized by the family except for the church because of the inability to attend due the
fatigue of pregnancy and postpartum on top of other household responsibilities. Nevertheless,
they listen to the teachings through the loudspeaker which reaches their house. Outside, near the
borders of Pampang are the police and fire stations which are currently of no use to them but are
still accessible for their use if needed. Occasionally, the community holds events for the
enjoyment of its residents such as pageants, basketball tournaments, and pulosa. The family does
not usually participate in these events but their children sometimes watch them. In terms of
social support, the clients have not received help from anything beyond the barangay level which
30
included money and food during the pandemic, as well as free medicines, vitamins, feedings and
deworming.
Communication and Transportation Facilities Available
Pampang is a well developed area with fairly smooth concrete roads that make travel
using vehicles easy. The available modes of transportation in the barangay are jeepneys and
tricycles. The father of the house usually uses a bicycle to go to work while the rest of the family
usually stays within the barangay. But when the index client needs to buy groceries, she usually
uses a tricycle. Telecommunication and internet access is also fast and available in the area. But
in the case of the client’s home and its vicinity, although the index client testifies that the signal
within their house is “okay”, the group always receives one to two signal bars within the area and
is sometimes unable to access online documents with data. Nonetheless, internet access, text, and
calls are possible but may be slow. Since the family does not have a landline or an internet router,
the family loads their SIM cards with credit to register to promos.
31
In the heart of Angeles City, within the thriving community of Barangay Pampang,
resides the Berry family. This barangay, one of 33 that make up the city, is situated in the Central
Luzon region of the Philippines. According to the PhilAtlas 2020 Census, there are 24,653
residents residing there, constituting approximately 5.33% of the total population of the city.
Positioned at an estimated elevation of 116.2 meters (381.2 feet) above sea level,
Pampang is surrounded by neighboring barangays: Pulung Cacutud to the north, San Agustin to
32
the east, Santo Rosario to the south, and San Jose to the west. The place provides a wide range of
facilities and services that are easily available to its residents, including the Berry family.
Considering the 12 elements that outline what constitutes a healthy community, the Berry
family finds themselves in a community that offers a comprehensive and easily reachable
environment. In terms of access to care, the ecomap illustrates the family's utilization of services
through green circles and connecting lines. The Pampang Barangay Health Center and Ospital
ning Angeles are shown to be fully utilized into their healthcare routine, indicating that these
facilities are preferred and actively used by the family.
On the other hand, various hospitals in the Angeles City area, including PRI Medical
Center, Angeles University Foundation Medical Center, Holy Family Medical Center, Dr.
Armando L. Garcia Medical Center, St. Catherine of Alexandria Foundation & Medical Center,
Angeles Medical Center, Inc., Sacred Heart Medical Center, and The Medical City Clark, are
represented by red circles and a line. This signifies that these hospitals are not part of the family's
healthcare choices. It's clear that the family selectively opts for the Pampang Barangay Health
Center and Ospital ning Angeles, reflecting a distinct preference for these specific healthcare
providers.
Given that the Berry family already owns a house, there are two affordable housing
options within Angeles, namely Carmenville and Deca Homes. However, they are depicted in
red on the ecomap, indicating that the family is not making use of these housing options.
33
Regarding community safety, the family slightly utilized Pampang Barangay Tanod since
it is conveniently located in close proximity to them. The index client is aware of the nearby
police station and fire station, but, currently, they do not make use of these services.
In the context of economic opportunities, the ecomap reveals that Mr. Blackberry is
employed in construction in the Carmenville area, while Mrs. Strawberry engages in home-based
tailoring with a focus on small stitches. Both of these occupations are highlighted in green,
indicating that the parents actively utilize them as sources of income. Moreover, there are two
more economic opportunities, Rockwell Construction and SuperL, that are in alignment with
their respective occupations. However, these are represented in red, indicating that Mr. and Mrs.
Berry are not currently availing themselves of these specific opportunities.
Raspberry, a fifth-grade student, and Blueberry, who is in the third grade, both attend
Pampang Elementary School. Although there are numerous schools in the vicinity, including
high schools and colleges, they are not currently being utilized by the family.
In terms of environmental quality, the family makes full use of waste disposal available
within their compound.
When it comes to accessing quality and affordable food, the family primarily buys at the
Atchi Linda Store for their grocery needs, including freshly cooked "lutong-ulam," as per the
verbalization of the index client. They also make limited use of other food sources, such as the
34
Pampang Wet Market, Anecia Mini Mart, and 7/11, with the latter being particularly favored by
Raspberry. The rest of the food options available are not being utilized by the family.
The family makes full use of the community design provided by Barangay Pampang to
meet their various needs and preferences within the neighborhood. This utilization encompasses
a range of resources and services offered by the community.
Blueberry and Mulberry engage with the parks and recreation facilities, which include a
barangay-covered court and a playground. The family also makes limited use of the Sto. Nino
Chapel and SM Telabastagan. However, they do not utilize other options, such as the Holy
Rosary Church, the various malls in Angeles City, and Astro Park.
When it comes to social and cultural cohesion, the family engages and integrates with the
Pampang community and their neighboring residents.
The family utilizes the Barangay Pampang Hall as a resource, demonstrating their
involvement, primarily when it comes to local community matters. However, they do not make
use of Angeles City Hall for similar purposes.
The family has a range of transportation options around the Angeles City, which
encompass airplanes, taxis, buses, jeeps, and tricycles. While they only make limited use of
jeeps, they fully utilize tricycles for their transportation needs.
35
Figure 2. Ecomap
36
37
Health status of each family member (Physical Examination)
Note: Mr. Blackberry (husband the index client) is not available/ present during the
assessment process.
Table 3. Physical Assessment Result for Mrs. Strawberry (index client)
PAST MEDICAL HISTORY History of Urinary Tract Infection
ANTHROPOMETRICS Age: 39 yrs old
Height: 147 cm
Weight: 45kg
BMI: 20.8 (normal)
*See appendix _____ for the reference of the
BMI classification
VITAL SIGNS September 11, 2023 - 9:00 am
HR: 85 bpm
T: 36.7°C
RR: 18 cpm
BP: 150/90 mmHg
September 18, 2023 - 9:00 am
HR: 71 bpm
38
T: 35.7°C
RR: 20 cpm
