community health nursing

COMMUNITYHEALTH

NURSINGCASE STUDY

TABLE OF CONTENTS

I. INTRODUCTION 2

II. BASELINE INFORMATION 3

III. INITIAL DATA BASE 4

IV. SPOT MAP 6

V. FIRST LEVEL ASSESSMENT 8

VI. SECOND LEVEL ASSESSMENT 11

VII. PROBLEM PRIORITIZATION TABLE 19

VIII. FAMILY NURSING CARE PLAN 20

IX. HOME VISIT 28

X. FAMILY COPING INDEX 34

XI. RECOMMENDATION 35

I. INTRODUCTION

It is really surprising that today, in our so-called highly standardized society, an increasing number of people feel rejected, depressed and belong to the poverty line here in the Philippines. And the worst thing is that others are unable to see any meaning in life. Did you ever wonder how these people eat every day? How these situations affect the children of this time? Are they satisfied with what they are experiencing right now? Are they not in pain and hunger as they continue their journey in life? These children desire to eat and play but they don’t have any option at all. All these questions arose as we witnessed all of these scenarios.

For approximately 91, 983, 000 people comprising the total population of the Philippines, 32.9 or 9.67% are below the poverty line and it ranks as the number 59 worldwide. Those families belong to the low-socio economic level is the most affected people. These families have little or no access to health services and education and limited prospects for a better life.

We, the nursing students play an important role as we practice our learned concepts about the community health nursing. Community health nursing is centered on the individual and family. With the variety of interventions rendered for them, one general objective is fir the family to become self-reliant. Health workers want to emphasize that they should offer their commitment as well as their full support to their co-members for them to attain good health. We decided to chose family Major to be the focus of our study.

Specifically, we aim to:

a) Take note the family’s baseline information.

b) Identify their health condition.

c) Assess if there are presence of health threat, health deficits, wellness condition and foreseeable crisis.

d) Prioritize their health-related problems.

e) Render effective family nursing care plan.

f) Promote health prevention of possible occurrence of diseases.

g) Encourage the family to initiate effective problem solving skills to uphold their quality of health and life.

There is really in need for the government, institutions, as well as us student nurses to focus on how these poor voice out their concerns that can affect their lives. The ways and the means that enable the poor to join and work towards better future are the focus of health and development.

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II. BASELINE INFORMATION

NAME AGE SEX RELATIONSHIP RELIGION TRIBE EDUCATIONAL

ATTINMENT

IMMUNIZATION

Mr. M 48yo Male Father Roman

Catholic

Bisaya Elementary graduate

Complete

Mrs. M 45yo Female Mother Roman

Catholic

Bisaya Elementary graduate

Complete

Child 1 17yo Male Eldest Roman

Catholic

Bisaya 4th year Highschool

Complete

Child 2 15yo Female Second Roman

Catholic

Bisaya 2nd year Highschool

Complete

Child 3 12yo Female Third Roman

Catholic

Bisaya 1st year Highscool

Complete

Child 4 10yo Male Fourth Roman

Catholic

Bisaya Grade 5 Complete

Child 5 9yo Male Fifth Roman

Catholic

Bisaya Grade 2 Complete

Child 6 6yo Female Sixth Roman

Catholic

Bisaya Kinder Complete

Child 7 3yo Female Seventh Roman

Catholic

Bisaya Not yet in school

Complete

Address: Buenbrazo St. San Isidro, Cotabato City

Head of the family: Father

Source of income: Works as a baker, Works at tailoring

Income: Father- 2,800/month

Mother-200/day

Behavior: The family was cooperative and hospitable enough during the course of assessment.

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III. INITIAL DATABASE

A. Family structure and Characteristics

Family M is a nuclear type of family composed of Mr. and Mrs. M and their 7 children. In their family, Mr. M does the decision making and shoulders the expenses of the family. Mr. M is 48 years old and works at the bakery as a baker. While Mrs. M is 45 years old and works on the tailoring shop. Child 1 is 17years old and he is in 4th year high school, Child 2 is 15years old and she is in 2nd year high school, Child 3 is 12years old and she is in 1st year high school, Child 4 is 10 years old and he is in Grade 5, Child 5 is 9years old and he is in Grade 2, Child 6 is 6years old and she is in Kinder and Child 7 is 3years old and she is not in school yet.

