FAMILY CASE
PRESENTATION
GROUP 2 -
WIEDENBACH
Chapter I
INTRODUCTION

“Family is not an important thing. It’s everything.”

-Michael J. Fox:

The family is the nucleus of civilization and the basic social unit of society. Family is not just defined as
two or more people who live in the same household, share a common emotional bond, and perform certain
interrelated social tasks (Allender & Spradley, 2008). Community is a group of people with diverse
characteristics who are linked by social ties, share common perspectives and engage in joint action in
geographical locations or settings (MacQueen et al., 2002). The status of each family will always affect the
status of the community as a whole. The family as a unit of care has been a focus in community health nursing
since its beginning (Whall, 1993). People’s lifestyles and, consequently, their health are intimately tied to the
culture, values, beliefs, practices, and socioeconomic status they share with their families.
Chapter I : INTRODUCTION
Community health nursing is a response to the health needs of the people. It does not focus on a
particular class or family. It is a comprehensive and general approach. Community health service is not an
episodic as it requires continuous observation and monitoring of the community as a whole.
Conducting a case study is a way where student nurse improves and apply all the concepts. It is a tool in
determining the health status of family through assessment and critical inspection. Through this, health related
problems are identified which gives an indication to the student nurse on how to intervene just to give a holistic
care and improve the deficiency. Thus, conducting a family case study is a means by which a student nurse
reaches and feels the community through its basic structure – the family.
 Chapter OBJECTIVES OF THE
STUDY
II :
This chapter presents the general and specific objectives of
this family case study. Setting objectives provides direction
for planning a family nursing intervention. It facilitates
motivation for the client and the nurse by providing a sense
of achievement. (Kozier, Erb et. al., 2004).
 Chapter OBJECTIVES OF THE
STUDY
II :
General Objectives:

At the end of the student nurse-family relationship, the chosen

family will be able to improve their health status, become self-reliant
in maintaining their health through appropriate interventions in a
given time frame and apply and practice health promotion and
awareness to achieve optimum level of well-being through good
health and wellness.
 Chapter OBJECTIVES OF THE
STUDY
II :
Specific Objectives:
After 1 month of home visits and student nurse-family interaction, the family should be able to:
- Create rapport and trust with the student nurse.
- Provide pertinent and factual information during surveys and interviews.
-Participate actively and diligently during home visits and assessment interviews.
-Identify actual and potential problems which may be a hindrance in attaining optimum health.
- Learn from the student nurse about the possible risk factors.
- Categorize the identified health problems as health threat, health deficit or foreseeable crisis through
the assistance of the student nurse.
- Prioritize the identified family health nursing problems with the assistance of the student nurse
- Plan possible solutions or nursing actions to the prioritized health problems
- Generate interventions considering the student nurses’ capabilities, community and the family’s resources
- Carry out the planned interventions together with the student nurse
- Perform the health teachings taught by the student nurse
- Evaluate the effectiveness of the intervention using the set objectives as a basis, and
- Evaluate changes in condition after giving interventions
 Chapter III: INITIAL
DATABASE
A. Family Structure, Characteristics, and Dynamics

Name Age Sex Civil Status Position in the Occupation Educational

Family Attainment

Mr. C N/A Male N/A Father N/A Elementary

(Deceased) Graduate

Mrs. C 75 Female Widowed New Head of the Homemaker Elementary

Family Graduate
(Mother)

Child C 46 Male Widower Child Unemployed College

Undergraduate
Grandchild AC 16 Female Single Grandchild Student Grade 10 Student

Grandchild BC 14 Male Single Grandchild Student Grade 8 Student

Chapter III: INITIAL DATABASE
A. Family Structure, Characteristics, and Dynamics

• The Family C is considered as an extended type of family.

• The C Family resides at Tizon St. Old Slaughter Brgy. Pob. I Sagay City. They have
started living there since 9th of June in the year 1978.
• Mrs. C is in charge of planning and budgeting for their family.
• When problem arises, Mrs. C makes sure that all of them are involved in solving the
problem.
• In terms of matter concerning health, Mrs. C is also hands-on.
 Chapter III: INITIAL DATABAS
B. Socio-Economic and Cultural Characteristics

• The C family’s main source of income is coming from the monthly pension of the late Mr. C. His monthly pension is
roughly only about Php 5,000.00 a month.
• Mrs. C budgets the money in terms of food, education and miscellaneous where clothes, shoes and slippers comes in.
• The education of the children is free.
• Mrs. C told the student nurse that she makes sure that she buys a sack of rice that is good to last for a month already.
She said that it is way more important to have rice rather than not having anything for them to eat.
• Mrs. C also informed the student nurse that they do not have any financial assets at hand in case of emergency. They
typically borrow money from their neighbors.
• All of them are affiliates of Roman Catholicism. Mrs. C mentioned that they always go to church and her son and
grandchildren are part of the choir.
• The family uses the faucet as their means of water source in washing their clothes since their water source comes from
the Sagay Water District. This is also where the family gets their water source for drinking and cooking.
 C. Home and Environment Chapter III: INITIAL DATABAS
• The house is made of plywood, mostly bamboo.
• The house has 4 windows and can sustain the adequate ventilation needed by the family. Mrs. C told the
student nurse that their house is usually “presko” since it lies close to the trees and their plants thus; the fresh
air goes freely inside and outside their house.
• The house has 3 rooms.
• The C Family has only three appliances which are the radio, television and electric fan.
• In terms of garbage disposal, their garbages are being collected weekly by the City Dump Truck.
• Mrs. C uses charcoal in cooking.
• When it comes to storing their food, they put it inside a plastic container or Tupperware.
• The C Family has a comfort room.
• The drainage system of the family is an open type wherein the drainage flows through the canals and is
continuous.
• The canals are dirty and have a stinky smell. These might be a breeding site for some vectors such as
mosquitoes and flies. There are some rice grains noted. There is no obstruction present at the drainage system
since it is open and flows anywhere.
• The family has one dog and a cat. There are vegetables planted near the house.
 Chapter III: INITIAL DATABASE
D. Health Assessment of Each Family Member
D1. PAST AND PRESENT ILLNESS