BP: 150/90 mmHg
September 25, 2023 - 9:00 am
HR: 69 bpm
T: 35 °C
RR: 22 cpm
BP: 140/90 mmHg
October 02, 2023 - 9:00 am
HR: 68 bpm
T: 35.7°C
RR: 16 cpm
BP: 140/90 mmHg
PREGNANCY INFORMATION Number of pregnancies: 4
OB score: G4P4 (4004)
Post-partum BUBBLEHEP (September 18, 2023)
- 10:00 am
Breast: (+) engorgement, no signs of nipple cracks and
redness
Uterus: uterus is at the level of 4 fingerbreadths (4th day
39
postpartum; uterine involution occurs naturally
Bladder: s̅ bladder distention
Bowels: normal bowel movement; excrete feces every day
; (+) flatus
Lochia: c̅ light amount of Lochia Serosa (6cm on
menstrual pad in 1 hour)
Episiotomy: (+) right mediolateral
H: negative homan’s sign
E: no signs of edema
P: no pain present
Post-partum BUBBLEHEP (September 25, 2023)
- 10:00 am
Breast: slight engorgement, no signs of nipple cracks and
redness
Uterus: returned to prepregnant size; cannot be palpated
anymore
Bowels: normal bowel movement; excrete feces everyday;
(+) flatus
Lochia: c̅ slight amount of Lochia Alba (2cm on menstrual
pad)
E: no redness, swelling or inflammation in right medio-
40
lateral episiorrhaphy site
P: no pain present
Post-partum BUBBLEHEP (October 02, 2023)
- 10:00 am
Breast: no signs of engorgement, no signs of nipple cracks
and redness
Uterus: returned to prepregnant size; cannot be palpated
anymore
Bowels: normal bowel movement; excrete feces everyday;
(+) flatus
Lochia: c̅ no amount of lochia present
E: no redness, swelling or inflammation in episiorrhaphy
site
P: no pain present
HEAD Symmetry: symmetric, round, normocephalic
Facial movement symmetry: full control of movement,
41
able to make different expressions, symmetric movement
Deformities: none
HAIR Scalp: no tenderness, masses, or lessons, sparse
dandruff visible
Infestation: free from lice and nits
Texture: medium straight hair strands
Color: black c̅ some white hairs
Distribution: evenly distributed
EYES Eyebrows: symmetrically, bilateral movement, hair is
evenly distributed
Eyelashes: evenly distributed, short, turned outwards
Eyelids: skin intact, no discharge or discoloration
Jaundice: absence of jaundice
Bulbar conjunctiva: clear and without redness, swelling,
or irritation
Palpebral conjunctiva: pink and moist
Cornea and Iris: clear and without any cloudy or hazy
areas
Pupils: black in color and equal in size, reactive to light
and accomodation
Sclera: white
42
Extraocular muscle test: smooth, coordinated movements
in all directions of gaze
Eyes movement: both eyes are parallel, coordinated,
smooth, and move in all directions without discomfort.
EARS Auricles:firm,mobile, free from signs of deformities and
skin lesions
Color: consistent with the fair skin tone, no signs of
redness, pallor and discoloration
Symmetry: symmetrical
Position: aligns with the corner of each eye
Watch Tick test: able to hear ticking sounds
NOSE Symmetry: symmetrical at midline
Discharge: clear and free from excessive mucus, pus, or
blood
Nasal patency: both nares are patent, no significant
blockage or congestion
MOUTH Gums: pinkish in color, free from signs of redness,
swelling, or bleeding
Texture of lips: moist
Color of teeth: off-white
43
Number of teeth: 18 teeth remaining
Upper:
3 molars right 2 molars left
2 front
1st molar broken right
Lower:
3 left molar
2 right molar
6 front including 2 incisors
Decay: All 18 remaining teeth are affected by decay
Upper:
3 molars right 2 molars left
2 front
1st molar broken right
Lower:
3 left molar
2 right molar
6 front including 2 incisors
Dentures: none
Odor: no present foul odor
Tongue color & texture: pink with raised papillae
Frenulum: center
44
NECK Presence of Jugular vein: not visibly distended or
enlarged
Lymph nodes: small, mobile, and not tender to the touch
Trachea: centrally located in the neck and aligned with
the midline of the body
Swallowing: normal and upward symmetrical movement
of cartilage without discomfort or difficulty
THORAX (HEART & LUNGS) Inspection
Shape and symmetry: symmetrical appearance and
normal shape, without significant deformities or
asymmetry
Spinal alignment: straight and aligned with the midline
of the body
Use of accessory muscle: no noticeable use of the
sternocleidomastoid muscle
Palpation
Skin integrity: intact
Bulge: no abnormal bulges or masses on the chest wall
Tenderness: not tender to touch
Bilateral fremitus: present and symmetric in different
45
areas of the chest
Resonant: clear, hollow, and loud sound
Auscultation
Cough: Absence of coughing
Hemoptysis: Absence of hemoptysis
Wheezing: Absence of wheezing
Palpitations: Absence of palpitations
Syncope: Absence of syncope
Orthopnea: Absence of orthopnea
ABDOMINAL & GI Inspection
Skin color: fair skin color without any unusual pallor or
jaundice
Appearance of the abdomen: symmetrical and without
visible masses or bulges
Over-all contour: smooth and even without any
noticeable bulges, masses, or abnormalities
Lesion: no open sores, wounds, or abnormalities
Rashes: absence of rashes or skin eruptions
Distended: not distended
Color of stool: brown stool
46
Auscultation
Bowel sound: normal, active bowel sounds
Passing stools: no involuntary passing of stools
Palpation
Character of the abdomen: soft, non-tender, and without
any masses or areas of rigidity
Nausea: absence of persistent nausea
Vomiting: no recent episodes of vomiting
Dysphagia: no difficulty in swallowing
Heartburn: absence of heartburn
Diarrhea: normal bowel movements
Constipation: normal bowel movements
Rectal bleeding: absence of rectal bleeding
PELVIS & GU TRACT Dysuria: no evidence of dysuria
Discharge:
September 18, 2023 - 10:00 am
presence of lochia serosa
September 25, 2023 - 10:00 am
presence of lochia alba
October 05, 2023 - 10:00 am
47
no presence of lochia
UPPER & LOWER Inspection
EXTREMITIES Skin color: fair skin color, without unusual
pallor, cyanosis, or redness
Distribution of hair: evenly distributed across the
extremities
Edema & masses: no significant swelling or visible
masses on the extremities
Lesion: no presence of lesions
Varicose veins: visible veins on the lower extremities
Nailbed: no presence of clubbing
Rashes: no abnormal rashes or skin eruptions present
on the extremities
Pulse: equal strength bilaterally present
Sores: no presence of open or infected sores
Capillary test: < 2 seconds
Light touch testing: sensation of light touch is felt on the
skin
Palpation
Tenderness: no significant tenderness or pain
48
Skin: warm, dry, and intact, without excessive moisture
or significant texture changes
INTEGUMENTARY Inspection
Skin: appears intact
Rashes: no visible rashes or areas of skin irritation
Sores: no open sores, ulcers, or areas of infection are
present
Lesions: no unusual or concerning skin lesions
Changes in color: no abnormal pigmentation or
discoloration present
Muscle pain: absence of muscle pain
Nails appearance: clean, smooth, and convex
Nails color: pink nail bed
Palpation
Capillary Refill Time: < 2 seconds
SENSORY SYSTEM Light touch testing: exhibits a normal response to light
touch
Sensation: both sides are functioning equally
REFLEX Knee-jerk reflex: responds with a quick, involuntary kick
49
Gag reflex: responds with a gagging/choking reflex
Corneal reflex: blinks/closes their eyelid in response
Table 3.1. Physical Assessment Result for Raspberry
PAST MEDICAL HISTORY None
ANTHROPOMETRICS Age: 11 years old
Height: 139 cm
Weight: 40 kg
BMI: 21 (Normal)
*See appendix ____ for reference of the BMI classification
VITAL SIGNS September 11, 2023
HR: 97 bpm
T: 36.4°C
RR: 17 cpm
BP: not recorded
September 18, 2023
HR: not assessed
