NAGA COLLEGE FOUNDATION

College of Health Sciences

City of Naga, Philippines

FAMILY CASE PROFILE

QUESTIONNAIRE

FAMILY NAME OF FAMILY CLIENTE: Ceron

COMPLETE ADDRESS __Zone 2, Itulan, Pasacao, Cam. Sur_
TIME OF INTERVIEW WITH FAMILY: _3:00pm
DATE/S OF INTERVIEW/S WITH FAMILY: _November 21, 2023_______

I- INITIAL DATABASE
A. Family Background, Structure, Function, Dynamics and Characteristics
Ilan ang miyembro ng pamilya: __5____
Sino ang namumuno ng pamilya: _Tatay_____
Posisyon sa pamilya: Anak (Panganay)

Family Age Sex* Civil Relationship Educational Occupation Religion

Members Status** to the Family Attainment
Head

Ian 44 L M Tatay(Head) CG CG RC

Nerisha 40 B M Ina CG CG RC

Nerian 20 B S Anak CS N/A RC

Ashley 17 B S Anak SHS N/A RC

Sheena 14 B S Anak JHS N/A RC

OTHER MEMBERS

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 *F-Female; M-Male
**S-Single; M-Married; W1-Widower; W2-Widow; S-Separated;A-Annulled

DIRECTION: Put a check (/) to indicate answer from the options presented
Family Structure: (✔) Nuclear ( ) Dyad ( ) Extended ( ) Blended/Reconstituted
( ) Compound ( ) Cohabiting/Live-in ( ) Single Parent
( )Gay or lesbian family ( ) No kin ( ) Foster ( ) Others ________
Family Function:
Decisions in the Family (Authority): ( ) Patriarchal ( ) Matriarchal
(✔) Egalitarian ( ) Democratic ( ) Autocratic ( ) Laissez Faire
( ) Matricentric ( ) Patricentric ( ) Others _____________

DIRECTION: Put a check (/) to ALL THAT APPLIES

Family Dynamics:
Anong klase ang Relasyon sa loob ng Pamilya
( ) Kaaya-aya (✔) May interaksyon sa loob ng pamilya ( ) Hindi naguusap-usap
( ) Iba pa ______________

Ang gawain sa loob ng bahay

( ) tulong tulong (✔) Nanay lang ( ) Tatay at Nanay (✔) Panganay na anak
( ) Lolo/Lola ( ) kamag anak ( ) kasambahay ( ) iba pa ___________

Pag may suliranin sa loob ng pamilya

( ) tulong tulong sa paglutas (✔) magulang ang humaharap ( ) nagkokonsulta sa mga
Nakakatanda ( ) nag rereport sa barangay ( ) humihingi ng tulong sa
kamag anak ( ) lumalapit sa pulitiko/ahensya ng gobyerno
( ) nagdarasal/ipapasa Diyos ang suliranin ( ) iba pa _________

B. Socio-Economic and Cultural Characteristics

DIRECTION: Put a check (/) to indicate answer from the options presented.
Anong lenggwahe o dialect ang gamit ng pamilya sa pag uusap
(✔) bikol ( ) tagalog ( ) bisaya ( ) Ilonggo ( ) ingles ( ) iba pa_____

Ano-ano ang mga tulong na natanggap na at tinatanggap ng pamilya :

(✔) gobyerno ( ) NGOs ( ) civic organizations ( ) simbahan ( ) indibidwal
(✔) programa ng mga institusyong pang edukasyon

Gaano ka epektibo ang mga tulong na nakamit ng pamilya (✔) epektibo ( ) walang epekto

Ano ang main na pinagkukunan ng pagbuhay ng pamilya Sweldo ng ama(OFW) ___________

Ibang pinagkukunang pagbuhay ng pamilya________________________________________
Magkano ang combined/gross na buwanang kita ng pamilya
( ) Below PHP 1,000 ( ) PHP 1,001-3,000 ( )PHP 3,001-5,000
( ) PHP 5,000 -7,000 ( ) PHP 7,000 – 10,000 (✔) PHP 12,500 and Above