1. Health Assessment on Each Member

A. Mrs. C – She is suffering from cataracts as of the present time. She has also not completed immunizations. When she was

still 5 years old, she experienced chicken pox and mumps. She is 5 feet and 2 inches and weighs 48 kilograms. Her BMI

reveals normal weight with a value of 19.4. Her only complaints as of the present time is her cataracts and has not taken

any medications as of the moment. Before, she had the chance to see a doctor to have her eyes checked during a medical

mission at their barangay and because of that, she knew that she had cataracts. The doctor recommended that she needs to

undergo a cataract surgery to prevent total blindness. At times of illness, she would just drink paracetamol for fever, 1 tab

PO q4h and treat wounds with betadine. She already had her menopause during her late 40’s. Mrs. C likes to eat fruits

and vegetables.
 Chapter III: INITIAL DATABASE
D. Health Assessment of Each Family Member
D1. PAST AND PRESENT ILLNESS

1. Health Assessment on Each Member

B. Child C – He is suffering from cataracts as of the present time. He was not able to consult a doctor with

his current condition. He has not completed immunizations. He is 5 feet and 5 inches and weighs 60

kilograms. His BMI reveals normal weight with a value of 22.0. He was a smoker back then but

already quitted smoking a year after his father died. He cannot contribute financially to the family due

to his condition. He likes to eat vegetables and fruits.

 Chapter III: INITIAL DATABASE
D. Health Assessment of Each Family Member
D1. PAST AND PRESENT ILLNESS

1. Health Assessment on Each Member

C. Grandchild AC – She has no any underlying conditions as of the present time. She has not completed

her immunizations. She is 5 feet and 1-inch tall and weighs 50 kilograms. Her BMI reveals normal

weight with a value of 20.8. She likes to eat eggs and fruits.
 Chapter III: INITIAL DATABASE
D. Health Assessment of Each Family Member
D1. PAST AND PRESENT ILLNESS

1. Health Assessment on Each Member

D. Grandchild BC – He has no any underlying illnesses as of the present time. He has not completed

immunizations. He is 5 feet and weighs 55 kilograms. His BMI reveals normal weight with a value of

21.5. He likes to eat eggs and vegetables.

 Chapter III: INITIAL DATABASE
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN
1. Health Perception-health management patterns
• With no known vices like smoking and drinking

2. Nutritional-metabolic pattern
• Do not take any food supplements or vitamins
• Daily food intake is mainly rice, fish and vegetables
• Children have a good appetite according to Mrs. C
 Chapter III: INITIAL DATABASE
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN
3. Elimination pattern
• Eliminates every day with an average frequency of urine: at least 6 times
• According to Mrs. C, all of the family members have no difficulty in voiding.
• The family members defecate every day and some, every other day with no difficulty in defecating
noted.
 
4. Activity-exercise pattern
• “Maka-exercise lang kami if may tyempo kag indi kami sako kanang wala na nabilin nga ulubrahonon
sa balay” verbalized by the mother.
• Family preferred to stay at home and take a nap if they have free time
 Chapter III: INITIAL DATABASE
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN
5. Sleep-rest pattern
• Family usually has 7-8 hours of uninterrupted sleep according to the mother/grandmother.
• They usually sleep at around 9 to 10 in the evening and wake up at around 4 to 5 in the morning.
• They also take a nap at free time.

6. Cognitive-perceptual pattern
• Was oriented to time, place and is able to identify people and significant others by their first names.
• Was able to respond accordingly and correctly to questions. Retaliates as soon as he can and was able to
rationalize. Verbal pattern and spontaneity is normal.
• Memory intact
• Has sensory defects (sense of sight due to cataracts)
 Chapter III: INITIAL DATABASE
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

7. Self-perception/self-concept
• Perceives the problems to be very stressful at times but remain optimistic about life.

8. Roles and relationship

• Family members have an open communication and is able to discuss their problems with each other.

9. Sexual reproductive
• Mrs. C is not in the reproductive age anymore for she already had her menopause a long time ago
• Meanwhile, Child C is still in the reproductive age but not sexually active for he is already a widower.
 Chapter III: INITIAL DATABA
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

10. Coping Stress

• Gains strength in the “assurance and guarantee” provided by family members.
• They usually help each other out in times of need. They comfort each other and care for every member
of the family especially if they go through a lot of problems and trials in life. They help each other in
coping difficult situations.
• Since, they have strong faith, they usually surrender their problems to God by praying.