T: not assessed
50
RR: not assessed
BP: not assessed
September 25, 2023
HR: 90 bpm
T: 36°C
RR: 19 cpm
BP: not recorded
October 02, 2023
HR: not recorded (pt not present)
T: not recorded (pt not present)
RR: not recorded (pt not present)
BP: not recorded (pt not present)
HEAD Symmetry: symmetric, round, and normocephalic
Deformities: none
HAIR Scalp: sparse dandruff visible, lice and nits are
predominantly concentrated in the crown region of the
scalp, and scattered throughout the rest of the scalp.
Infestation: live lice and cluster of nits attached to the
hair shaft are present
51
Texture: appears dry, coarse, and lacks its usual
smoothness and shine
Color: black
evenly distributed
Eyelashes: evenly distributed, short, turned outwards.
or irritation
Palpebral conjunctiva: pink and moist, without any
visible signs of inflammation or discharge.
areas
and accomodation
Sclera: white
Extraocular muscle test: smooth, coordinated
movements in all directions of gaze
52
EARS Auricles:firm,mobile, free from signs of deformities
and skin lesions
Color: consistent with the brown skin tone, no signs of
redness, pallor and discoloration
Watch Tick test: able to hear tick sounds
Discharge: clear and free from excessive mucus, pus,
or blood
Nasal patency: both nares are patent,no significant
MOUTH Gums: pinkish in color, free from signs of redness, swelling
Number of teeth: 26 permanent teeth with presence of
stains and plaque
Decay: Absence of visible dental decay or cavities on
tooth surfaces
53
Dentures: none
Frenulum: center
enlarged
Shape and symmetry: symmetrical appearance and norma
without significant deformities or asymmetry
Spinal alignment: straight and aligned with the midline of
Palpation
Skin integrity:intact, without significant lesions or abnorm
54
Bilateral fremitus: present and symmetric in different area
Resonant: clear, hollow, and loud sound when the chest wa
gently tapped with the fingers
Auscultation
Skin color: brown skin color without any unusual pallor
or jaundice
Appearance of the abdomen: Symmetrical and without
Over-all contour: flat, slightly rounded, with no visible
bulges or protrusions and it appears symmetrical
Lesion: no open sores, wounds, or abnormalities on the
skin of the abdomen
55
Auscultation
Palpation
Character of the abdomen: soft, non-tender, and
without any masses or areas of rigidity
PELVIS & GU TRACT Dysuria: absence of dysuria
Discharge: absence of abnormal discharge from the
genital area
56
EXTREMITIES Skin color: brown skin color, without unusual pallor,
cyanosis, or redness
extremities
Edema & masses: no significant swelling (edema) or
visible masses on the extremities
Lesion: small, red, itchy bumps on the skin from ant bites
Varicose veins: no presence of varicose veins
Nailbed: no presence of clubbing, fingernails on lower
extremities have visible dirt or debris
Rashes: no abnormal rashes or skin eruptions present
on the extremities
Pulse: equal strength bilaterally present with normal rate
and rhythm
Sores: well-healed small wounds scars without signs of
infection
Capillary test: dorsalis pedis and posterior tibial pulses 2+
equal bilaterally
skin
57
Palpation
Tenderness: no significant tenderness or pain on palpation
of the extremities
Skin: warm, dry, and intact, without excessive moisture
or significant texture changes
Skin: small red bumps are noted on the skin, primarily in ar
consistent with ant bites
Rashes: no other rashes are observed on the skin.
Sores: no open sores or wounds are identified.
Lesions: apart from the ant bite-related bumps, no other les
are evident.
Changes in color: no abnormal pigmentation or discolorati
Muscle pain: there are no visible signs of muscle pain or di
Nails appearance:
September 11, 2023
nails appear dirty with visible debris
September 25, 2023
toenails appear dirty with visible debris
October 02, 2023
not recorded
58
Palpation
Capillary Refill Time: capillary refill time is less than 2 se
indicating good circulation
SENSORY SYSTEM Light touch testing: exhibits a normal response to
light touch
Sensation: being intact and symmetrical on both sides of
the body
REFLEX Knee-jerk reflex: present and normal
Gag reflex:present and normal
Corneal reflex:present and normal
Table 3.2. Physical Assessment Result for Blueberry
ANTHROPOMETRICS Height: 128 cm
Weight: 22.1 kg
BMI: 13.5 (Underweight)
HR: 99 bpm
59
Weight: 22.1 kg
T: 35.6°C
RR: 21 cpm
BP: not recorded
September 18, 2023
HR: 96 bpm
T: 35.7°C
RR: 18 cpm
BP: not recorded
September 25, 2023
HR: 98 bpm
T: 35.7°C
RR: 19 cpm
BP: not recorded
October 02, 2023
HR: 94 bpm
T: 36°C
RR: 17 cpm
60
Weight: 22.1 kg
BP: not recorded
HEAD Symmetry: symmetric, round, and normocephalic
Deformities: none
HAIR Scalp: clean, free from excessive oiliness or dryness,
and any visible signs of infection or inflammation
Infestation: free from lice, nits and dandruff
Texture: neither brittle nor dry
Color: black
evenly distributed
61
Weight: 22.1 kg
or irritation
areas
and accomodation
Sclera: white
Extraocular muscle test: smooth, coordinated movements i
directions of gaze
skin lesions
62
Weight: 22.1 kg
Color: brown skin tone, no signs of redness, pallor and
discoloration
blood
Number of teeth:
September 11, 2023
63
Weight: 22.1 kg
22 teeth with crooked teeth between the
upper lateral incisor and canine with presence of stains and
plaque
September 25, 2023
22 teeth with crooked teeth between the
upper lateral incisor and canine with minimal presence of
stains and plaque
October 02, 2023
22 teeth with crooked teeth between the upper lateral
incisor and canine with absence of stains and
minimal plaque
Decay: present on left lower lateral incisor and canine
Dentures: none
Frenulum: center
64
Weight: 22.1 kg
enlarged
Trachea: centrally located in the neck and aligned with the
midline of the body
65
Weight: 22.1 kg
Shape and symmetry: symmetrical appearance and normal
of the body
Palpation
Skin integrity:intact, without significant lesions or
abnormalities
areas of the chest
Resonant: clear, hollow, and loud sound when the chest
wall is gently tapped with the fingers
66
Weight: 22.1 kg
Auscultation
or jaundice
67
Weight: 22.1 kg
skin of the abdomen
Auscultation
Palpation
68
Weight: 22.1 kg
genital area
EXTREMITIES Skin color: normal skin color, without unusual pallor,
extremities
Nailbed: no presence of clubbing, nails have visible dirt
or debris
69
Weight: 22.1 kg
Rashes: no abnormal rashes or skin eruptions present on
the extremities
and rhythm
infection
equal bilaterally
Light touch testing:sensation of light touch is felt on the
skin
Palpation
of the extremities
Skin: warm, dry, and intact, without excessive moisture or
significant texture changes
70
Weight: 22.1 kg
Skin: small red bumps are noted on the skin, primarily in
areas with ant bites
Lesions: apart from the ant bite-related bumps, no other
lesions are evident.
Muscle pain: there are no visible signs of muscle pain or
discomfort
Nails appearance:
September 18, 2023
toenails appear dirty with visible debris
October 02, 2023
not recorded
71
Weight: 22.1 kg
Palpation
Capillary Refill Time: capillary refill time is less than
2 seconds, indicating good circulation.
SENSORY SYSTEM Light touch testing: exhibits a normal response to
light touch
Sensation: being intact and symmetrical on both sides
of the body
72
Table 3.3. Physical Assessment Result for Mulberry
Weight: 14.4 kg
BMI: 16 (Healthy)
HR: 99 bpm
T: 36.0°C
RR: 18 cpm
73
BP: not recorded
September 18, 2023
HR: 95 bpm
T: 36.2°C
RR: 16 cpm
BP: not recorded
September 25, 2023
HR: 98 bpm
T: 36.1°C
RR: 17 cpm
BP: not recorded
