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The Family Health Nursing

Process
Cristina Marie Manzano, RN, RM, MAN
Assistant Professor II, School of Nursing
Global City Innovative College

Nursing Process in Family


Health
Reflect sequential progress, interdependent

and overlapping in their execution

Sequence of Activities in FHN


Establishes a working relationship with the

client
Conducts an initial assessment
Categorizes Health Problems
Determine the nature and extent of the

familys performance of the health tasks on


each of the health problems
Determine priorities among the list of health

problems
Ranks health problems according to priorities.
Decides on what problems to tackle in the order

of immediacy/urgency
Defines nursing objectives in realistic

measurable terms
Plans approaches, strategies of action
Implements the nursing care plan
Evaluates the effectiveness of the

Initial Data Base for Family Nursing


Practice

Family Structures, Characteristics &


Dynamics
Members of the household and

relationship to the head of the family


Demographic Data or Rank in the

family
Place of residence of each member
Type of family structure and

government
Dominant family members in terms

of decision making in matters of


health care
General family relationship/

dynamics

Socio-Economic & Cultural


Factors
Income and Expenses
Educational attainment

of each member
Ethnic Background and

Religious Affiliation
Significant Others
Relationship of the family

to larger community

Home and Environment


Housing
Kind of neighborhood
Social & Health facilities available
Communication & Transportation Facilities

Available

Health Status of Each Family


Members
Medical & Nursing history
Nutritional Assessment
Developmental

Assessment
Risk Factor Assessment
Physical Assessment
Results of Diagnostic or

Laboratory Tests

Values, Habits, Practices on Health Promotion,


Maintenance and Disease Prevention
Immunization
Healthy lifestyle

practices
Adequacy of rest and

sleep, exercise and use


of protective measures
Use of promotive-

preventive health
services

Typology of Nursing Problems

FIRST LEVEL ASSESSMENT


1.Wellness
Condition
Wellness Potential
A nursing judgment on

wellness state or condition


based on clients
performance, current
competencies or clinical data
BUT NO explicit expression of
client desire.
Readiness for Enhanced
Wellness
A nursing judgment on
wellness state or condition
based on clients
performance, clinical data and

FIRST LEVEL ASSESSMENT


2. Health Threats
Family history
Threat of infection
Family size beyond what family can

adequately provide
Accident Hazards
Faulty/unhealthy eating habits
Stress provoking factors
Poor home/environment condition
Unsanitary food handling and

preparation
Unhealthy lifestyle and personal

habits/practices

FIRST LEVEL ASSESSMENT


Health Threats
Unhealthful lifestyles
Physical inactivity
Inadequate relaxation techniques
Non-use of self protection methods
Inherent personal characteristics
Health history which induce the

occurrence of a health deficit


Inappropriate role assumption
Lack of immunization

FIRST LEVEL ASSESSMENT


3. Health Deficits
Illness states
Failure to

thrive/develop
according to normal
rate
Disability

FIRST LEVEL ASSESSMENT


4. Foreseeable Crisis
Situations
Marriage
Pregnancy
Parenthood
Abortion
Adolescence
Loss of Job
Death of a member
Divorce

SECOND LEVEL
ASSESMENT
Inability to recognize the presence of a

problem
Inability to make decisions with respect

to taking appropriate health action


Inability to provide adequate nursing

care to the sick disabled, dependent or


vulnerable/ at risk member of the family
Inability to provide a home environment

which is conducive to health


maintenance and personal development
Failure to utilize community resources

for health care

Criteria in Different
Priorities
Nature of the
Problem Presented
Categorized whether a

Health Threat, Health


Deficit or Foreseeable
Crisis

Modifiability of the
Problem
Refers to the probability of

success in minimizing
alleviating or totally
eradicating the problem
through health intervention

Criteria in Different
Priorities
Preventive Potential
Refers to the nature and

magnitude of the future


problem that can be
minimized or totally
prevented if intervention
is done in the problem.

Salience
Refers to the family

perception & evaluation


of the problem in terms
seriousness & urgency of
attention needed.

SCALE FOR RANKING FAMILY HEALTH


PROBLEMS ACCORDING TO PRIORITIES
Criteria

Weight

1.Nature of the problem presented

Scale:
Wellness state
Health Threat
Health Deficit
Foreseeable Crisis

1
3
3
2
1

SCALE FOR RANKING FAMILY HEALTH


PROBLEMS ACCORDING TO PRIORITIES
Criteria

Weight

2.Modifiability of the Problem


Scale:
Easily modifiable
Partially modifiable
Not modifiable

2
2
1
0

SCALE FOR RANKING FAMILY HEALTH


PROBLEMS ACCORDING TO PRIORITIES
Criteria

Weight

3. PreventivePotential
Scale:

1
High

Moderate

Low

SCALE FOR RANKING FAMILY HEALTH


PROBLEMS ACCORDING TO PRIORITIES
Criteria

Weight

4. Salience
1

Scale:
A serious problem, immediate

attention
A problem but not needing

immediate attention
Not a felt need / problem

SCORING
1. Decide on a score for each of the criteria.
2. Divide the score by the highest possible score and
multiply by the weight.
Score
----------------- X Weight
Highest Score
3. Sum up the scores for all the criteria. The highest
score is 5, equivalent to the total weight.
The higher the score (near 5 and above) of a given
problem, the more likely it is taken as a PRIORITY.
With the available scores, the nurse then RANKS
health problems accordingly.

Example
Cues/Data

Family Nursing
Problem

37 year old mother of seven at 21

weeks AOG, with BP of 140/90 and


slight pedal edema
Mother verbalized, I did not have

problems during my previous


pregnancies, and even with my
present pregnancy it just
happened that I passed by the
health center on my way to my inlaws so I thought of dropping by
the clinic but actually I feel
alright, I dont think I have to worry.

Possible Complicated Pregnancy

Inability to recognize

presence of a possible
complication of pregnancy
due to lack of knowledge
Inability to provide
adequate nursing care to a
pregnant member due to
lack of knowledge on the
nature and management of
health condition
Failure to utilize community
resources for health care

Possible Pre-eclampsia
Criteria
Nature of
the
Problem
Modifiabil
ity of the
Problem

Preventiv
e
Potential

Salience
of the

Computati
on

Actual
Score

Justification

The problem is a health


deficit and requires more
immediate intervention

The resources and


interventions needed to
solve the problem are
available

3/3 x 1

Possibility of complications
during labor and delivery
and occurrence
odabnormalities in the infant
are prevented if preeclampsia is eliminated as
early as possible

0/2 x 1

The family doesnt recognize


the existence of the problem

3/3 x 1

2/2 x 2