11. Values/ Beliefs Pattern

• The family is Roman Catholic in faith. Expressed great belief and faith in God. Is certain that the Divine
providence would protect them from any unidentified and possibilities of harm.
• They always go to church and three of their family members are part of the choir in their church.
 Chapter III: INITIAL DATABASE
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
● All of them have not completed their immunization.
● The family has adequate rest and sleep. They sleep and wake up early. The usual time of sleeping is 9 to
10 pm and they wake up at around 4 to 5 am.
● Mrs. C stated that doing the household chores and walking are their ways of exercise.
● The mother recognizes the importance of health in the family, however, because of financial constraints
made them ignore any major health problems that may arise.
● They use betadine for treating their wounds and drink paracetamol for fever. If the symptoms
manifested by the family member becomes severe, they immediately go to the barangay health center or
to the nearest hospital.
 Chapter IV: FAMILY
BACKGROUND
Family History

● Family C was originally composed of five members including the grandchildren.

● The late Mr. C was the former head of the family, Mrs. C as the mother and they have one offspring.
● When Child C’s wife died from childbirth last 2006, he came back to his parents’ house, together with
his two kids.
● 2 years later, his father also died from pneumonia.
● Now, Mrs. C is the head of the family. She is 75 years old. Her son, Child C is 46 years old. Her two
grandchildren, Child AC and Child BC are 16 and 14 years old respectively.
● The late Mr. C was born and grew up in the Municipality of Calinog, Province of Iloilo. His father
worked in a Sugar Corporation and his mother was a homemaker.
● Mr. C had 13 siblings and he was the second child. He was able to go to school and graduate high
school. After that, he did not continue pursuing a college degree in order to help his parents look for
money for their household expenses by working at the Sugar Corporation together with his father.
 Chapter IV: FAMILY
BACKGROUND
Family History

● Mrs. C was born and grew up in Sagay City, Province of Negros Occidental. Her father worked as an
“enkargado” at one of the haciendas in the city and her mother was a homemaker.
● Mrs. C has 19 siblings and she was the fourteenth child.
● Mrs. C was able to go to school and graduated elementary. After that, she did not continue schooling
because of financial instability. Instead, she helped her parents in doing household chores and worked at
a local bakery in order to help her parents look for money to sustain their everyday needs.
 Chapter IV: FAMILY
BACKGROUND
Data Base of the Respondent
The respondent upon interview is Mrs. C, the mother/head of the family

NAME : Mrs. C
AGE : 75 years old
GENDER : Female
ADDRESS : Tizon St. Old Slaughter Brgy. Pob. I Sagay City
BIRTH PLACE : Sagay City, Negros Occidental
RELIGION : Roman Catholic
OCCUPATION : Housewife
CIVIL STATUS : Widowed
NATIONALITY : Filipino
NO. OF CHILDREN : 1
EDUCATIONAL ATTAINMENT: Elementary Graduate
ESTIMATED MONTHLY INCOME: 5000 php
NAME OF HUSBAND: Mr. C
 Chapter IV: FAMILY
BACKGROUND
C. General Household Data

Name Relation to Age Sex Status Education Occupation

Head
Mr. C Former Head of N/A Male N/A High School N/A
(Deceased) the Family Graduate
Mrs. C New Head of the 75 Female Widowed Elementary Homemaker
Family Graduate
(Respondent)
Child C Son 46 Male Widower College Unemployed
Graduate
Grandchild Grandchild 16 Female Single Junior High Student
AC School
(Grade 10)
Grandchild Grandchild 14 Male Single Junior High Student
BC School
(Grade 8)
 Chapter V: FAMILY COPING
INDEX
C. General Household Data
R
a
t
CRITERIA IDEAL ACTUAL JUSTIFICATION
i
n
g

    The members are all able    

1. Physical Is concerned with ability to
Independence move about, to get out of
bed, to take care of daily
grooming, walking, etc.
to move without 5 There are no abnormalities in
assistance and difficulty. the physical independence of the
They do their activities of family members. Every member
daily living without aid. has no noted disabilities or
They are independent in disparities in moving and/or
moving about and using doing their ADL.
their musculoskeletal
system.

2. Therapeutic Includes all of the procedures or
Competence treatments prescribed for the care
of illness such as giving
medications, using appliances,
dressing, exercise, relaxation,
special diets, etc.
C. General Household Data
Mrs. C is aware on what to do 4
if a member feels ill. Since the
health center is only a walking
distance from their house, it is
convenient for them to go
there and ask for medical help.
Although, they do not
immediately go there to ask for
help. If the symptoms get
severe that is just the time they
go seek for help.
Mrs. C is aware of their lapses in
therapeutic competence. They are
sentient of their financial difficulties,
which is the primary reason for not
having or following the appropriate
procedure or treatment. When
symptoms get severe, that is just the
time where they bring the sick
member of the family to a health
center or hospital to receive proper
medical treatment.
         