October 02, 2023
HR: 97 bpm
T: 36.8°C
RR: 18 cpm
BP: not recorded
HEAD Symmetry: symmetric, round and normocephalic
Deformities: none
HAIR Scalp: sparse dandruff visible, lice and nits are few
74
scattered in the crown region and the rest of the scalp
Infestation: lice and cluster of nits attached to the hair
shaft are present
Texture: somewhat rough to the touch, indicating a mild
lack of moisture and natural oils, but it is not excessively
brittle.
Color: black
evenly distributed
or irritation
areas
and accomodation
75
Sclera: white
directions of gaze
skin lesions
discoloration
blood
76
Number of teeth:
September 11, 2023
21 teeth with presence of stains and plaque
October 02, 2023
21 teeth with absence of stains and minimal plaque
Decay: noted on one tooth in the upper central incisor,
three teeth in the lower 2nd premolar, 1st premolar, and
canine.
Dentures: none
Frenulum: center
enlarged
77
normal shape,
of the body
Palpation
abnormalities
areas of the chest
Auscultation
78
or jaundice
skin of the abdomen
Auscultation
79
Palpation
genital area
extremities
80
Nailbed: no presence of clubbing, fingernails on lower
extremities have visible dirt or debris
Rashes: no abnormal rashes or skin eruptions present on
the extremities
and rhythm
infection
equal bilaterally
skin
Palpation
of the extremities
81
Skin: small red bumps are noted on the skin, primarily in
areas consistent with ant bites
Lesions: apart from the ant bite-related bumps, no other
lesions are evident.
Muscle pain: there are no visible signs of muscle pain or
discomfort
Nails appearance:
September 18, 2023
nails appear dirty with visible debris
September 25, 2023
fingernails appear clean and well-groomed but the toenails
appear dirty with visible debris
October 02, 2023
appear clean and well-groomed, there are no visible signs
of dirt, debris, or staining on the nail surfaces
82
Palpation
Capillary Refill Time: Capillary refill time is less than 2
seconds, indicating good circulation
touch
Sensation: being intact and symmetrical on both sides
of the body
83
Table 3.4. Physical Assessment Result for Cranberry
Weight: 3.31 kg
Head circumference: 34cm
Chest circumference: 33cm
HR: 100 bpm
T: 36.6 ℃
RR: 58 cpm
BP: not recorded
September 25, 2023
HR: 110 bpm
T: 36.5 ℃
RR: 53 cpm
84
BP: not recorded
October 02, 2023
HR: 112 bpm
T: 36.3℃
RR: 60 cpm
BP: not recorded
HEAD Symmetry: symmetric, round and normocephalic
Facial movement symmetry: symmetrical facial
expressions and reflexes
Deformities: none
HAIR Scalp: smooth with no signs of redness, swelling, or
lesions
Infestation: free from lice, nits and dandruff
Texture: fine and soft
Color: black
evenly distributed
85
or irritation
areas
and accomodation
Sclera: white
directions of gaze
skin lesions
discoloration
86
Watch Tick test: not recorded
blood
Color of teeth: N/A
Number of teeth: N/A
Decay: none
Dentures: none
Frenulum: center
NECK Presence of Jugular vein: not persistently distended or
enlarged
87
Trachea: centrally located in the neck and aligned with the m
of the body
normal shape, without significant deformities or
asymmetry
Spinal alignment: straight and aligned with the midline of
the body
Palpation
abnormalities
areas of the chest
88
Auscultation
or jaundice
Appearance of the abdomen: soft and round without
Over-all contour: gentle, rounded contour, with no
visible bulges or protrusions and it appears symmetrical
skin of the abdomen
Color of stool:
89
September 18, 2023
September 25, 2023
October 02, 2023
Auscultation
Palpation
PELVIS & GU TRACT Dysuria:absence of dysuria
90
genital area
extremities
Edema & masses: no significant swelling (edema) or
visible masses on the extremities
Lesion: no presence of lesion
Nailbed: no presence of clubbing
Rashes:
September 18, 2023
presence of minimal rashes on the upper extremities
September 25, 2023
localized rashes in upper extremities, appear as red,
raised, or bumpy areas on the skin
and rhythm
Sores: no presence of open or infected sores on the skin
91
equal bilaterally
skin
Palpation
of the extremities
Skin:The skin appears healthy, with no visible signs of
erythema, pallor, or cyanosis
Rashes:
September 18,2023
mild, non-persistent rashes is present, appears slightly red
patches, and they are non-blistering, non-pustular, and
non-oozing
September 25, 2023
92
localized rashes on the face and arms, appear as red,
raised, or bumpy areas on the skin
Sores: No open sores, ulcers, or lesions are observed
Lesions: no other abnormal growths, lesions, or
concerning moles
Muscle pain: no visible signs of muscle pain, tenderness,
or muscle-related issues
Nails appearance: fingernails and toenails are clean, with
a pinkish hue, and free from deformities or visible debris
Palpation
Capillary Refill Time: capillary refill time is less than 2
seconds, indicating good circulation
touch
Sensation: being intact and symmetrical on both sides of
the body
REFLEX Knee-jerk reflex: not recorded
93
Gag reflex:not recorded
Corneal reflex:not recorded
Family Culture, Values, Belief and Practices
The culture of the Berry Family encompasses the shared values, beliefs, and practices
that shape the dynamics within a family unit. These elements form the foundation for how a
family interacts and operates. The facet of this family culture is Mrs. Strawberry, she places great
importance on her family's health. She mentioned that they have a good immune system
(subjective) because all of them received “bakuna” when they were kids. She said that her
children received these vaccinations through the barangay health center, highlighting the role of
community health practices in maintaining their well-being.
Next, for the family's nutrition and eating habits, they present a noteworthy concern. As
per the index client’s verbalization, “Ayaw nila ng mga gulay, hindi sila kumakain. Pero kapag
nagluto ako ng gulay, ako lang at panganay ko ang kumakain.” According to the cephalocaudal
assessment, every member has normal BMI except for the son, Blueberry. Their dietary pattern
predominantly consists of eating rice in every meal (Breakfast, Lunch, Dinner) and adding
whichever is available that they could get from the sari-sari store of Aling Linda including
canned foods, eggs, ready-to-eat foods from the carinderia.
94
As for their religious belief and practices, these hold a significant place in the Berry
family's life. Since Mrs. Strawberry's pregnancy, their ability to attend weekly masses has been
constrained. However during Sundays, they could hear the priest from the church to their house
which is only one block away from their compound. They pray the rosary before bedtime, attend
crusades or parades and listen to bible readings, bring a blessed “palaspas” and put on their
windows during Holy week. With regards to health, as per the index client, whenever their
family member is ill, they lift it up to the Lord and pray for recovery first before seeking
appropriate medical help because of financial constraints.
The identity of the family is also strongly influenced by cultural practices. They have
diligently preserved numerous Filipino cultural traditions, including the respectful use of "po"
and "opo" in their daily interactions, which demonstrates their dedication to Filipino etiquette
and values. Additionally, they actively engage in the festivities of their local community by
participating in barangay fiestas.
Social collaboration and communication also play roles in the Berry family’s life. Mrs.
Strawberry mentioned that whenever she gets bored, she goes to her husband’s cousin’s house to