According to them they can eat three times a day but sometimes due to the inadequate income they only eat two times a day. Sometimes there are inadequacy in terms of the amount and quality of foods they are eating. Vegetables like alugbati, malunggay, and kamote tops are their usual viands. Sometimes they have rice sometimes they don’t have. They don’t have any garden in their house. They buy on market or ask to their neighbors. They also eat fish like bolinao, and matambaka.

When the children are free, they usually play with their neighbors at the back of their house. Mrs. M used to stay outside their house under the tree when she wants to rest. Mr. M seldom stays on their house. He always works at the bakery.

B. Socio – economic and Cultural Characteristics

According to the family, the sources of their income are their works at the bakery and tailoring shop. The father is a baker and the mother works at the tailoring shop. Mrs. M’s daily income is 200 while Mr. M’s monthly income is 2, 800. This money earned by them are the only means for them to eat three times a day. But sometimes if they are short they eat 2 times a day. Mrs. M is the one who is in charge for the budget of their income. There is a time that their income is not enough for their necessities.

Mr. M finished elementary education and his wife also. For the kind of educational attainment they have, they don’t expect much for their family. They just want to live a simple life with their 7 children. The religion of the family is Roman Catholic and they are Bisaya.

C. Home and Environmental Factors

They already stayed in their house for almost 10 years. Within that span of time, they are paying 300 pesos every month as a house rental. The family resides at San Isidro, Cotabato City. Approximately, there are 263 steps from Casa Blanca. The house is made up of light materials such as bamboo and low quality woods. Their house was not that organize. There are parts which were not properly fixed and nailed. They have 2 doors and 4 windows located at the front and side of the house. There are holes and defects noted at the floor and ceiling of the house. The area of the house is 135x120 which not a conducive area is for 9 people. The family’s surrounding is prone to accident due to several hazards noted.

Inside their house, there are things scattered that can be a cause of an accident. There was no furniture present. They cooked outside beside their garbage area. They used “kaldero” upon

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cooking. They used “kalan” and woods to make fire. They have a source of light. When they sleep they use banig and mosquito nets. They usually go to sleep at around 9pm.

They get their drinking water at the “poso”, and sterilized it. They store it in different galloons. For the garbage disposal, they did not separate biodegradable from non-biodegradable garbage. Their comfort room is located outside and at the back of their house. They have bowl and they need to get water to flash it. Their neighbors are meters away from them.

D. Health status and Medical history

According to the client, her children’s usual complaints are fever, cough, and colds. Mr. M’s usual complain is headache and Mrs. M’s usual complaint is dizziness. These health problems might be related to the weather and everyday’s activities of the family members. The anthropometric data of the family which measures nutritional status where as follows.

Client Weight Height Abdominal Girth

Classification of BMI

Interpretation

Mrs. M 39 kg 146 cm 66 cm Emaciation(less than 14.9)

18.30 Normal

Child 4 21 kg 125 cm 55 cm Underweight(15-18.4)

13.44 Underweight

Child 5 18 kg 115 cm 56 cm Normal(18.5-22.9)

14.37 Underweight

Child 6 16 kg 107 cm 54 cm Overweight(23-27.9)

13.93 Underweight

Child 7 12 kg 89 cm 53 cm Obese(27.6-40) 15.15 Underweight

Morbidly obese(greater

than 40)

The table shows that only Mrs. M has a normal BMI, and that her children were underweight. These findings indicate that the family suffers from malnutrition. Even though Mrs. M mentioned that they manage to eat three times a day, still it was not enough because their food were insufficient to satisfy the needs of their growing body. The other members of the family were not included in the table, because they were not there during the home visitation.

E. Values, Habits, Practices and Health Promotion

When asked about health practices of their family, they said that for them health is very important as the saying says, “Health is wealth”. But because of the unfortunate situation, they cannot afford to maintain check-ups because of lack of financial capacity. They just consult for medical condition if one of them is sick. Sometimes they failed to do so; instead they self-medicate which is not supposed to be. Fortunately, they all completed their immunizations.

