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Family Nursing Care Plan (FNCP) for Community Health


Nursing (CHN)
Nursing (Adventist University of the Philippines)

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FAMILY NURSING CARE PLAN

Presented to
The College of Nursing

Manila Adventist College


Pasay City

In Partial Fulfillment
Of the Requirements
For the Course
CHNN 213 Community Health Nursing

Submitted by:
Alagar, Aira Yvonne
Davilmar, Herold
Esteban, Marianne
Filomeno, John Ford
Maderaje, Katherine Joy
Moreno, Jesem Beth
Pajardo, Maekyla
Pelayo, Ma. Denielha Angel
Sarmiento, Jeistha Melo

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TABLE OF CONTENTS
INTRODUCTION 4
SPOT MAP DESCRIPTION 5
SPOT MAP 7
COMMUNITY IN GENERAL 8
FAMILY NURSING ASSESSMENT 9
Assessment of the Family
- Family Structure
- Education
- Occupation
- Income
- Civil Status
Home Characteristics 9
Environmental and Health Sanitation 10
- Water Supply
- Garbage Disposal
- Toilet Facility
- Cooking Facility and Food Storage
- Domestic Animals
Lifestyle and Health Behavior 11
HEALTH PROBLEM 12
1. Family size beyond what family can adequately provide
2. Presence of vector breeding sites
3. Poor home and environmental condition and sanitation.
4. Presence of accident hazards

SCALE FOR RANKING HEALTH CONDITIONS AND 16


PROBLEMS ACCORDING TO PRIORITIES
FAMILY NURSING CARE PLAN 20
SERVICES AND PROGRESS NOTES 25
APPENDICES 27

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Appendix A: Pictures 27
Appendix B: Letter of invitation 44
Appendix C: Food stub and raffle stub 45
Appendix D: General assembly program 46
Appendix E: Certificates of Appreciation and Participation 47
Appendix F: Attendance sheet 48
REFERENCES 50

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INTRODUCTION

In the traditional context of human society, a family is a group of people who are either

biologically related or bonded through marriage and other types of relationships. Ideally, a family

is composed of a father, mother and children. Currently, there are six types of family structures

and these are nuclear family, single parent family, extended family, childless family, step family,

grandparent family, and dyad type of family. A family is not just a simple set of individuals engag-

ing in their activities. It is a complex social formation organically connected with the society.

Community is a group of people living or working together in the same area with common

agenda, cause, interest, who collaborate by sharing ideas, information, and other resources. A

family’s involvement to the community is very important. They must work together to promote

health, well- being, and peace in the community. Good interactions in the community develop

healthy behaviors and healthy families while problems within the area greatly affect its residents.

It might affect their health, livelihood and lives.

On the other side, Community Health Nursing or Public Health Nursing is the synthesis of

nursing and public health practices applied to protect and improve the health of the population.

It combines all the basic elements of professional clinical nursing together with the public health

and community health practices. Another goal of community health nursing is to promote self-

care among individuals and families. Nurses today are playing important roles in coordinating

and providing care to the community. And so, as an individual who wants to prevent illness and
promote wellness, a group of community health nurses go to the community together with health

professionals to identify health and nursing problems that need immediate actions.

The chosen community was Barangay 186, Zone 19, Pasay City, which needed assistance

for health, sanitation, and environmental improvement. It is a congested area faced with rising

demands for health care, limited resources and inequalities of life and environment. Upon as-

sessment, there were families who are facing struggles in terms of health, sanitation, and home

conditions that need supervisions and help. That is why community health needs assessment has

a central part to play, enabling practitioners to identify those in greatest need and to ensure that

health care resources available are used to maximize health improvement. Our group selected to

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study the families to describe ways how these local people identify the existing problems arising

in their family and confidently solve those problems in their own through the help and guidance

of community health nurses. Implementations of good health and promotion of clean and safe

environment conducive to health problems are the primary goal of this act. To attain that, the

level II nursing students with their clinical instructors must provide health actions and interven-

tions effectively. Planning is vital tool used to achieve goals which is to provide health care for the

important client -- family.