have conversations with the cousin’s wife and cousin’s wife’s sister. The house was two blocks
away from their house. In addition to that, she communicates as well with her husband’s relatives
in the compound. That is how she maintains her social being aside from their religious practices.
For marriage, according to Mrs. CB, her preference is love marriage which succeeds in a
relationship. Mr. AB worked together with Ms. CB’s cousin and that is the reason how she knew
him. Sharing their lives and dreams since September 22, 2011, they took a significant step
95
forward by officially becoming husband and wife on January 16, 2022. Since they got engaged
through love marriage, they have a deep mutual understanding with each other.
Regarding the complexity of gender expression, the index client stated that her
acceptance of gender expression is dependent on their appearance and beliefs. According to the
client, a person's expression of their gender or sexuality should align with qualities such as being
"desente" and "makadiyos" despite expressing a different gender or sexuality form what is
expected of their biological sex.
Finally, when delving into the index client's view on supernatural beliefs and practices a
question asked about whether the index client believes in supernatural creatures, she stated,
”maniwala ku karen kasi ing tatang ku manakit ya. Tutu la reta”. She also mentioned
superstitious practices “istung measug ka king metung a tau nung emu bali nung ninu ing meg
asug keka. Itang malang pilukasan mu tugtugan me king danum a mapali”. This responses shows
enduring significance of the supernatural in her life.
Family Coping Index
Table 4. Family Coping Index
Area Score Justification
Physical Independence 2 The only members of the
family that truly need
96
physical assistance are the
two youngest members of the
family. This is because even
though Sabrina is 4 years old,
she still needs assistance or
guidance to perform certain
daily activities such as taking
a proper shower. On the other
hand, Khatelyn as a newborn
baby is completely dependent
on her mother. The index
client is also, to an extent,
physically dependent due to
her ongoing postpartum
healing process as she
requires her husband to take
up some household
responsibilities that were
originally hers.
Therapeutic Competence
Knowledge of Health 3
97
Conditions
Applications of Principles of 1
General Hygiene
Health Attitudes 3
Emotional Competence 4
Family Living 3
Physical Environment 1 The physical environment is
poor due to their inability to
adequately cope with the
current alteration in the index
client’s ability to perform her
usual cleaning routine. The
husband is currently trying to
close the gap by taking up the
index client’s role of regularly
doing laundry for the family.
There are also factors in
which the family has trouble
making appropriate changes
such as irresponsible users of
98
their communal toilet facility
and infrequent disposal of
waste by the garbage
collectors. Additionally, since
there are 3 children living in
the household, it is inevitable
that they may cause
untidiness and accumulation
of dirt inside the house that
the adults have to manage.
Use of Community Facilities 4 The family members utilize
all available facilities within
their community in an attempt
to meet their needs. These
include but are not limited to
the sari-sari stores and public
markets for food, the health
care center for free medicines
and vaccinations, and the
public elementary school for
the children’s education.
99
Occasionally the children
may also use the basketball
court to watch plays or have
fun.
Rating Description/Indicator
4 High level of Competency (All family members are competent/compliant)
3 Moderately High Level of Competency (Less than 25% of the family
members are incompetent/noncompliant)
2 Moderate Level of Competency (Less than 50% of the family members are
100
incompetent/noncompliant)
1 Low Competency (More than 50% of the family members are
incompetent/noncompliant)
0 Incompetent (No member of the family is incompetent/noncompliant)
Management
1. Medical management
Table 5. Rank and Score of Family Nursing Problems
RANK SCORE DIAGNOSIS
101
1 4.50 Inability to provide adequate nursing care to the dependent of
the family due to lack of knowledge about child development
and care specifically on proper breastfeeding as manifested by
supplemental feedings in a bottle.
· “Walang lumalabas na gatas sa dede ko, ang tagal ko na
kasing hindi nagpapa-dede, huli ko pa nung kay Mulberry”
· Mother's Perceived Milk Supply
· The use of supplemental feedings in a bottle
· Poor infant latching
· Breast engorgement
102
2 3.67 Inability to recognize the presence of poor personal hygiene in
children related to self-neglect due to non-compliance with
personal hygiene practices as evidenced by:
· Mrs. Strawberry verbalized “Matamad ya yan
mangonsumisyun ku kaya papandilwan meng alas
dose miras pang bengi” and “ala, enaku
pakiramdaman pati i tatang na panyanbyanan neh,
ali ya talaga makiramdam, masakit” referring to
Raspberry
· Mrs. Strawberry verbalized “Magkasakit ku
magpakuko ka ya, mikakayi kami na man, eya
bisang magpakuko” referring to Blueberry
· Scalp shows signs of sparse dandruff - Raspberry
and Mulberry
· Live lice and nits are present - Raspberry and
Mulberry
· Teeth showing signs of staining, plaque
accumulation, and decay - Raspberry, Blueberry,
Mulberry
103
· Nails appear dirty, with visible debris - Raspberry,
Blueberry, Mulberry
3 3.67 Inability to make decisions with respect to taking appropriate
health action due to inaccessibility of appropriate resources for
dental needs specifically cost constraints as evidenced by
· Mrs. Strawberry verbalized “Kung papatingin ko,
gagastos rin”
· Decay affects all 18 remaining teeth. Upper teeth: 3
molars on the right, 2 on the left, and 2 front teeth;
the first molar on the right is damaged. Lower
teeth: 3 molars on the left, 2 on the right, and 6
front teeth, including 2 incisors - Mrs. Strawberry
· Has not undergone a dental check-up for
approximately three years since teeth as the dental
issues started after giving birth to Mulberry.
· Evidence of financial constraints
104
4 3.67 Inability to provide a home environment conducive to health
maintenance and personal development due to financial
constraints / limited financial resources as evidenced by:
· The Berry family’s expenditures exceeding their income by
₱ 350
· “Kapag may pangluto ako, magluluto ako kasi may madami
kami utang dun (Carinderia)” “sa ngayun naguutang lang
kami nyan”
5 2.50 Inability to provide a home environment conducive to health
maintenance and personal development due to lack of skill in
carrying out measures to improve home environment as
evidenced by:
· Existence of moss on the walls and corners of the toilet
facility
· Occasional cloudy water with white specks in the pail of the
toilet facility
· Muddy floors
· Open doors to the toilet facility
· Uncovered and overfilled garbage containers
105
· Presence of ants, rodents, flies, and maggots
· Accumulation of dust on the floor and roof of the house
· Dust on the floor and mattress
· Disorganized clothes and other belongings
Table 5.1. Priority Setting of Problem Rank 1
Diagnosis: Inability to recognize the presence of ineffective breastfeeding due to lack of
knowledge on how to stimulate milk production as manifested by the use of supplemental
feedings in a bottle.
CRITERIA SCALE SCO WEIG COMPUTATI ACTU JUSTIFICAT
RE HT ON AL ION
SCOR
106
Nature of Wellness 3 The nature of
the the condition