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IV. SPOT MAP

Legends:

Paths: : San Isidro Ave.

: Buenbrazo St.

Establishments:

A : Casa Blanca

B : Rafael’s Pension House

C : House of the Patient

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V. FIRST LEVEL ASSESSMENTCues/ AMB Health Problem Category Justification

Mother verbalizes “Kapag walang pasok, hindi na sila minsan naliligo kasi puro laro na lang ginagawa nila”

Untrimmed nails

Untidy dress

Children don’t wash their faces even with dirt.

Poor hygiene Health Threat Poor hygiene increases the client’s vulnerability to infection or diseases among children. Too much contact outside the house and expose to soil which contains microbes can cause diseases and illness to the children.

Mother verbalized “Minsan lang kami makakain ng isda at karne. Wala kasing pera. Minsan toyo lang at suka. Madalas gulay ang pagkain namin.”

Mother sometimes borrows money for them to buy food and baon of her children.

The father seldom gave his income for their home expenses.

Family income of 2,000 Php a month.

Insufficient food intake both in quality and quantity.

Malnutrition Health Deficit Health deficit requires immediate intervention to eliminate further consequences. due to inadequate knowledge on proper nutrition and financial capacity, family is unable to avail the nutritional requirement needed by our body to maintain its normal functioning. If this would be left untreated, it can lead to physical and mental disabilities, then would possibly lead to death.

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Mother verbalized “Madami nga lamok lalo na kapag nagaulan.”

Presence of uncovered water containers.

Presence of stagnant water in pots.

Presence of breeding/ resting sites of vector

Health Threat It is classified as health threat because mosquito can bring diseases such as dengue Fever and Malaria which can harm the body. The shown cues can be a site for the mosquito to breed. Since that mosquito have the capability to transmit virus, it should have an immediate action.

Mother verbalizes “Dito kami nagluluto. Iniingatan na lang naming baka kasimakaabot ang apoy sa bahay naming.”

Kitchen was situated beside their house.

House was made up of light materials (Wood)

Accident hazard specifically fire hazard.

Health Threat Risk for fire poses grave danger not only to health but to life as well. It can happen when the family finishes cooking and the fire is left unattended especially at night.

They use stairs in climbing on their house. The stairs don’t have a handle.

There are large irregular-shaped stones in their ground.

Risk for InjuryHealth Threat It is classified as health threat because the children were fun

of going upstairs. And even if they wear their slippers, still it is not a protective gear for them, because nails are sharp enough to penetrate in the feet and other parts of the body of the person.

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Mother verbalizes “Marami talaga sila magkakapatid. Pito sila. Tapos ang tatay nila minsan lang magbigay ng pera.”

Mother refuses to have tubal ligation.

Ineffective parenting Health Threat It is classified as health threat because of inadequate knowledge about parenting, there is an increase number of child in the family, thus can lead to inability to support the entire member of the family.

Failure to do handwashing before and after eating.

Unclean water container.

Food and water were not covered.

Eating utensils were not properly kept.

Risk for food and waterborne diseases

Health Threat The problem it classified as health threat because many disease causing microbes or pathogen that can be acquire through contaminated water. Diseases which can harm the client include amoebiasis, typhoid fever and Hepatitis. This said diseases can harm and can alter the body’s normal functioning.

Mother verbalizes “Kapag matulog kami ditto lang. Kaya sikipan talaga kami.”

9 members of the family are living in a house with a dimension of 135 inches length and 120 inches width.

Family income of 2,000 Php per month.

Inadequate living space Health Threat It is classified as health threat because congested living space promotes the easy transmission of diseases.

VI. SECOND LEVEL ASSESSMENT

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Cues/AMB Health Problem Category Family NursingProblem

Computation Justification

Mother verbalized “Minsan lang kami makakain ng isda at karne. Wala kasing pera. Minsan toyo lang at suka. Madalas gulay ang pagkain namin.”





Malnutrition Health Deficit Inability to provide adequate nursing care to family suffering from malnutrition due to:

a. Inability to recognize the presence of the problem due to inadequate knowledge on proper diet and consequences of the problem.b. Inadequate resources for care such as responsible family member and financial restraint.