The main purpose of this study is to determine the existing health and environmental

problems of the selected family of Barangay 186, zone 19, Pasay City, Philippines and to carry out

nursing interventions or solutions for the problems identified. Specifically, this study will strive

to meet the following specific objectives: assess the health condition of the family and its re-

lationship to the community, identify the actual and potential health problems of the selected

family according to priorities, determine the health practices of the family, and provide nursing

interventions and nursing care plan for the family including the health teachings and tips to in-

crease knowledge and awareness of the community. This study will use the survey, interview and

descriptive methods of elaborating the information gathered. For the family assessment, service

and progress record, the primary instrument in gathering data regarding this matter was the in-

terview sheet. Limitations of the study limited also the community-based resources about health

problems and conditions. This study only focuses on the Tugade Family and does not include other

families in the community. Student nurses will use purposive sampling procedure and it will de-
crease the generalizability of results. Therefore this study will not be generalizing the family health

conditions of all residences of the community.

SPOT MAPPING DESCRIPTION

Barangay 186 – Zone 19 is one of the barangays in Pasay. The barangay has a total land
area of 2.88 hectares. There are 1,340 households and has a total population of more than 5,093.

The male population has a total number of 2,531 while the female population is 2,562. The total

voting population is 2,645. The number of households with an average size of 5 members is 707.

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Its North barangay boundary is barangay 156 Tripa De Gallina; south boundary is Saint Augustine

Street; east boundary is from Saint Claire; its west boundary is Aurora Boulevard. The barangay

office is located in 2313 Saint Joan Street Maricaban. The landmark that can help people to find

the barangay is the Dona Nena Health Center. Another landmark is the Pasay Central Post Office.

Majority of the houses inside this barangay are made of concrete materials and the rest

are wood type and some are mixed materials of concrete and wood. There are 300 houses in the

surveyed area. The climate in Maricaban ranges from hot to rainy season. The barangay has light

and electrical posts which can be found in all parts of the barangay. For security, the barangay has

closed-circuit television (CCTV) cameras. They have sports and recreational facilities like covered

court and physical fitness located at the 3rd floor of their gymnasium. There are also 2 available

basketball courts near the post office. One is covered and the other is not. However, the open

court functions now as a parking lot and place to dry rice grains. The most popular livelihood

this barangay has is selling coconuts. The barangay has establishments of 18 sari-sari stores, 3

carinderia, and 1 bakery. Their mode of transportation is mostly tricycles and motorcycles. Gold-

en-Pistons motor shop, Tramo Radiator shop, Basco Lolita Z Motorcycle Spare Parts, and JOEM

Marketing are shops that sell motorcycle and car parts or accessories. These shops can be found

along Aurora Boulevard. A truck site is also present near the Maricaban creek. The barangay also

has a fire hydrant where firefighters or the people in the community can get water supply when

fire happens. Water meters and water tanks are also present within the barangay. The barangay

also has a bridge with guardrails along the Maricaban creek.

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COMMUNITY IN GENERAL

Located on 2313 Saint Joan St., Maricaban Pasay lies Barangay 186. On May 1, 1990, Ba-

rangay 186 Zone 19 was born with an population of 3272. On September 1 of 1995, the population

has grown 7.80%. When it reached May 1, 2000, the population has decreased by -1.07%. By Au-

gust 1, 2007, the growth rate has dropped -2.28%. By May 1, 2010, the population has significantly

grown 15.12% to a total of 5,786 residents and as of writing, the barangay has maintained an av-

erage of more than 5,000 in 2019. According to the 2015 Census, the age group with the highest

population in Barangay 186 is 20 to 24, with 567 individuals. This barangay represents 1.2 % of the

total population of Pasay. Some physical features are that it is quite clean, meaning they sweep

the main road but some dog feces are still seen on the road. The climate around the barangay is

rather rainy in the mornings and is tremendously hot in the afternoons. Because they are located

in Metro Manila they do not have much fresh air as the different parts of the country.