State
Condition of of the problem
the Problem presented is in

1 3/3x1 1
Presented a score of 3 for
Wellness State
due to the
limited
knowledge of
the index client
with regards to
proper
Health 3
breastfeeding.
Deficit
Ineffective
breastfeeding
can occur in
situations such
as where
family clients
are in
depressed
areas and in
107
Health 2 need of health
education. This
Threat
is considered a
normal or
expected
transition in
life of Mrs.
Strawberry,
Foreseeable 1
since
Crisis
breastfeeding
is a natural and
biologically
normal way to
feed infants,
and it is
typically
expected to
provide the
necessary
nutrition and
bonding
between the
108
mother and
baby.
Modifiabilit Easily 2 A score of 2 as
y of the easily
Modifiable
Condition or modifiable is
Problem 2 justified
2/2x2 2
because with
appropriate
support,
guidance, and
Partially 1 interventions it
Modifiable can help the
client
overcome her
breastfeeding
difficulties.
These
interventions
would include
proper
monitoring and
109
Not 0 teachings of
the nurse about

Modifiable
breastfeeding,
addressing
pain
management
during
breastfeeding
and continuous
engagement or
interest of the
client in the
problem.
Preventive High 3 The percentage
Potential of preventive
1 3/3x1 1
potential for
ineffective
breastfeeding
is high because
it can vary
widely
110
Moderate 2 depending on
various factors,
including the
mother and the
baby being
considered, the
level of health
education and
support
Low 1 available.
These
breastfeeding
outcomes are
influenced by
numerous
complex and
interconnected
factors.
However,
efforts to
promote and
support
111
breastfeeding
can
significantly
reduce the
occurrence of
ineffective
breastfeeding.
Salience A condition “Matagal na
or problem kasi ako hindi

2
needing nagpasuso,
immediate walang
attention lumalabas
kapag
dumedede
1/2x1 0.5
1 siya”
“Gagamit pa
rin ako ng bote
pero dadahan
dahanin ko
112
A condition naman na
or problem padede-in siya

1
not needing sa akin
immediate hanggat sa
masanay ako
attention
ulit”
A score of 1
which means
Not the problem is
perceived not needing
0
as a immediate
problem or attention as per
condition the index
needing client’s
change verbalization.
Even though
her steps is not
showing
immediate
attention, it is
113
evident from
the client that
she wants to
take an effort
to introduce
breastmilk to
her newborn
child in a slow
pace.
Total Score: 4.50
Diagnosis:
Inability to recognize the presence of poor personal hygiene in children related to self-neglect
due to non-compliance with personal hygiene practices as evidenced by dirty fingernails, dental
decay, and presence of lice and nits in hair
CRITERIA SCALE SCO WEIG COMPUTATI ACTU JUSTIFICATI
RE HT ON AL ON
114
SCOR
Nature of Wellness 3 The problem is

the a health deficit.
State
Condition of The severe
the Problem impact of dirty
1 3/3x1 1
Presented fingernails,
Health 3
dental decay,
Deficit
and the presence
of lice and nits

Health 2
on the
Threat individual's
health and
well-being.
Foreseeable 1 These signs
Crisis indicate that the
necessary
hygiene
measures are
not being
followed,
115
resulting in a
deficit in
maintaining
good health.
Modifiabilit Easily 2 The problem is

y of the partially
Modifiable
Condition or modifiable
Problem 2 because the
1/2x2 1
potential for
improvement
varies across
Partially 1
different aspects
Modifiable
of this nursing
diagnosis.
While some
Not 0 issues, like dirty
fingernails, can
Modifiable
be addressed
with education
and
encouragement,
116
others, such as
dental decay
and lice
infestation, may
require more
complex and
ongoing
interventions.
Preventive High 3 The problem

Potential has moderate
1 2/3x1 0.67
preventive
potential
because
Moderate 2
preventing or
improving each
aspect of poor
personal
hygiene is
Low 1
possible, but it
may not be
direct due to
117
factors such as
the individual's
willingness to
change, the
severity of the
issues, and
external
influences.
Salience A condition It is a condition
or problem or problem
2
needing needing
immediate immediate
attention attention based
on the
statements
2/2x1 1
1 indicating the
children's
difficulty with
personal
hygiene and
their behavior of
118
A condition not wanting to
or problem address it and

1
not needing not listening to
immediate their mother
(index client).
attention
Behavioral
issues,
especially when
they lead to
neglect of
personal
hygiene, can
impact their
physical and
mental health,
social
relationships,
and overall
quality of life.
Immediate
attention is
needed to
119
Not address and
perceived as modify these