3. Knowledge Concerned with the Mrs. C is 3 Mrs. C recognizes pertinent health issues. She regards it as
of Health particular health knowledgeable on important. However, due to financial constraints, some health
Condition condition that is the salient health issues are not given the right attention. Thus, this could be
occasion for care issues and detrimental to the lives of the members especially the children
such as knowledge responsibilities.
of the disease or Yet due to
inability to financial problems,
understand health issues are
communicability of overlooked.
diseases and mode
of transmission.
Understanding the
general pattern of
development of
newborn baby and
basic needs of
infants for physical
care.

4. Application of Concerned with family action in
Principles of General relation to maintaining family
Hygiene nutrition, securing adequate rest
and relaxation for family
members, carrying out accepted
preventive measures.
The family sleeps well and 5
eats nutritious food every day.
Their source of water also is
in a good condition. They also
practice healthy habits in food
storage and preparation.
The family practices good hygienic
skills. They take a bath every day
and has a clean water source. In
addition, they also have healthy
eating habits and they take
consideration in maintaining a
healthy lifestyle by being physically
active through exercising.
         
5. Health Attitudes Concerned with the way the Mrs. C is concerned about 3 Mrs. C, as much as possible, wants
family feels about health care the health of the members of to protect her children and
in general, including the family yet they do not grandchildren from any harm but
preventive services, care of participate actively in then, they lack money for them to
illness, and public health maintaining optimum health carry out the right health care for
measures. due to financial constraints. the family.
The family has some
information regarding
healthy lifestyle and
healthful ways toward
improvement of life.
However, due to some
financial issues they cannot
achieve optimum wellness.
         
6. Emotional Has to do with the maturity The family are competent 5 The family lives harmoniously at
Competence and integrity with which the enough emotionally. They home. Even though conflicts arise,
members of the family are able see stress just like any other they really see to it that they would
to meet the usual stresses and family does. The parents discuss each concern in a calm
problems of life, and to plan take responsibility for the manner.
for happy and fruitful living. children. They discipline
The degree to which them and teach them the
individuals accept the morals of life.
necessary disciplines imposed
by one’s family and culture.
The development of the
individual’s responsibilities
and decision. Willingness to
meet reasonable obligations, to
accept adversity with fortitude,
to consider the needs of others
as well as one’s own.
 
7. Family Living Concerned with the interpersonal
or group aspect of family life.
The family members get along
with one another, the ways in
which they make decisions
affecting the family, the degree to
which they support one another
and do things as family, the
degree of respect and affection,
and the ways in which they
manage the family budget.
The children are open for 5
suggestions in decision-
making. It is because their
parents/grandparents taught
them that it is important for
them to be vocal about their
opinions. Their
parents/grandparents made it
sure that each member is heard
and acknowledged.
Others respect individual
relationships of each member of the
family. Decision-making is shared
among its members. Each has his or
her own part or role in the family,
which is well respected. Every
member of the family is heard and
acknowledged.
8. Physical Concerned with home, the The family’s house space is 1
Environment community and work not good enough for the
environment as its affect family family. There are presence of
health. The condition of the insects and other vectors.
house such as pressure of Their house is also located
accident hazards, screening, near a canal. It smells awful
plumbing, system, facilities of and it looks dirty. You can
cooking, privacy, level of see a lot of flies and
community (deteriorated mosquitoes flying around. In
neighborhood, presence of addition, they cook their food
social hazards, pests), inside their house using
transportation of schools and charcoal. They live in a place
availability. wherein it is congested and
the distances between their
neighbors are very close
from each other.
The house environment is not fitted
for them especially for the children,
because of the presence of pests and
accident hazards in their
community. In fact, they are living
in their house for 42 years already.
In addition, they can possibly
acquire serious diseases from their
surroundings. Having their
“dapugan” inside their house is
really a fire hazard because some of
the coal fire might come in contact
with their bamboo wall. Thus, their
house is in a poor condition

9. Use of Community Degree of the family use and
Facilities awareness of the available
community facilities for
education and welfare.
Mrs. C is aware of the 5
available resources in the
community, both in health
and education. They can
utilize the health and
education facilities since it is
near from their house.
The school, barangay health center
are the community facilities the
family uses. They can easily go to
these facilities since they just have
to walk to reach these places since it
is a walking distance from their
house. Thus, they can save more
money instead of spending for
transportation and utilize it for more
important and essential items such
as food.
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C
Cues or Data Family Nursing Problems
Objective data: I. Accident hazards, specifically fire hazard as a health threat.
The house of Family C is a bungalow style of house. It is mainly made up of  
bamboo and wood. The mother usually cooks inside the house using wood and A. Inability to provide a home environment conducive to health maintenance and
charcoal. personal development due to:
  a. Inadequate family resources; specifically financial constrains/limited
Subjective data: financial resources.
Mrs. C verbalized “Ang amon ni nga balay dugay na ni siya, 42 years na b. Failure to see benefits of investment in home environment improvement.
 
kami diri gaistar sa akon pamilya. Gibakal ni namon sa amon lang man kilala sang B. Inability to make decisions with respect to taking appropriate action due to:
una kag asta sbng gatindog pa. Dira ko galuto sa may sulod namon balay. Wala ta a. Failure to comprehend the nature, scope, and magnitude of the problem.
may mahimo kay amo lang gid ni amon makaya. Sa kapigaduhon sa kabuhi, wala b. Negative attitude towards the problem.
c. Low salience of the problem
na kami may ikabakal pa sang mga materyales na ipakay o kung tani sa amon
 
balay. Ang amon kwarta nga ipa ubra sang balay, ikaon na lang namon. Wala kami
mahimo kay sa pension nga kada bulan gaabot na lang gid kami gaasa sang kwarta
nga amon gamiton sa amon pang adlaw adlaw na ginawi. Kag ini kulang gid kayo
para sa amon apat.
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C