Mga pinagkakagastusan:
DIRECTION: Lagyan ng bilang (1) pinaka-importante, (7) pinaka-mababa, (N/A) kung hindi
pinagkakagastusan

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 Pagkain _1__ Tubig _1__ Kuryente _1__ Pag-aaral _1__ Transportasyon _ 3 _Medikal _2__
Netflix _N/A_ Internet _4_ Telepono _N/A_ Libangan _7_ Ipon _2 _ Bisyo (sabong) N/A_
Sugal _N/A_ Sigarilyo _N/A_ Alak_N/A_ Iba pa (specify) _________
C. Home and Environment
DIRECTION: Put a check (/) to indicate the answer from the options presented.
Klase ng Bahay:(✔) konkreto ( ) mixed materials (semi-concrete)
( ) light materials specify: ________________

Estado ng pamilya sa bahay na tinitirhan: (✔) Pag-aari ( ) Nirerentahan

( ) Nakikitira ( ) iskwater

Dibisyon ng Bahay: (✔) sala (✔) kwarto (✔) Lutuan/kusina (✔) Palikuran
( ) Iba pa ______________

Sleeping Arrangements:( ) Magkakasama sa isang tulugan

(✔) Hiwalay ang mga anak sa magulang
( ) kanya kanyang kwarto ( ) iba pa _____________

Accident Hazards: __Puno nang niyog, ahas sa bakuran (likod ng bahay) _________________
____________________________________________________________________________

Mga posibleng pinanggalingan ng sakit: __Makahoy at madamo na bakuran________________

____________________________________________________________________________

Klase ng ginagamit sa pagluluto: (✔) Kahoy ( ) Uling (✔) Gas

( ) Iba pa ______________________

Klase ng pinagtataguan ng Pagkain: ( ) Refrigerator (✔) Plastic wares ( ) Iba pa _____

Pinanggagalingan ng tubig: (✔) NAWASA ( ) Poso ( ) Balon

( ) Batis/Ilog ( ) Rasyon ( ) iba pa Mineral

Toilet Facility: (✔) May-arI ( ) Nakikigamit ( ) Walang sariling toilet

Uri ng Toilet Facility: (✔) Water-sealed ( ) Flush Type ( ) Pit-privy ( ) Others_____

Waste Disposal: ( ) Compost Pit ( ✔ ) Open Burning ( ) Garbage Collection

( ) Others____________

Drainage: ( ) Open ( ) Closed

Facilities found in the Barangay

(✔) Barangay hall (✔) Health Center (✔) Day Care Center (✔) Basketball Court
( ) Lying-in ( ) Women's Center (✔) Schools ( ) Wet Market
( ) Crematorium ( ) Grocery Stores ( ) Others:________________

Communication
(✔) Cellphone ( ) Telephone ( ) Postal ( ) Email
(✔) Social Media (✔) Radio/Kabalikat ( ) Bulletin ( ) Others_________

Sources of Information: (✔)Newspapers/ Magazines (✔)Television (✔)Radio

(✔) Internet ( ) Others____________

Domestic Animals
TYPE OF NUMBER OF BREED LOCATION CAGE STATUS OF
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 ANIMAL ANIMALS VACCINATION If
applicable
N/A

D. Health Assessment of Each Family Member

D1. Past and Present Illnesses

MEMBERS PAST PRES CHECK ADMITTE HAD AN TREATED TREATE GIVEN REM
ILLNE ENT UP AT D TO OPERATI BY D BY MEDICA ARK
SSES ILLNE CLINIC/ HOSPITAL ON ALBULAR HILOT TIONS S
SSES CENTER YO
Ian ✔ ✔ ✔

Nerisha ✔

Nerian ✔ ✔ ✔

Ashley Asthma ✔ ✔

Sheena Asthma ✔ ✔ ✔

OTHER MEMBERS

LEGEND: Hypertension, Common colds, Diabetes, Covid-19, Tuberculosis, Asthma, Cancer, Kidney disease, Scabies, Pediculosis, Psychosis,
Neurosis, Bipolar Disorder, Generalized Anxiety

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D2. Family Health Assessment based on Functional Health Pattern
DIRECTION: Put a check (/) to indicate answer from options presented.