1. Nature of the Probem:

3 / 3 x 1 = 1

2. Modifiability of the Problem:

2 / 2 x 2 = 2

3. Preventive Potential:

3 / 3 x 1 = 1

4. Salience :

0 / 2 x 1 = 0

Total Score: 4

Health deficit that requires immediate intervention to eliminate further consequences due to inadequate knowledge on proper nutrition and financial capacity. If left untreated malnutrition can lead to mental or physical disability illness and possibility of death.

The problem is easily modifiable since there are student nurses, community and family resources are available.

It is preventable if the family especially the mother is knowledgeable on proper nutrition for each family member. Proper growth and development could be achieved.

The problem is not recognized by the family due to unawareness of its magnitude.

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Untrimmed nails

Untidy dress

Children don’t wash their faces even with dirt

Poor hygiene Health Threat Inability to make decisions with respect to taking appropriate health action due to low salience of the problem.


2 /3 x 1 = 0.67


2 / 2 x 2 = 2


2 / 3 x 1 = 0.67

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 3. 84

It is a health threat since poor hygiene increases clients vulnerability to diseases especially among children

The alternative resources and interventions are available to the family making the problem highly modifiable

Through reinforcement and health teachings and client’s willingness to cooperate on the occurrence of the diseases brought about by poor hygiene could be prevented

The family recognizes it as a problem but their financial resources are limited

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Risk for injury Health Threat Inability to provide a home environment conducive to health maintenance and personal development due inability to foresee possible threats in the construction materials


2 / 3 x 1 = 0.67


2 / 2 x 2 = 1


2 / 3 x 1 = 0.67

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 3.84

It is classified as health threat because the children were fun of going upstairs. And even if they wear their slippers, still it is not a protective gear for them, because nails are sharp enough to penetrate in the feet and other parts of the body of the person.

The problem is easily modifiable because preventive measures can be done if they want to.

It has a moderate preventive potential since the resources can be easily acquired.

The problem was observed by the family but they do not perceive it as something that needs an immediate attention.

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Mother verbalizes “Dito kami nagluluto. Iniingatan na lang naming baka kasi makaabot ang apoy sa bahay naming.”



Accident hazards specifically fire hazards

Health Threat Inability to provide a home environment conducive to health maintenance and personal development due to inadequate family resources

Inability to make


2 / 3 x 1 = 0.67


1 / 2 x 1 = 1


3 / 3 x 1 = 1

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 3.67

Problem is classified as health threat since Risk for fire poses grave danger not only to health but to life as well. It can happen when the family finishes cooking and the fire is left unattended especially at night.

Lack of enough financial resources makes the problem partially modifiable.

Preventive measure can be done like putting of the gas range after cooking .

The problem is recognized but the family didn’t see it as something serious to be acted upon immediately.

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Mother verbalized “Madami nga lamok lalo na kapag nagaulan.”



Presence of breeding/ resting sites of vector

Health Threat decision with respect to taking appropriate health action due to low salience of the problem

Inability to make


2 / 3 x 1 = 0.67


2 / 2 x 2 = 2


3 / 3 x 1 = 1

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 3.17

It is classified as health threat because mosquito can bring diseases such as dengue Fever and Malaria which can harm the body. The shown cues can be a site for the mosquito to breed. Since that mosquito have the capability to transmit virus, it should have an immediate action.

The problem is easily modifiable since they can easily modify their place to lessen or eliminate the sites of the vector.

It is a high preventive potential since there are a lot of preventive measures they can do for this situation.

The problem was observed but the family didn’t see it as something that needed to be acted immediately.

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Risk for food and water borne diseases

Health Threat decision with respect to taking appropriate health action due to low salience of the problem

Inability to


2 / 3 x 1 = 0.67


2 / 2 x 2 = 2


2 / 3 x 1 = 0.67

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 2.84

The problem is classified as health threat because many diseases causing microbes or pathogen that can be acquire through contaminated water. Diseases which can harm the client include amoebiasis, typhoid fever and Hepatitis. This said diseases can harm and can alter the body’s normal functioning.

Problem can be managed through health teachings on sanitation and proper food handling.

Proper food handling, preparation and personal hygiene could be encouraged to prevent the occurrence of this health problem.