Objective data: II. Family size beyond what family resources can adequately
The income of the family is about Php 5000 per month. There provide as a health threat.
are four members in the family A. Inability to make decisions with respect to taking appropriate
  health action due to:
Subjective data: a. Inaccessibility of appropriate resources for care such
The Mrs. C verbalized, “Gamay lang gid ang amon income as financial constraints.
intawon. Indi na gani kami makabakal sang mga bayo sa mga bata
kag mga kinahanglan nila labi na gid sa eskwelahan. Luoy kaayo.
Galing wala man ko may mahimo kay amo lang gid ni amon kaya.
Ang amon pagkaon budget budget lang nga kaigo para sa amon.
Uga, ginamos, itlog kag utan nga ari diri sa amon palibot ang sud-an
namon permi. Kay wala man kami iban nga choice kundi mangita
medyos kag kung ano na lg ang ara.”
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C
Objective data: III. Poor environmental sanitation specifically improper drainage
The family’s drainage is an open type. Rice grains and pieces disposal as a health threat.
of plastics are visible in the canals beside their house. The canals are  
black and dirty. They have a foul smell too. A. Inability to make decisions with respect to
  taking appropriate health action due to:
Subjective data: a. Low salience of the problem.
Mrs. C verbalized “ang iban namon nga sagbot dira lg kis a b. Negative attitude towards health problem
namon ginalabay kag ang iban man nga gaagi, kis a dira lg pud nila
ilabay.
 
 
 
 
 
 
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C
Objective data: IV. Presence of breeding or resting sites of vectors or diseases as
The family’s house lies beside a dirty and foul-smelling a health threat.
canal that is a breeding or resting site for vectors such as  
mosquitoes, flies and cockroaches. A. Inability to make decisions with respect to taking appropriate
  health action due to:
Subjective data: a. Low salience of the problem.
Mrs. C verbalized “sa amon di lugar, dugay na di namon gina b. Negative attitude towards health problem.
tiis ang kahigko kag kabaho sang amon kalog.” c. Ignorance
   
 
 
 
 
 
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C
Objective data: V. Lack of immunization/ inadequate immunization status as a
None of them have completed their immunization. They are health threat.
not aware that immunization is free.  
  A. Failure to utilize community resources for health care due to:
Subjective data: a. Inaccessibility of required service due to lack of efficient
Mrs. C verbalized “sang amon tion, ang pagbakuna nga ina, knowledge about free immunization
indi pa na uso. Gusto man tani namon mag pabakuna galing abi  
namon may bayad ini.”  
   
   
 
 
 

 
 
 TYPOLOGY OF NURSING
Chapter VI : PROBLEM
Table 4. Typology of Nursing Problems identified in Family C
Objective data: VI. Cataract as a health deficit.
Child C has severe clouding of the lens of the eyes; on the  
other hand, Mrs. C has a mild one. A. Inability to make decisions with respect to taking appropriate
  health action due to:
Subjective data: a. Inaccessibility of appropriate resources for care specifically
Mrs. C verbalized “dugay na ni ang cataract ko bala, naka financial constraints.
pa checkup ko kaisa galing wala nako kabalik kag ang akon nga
bata may ara man, galling anhon ta man kay wala gid kami kwarta
nga ipa opera. Ang lain lang da kay iya mata naglala pa gid, basi
dasun indi na siya makakita.”
 I. Accident hazards specifically fire hazard, as a health
threat.
PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification
1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 1/2 x 2 1 The problem is partially modifiable. The only way to solve this
problem is to renovate the house, thus it needs money.

3. Preventive 2/3 x 1 0.67 The problem could be moderately prevented. This could be done if
Potential the family will be very alert in watching out especially if they are
cooking since the house could catch fire anytime.

4. Salience 1/2 x 1 0.5 The problem, compared with the other problems does not need
immediate attention since it requires time and money.

Total Score: 2.84

 
II. Family size beyond what family resources can
adequately provide as a health threat.
PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification

1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 0/2 x 2 0 The problem could not be modified at all. The family size
cannot be trimmed down to smaller size

3. Preventive 1/3 x 1 0.33 The problem may be prevented but the family size cannot
Potential be trimmed down.

4. Salience 1/2 x 1 0.5 The problem, compared with the other problems does not
need immediate attention for they are used to live with
the bare minimum.

Total Score: 1.5

 III. Poor environmental sanitation specifically improper
drainage disposal as a health threat
PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification

1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 2/2 x 2 2 The problem is easily modifiable by teaching the family
the importance of having a proper drainage.

3. Preventive potential 3/3 x 1 1 This is highly preventable if the family has learned the
importance of having a clean drainage.