FUNCTIONAL
HEALTH DESCRIPTION MGA TANONG SAGOT REMARKS
PATTERN
Health Describes client’s ● Kumusta ang buhay (✔) mabuti Excellent
Perception- perceived pattern kalusugan ng pamilya ? ( ) di mabuti
health of health and well
management being and how Excellent
● Nagkaroon ba ng (✔) meron
patterns health is
pagkakasakit sa
managed. ( ) wala
pamilya sa nakalipas
na taon ?
Excellent
● Nagresulta ba ito sa di
pagpasok /di (✔) oo
pagtatrabaho at pag ( ) hindi
pasok sa school?

● Naniniwala po ba kayo Excellent

sa turo ng mga doctor,
nurses at midwives sa (✔) oo
center at hosp? ( ) hindi

● Naniniwala po ba kayo Excellent

sa pagbabakuna ng
mga bata at matanda? (✔) oo
( ) hindi
● Aling mga health
resources ang iyong
ina avail? Check all
( ) hospital
that apply
(✔) clinic
(✔) barangay health
center
( ) hilot
( ) albularyo
(✔) herbal
● Distansya ng bahay sa
Health Facility medicine
( ) iba pa

Malayo
Nutritional- Describes ● Ano ang tipikal na (✔) gulay
metabolic pattern of food pagkain ng pamilya ?
pattern and fluid (✔) kanin
consumption (✔) isda
relative to
metabolic need (✔) fruits
and pattern (✔) karne
indicators of
( ) de lata
local nutrient
( ) noodles
supply.
● Gaano kadalas kumain ( ) iba pa____
pagkain ng pamilya ?
Once a day _4x_ a week gulay
Twice a day _6x_ a week kanin
Thrice a day _3x_ aweek isda
1-3x/ week _1x_ a week fruits

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 4-6x/ week __ _ a week karne
____ processed foods
____ noodles
____ fast food
___________ iba pa Excellent
● Nagtataka po ba kayo
ng
supplements/vitamins? (✔) oo
Excellent
( ) hindi
● Tipikal na pag inom ng
tubig bawat araw
( ) less than
8 glasses
(✔) more
than 8 Excellent
● Magana bang kumain
glasses
ang pamilya?

(✔) magana
● May food or eating ( ) walang
discomfort? Paglolon? gana
Diet restrictions? If
appropriate, ( ) meron
breastfeeding? May (✔) wala
problem ba sa pag
breastfeeding?
Excellent
● May skin problems,
lesions, dryness?

( ) meron Excellent
● May dental problems?
(✔) wala

( ) meron
(✔) wala
Elimination Describes ● May problem ba sa (✔) meron Excellent
pattern pattern of bowel elimination? Sa ( ) wala
excretory pag ihi ?
function (bowel,
bladder, and
● Malakas ba ang pag ( ) meron
skin
perspire? May odor (✔) wala
problems ba?