The family is not aware by this problem.

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Family income of 2,000 Php per month

Inadequate living space

Health Threat provide home environment which is conducive to health maintenance and personal development due to inadequate family financial resources.

Inability to make


2 / 3 x 1 = 0.67


1 / 2 x 2 = 1


2 / 3 x 1 = 0.67

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 2.83

It is classified as health threat because congested living space promotes the easy transmission of diseases.

The family’s income cannot compensate the renovation since it requires more financial expenditures, however things inside the house can be rearrange to allow more space.

Possible transmission of communicable diseases can be minimized by means of proper health teaching.

The problem is recognized by the family but because of lack of stable financial resources, family is unable to find a solution to the problem.

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Ineffective Parenting

Health Threat decisions with respect to taking appropriate health action due to low salience of the problem.


2 / 3 x 1 = 0.67


2 / 2 x 2 = 1


2 / 3 x 1 = 0.67

4. Salience :

1 / 2 x 1 = 0.5

Total Score: 2.83

It is classified as health threat because of inadequate knowledge about parenting, there is an increase number of child in the family, thus can lead to inability to support the entire member of the family.

It can be modifiable if the parents could be given a health teaching regarding proper parenting management.

The problem could be preventive by proper health teaching to the parents regarding an effective parenting.

The problem is recognized by the family or the parents didn’t see it a see it as something to be acted immediately.

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VII. PROBLEM PRIORITIZATION

PROBLEM RATING

1. Malnutrition 4

2. Poor hygiene 3. 84

3. Risk for injury 3.84

4. Accident hazards specifically fire hazards

3.67

5. Presence of breeding/ resting sites of vector

3.17

6. Risk for food and water borne diseases 2.84

7. Inadequate living space 2.83

8. Ineffective Parenting 2.83

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VIII. FAMILY NURSING CARE PLAN

Cues/AMBHealth

ProblemNursing Problem Nursing

ObjectivesInterventions Method of

Contact Resources Evaluation Mother verbalized

“Minsan lang kami makakain ng isda at karne. Wala kasing pera. Minsan toyo lang at suka. Madalas gulay ang pagkain namin.”





Malnutrition Inability to provide adequate nursing care to family suffering from malnutrition due to:

a. Inability to recognize the presence of the problem due to inadequate knowledge on proper diet and consequences of the problem.b. Inadequate resources for care such as responsible family member and financial restraint.

At the end of nursing intervention: Mother will

state the importance of proper nutrition.

Family will enumerate some effects of malnutrition and surviving needs.

Mother will identify economical food rich in nutrients.

Measure the height and weight of the family members.

Advise the mother to seek help in their barangay health center for referral to avail medical assistance.

Provide information that malnutrition is a great risk to one’s growth and it decreases the resistance of the body.

Let the mother enumerate effects of malnutrition.

Encourage mother to think of food rich in nutrients that are economical.

Advise mother to tell her children not to buy “junk food”

Home visit Lecture Discussion

Family Student

nurses

Goal met:The mother stated the importance of proper nutrition by verbalizing “Mahirap talaga kapag may malnutrition. Maghina ang resistensiya ng katawan. Madaling Magkasakit mga anak ko.”

Goal met:The family was able to enumerate some effects of malnutrition by verbalizing “Kapag malnourish ang bata payat talaga tapos madali magkasakit.

Goal met:The family was able to identify economical food rich in vitamins as verbalized by “Naglinis nga ako kanina diyan kay taniman ko ng gulay. Para diyan na lang kami magkuha. Importante din ang gulay sa katawan.”

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Cues/AMB Health Problem

Nursing Problem

Nursing Objectives

Interventions Method of Contact Resources Evaluation


Untrimmed nails

Untidy dress

Children don’t wash their faces even with dirt.

Poor Hygiene

Inability to make decisions with respect to taking appropriate health action due to low salience of the problem.

At the end of nursing intervention:

The family will verbalize the importance of proper hygiene in promoting health.

Mother will enumerate ways on how to maintain proper hygiene.

Provide information that poor hygiene can cause body odor, skin disease and infection.

Provide techniques on proper hygiene maintenance especially after toilet use, regular bathing, oral care and trimming of nails.