The barangay is led by Captain Losendo B. Garbo followed by Hon. Arnie Marlois T. Marzo

SK Chairman; Cesar M. Castro Lugeon, coordinator; Alvin J. Baldemor, secretary; and Amelinda

Y. Tabios treasurer. The whole barangay is composed of 2.88 hectares of land with 475 house-

holds which averages 5 members. The majority of the houses are mostly built with concrete but

some are mixed. Some of the major establishments are Golden-Pistons Motor Shop, Tramo Ra-

diator Shop, Basco Lolita Z Motorcycle Spare Parts, and JOEM Marketing. Other establishments
are mineral water shops, the post office, health center, and 2 multipurpose halls. There is a a big

multipurpose hall and a small one for smaller gatherings. There are many health centers around

the area, but the main health center is Dona Nena Health Center located across the Pasay Central

Post Office. Some of the services they offer are free syphilis tests, dental check-ups, TB tests, and

HIV counselling. On an average, 100-120 people come to visit the health center daily. Their way of

living is highly productive like washing their clothes, cooking, and selling different kinds of foods,

etc. The foods they sell are coconuts, fruits, baked goods, ice cream, and junk foods. Their source

of communication is mostly through mobile phones. Their ways of transportation are comprised

of motorcycles, tricycles, jeeps, and cars. Their feast day is called Mary Comforter and it is every

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year on the 3rd Sunday of August. Otherwise, the residents around the barangay are happy and

hard workers.

FAMILY NURSING ASSESSMENT

Assessment of the Family

Mr. JT and Ms. AP were living in a common law marriage situation for 16 years and they

decided to get married on January 2020. The head of the family is JT, 39 years old and was born on

June 13, 1980 at Ospital ng Maynila Medical Center. He was a high school graduate at Parañaque

Multinational and currently working as a house painter in Valenzuela City. He comes home every

Saturday evening. He is the only one working for the family and earns a salary of P3,000 per week.

AP, 32, is the mother, who was born on April 13, 1987. She was also a high school graduate at

MacArthur National High School in Leyte. She stays at home taking care of their children.

The family consists of seven children. CT, first child, was born on April 23, 2004. He is 15,

a Grade 8 student. The second child is JT, 14, was born on June 20, 2005. He is a Grade 8 student

also. The third child is CT, 13, was born on November 20, 2006. She is a Grade 7 student. All of

them attend the same school at Corazon Aquino National High School. CT, 12, was born on De-

cember 14, 2007, a Grade 5 student. CJT, 10, was born on December 25, 2008. She is a Grade 4

student. JT, 5, was born on May 1, 2014, a kindergarten student. All of them study at Maricaban
Elementary School. Jefferson Tugade, 3, was born on June 25, 2016. He is not yet attending school

and just stays at home with his mother.

The family has a good communication where they share their opinions or problems with each

other in terms of finances, marital issues and academic concerns. The parents were both making

the decisions for the family and they respect each other’s perspectives.

Home Characteristics

Home is a place where we can feel comfortable and safe. Keeping the surroundings con-

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ducive to health maintenance and well-being of the family is vital. But there are also situations

that are inevitable and the truth is that there are still families that living and surviving under un-

stable conditions.

The family is living in a congested community, located at 272 St. Rita, Barangay 186, Zone

19 Maricaban, District 2, Pasay City. The house is a two-storey building composed of mixed con-

crete and wood. It is small and messy with scattered clothes everywhere. The house also lacks

proper ventilation. Unpleasant odor is also present due to poor environmental sanitation and the

space is inadequate for them to live in. Outside the house, an old motorcycle and clotheslines

are seen as well. At the entrance, there is a TV in front, one chair made of plastic, one wall fan on

the right side to facilitate ventilation, two fluorescent lights for the kitchen, living room, and the

bedroom. Stuff toys are well organized in a glass cabinet located atop the television and two Du-

raBoxes tower the scene where they put their clothes and other stuffs. Accidental hazards such as

unstable foundation of the flooring and stairs that will be a risk for falling are present.

The area is too small that the receiving area also serves as their bedroom too. The mother,

together with the children, sleeps on two connecting wooden beds with foam situated near the

entrance which also serves as their couch. On the head of the bed, there is a small table where

small materials are placed. Blanket and foams were scattered on the bed. Other beds are located

upstairs and only curtains served as the division of the kitchen and the bedroom/living room.

Environmental and Health Sanitation

Environmental sanitation means the art and science of applying sanitary to improve the

environmental conditions and to control the spreading of diseases caused by bacteria and other

factors. It provides protection of the health and protects the welfare of the public. Pollution of the

environment such as water and earth pollution is observed. A lot of holes on the ground is evident

of the canalization that was poorly done in the streets.