4. Salience 1/2 x 1 0.5 With regards to the family’s perception, the problem does
not need immediate attention.

Total Score: 4.17

IV. Presence of breeding or resting sites of vectors or
iseases as a health threat
PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification
1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 2/2 x 2 2 The problem is easily modifiable by teaching the family the
importance of having a clean environment including their
canals so as not to be a breeding or resting site for different
vectors or diseases.

3. Preventive potential 3/3 x 1 1 This is highly preventable if the family has learned the
importance of having clean surroundings including their
canals.

4. Salience 2/2 x 1 1 This needs immediate attention because vectors can bring
different kind of diseases that might harm the family’s
health.

Total Score: 4.67

 Lack of immunization/inadequate immunization
tus as a health threat
PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification
1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 2/2 x 2 2 The problem is easily modifiable by teaching the family the
importance of having a clean environment including their
canals so as not to be a breeding or resting site for different
vectors or diseases.

3. Preventive potential 3/3 x 1 1 This is highly preventable if the family has learned the
importance of having clean surroundings including their
canals.

4. Salience 2/2 x 1 1 This needs immediate attention because vectors can bring
different kind of diseases that might harm the family’s
health.

Total Score: 4.67

 VI. Cataracts as a health deficit

PRIORITIZING
Chapter VII : PROBLEMS
Criteria Computation Score Justification
1. Nature of the problem 2/3 x 1 0.67 This problem is a health threat.

2. Modifiability of the problem 1/2 x 2 1 The problem is partially modifiable since there are available
resources such as in the health center yet the family cannot
easily go to the health center because of hectic schedule and
financial constraints.

3. Preventive potential 2/3 x 1 0.67 The problem is moderately preventive since the family
could have had immunization way back then but they have
not completed it due to lack of knowledge about free
immunization.

4. Salience 2/2 x 1 1 Need immediate attention since negligence about

immunization will make them vulnerable from different
diseases.

Total Score: 3.34

 Chapter VIII: NURSING CARE
PLAN
Problems Score
Presence of breeding or resting sites of vectors or
diseases as a health threat. 4.67

Poor environmental sanitation specifically improper

drainage disposal as a health threat. 4.17

Lack of immunization/inadequate immunization status

as a health threat. 3.34

Cataracts as a health deficit 3.33

Accident hazards specifically fire hazard, as a health
threat. 2.84

Family size beyond what family resources can

adequately provide as a health threat. 1.5

CUES
 
Subjective data:
Mrs. C verbalized
“sa amon di lugar, dugay na
di namon gina tiis ang
kahigko kag kabaho sang
amon kalog kag gaapaw na
di kag kis a gabaha na gid
mag todo ang ulan.”
 
 
Objective data:
The family’s house lies
beside a dirty and foul-
smelling canal that is a
breeding or resting site for
vectors such as mosquitoes,
flies and cockroaches.
ANALYSIS OF THE
PROBLEM
A. Inability to make
decisions with respect to
taking appropriate health
action due to:
 
a. Low salience of the
problem.
 
b.Negative attitude towards
health problem.
 
c. Ignorance
Problem #1: Presence of breeding or resting sites of vectors or diseases as a health threat.
OBJECTIVES
After 2 weeks of community
exposure, the family will be able to:
·Educate themselves about the
importance of clean surroundings
 
·Know the different measures on how
to maintain the cleanliness of their
environment
 
·Eradicate the presence of these
unwanted sites of vectors
 
 
·Demonstrate understanding of the
health teachings with regards to
possible causes and effects of the
presence of these vectors.
 
INTERVENTION PLAN
NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME
> To know how much the
family knows about these
>Assess the family’s ideas
issues.
about the breeding sites of
>Knowing the causes of the
vectors.
problem is one way of
>Discuss the possible
solving it.
sources of the presence of
> To increase their
vectors.
awareness regarding to the After 2 weeks of community
>Explain to the family all of H
presence of breeding/resting exposure, the family will be able to:
the possible harmful effects O
sites to avoid diseases such - Educate themselves about the
that these vectors can cause M
as dengue fever, malaria and > Man power resources: Time and importance of clean surroundings
to the family and the E
other infections or diseases. effort, patience and determination - Know the different measures on
community.
> facilitates the importance > Pamphlets and brochure with how to maintain the cleanliness of
V
of a clean environment and information about the importance of their environment
  I
surroundings having a clean environment and the - Eradicate the presence of these
> discuss the importance of S
> to make the family cause and effect of the presence of unwanted sites of vectors
clean environment and I
members realize the vectors. - Demonstrate understanding of the
surroundings T
consequences of health teachings with regards to
irresponsible drainage and possible causes and effects of the
> explain the effects of  
garbage disposal which presence of these vectors.
untidy environment to a
serves as breeding sites of
healthy living
vectors thereby increasing
the possibility of infections
>Explore the family’s
or other diseases.
reaction to the health
> To measure the level of
teachings given.
understanding of the health
teachings presented.
 Problem #2: Poor environmental sanitation specifically improper drainage disposal as a health threat.
INTERVENTION PLAN

ANALYSIS OF THE
CUES OBJECTIVES
PROBLEM NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME

  A. Inability to make After 2 weeks of community

Subjective data:
Mrs. C verbalized
“Ang iban namon nga
sagbot dira lg kis a namon
ginalabay kag ang iban man
nga gaagi, kis a dira lg pud
nila ilabay.
 