Encourage mother to enumerate ways on how to improve proper hygiene.

Demonstrate on proper oral care, bathing and hand washing.

Home visit Discussion Demonstrat

ion

Family Student

nurses Hand

washing, and oral care materials

Goal met:The mother verbalized “Importante man talaga ang maligo para malinis at makaiwas sa sakit ang mga anak ko.”

Goal met:The mother enumerated ways on how to maintain proper hygiene by verbalizing “Maligo dapat araw-araw. Tapos dapat mag-iwas sa dumi. Magtoothbrush din dapat para hindi magkaroon ng bad breath. Tsaka maghugas ng kamay bago magkain at pagkatapos.

Cues/AMBHealth

ProblemNursing Problem Nursing


Contact Resources Evaluation

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Risk for injury as health threat

Inability to provide a home environment conducive to health maintenance and personal development due inability to foresee possible threats in the construction materials.

At the end of the nursing intervention, the family will be able to:

The family will know the importance of environment free from hazards and accidents.

The family will enumerate some measures to prevent accidents.

Provide information that the non-handle stairs and irregular stones in the ground can cause injury to any family member.

Provide measures that can prevent the occurrence of accident.

Encourage mother to assist the little ones in climbing the stair.

Advise the children to wear slippers when going out to prevent stone puncture.

Facilitate on the removal of sharp stones in their place.

Home visit Discussion

Family Student

nurses Broom stick

Goal met:The family knew the

importance of environment free hazards by verbalizing “Dapat talaga maayos ang bahay kasi mahirap na madisgrasya.”

Goal met:The family has enumerated

several measures to prevent accidents like removing the sharp stones in their ground, assisting the little ones during climbing, discouraging their children to play near the stair.

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Cues/AMBHealth

ProblemNursing Problem

Nursing Objectives


Mother verbalizes “Dito kami nagluluto. Iniingatan na lang naming baka kasimakaabot ang apoy sa bahay naming.”



Accident hazards specifically fire hazards

Inability to provide a home environment conducive to health maintenance and personal development due to inadequate family resources.


Recognize the presence of the risk factors.

Identify fire preventive measures.

Discuss with the family what are the risk factors that may cause fire.

Encourage the family to enumerate ways on how to prevent fires.

Provide information on fire safety and precaution.

Advise the family not to leave the fire in their kitchen unattended.

Never let the children play fire.

Advise the family to put off the fire when not in use and keep away flammable liquids.

Home visit Discussion

Family Student

nurses

Goal met:The family was able to recognize presence of risk factors that may cause fire.

Goal met:The family identified fire preventive measures like putting off the fire after using, don’t make too big fires, never put things beside the stove that can be burned easily.

Cues/AMBHealth

ProblemNursing

ProblemNursing



Mother Presence of Inability to At the end of Assess if the problem can Home visit Family Goal met:The family has identified

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verbalized “Madami nga lamok lalo na kapag nagaulan.”



breeding/resting sites of vector (mosquitoes)

make decision with respect to taking appropriate health action due to low salience of the problem.

the nursing intervention, the family will be able to:

Identify ways on how to get rid of mosquitoes and other insects.

Remove pots and cover the water containers.

be modify right away.

Discuss some diseases transmitted by insects like dengue fever.

Provide information how can the family prevent the breeding of mosquitoes.

Let the mother enumerate measures how to get rid mosquitoes and other insects.

Advised the family to use mosquito net.

Facilitate in general cleaning activity.

Encourage the family to keep their environment clean.

Discussion Student nurses

ways to get rid mosquitoes by verbalizing “Dapat walang mga pwedeng tirhan ng lamok. Tapos lagi maglinis.”

Goal met:The family, together, with the

student nurses removed the pots with stagnant water and covered the water container.

Cues/AMBHealth


Nursing Objectives


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Risk for food and water borne diseases.

Inability to make decision with respect to taking appropriate health action due to low salience of the problem.

At the end of the nursing intervention, the family will be able to recognize the importance of sanitary food handling and preparation.

Provide information about the importance of proper food handling and preparation.

Discuss the effects of improper handling and preparation of food.

Advice the family to boil their water before drinking for at least 15 minutes.