Activity- Describe ● May sapat ang lakas sa (✔) meron Excellent

exercise patterns of araw na gawain? ( ) wala
pattern exercise,
activity, leisure,
● Uri ng ehersisyo (✔) walking
and recreation.
(✔) dancing
( ) biking
( ) jogging
( ) weight
lifting
( ) iba pa _________
( ) wala
● Ano ang pattern ng pag
eehersisyo ? (✔) regular
1x/wk

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 Daily
monthly
( ) hindi nag
Eehersisyo

● Ano ang libangan ng

adult members ng (✔) tv
pamilya? ( ) radio
(✔) Kdrama
(✔) online games
( ) baraha
( ) chismis

● Ano ang mga

laro/libangan ng mga
bata ? ( ) online games
( ) tv
( ) tumbang preso
( ) Chinese garter
● Ano ang malimit na ( ) iba pa_________
activities ng
Tatay Pag-eehersisyo
Nanay bonding/quality time
Mga anak
Ibang members

Sleep-rest Describes ● Generally rested at (✔) oo Excellent

pattern patterns of ready sa activities after ( ) hindi
sleep, rest, sleep?
and
relaxation.
● Merong may insomnia ( ) meron
sa pamilya? (✔) wala

● May binabangungot bas ( ) meron

a pamilya?
(✔) wala
Cognitive- Describes ● Meron bang may ( ) meron Excellent
perceptual sensory, hearing difficulty sa (✔) wala
pattern perceptual, and pamilya?
cognitive
pattern
● Meron bang may ( ) meron
problema sa mata?
Gumagamit na ba ng (✔) wala
eyeglasses?

● May pagbabago bas a

memorya ng (✔) meron
kapamilya?
( ✔) wala

● Meron bang may

discomfort? Pain sa
(✔) meron
pamilya?
( ) wala
Self- Describes self- ● Malimit ba na mabuti (✔) oo
perception/self concept and ang tingin mo sa sarili ( ) hindi
-concept perceptions of mo ?
self (body
comfort, image,
● Pag may changes sa
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 feeling state) iyong katawan eto ba (✔) oo
ay nagiging problema
( ) hindi
para saiyo?

● Sino madalas na
nakaka pag galit sayo?
( ) Asawa
Nakakapag paalala?
( ) anak
Nakakainis?
( ) parents
Nakakapagpa Lungkot?
( ) neighbor
Naka kacause ng takot?
( ) kasama
sa trabaho
( ) kaibigan
(✔) iba pa_kapatid_
● Ever feel you lose hope?
Not able to control Oo, music
things in life? What
helps?

Roles and Describes ● Pano hina handle ng (✔) pinag Excellent

relationship pattern of role pamilya ang mga uusapan
engagements pagsubok? ( ) hingi ng
and
Tulong
relationships.
(✔) ipagdasal
( ) iba pa_________
( ) hayaan
lang

● If appropriate, may
problem ba sa mga
( ) meron
anak ? mahirap ihandle?
(✔) wala
● Kabilang ba ang
pamilya sa mga social
groups? (✔) kabilang
( ) hindi kabilang

● May malapit bang mga

friends?
( ) meron
(✔) wala
● Pakiramdam na
kabilang sa komunidad
na tinitirhan (✔) kabilang
( ) hindi kabilang

Sexual / Describes ● If appropriate to ( ) meron

Reproductive client’s pattern age/situation, ang (✔) wala
of satisfaction sexual na relasyon po
and ba ninyo ay wala
dissatisfaction namang problema?
with sexuality
pattern,
● If appropriate, (✔) Natural Family
describes
gumagamit po ba kayo
reproductive Planning
ng contraceptives? Or
patterns. ( ) Artificial Family
nagfa-family planning?
Planning

● For females, kelan Nerisha - 12 yrs old

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 nagsimula ang Nerian - 11 yrs old
menstruation? Kelan Ashley - 11 yrs old
ang huling menstrual Sheena - 12 yrs old
period? May menstrual
problems ba? Para?
Gravida?