0
a problem behaviors. Early
or condition intervention and
needing support are
change crucial to
prevent further
deterioration
and to help the
children
establish better
personal
hygiene
practices and
behaviors.
Total Score: 3.67
120
Diagnosis:
Inability to make decisions with respect to taking appropriate health action due to inaccessibility
of appropriate resources for dental needs specifically cost constraints as evidenced by all the 18
remaining teeth are affected by decay, limited income, and client verbalized “kung papatingin ko,
gagastos rin”
RE HT ON AL ION
SCOR
Nature of the Wellness 3 The problem is

Condition of a health
State
the Problem deficit. The
Presented client’s
1 3/3x1 1
evidence that
Health 3 all 18
Deficit remaining
teeth are
affected by
121
Health 2 decay
indicates a
Threat
significant
dental health
problem.
Foreseeable 1 Despite being
Crisis aware of the
need for dental
care, the client
is unable to
access these
resources due
to financial
constraints.
Modifiability Easily 2 The problem is

of the partially
Modifiable
Problem 2 because the
1/2x2 1
client may
refer to the
barangay
122
Partially 1 health center
Modifiable to avail free
dental services
with effort and

Not 0
support, the
Modifiable core issue of
limited income
may remain
largely
unmodifiable
in the short
term.
Preventive High 3 The problem

Potential has moderate
1 2/3x1 0.67
preventive
potential
because to
address the
dental issues
and financial
constraints, it
123
Moderate 2 may not be
rated as high
due to the
existing state
of severe
decay in all 18
remaining
Low 1
teeth.
Preventive
actions may
help improve
the situation to
some extent,
but they may
not fully
reverse the
damage that
has already
occurred.
124
A condition 2 It is a
or problem condition or
needing problem
immediate needing
attention immediate
attention
because the
2/2x1 1
1 client is facing
serious dental
health
problems, with
all 18
remaining
teeth affected
by decay. It
not only
affects their
oral health but
could also
harm their
overall
well-being.
125
A condition 1 The client's
or problem limited income
not needing and reluctance
immediate to seek care
due to
attention
anticipated
expenses
highlight the
urgency of
addressing
their dental
and financial
issues
promptly.
Delaying
intervention
may lead to
further oral
health decline
and potential
systemic
126
Not 0 health
perceived as problems.
a problem or
condition
needing
change
Client’s
verbalization
of “Oo yun
ang ano ko
maam
resolusyon ng
ngipin ko,
ayun talaga
pangarap ko
maam para
magka ipin
ako uulit
mababalik ang
dati kong ano
beauty, kung
libre papustiso
127
bakit hindi”
when asked if
the condition
of the problem
is needing
immediate
attention.
Total Score: 3.67
Diagnosis:
Inability to provide a home environment conducive to health maintenance and personal
development due to financial constraints / limited financial resources as evidenced by the Berry
family’s expenditures exceeding their income by ₱ 350
128
RE HT ON AL ION
SCOR
Nature of Wellness 3 Financial
the restraints can

State
Condition of affect a
the Problem family's

1 3/3x1 1
Presented wellness state
Health 3
by restricting
Deficit
access to
healthcare,
Health 2
education, and
Threat
basic needs.
Stress, less
Foreseeable 1
opportunities,
Crisis
and strained
relationships
can all occur,
affecting your
mental and
129
physical
well-being.
Modifiabilit Easily 2 While certain
y of the factors leading

Modifiable
Condition or to financial
Problem restraints are

1/2x2 1
beyond
1
individual
control, there
are strategies
to influence
and minimize
Partially 1
these
Modifiable
limitations.
Personal
financial
habits, and
education, on
the other hand,
may be
adjusted to
130
Not 0 enhance one's
financial
Modifiable
condition.
Budgeting,
saving, or
investing
wisely can all
help to
improve
financial
stability. As a
result,
financial
restrictions are
somewhat
modified via
both individual
and
collaborative
initiatives.
131
Preventive High 3 Preventing
Potential financial
1 2/3x1 0.67
troubles is
moderately
preventive
because it
usually
operates
Moderate 2
indirectly. It is
determined by
aspects such as
whether
people are
willing to
make
Low 1
adjustments,
the severity of
the financial
problems, and
outside
influences.
Solving
132
financial
problems is
possible, but it
is typically
complicated
and requires a
thorough
approach to
achieve
long-term
financial
health
improvements.
133
Salience A condition When asked
or problem about their

2
needing daily cooking
immediate habits, to
attention which Mrs.
Strawberry
responded,
2/2x1 1
“Hindi man
1 ako nagluluto
ma’am. Kapag
may pangluto
ako, magluluto
ako kasi may
madami kami
utang dun
(Carinderia)”
“sa ngayun
naguutang
lang kami
nyan”
134
A condition The
or problem Strawberry
1
not needing family's
immediate adoption of
deficit finance
attention
is a pressing
matter
requiring
prompt action
due to the
potential
challenges in
meeting
crucial
expenses,
which could
lead to
financial
instability and
increased
stress. Taking
immediate
135
Not steps will help
perceived avert the

0
as a escalation of
problem or debt, ensure
condition the fulfillment
needing of essential
change needs, and
protect the
family's
well-being and
future
opportunities.
Total Score: 3.67
136
Diagnosis:
Inability to provide a home environment conducive to health maintenance and personal
development due to lack of skill in carrying out measures to improve home environment as
manifested by existence of moss on the walls and corners, occasional cloudy water with white
specks in the pail, muddy floors, consistently open doors to the toilet facility, uncovered and
overfilled garbage containers, presence of ants, rodents, flies, and maggots, accumulation of dust
in the corners and roof of the house, dust on the floor and mattress, and disorganized clothes and
other belongings.
CRITERIA SCALE SCO WEIG COMPUTATI ACTU JUSTIFICATIO
RE HT ON AL N
SCOR
137
Nature of Wellness 3 The problem is a
the health threat.

State
Condition of Improperly
the Problem cleaned

1 2/3x1 0.67
Presented bathrooms allow
bacteria to thrive
and may cause or
Health 3 spread diseases
Deficit especially
because their
toilet facility is
Health 2 for communal
use.
Threat
Accumulation of
dust may cause or
aggravate
Foreseeable 1
respiratory
Crisis
problems such as
asthma, especially
for newborns.
Improper disposal
of garbage
138
attracts disease
vectors such as
ants, flies, and
rodents, and may
elicit odors that
may reduce the
level of comfort a
person feels.
Modifiabilit Easily 2 The problem is
y of the partially
Modifiable 1
Problem because the

1/2x2 1
family does not
have the
knowledge and
community
support with
regards to
cleaning the
communal toilet
facilities and
139
Partially 1 managing the
Modifiable waste. They also
do not have
enough
manpower and
time to throughly
clean the house
Not 0 and remove the
dusts. But
Modifiable
essentially, they
may improve the
state of their
environment
through
education,
guidance, and
encouragement
for the necessary
tools may be
easily acquired
and proper time
management may
140
be done through
discipline.
Preventive High 3 The problem has
Potential low preventative