 
Objective data:
The family’s drainage is an
open type. Rice grains and
pieces of plastics are visible
in the canals beside their
house. The canals are black
and dirty. They have a foul
smell too.
decisions with respect to
taking appropriate health
action due to:
 
a.Low salience of the
problem.
 
b. Negative attitude towards
health problem
exposure, the family will be able to:
· Educate themselves
about the importance of proper
drainage disposal
· Know the different
measures on how to maintain the
cleanliness of their environment
> discuss the importance of
proper drainage disposal
> explain the effects of
untidy environment to a
healthy living
 
>Explore the family’s
reaction to the health
teachings given.
H
> facilitates the importance
O
of proper drainage disposal
M After 2 weeks of community
system
E > Man power resources: Time and exposure, the family will be able to:
effort, patience and determination  
> to make the family
V   - Educate themselves about the
members realize the
I > brochure with information on importance of proper drainage
consequences of
S proper drainage disposal and the disposal
irresponsible drainage
I effect of having a clean - Know the different measures on
disposal
T environment how to maintain the cleanliness of
> To measure the level of
  their environment
understanding of the health
teachings presented.

ANALYSIS OF THE
CUES
PROBLEM
Subjective data: A. Inability to make
Mrs. C verbalized “Sang decisions with respect in
amon tion, ang pagbakuna taking appropriate health
nga ina, indi pa na uso. action due to:
Gusto man tani namon mag  
pabakuna galing abi namon a. Inability to make
may bayad ini.” decisions with respect to
  taking appropriate health
  action due to:
Objective data: b. Inaccessibility of
Not all of them have appropriate resources
completed their for care specifically
immunization. They are not financial constraints
aware that immunization is  
free.  
B. Failure to utilize
community resources for
health care due to:
a. Inaccessibility of
required service due to lack
of deficient knowledge
about free immunization
Problem #3: Lack of immunization/inadequate immunization status as a health threat.
INTERVENTION PLAN
OBJECTIVES
NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME
After 2 weeks of community
exposure, the family will be able to:
 
Employ the importance and urgency H
of immunization O
  M
Specifically: E
 
Know the importance and need for V
immunization. I
S
>To know how much the
I
family knows about these
>Assess the family’s ideas T
issues
about immunization status  
  & After 2 weeks of community
>To educate the family
>Discuss with the family   > Human resources: Time and effort exposure, the family will be able to:
about the immunization and
about the importance and O of both the nurse and family.  
its benefits.
need for immunization N   Employ the importance and urgency
  L > Material resources for visual aid of immunization
>Inform the family about the > To make sure that the
I on about useful information about  
benefit and urgency of the family is aware of the
N immunization and its benefits and Specifically:
need for immunization. diseases that they are prone
E purpose.  
  to if immunization is
C   Know the importance and need for
>Explore the family’s ignored.
O immunization.
reaction to the health  
M
teachings given. > To measure the level of
M
understanding of the health
U
teachings presented.
N
I
C
A
T
I
O
N

ANALYSIS OF THE
CUES
PROBLEM
Subjective data: A. Inability to make
Mrs. C verbalized “Sang decisions with respect in
amon tion, ang pagbakuna taking appropriate health
nga ina, indi pa na uso. action due to:
Gusto man tani namon mag  
pabakuna galing abi namon a. Inability to make
may bayad ini.” decisions with respect to
  taking appropriate health
  action due to:
Objective data: b. Inaccessibility of
Not all of them have appropriate resources
completed their for care specifically
immunization. They are not financial constraints
aware that immunization is  
free.  
B. Failure to utilize
community resources for
health care due to:
a. Inaccessibility of
required service due to lack
of deficient knowledge
about free immunization
Problem #4: Cataract as a health deficit
INTERVENTION PLAN
OBJECTIVES
NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME
After 2 weeks of community
exposure, the family will be able to:
 
Employ the importance and urgency H
of immunization O
  M
Specifically: E
 
Know the importance and need for V
immunization. I
S
>To know how much the
I
family knows about these
>Assess the family’s ideas T
issues
about immunization status  
  & After 2 weeks of community
>To educate the family
>Discuss with the family   > Human resources: Time and effort exposure, the family will be able to:
about the immunization and
about the importance and O of both the nurse and family.  
its benefits.
need for immunization N   Employ the importance and urgency
  L > Material resources for visual aid of immunization
>Inform the family about the > To make sure that the
I on about useful information about  
benefit and urgency of the family is aware of the
N immunization and its benefits and Specifically:
need for immunization. diseases that they are prone
E purpose.  
  to if immunization is
C   Know the importance and need for
>Explore the family’s ignored.
O immunization.
reaction to the health  
M
teachings given. > To measure the level of
M
understanding of the health
U
teachings presented.
N
I
C
A
T
I
O
N
 Problem #5: Accident hazards, specifically fire hazard as a health threat
INTERVENTION PLAN
ANALYSIS OF THE
CUES OBJECTIVES
PROBLEM NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME

Subjective data: A. Inability to provide a After 2 weeks of community

Mrs. C verbalized “Ang
amon ni nga balay dugay na
ni siya, 42 years na kami
diri gaistar sa akon pamilya.
Gibakal ni namon sa amon
lang man kilala sang una
kag asta sbng gatindog pa.
Dira ko galuto sa may
sulod namon balay. Wala ta
may mahimo kay amo lang
gid ni amon makaya. Sa
kapigaduhon sa kabuhi,
wala na kami may ikabakal
pa sang mga materyales na
ipakay o kung tani sa amon
balay. Wala kami mahimo
kay sa pension nga kada
bulan gaabot na lang gid
kami gaasa sang kwarta nga
amon gamiton sa amon pang
adlaw adlaw na ginawi. Kag
ini kulang gid kayo para sa
amon apat.
 