Coping- stress Describes ● Meron bang big changes (✔) meron

tolerance general coping na naganap sa buhay ( ) wala
Pattern patterns and nyo last year or two?
effectiveness of Crisis?
the pattern in
terms of stress
● Sino ang makakatulong ( ) pamilya
tolerance.
sa inyo pagka (✔) kaibigan
dumadaan kayo sa pag
( ) gobyerno
subok?
( ) NGOs
( ) civic grp
( ) simbahan
( ) wala
-Sarili

● Pag tensed kayo

gumagamit ba kayo ng
gamot? Drugs? Alcohol? ( ) gumagamit
(✔) hindi gumagamit
Values/ Belief Describes a ● Mahalaga ba ang (✔) mahalaga
Pattern pattern of paniniwala sa relihiyon ( ) hindi
values and sa pamilya? mahalaga
beliefs, including
spiritual and /or
● Nakakatulong ba ang (✔) oo
goals that guide
inyong paniniwala sa
choices or ( ) hindi
Diyos sa pagharap sa
decisions.
mga pagsubok?

● May importanteng plano

(✔) meron
baa ng pamilya sa
hinaharap? If so, ano ( ) wala
yun?
Migrate sa Canada

MEMBERSHIP IN ORGANIZATIONS:
DIRECTION: Put a check (/) in the appropriate column to indicate answer/s
4Ps SENIOR PWD SOLO GSIS SSS 4H CHURCH OTHERS NONE
MEMBERS CITIZEN PARENT (Specify) (Specify)

Ian ✔

Nerisha

Nerian ✔

Ashley ✔

Sheena YCE ✔
(Young
Catholic

9
 Evangeli
zers)

OTHER MEMBERS

MEMBERSHIP IN HEALTH CARE INSURANCE COMPANIES/ HEALTH MAINTENANCE

ORGANIZATIONS (HMOs): DIRECTION: Put a check (/) in the appropriate column to
indicate answer

HEALTH CARE INSURANCE COMPANIES/ NAME OF FAMILY MEMBER NON-MEMBER

HEALTH MAINTENANCE ORGANIZATIONS MEMBERS
(HMOs)

Philhealth Ian & Nerisha ✔

Carehealth Plus Systems International, Inc.
Asalus Corporation (Intellicare)
Carewell Health Systems, Inc.
Caritas Health Shield, Inc.
Fortune Medicare, lnc.
Health Maintenance, lnc
Health Plan Philippines, Inc
Insular Health Care, Inc.
AXA
Philam
Others(Specify):
‘
IMMUNIZATION STATUS OF FAMILY
DIRECTION: Put a check (/) in the appropriate column to indicate answer

Family Immunization Status COVID-19 Vaccine

Members Remarks

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 Complete Incomplete 1st 2nd 1st 2nd
dose dose booster booster

Ian ✔ ✔ ✔ ✔ ✔

Nerisha ✔ ✔ ✔ ✔ ✔

Nerian ✔ ✔ ✔ ✔

Ashley ✔ ✔ ✔ ✔

Sheena ✔ ✔ ✔ ✔

OTHER MEMBERS

Legend: Complete = immunized with BCG, HEPA B, PentaVac, OPV, IPV, PCV, ROTA, MMR

OTHER VACCINES: _____________________________________________________

DIRECTION: Put a check (/) to ALL THAT APPLY from options presented.
Transportation
( ) Tren ( ) Motor ( ) Padyak ( ) Bangka (✔)Jeep ( ) Skates
(✔) Tricycle ( ) Bisikleta ( ) kalabaw ( ) iba pa____________________

Breastfeeding
Sa mga anak kung nabreasfeed: ( ) oo, Gaano katagal? __________
( ) Hindi, Bakit at ano ang pinasuso?_________

Maternal Record
Ilang buwan ng buntis, pang ilang anak na? __N/A____________________________________
Kailan ang huling regla? _N/A_____________________________________________________

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 Ano-anong gamot ang iniinom? _N/A_______________________________________________
Ano ang trabaho? __N/A_________________________________________________________
Ano ang bisyo, kung meron? __N/A________________________________________________
Nageehersisyo? ano at paano? _N/A_______________________________________________
Nagpapacheck-up ba? Saan at gaano kadalas? _N/A___________________________________