1 1/3x1 0.33
potential because
the case of
unsanitary toilet
facility and
accumulated dust
Moderate 2 is quite severe
that it requires
expensive effort
to fix. The
long-continued
existence of these
problems is also
proof that the
family’s current
management is
ineffective. Many
people, not only
141
Low 1 the Berry family,
are also involved
and affected by
the issue of
unsanitary
bathrooms and
improper waste
disposal, making
it hard to manage
its cleanliness or
any effort towards
its maintenance.
Salience A condition It is a condition or
or problem problem that does

2
needing not require
immediate immediate
attention attention because
although the
1
family values
1/2x1 0.5
cleanliness, they
do not always
142
A condition have the right
or problem solutions or
1
not needing control over it.
immediate When asked
about how often

attention
the facility was
cleaned, Mrs.
Strawberry states,
“tuwing may
maliligo. Minsan
naman
nakakatamad na.
Kung minsan
yung iba hindi
nila nililinis yan.
Kami lang dalawa
ng bayaw ko”,
and when she is
asked about the
management of
dust, she states
that, “ngayon lang
143
Not naano yan,
perceived ma’am, buhat

0
as a nung nabuntis ako
problem or di ko na
condition naasikaso.
needing Naaano ko yan
change dati, ma’am.
Nalilinis ko yung
bahay”.
Regarding the
management of
waste, Mrs.
Strawberry also
states that, “may
kumukuha diyan,
ma’am. Kada
Martes” and “
hindi kasi kami
may hawak dyan.
Yung bayaw ko
kasi ang
144
nagko-kontrol
diyan”.
Total Score: 2.50
FNCP
X. FDAR
XI. SBAR
145
XII. References
• Use APA 7 format for referencing

146
XIII. Appendices
1. Informed Consent (for actual client)
2. Referral Letters
3. Health Education Materials
XIV. Photo documentation
• Insert group photo of every group meetings with the client (for actual) and with the
clinical instructor (for virtual). If the meeting was held without the CI, the team leader is in
charge to carry out all objectives and activities for the day.
• Team leader should be in – charge of the photo documentation
• Each photo should have a narrative explanation that contains the objectives for the
meeting, date, attendees, and achievement for the day.
XV. Individual Reflection
Consider the following:
• Meeting the learning objectives in making family case analysis

147
• Meeting the HAU Core Values
• Experiential / empirical learning and development
• Working with the team / group and clinical instructor/s
XVI. Curriculum Vitae (individual with picture)
148
Name: Allyssa G. Llaneta, HAU SN
Address: Lot 79, Remedios Triangle, Capaya Uno,
Angeles City, Pampanga
Age: 24 years old Contact Number: +639 76 246 7446
Email: agllaneta@student.hau.edu.ph
Objective: A compassionate and committed nursing student who is seeking to gain more
hands-on-experience at HAU to broaden the skills, knowledge and learnings. With an expected
graduation date of 2026. In this, it is a must to be more flexible, competent and confident.
Academic Experience:
Holy Angel University Holy Angel University
College (A.Y. 2018-2019) Senior High School (A.Y. 2016-2018)
School of Nursing (1st Year College) Tech-Vocational Livelihood Strand
Claro M. Recto ICT High School
Junior High School (A.Y. 2012-2016)
Extra-curricular Activities and Hobbies: Volleyball, Guitar, Singing
149
Key Skills: Microsoft Efficient, People Skills, Adaptability, Empathetic, Communication Skills,
Leadership skills, ERP and CRM Programs
Awards, Honors and Certificates: Dean’s lister, SNAMS Genius of the Year (A.Y. 2018-2019),
With High Honors, NCII (TESDA) Certifications, Best Thesis in Programming (A.Y.
2015-2016)
150

SNAMS Paper Template Group 2B

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

SNAMS Paper Template Group 2B

Uploaded by

Copyright:

Available Formats

A Family Case Analysis

The Faculty of the School

of Nursing and Allied Medical Sciences

HOLY ANGEL UNIVERSITY

Of the requirements for the degree

Bachelor of Science in Nursing

Briton, Ildee Marie B.

Ilagan, Jarah Maica A.

Pacis, Isabella Nicole R.

Soriano, Jean Nicole M.

October 18, 2023

been possible without their collaboration.

community health nursing and giving us critiques regarding our outputs.

1. Include the following with pages

ii. List of figures

iii. List of Appendices

Objectives of the Study

restoration, and maintenance and rehabilitation of individuals and families in a community

nursing concepts and actions holistically and comprehensively.

restoration, maintenance, and rehabilitation.

disease prevention, rehabilitation, maintenance, and restoration based on priorities.

restoration of individuals and families in the community.

restoration, maintenance, and rehabilitation using selected planning models to targeted

individuals and families in the community.

status/competence regarding health promotion, disease prevention, restoration, maintenance, and

rehabilitation after the administration of basic nursing health care.

promotion, disease prevention, restoration, maintenance, and rehabilitation in a community

health promotion, disease prevention, restoration, maintenance, and rehabilitation of individuals

and families in, a community setting.

maintenance and rehabilitation of individuals and families in the community.

and family in a community setting.

prevention, restoration, maintenance, and rehabilitation.

LO13: Implement strategies/policies related to informed consent as it applies in the contexts of

terms of health prevention, disease prevention, restoration, maintenance, and rehabilitation.

appropriate communication / interpersonal techniques/strategies.

rendered and processes/outcomes of the family nurse-client working relationship.

LO16: Ensure completeness, integrity, safety, accessibility, and security of information of

family nurse-client working relationship in the community.

LO17: Adhere to protocols and principles of confidentiality in safekeeping and releasing of

LO18: Ensure intra-agency, inter-agency, multidisciplinary, and sectoral collaboration in

rehabilitation of individuals and families in the community.

LO19: Implement strategies/approaches to enhance/support the capability of the individuals,

maintenance and rehabilitation of individuals and families in the community.

programs and services to individuals and families in the community.

family health nursing services in the community.

LO26: Apply management and leadership principles in providing direction to manage an

individual and family health nursing program in a community setting.

basic nursing services in a community setting.

services in the community based on parameters/criteria.

individuals and families in the community.

LO30: Participate in conducting a family case analysis as a member of a care team.

maintenance of competence through a reading of current evidence relating to individual and

family nursing care in a community setting.

and social care service policies and access to services.

LO33: Model professional behavior as a community health nurse.

services to the Filipinos and their families in the community.

rehabilitation of individuals and families in the community.

families in the community.

country, and love of people.

LO38: Manifest Christ-centeredness, integrity, excellence, community, societal responsibility,

providing basic nursing care to individuals and families.

LO41: Apply strategic interventions to address health-related concerns of individuals and

families in a community health care setting.

Community health nursing is a specialized branch of nursing dedicated to addressing the