Encourage the family members to do proper handwashing before and after eating.

Cover your food left in the table.

Keep the eating utensils in a clean place or container.

Home visit Lecture Discussion

Family Student

nurses

Goal met: The family was able

to recognize importance of sanitary food handling and preparation through reinforcement on their knowledge regarding proper handwashing, boiling of drinking water and instructed them to immediately wash used eating utensils.

Cues/AMBHealth

ProblemNursing

ProblemNursing



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Family income of 2,000 Php per month.

Inadequate living space

Inability to provide home environment which is conducive to health maintenance and personal development due to inadequate family financial resources.


Identify disadvantages of congested living

Arrange things in the house and dispose unnecessary materials inside the house to allow more space.

Discuss the disadvantages of congested living space.

Ask the mother what they can do about it.

Instruct to remove unnecessary things to allow more space.

Facilitate a cleaning session.

Home visit Discussion Cleaning

session

Family Student

nurses Cleaning

materials.


to identify disadvantages of congested living space by verbalizing “Hindi maganda yung tulog naming kasi sikipan. Tsaka mahirapan yung mga bata.”


to arrange and dispose unnecessary materials inside their house.

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Cues/AMBHealth


Nursing Objectives




Ineffective Parenting

Inability to make decisions with respect to taking appropriate health action due to low salience of the problem.

At the end of the nursing intervention, the family will be able to know the importance of effective parenting.

Assess the status of the family.

Discuss the problems encountered as parents.

Ask the family what are their ways in dealing with this problem.

Encourage mother to do alternative ways that can help her raise some money for their family.

Home Visit Family Student

nurses

Goal met:The family already knew the importance of effective parenting by verbalizing “Mahirap talaga ang buhay kaya dapat hindi na dagdagan ang mga bata lalo na wala kami masyadong mapagkuhaan ng pera.”

X. HOME VISITHOME VISIT PLAN # 1

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General Objective: At the end of 35minutes, the family will be able to establish rapport with the student nurses and give pertinent baseline information.

Time Allotment

Specific Objective Activity Content Resources Evaluation

2 minutes

5 minutes

The family will be able to recognize the presence of student nurses.

The family will be able to express willingness to cooperate with the student nurses.

Greeting the client, showing house courtesy.

Self introduction, Interview, Stating the purpose of the home visitation, contract setting.

“Magandang araw po, mga 4rth year nursing students po kami ng notre dame university”

“mga nursing student po kmi n nandito para makausap po kayo upang itanong ang kalagayan ng kulusugan nyo kasama na ang asawa at mga anak nyo po at pangaraw-araw na pamumuhay nyo bilang pamilya, okey lng po b? kooperasyon lng nyo ang nais nmin maam”

Family, student nurse

Family, student nurses

Goal met. The family was able to recognize the presence of sudent nurses.

Goal met. The family verbalized “oo nman, mkikipagcooperate ako basta alam ko.“

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25 minutes

3 minutes

The family will be able to show cooperation in gathering baseline information and initial assessment.

The family will be able to verbalize acceptance of appointment set for the follow up care of student nurses

Interview, VS taking, health assessment, identify health-related needs.

Contract setting, expression of gratitude

Ask questions about family member’s name, age, sex, occupation, civil status, educational attainment, religion, source of income and immunization. Then, obtain the initial VS.

“maam babalik po kmi bukas mga ganitong oras po para po mapagpatuloy ang naumpisahan po namin. Maraming salamat po. Aalis n po kmi.”

Family, student nurses, BP apparatus, thermometer


Goal met. The family was able to give baseline information about their family.

Goal met. Thefamily verbalized “okey, sige balik lang kayo para nandito rin ibang anak ko”.

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HOME VISIT PLAN #2General Objective: Within the 45 minute visit, the Family will be able to identify potentially health problems and be able to enumerate resources that sufficient and effective to their development in problem solving skills.

Time Allotment


1-5 minutes

1-5 minutes

2-5 minutes


The family will be able to have a conversation with the student nurses.

The family will be able to participate in the conversation and identify potentially risky factors that will affect their health condition.

Greeting the client, showing house courtesy.

Integration by asking what they are doing and helping them in household chores, if any.