Attention was focused on the houses and its vicinity. Aside from being congested with

each other, the space inside the house is also not enough for nine members of the family and the

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dog that they have. Gas stove is used to cook food and whenever there is leftover food they just

cover it on the table. Large plates are sometimes utilized to achieve so. Beside the kitchen is the

toilet which is pour flush. The drinking water is purified water. Every Thursday the garbage collec-

tor collects the garbage of the houses, but before that the family needs to segregate their waste.

They have open canals and pipes for drainage. Every week also the barangay has clean-up drive

programs to promote sanitation for the community.

Lifestyle and Behavior

The family’s lifestyle is quite normal based on the interview. They do not smoke cigarettes

and drink alcohol. They get at least 6 hours of sleep daily which is inadequate because they need

at least 8 hours especially since they have 7 small children. From what has been observed, the

mother is fairly timid and does not really have control over her children. The children were wild

and loud. As reported by the mother, they are practicing family planning and get their supplies

from Sheidy Perminder Lying-In. They are using a modern method of intrauterine contraceptive

device (IUD). According to the interview they are satisfied with the family planning that they use.

When it comes to talking to their children, they do talk to them regarding their sexuality. As of

now, the mother is a housewife and the husband is the only one who works, providing and sup-

port the family, while the children (except for the youngest) are all in school.

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PROBLEM SHEET

DATE
HEALTH PROBLEM NURSING PROBLEM SUPPORTING DATA CUES
IDENTIFIED RESOLVED
1. Family size beyond Inability to make decision Subjective: “Ang trabaho po ng asawa ko ay
what family can ade- with respect to taking ap- painter. Siya lang po ang nagtatrabaho sa
quately provide propriate health actions amin.” the mother verbalized.
due to lack of knowledge
as to alternative courses
of action open to them Objective 21 Nov Not re-
2019 solved
• Family has 7 kids
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• Scanty food on the table

• Minimal income of father

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2. Presence of vector Inability to recognize the Subjective: “Madalas po talagang malamok
breeding sites presence of the condition dito, lalo na sa tapat ng bahay.” mother verbal-
or problem due to lack of ized.
or inadequate knowledge

Objective 21 Nov Not re-


• Presence of breeding grounds of mos- 2019 solved
quitoes in the environment within the
house vicinity

• Presence of nearby creek


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3. Poor home and envi- Inability to provide a Subjective: “Maliit lang po kasi ang bahay nam-
ronmental condition home environment con- ing. Hindi sapat para sa’ming lahat.” the moth-
and sanitation. ducive to health mainte- er verbalized.
nance and personal de-
• Inadequate
velopment due to limited
living space
financial resources Objective
• Poor lighting
• The home is small enough for the fam-
and ventila- Not
ily’s number
tion. 21 Nov
resolved
• Window not enough for proper venti- 2019
• Presence of
lation
air pollution
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• Narrow door entrance can hardly fit
people

• Poor lighting

• Humidity inside the house

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• Poor ventilation
4. Presence of accident Inability to provide a Subjective: “Nadulas na po sila d’yan dahil
hazards as evidenced home environment con- makitid.” the mother verbalized.
by: ducive to health mainte-
nance and personal de-
• Narrow stairs
velopment due to limited Objective:
• Fall hazards financial resources • Presence of pointed objects and nar-
• Fire hazards row staircase 21 Nov Not re-
2019 solved
• Absence of stair handrail

• Weak structure of stair (made of old


wood)
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• Octopus wiring

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SCALE FOR RANKING HEALTH CONDITION AND PROBLEMS ACCORDING TO PRIORITIES

Family size beyond from what family can adequately provide


CRITERIA COMPU- SCORE JUSTIFICATION

TATION
1. Nature of the 2/3 x 1 2/3 An increase size

Problem of family can be a

threat to the existing

family health.
2. Modifiability 2/2 x 2 2 Number of the family

of the prob- cannot be altered

lem but preventing to

add its number can

be modified
3. Preventive 1/3 x 1 1/3 Using permanent

potential family planning

method can increase

the potential of

decrease family size

however the family

resources is limited
4. Salience ½x1 1/2 The family recognizes

the need of action

through using IUD.

Total 3 1/2

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Presence of vector breeding sites

CRITE- COMPU- SCORE JUSTIFICATION

RIA TATION
1. Nature 2/3 x 1 2/3 It is a health threat because

of the of the presence of open

Prob- drainage as vectors breed-

lem ing site.