III. FAMILY COPING INDEX

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

CRITERIA IDEAL ACTUAL RATING JUSTIFICATION
1. Physical Is involved with the All members of the 3 The family is able
Independence ability to move around, to family can move to get out of bed
get out of bed, to take freely w/out any and move about
care of daily hygiene, assistance. on their own and
walking, etc the eldest child is
cooperative and
capable of
carrying out her
mother's duties
and obligations.
2. Therapeutic Involves all procedures or All family members 5 Every member of
Competence medications prescribed are obeyful of their the family is
for the treatment of meds whenever aware of how
illness, such as someone is sick or crucial it is to take
prescription drugs, ill. their medications
appliances, dressing, as prescribed
exercise, stress relief, when they are
diet plans, etc sick.
3. Knowledge Associated with the They are able to 5 When a member
of Health specific health condition identify when a of their family has
Condition that gives rise to member of their an illness, they
treatment, such as the family is ill or not are aware of what
awareness of the disease feeling well. They to do and when to
or the inability to are familiar with do it.
comprehend the the standard
communicability of indications and
illnesses and the mode of manifestations of
transmission. Recognizing prevalent ailments.
the general pattern of
development of newborn
infants and basic physical
care needs of infants
4. Application Concerned with family The family has 3 Not all of the
of Principles action in relation to received the Covid- family member
of General preserving family 19 vaccine and is were not boosted
Hygiene nutrition, ensuring fully inoculated. from Covid1-9
adequate rest and However, the only vaccines.
relaxation for family people who
members, implementing received the
accepted precautionary booster shot were
measures (immunization, the parents.
medical assessment, safe
home-making in relation
to food storage and
preparation).
5. Health Primarily concerned with The children take 5 They are aware of
Attitudes the way the family feels vitamins. their health
about health care in conditions and
general, including they are taking
preventive services, action on it.
health care and public
health measures

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6. Emotional It has to do with the Their emotional 3 When it comes to
Competence maturity and integrity competence is quite family problems,
with which the members good enough for they usually talk
of the family are able to them to face daily things out and
cope with the usual stress challenges and figure out a
and problems of life, and stress in life solution together.
to plan for a happy and however the eldest
fruitful life. The extent to prefers to take the
which individuals problem to herself
recognize the appropriate when it comes to
disciplines enforced by her own problems.
their own family and
culture. Developing the
responsibilities and
decisions of the
individual. An eagerness
to meet sensible
responsibilities, to accept
fortitude adversity, to
consider the needs of
others as well as one's
own.
7. Family Concerned about the Their is a strong 5 Interactions within
Living interpersonal or group attraction between the family are in
aspect of family life. every member of tune. Respect and
Members of the family the family. support are shown
get along with each to one another
other, the ways in which throughout
they make decisions that difficult times.
affect the family, the
extent to which they
support each other and
do things as a family, the
degree of respect and
affection, and the way in
which they organize the
household finances
8. Physical Concerned with the Despite the reality 1 There were trees
Environment home, community and that the home is and grass in the
work environment as it concrete, it is backyard of the
affects family health. extremely house.
House conditions such as dangerous and
accident hazard risky due to the
pressure, screening, grass and trees in
plumbing, system, the backyard.
cooking facilities,
privacy, community level
(deteriorated
neighborhood, presence
of social hazards, pests),
school transport and
accessibility.
9. Use of Degree of use of the There are just 3 Since there are
Community family and awareness of facilities accessible few facilities
Facilities the community facilities within the brgy. nearby, the
available for welfare and services, they can
education. avail limited.

IV-TYPOLOGY OF NURSING PROBLEM

Discusses the problems that were identified during assessment and interview with the family.
It includes the cues/data, the family nursing problem and the nursing diagnosis. The problems

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identified are categorized into the presence of wellness state, health deficits, health threats,
foreseeable crisis and stress points.