Objective data:
The house of Family C is a
bungalow style of house. It
is mainly made up of
bamboo and wood. The
mother usually cooks inside
the house using wood and
charcoal.
home environment
conducive to health
maintenance and personal
development due to:
a. Inadequate family
resources; specifically
financial constrains/limited
financial resources.
b. Failure to see
benefits of investment in
home environment
improvement.
 
B. Inability to make
decisions with respect to
taking appropriate action
due to:
a. Failure to comprehend the
nature, scope, and
magnitude of the problem.
b. Negative attitude towards
the problem.
c. Low salience of the
problem
exposure, the family will be able to:
Educate themselves about the
importance of safety precautions in
the house
Specifically:
·Learn different measures to prevent
fire accidents
 
>Assess the family’s ideas
·After several home visits, the family
about fire safety
will show concern in the teachings
given as evidenced by reconstruction
>Discuss with the family
of their cooking area.
about the importance and
need for fire safety
 
>Inform the family about the
benefit and urgency of the
need for the implementation
of fire safety in the house.
 
>Explore the family’s
reaction to the health
teachings given.
>To know how much the
family knows about these
issues
 
>To educate the family about
fire safety and its benefits.
> To make sure that the
family is aware of the
possible consequences that
they are prone to if fire
safety is ignored.
> To measure the level of
understanding of the health
teachings presented.
After 2 weeks of community
exposure, the family will be able to:
H
O
Educate themselves about the
M
> Man power resources: Time and importance of safety precautions in
E
effort, patience and determination the house
>Material resources for visual aid  
V
on about useful information about Specifically:
I
fire safety and its benefits and  
S
purpose. ·Learn different measures to prevent
I
  fire accidents
T
- After several home visits, the
family will show concern in the
 
teachings given as evidenced by
reconstruction of their cooking area.

CUES
Subjective data:
Mrs. C verbalized
“Gamay lang gid ang amon
income intawon. Indi na
gani kami makabakal sang
mga bayo sa mga bata kag
mga kinahanglan nila. Luoy
kaayo. Galing wala man ko
may mahimo kay amo lang
gid ni amon kaya. Ang
amon pagkaon budget
budget lang nga kaigo para
sa amon. Uga, ginamos,
itlog kag utan nga ari diri sa
amon palibot ang sud-an
namon permi. Kay wala
man kami iban nga choice
kundi mangita medyos kag
kung ano na lg ang ara.”
 
 
Objective data:
The income of the family is
about Php 5000 per month.
There are four members in
the family.
Problem #6: Family size beyond what family resources can adequately provide as a health threat.
INTERVENTION PLAN
ANALYSIS OF THE
OBJECTIVES
PROBLEM NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME
A. Inability to make After the nursing intervention, the
decisions with respect to family will be able to:
taking appropriate health  
action due to: Decide on appropriate action/s to
a. Inaccessibility of support family size based on a sense
appropriate resources for of responsibility for love and life
care such as financial
constraints.
H
>To educate the family about
O
the importance of
>Analyze with the family M
alternative/methods to > Man power resources: Time and
critical issues related with its E After the nursing intervention, the
encourage better decision- effort, patience and determination
capabilities to support family family will be able to:
making on the best option > Videos and pamphlet with
size V  
given the family’ situated information about how the family
  I Decide on appropriate action/s to
possibilities. can make additional possible
>Explore the family’s S support family size based on a sense
  income.
reaction to the health I of responsibility for love and life
> To measure the level of  
teachings given. T
understanding of the health
 
teachings presented.
 
 Chapter IX: SUMMARY, EVALUATION
AND RECOMMENDATION

Presented in this case study is the different characteristics and health condition of family C. This case

study presents the family structure, socio – economic and cultural factors, home and environmental factors,

health assessment of each member. It also contains data about identified problems on the living condition of

the family.
 Recommendations:

The student nurse have identified and prioritized problems and needs with the family. The

student nurse have also created a care plan on how to deliver the best nursing care for the family to address

their needs. The following below are propositions and commendations recognized by both the student nurse

and family:

· The C family should maintain a healthy and clean environment. They must clean their

surroundings to avoid the presence of vectors of diseases.

· They must also reorganize their cooking practices in terms of fire safety and precautions by

appropriate action(s) to prevent the occurrence of accidental fires.

· The C family should not wait for the ailment to become severe before seeking medical help.

· The C family should persevere to perform proper drainage disposal.

 They should know the importance, need and urgency of immunization for the family.

· The C family should be aware that organizations in the community are open and present for their

problems to be addressed properly.

· They should be encouraged to verbalize their concerns with regard to the community so that

resolutions can be made.