2. Modifi- 1/2 x 2 1 It is partially modifiable

ability through intervention and

of the health teaching but other

prob- factors like the environment

lem hinder/affects success.


3. Pre- 2/3 x 1 2/3 Although interventions will

ventive educate the community

poten- improper management and

tial prevention of communica-

ble diseases, inadequate

physical and financial

resources lower the com-

munity’s potential to totally

eradicate the problem.


4. Salience 2/2x 1 1 The family recognizes the

problem as the mother is

putting mosquito repellent

lotions for her children and

avoiding water storage for

too long.

Total 2 1/3

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Poor home and environment condition and sanitation


CRITE- COMPU- SCORE JUSTIFICATION

RIA TATION
1. Nature 2/3 x 1 2/3 Having poor home and

of the environment condition and

Prob- sanitation can be a health

lem threat to the family.


2. Modifi- 1/2 x 2 1 Increasing the living space

ability will require quite a financial

of the expenditure. The family

prob- resources are presently not

lem adequate considering the

other problems; however

the size of the house and

structure cannot be modi-

fied.
3. Pre- 2/3 x 1 2/3 The problem on home con-

ventive dition space is not easily

poten- preventable due to finan-

tial cial problems and space

but doing some arrange-

ments and cleaning, con-

gestion will be lessen.


4. Salience ½x1 1/2 The family perceives their

living space to have a slight

problem due to their family

number, but it can still ac-

commodate them.

Total 2 5/6

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Accident hazards due to narrow stairs

CRITERIA COMPU- SCORE JUSTIFICATION

TATION
1. Nature of the 2/3 x 1 2/3 The existence of the

Problem narrow stairs has its

risk for children and

is a health threat to

them.
2. Modifiability 1/2 x 2 1 The problem is

of the prob- partially modifiable

lem as related to budget

for repair thus giving

awareness to the

family can still be

modifiable.
3. Preventive 1/3 x 1 1/3 The problem can

potential be prevented upon

repairing their nar-

row stairs with their

available resources

and through inter-

ventions where the

family can be aware

of the threat of their

stairs
4. Salience 0/2 x 1 0 Not perceived as

problem by the

family.

Total 2

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FAMILY NURSING CARE PLAN

EVALUATION
NURSING OBJECTIVES OF PLAN OF
HEALTH PROBLEM Outcome criteria or
PROBLEM NURSING PROBLEM INTERVENTION Methods or tool
indicators
1. Family size be- Inability to make After nursing inter- 1. Analyze with the After nursing inter- • Home visits
yond what family decision with vention, the family: family critical vention, the family:
• Lectures
can adequately respect to taking issues related with
a. Can explain a. Explained
provide appropriate health marital relation- • Interviews
what plan- what planning
actions due to lack ships and the
ning the the family is
of knowledge as to parents’ respon-
family is all about;
alternative courses sibilities for love
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about;
of action open to and life as basis b. Enumerated
them b. Can enumer- for maintaining the vari-
ate the vari- family size. ous ways of
ous ways of maintaining
2. Discuss with

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maintaining the size of the
family alternative
the size of family;
courses of actions.
the family;
3. Explore the
c. Will select
advantages and
a method
disadvantages of
most appro-
each alternative to
priate for
encourage better
them
decision making
on the best option
on family planning
family is all about;
alternative courses sibilities for love
about;
of action open to and life as basis b. Enumerated
them b. Can enumer- for maintaining the vari-
ate the vari- family size. ous ways of
ous ways of maintaining
2. Discuss with
maintaining the size of the
family alternative
the size of family;
courses of actions.
the family;
c. Selected a
3. Explore the
c. Will select method most
advantages and
a method appropriate
disadvantages of
most appro- for them
each alternative to
priate for
encourage better
them
decision making
on the best option
on family planning
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2. Presence of vec- Inability to recog- The family will be 1. Discuss with The family will be • Home
tor breeding sites nize the presence able to: the family able to: visits
of the condition the dangers
a. Gain knowl- a. Gained • Lectures
or problem due to of stagnant
edge regard- knowledge
lack of or inade- waters in the • Interviews
ing the risk regarding the
quate knowledge house vicinity.
factors risk factors
Accompany
b. Commit to b. Committed to
the family in
the process the process
eliminating the
and man- and man-
factors that
agement of agement of
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contribute to
elimination elimination
the threat of
dengue.