Typology of Nursing Problems identified in Family

CUES OR DATA FAMILY NURSING PROBLEMS

The backyard was full of grass and coconut trees Health threat: Risk for accidents
Sprain Health threat: Discomfort pain
Dysuria Health deficit

V-PRIORITIZING PROBLEMS
Shows the setting of priorities of family health problems that have been identified. It
includes a computation on how priorities were shown with their corresponding justification
FAMILY HEALTH PROBLEM #1:
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1.Nature of the 2/3x1 0.6 It is classified as a health threat
Problem because even if it's in the
backyard, the family may be
affected and put in danger by
unclean surroundings.

2. Modifiability of 2/2x2 2 It is easily modifiable since there

the Problem are all girls and there are 2 minors
since the father is an OFW. It
depends on the mother if they
reach help to others like neighbour
and clean their backyard.

3. Preventive 3/3x1 0.67 It is highly preventable since there

Potential are several preventive steps the
family may take in this
circumstance. Maintaining a clean
and well-maintained garden can
reduce the risk of contracting
additional diseases.

4. Salience of the 1/2x1 0.5 The problem was observed but the
Problem family didn’t see it as something
that needed to be acted on
immediately.

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 TOTAL SCORE 3.77

FAMILY HEALTH PROBLEM #2:

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1.Nature of the 2/3x1 0.6 The nature of a sprain is a health
Problem threat sinces it involves damage
to these ligaments due to
overstretching or tearing, leading
to various degrees of injury and
symptoms.

2. Modifiability of 2 /2 x 2 2 Current knowledge,

the Problem interventions, and resources are
available to solve the problem of
sprain. Understanding the nature
of a sprain involves recognizing
its severity, symptoms, causes,
and the appropriate
management required for
effective healing and
rehabilitation.

3. Preventive 3/3x1 1 It is moderately preventable

Potential since it depends on the proper
preventive measures like warm-
ups, maintaining good physical
condition, using protective gear,
and being cautious during
physical activities can
significantly reduce the risk of
sprains.

4. Salience of the 1/2x1 0.5 It does not need immediate

Problem attention since addressing the
problem of sprains involves
preventive measures, such as
education on proper body
mechanics, appropriate warm-
ups, and using protective gear
during physical activities.

TOTAL SCORE 4.1

FAMILY HEALTH PROBLEM #3:

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 CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1.Nature of the 3/3x1 1 Dysuria as it can indicate various
Problem underlying conditions that require
proper diagnosis and treatment.

2. Modifiability of 1 /2 x 2 1.5 It is partially modifiable because

the Problem it's crucial to consult a healthcare
professional for an accurate
diagnosis and tailored treatment
plan. They can identify the
specific cause of dysuria and
recommend appropriate
modifications or interventions to
address the underlying problem
effectively.

3. Preventive 2/3x1 0.6 It is moderately preventible since

Potential it depends on the mother if she
will apply all the health teachings
given by the nurses and
community health workers.

4. Salience of the 1/2x1 0.5 The family recognizes this as a

Problem problem but due to their financial
problems, they cannot provide
immediate attention.

total 3.6

FAMILY HEALTH PROBLEM # 4:

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1.Nature of the
Problem

2. Modifiability of
the Problem

3. Preventive
Potential

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 4. Salience of the
Problem

TOTAL SCORE

FAMILY HEALTH PROBLEM #5:

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1.Nature of the
Problem

2. Modifiability of
the Problem

3. Preventive
Potential

4. Salience of the
Problem

TOTAL SCORE

VI- FAMILY NURSING CARE PLAN

Shows the identified and prioritized problems in a ranking order. This chapter also
presents the family care plan formulated by the student nurse together with the family.
PROBLEM LIST
PROBLEMS SCORE
Sprain 4.1
The backyard was full of grass and coconut tree 3.77
Dysuria 3.6

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_______Erika Mae A. Borlado/ BSN -2F________

INTERVIEWER
(Signature over printed Name of Student/ Group-Year and Section)

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