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3. Poor home and Inability to provide After nursing inter- 1. Provide health After nursing inter- • Home
environmental a home environ- vention, the family teaching on vention, the family visits
condition and ment conducive will be able to: the threats will be able to:
• Lectures
sanitation. to health mainte- posed by an
a. Name the a. Named the im-
nance and person- unhygienic • Interviews
a. I n a d e q u ate importance portance of a
al development environment.
living space of a clean clean environ-
due to limited
environment, 2. Encourage the ment, leading
b. Poor lighting financial resources
leading to a family to dis- to a conducive
and ventila-
conducive pose unneces- home
tion.
home sary things to
b. Verbalized
c. Presence of
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provide more
b. Verbalize effort and
air pollution space.
effort and commitment
commitment to maintaining
to maintain- a clean and
ing a clean healthy envi-

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and healthy ronment
environment
4. Presence of acci- Inability to provide After nursing inter- 5. Discuss with the After nursing inter- • Home
dent hazards as a home environ- vention, the family family the nature vention, the family visits
evidenced by: ment conducive will be able to: and consequences will be able to:
• Lectures
to health mainte- of risk factors for
a. N a r r o w Gain knowledge Gained knowledge
nance and person- accident hazards • Interviews
stairs about the dangers about the dangers
al development
of the presence of 3. Explore ways of the presence of
b. Fall haz- due to limited
accident hazards on how to accident hazards
ards financial resources
possibly lessen
c. Fire haz- or avoid such
ards accidents by
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minimizing the
factors

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SERVICE AND PROGRESS RECORDS

HEALTH CONDITION AND NURSING PROBLEMS NURSING INTERVENTIONS, ACTIONS AND


DATE
EVALUATION OF PROGRESS/OUTCOME
Health problem Nursing problem
Family size beyond what family Inability to make decision with re- 1. Analyzed with the family critical issues
can adequately provide spect to taking appropriate health related with marital relationships and
actions due to lack of knowledge the parents’ responsibilities for love
as to alternative courses of action and life as basis for maintaining family
open to them size.
21 Nov
2. Discussed with family alternative
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25
2019
courses of actions.

3. Explored the advantages and disadvan-


tages of each alternative to encourage
better decision making on the best

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option on family planning
Presence of vector breeding sites Inability to recognize the presence 1. Discussed with the family the dangers
of the condition or problem due to of stagnant waters in the house vicin-
21 Nov lack of or inadequate knowledge ity.
2019 Accompanied the family in eliminat-
ing the factors that contribute to the
threat of dengue.
Poor home and environmental Inability to provide a home en- 1. Provided health teaching on the
condition and sanitation vironment conducive to health threats posed by an unhygienic envi-
maintenance and personal devel- ronment.
opment due to limited financial
21 Nov 2. Encouraged the family to dispose
a. Inadequate living space resources
2019 unnecessary things to provide more
b. Poor lighting and ventila- space.
tion.

c. Presence of air pollution.


Presence of accident hazards as ev- Inability to provide a home en- 1. Discussed with the family the nature
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26
idenced by: vironment conducive to health and consequences of risk factors for
21 Nov maintenance and personal devel- accident hazards
a. Narrow stairs
2019 opment due to limited financial
2. Explored ways on how to possibly less-
b. Fall hazards resources
en or avoid such accidents by minimiz-

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c. Fire hazards ing the factors
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APPENDIX A: PICTURES

Courtesy call at Dona Nena Health Center

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Courtesy call at Barangay Maricaban Hall

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Spot Map

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Interviewing the people of the Community

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Interviewing the star family

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Star Family’s House

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Identifying Problems and Prioritization

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Synchronized Polio Immunization

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Preparation for community assembly at school

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Preparation for community assembly at barangay multipurpose hall

Registration during the community assembly

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Food Distribution

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Picture with star family

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APPENDIX B: INVITATION

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APPENDIX C: FOOD AND RAFFLE STUBS

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APPENDIX D: GENERAL ASSEMBLY PROGRAM

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APPENDIX E: CERTIFICATES OF APPRECIATION AND PARTICIPATION

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APPENDIX F: ATTENDANCE SHEET

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