Asking questions, list down important details, maintaining eye contact.

“Magandang umaga po”.

“Kumusta nman po kayo? Ang mga anak nyo po kumusta po?”

“Ano po ang problema natin dito?paano at saan po kayo nagluluto ng makakain ninyo? Ang palikuran nyo po sariling sainyo po?”



Family, student nurses.

Goal met. The family was able to recognize the presence of sudent nurses.

Goal met. The family was able to have conversation with the student nurses.

Goal met. The family was able to identify some of the factors that may affect their health.

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10-20 miniutes

1-2 minutes

2-5 minutes

The family will be able to verbalize any difficulties as they encounter those problems.

The family will be able to identify resources to accommodate their needs and also they will be able to verbalize their management on those problems.

The family will be able to receive basic care from the student nurses.

Accepting their feelings on certain problem, eye contact

Recognizing their opinion on how do they manage to accommodate their needs. Giving health teaching. Discussion.

BP taking

“Ano po ang mga nararamdaman ninyo s mga problemang yon?”

“Ano po gingawa nyo pagmalamok po? Iwasan lng po o tanggalin lng natin nga puwedeng pamugaran ng mga lamok po.”

“okey na po bah?may mga katanungan po kayo? Mahalaga lng po na huwag natin pabayaan ang ating kalusugan.”




Goal met. The family was able to share their difficulties as they encountered those problems.

Goal met. The family was able to identify resources to accommodate their needs.

Goal met. The family was able to receive basic care given by the student nurses.

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HOME VISIT PLAN # __3__General Objective: Within the 45 minute visit, the family will be able to participate in the assessment or interview process about their problem and be abel to receive health teachings from student nurses regarding those identified problems and accept the end of the home visits.

Time Allotment


1-3 minutes

5-10 minutes

10-30 minutes


The family will be able to receive health teachings from the student nurses.

The family will be able to verbalized their feelings in facing problems they encouter.

Greeting , showing courtesy.

Discussion, health teachings.

Asking open-ended questions, accepting their opinion, listening.

“Magandang umaga po, nandito naman po kami para interview kayo ulit”.

“ Mainam po na kung naglalaro po ang mga anak nyo ay sa baba na lang po dahil delikado pong akyat baba sila ng hagdanan nyo po”

“Pag may problema po kayo pinaguusapan nyo poi to ng asawa nyo?ano po nararamdaman nyo tungkol dito?



Family, student nurses.

Goal met. The family was able to recognize the arrival of sudent nurses.

Goal met. The family was able to participate in the health teachings rendered by the student nurses.

Goal met. The family said that they can cope up with any problems they encountered.

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10-15 miniutes

5-15minutes

3-5 minutes

The family will be able to receive basic care from the student nurses.

The family will be able to verbalized understanding of health teachings given.

The family will be able to depart ways with the student nurses properly.

VS taking, trimming the nails of the children

Asking them to do return demonstration.

Leaving the family, thanking them

“kukuhan ko po kayo ng BP”

“Sige po maam kayo naman po ang gumawa para mlaman ntin kung naintindihan nyo po.”

“Maam aalis na po kami, heto n po ang huling pagbisita naming.maraming salamat po”




Goal met. The family and student nurse were both occupied with their assessment and interview process.

Goal met. The family was able to show and verbalized understanding on the health teachings given.

Goal met. The family and the student nurses departed properly.

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IX. FAMILY COPING INDEXCategory Description Justification

Physical environment

Use of Community Facilities

Health attitude

Family living

Knowledge to the family

Emotional competence

Poor

Fair

Fair

Poor

Fair

Fair

It is poor because as we noticed, their environment is

not healthy; as the mother verbalized there was an

accident where her son and daughter were victims of

Dengue Fever 1 week ago and hospitalized.

The family uses their available community facilities; they sometimes had checkups in

the community health center. They also use herbal medicine

as alternative medicine.

The family consults to the barangay health center

whenever there is a sick member of the family.

It is related to low income of both parents which does not met the basic needs of the

family. Also sometimes the father didn’t share his income to the family, children are sent to school but their educational supply is not enough to sustain

their studies. They have P300.00 house rental per

month.

The family was able to identify their existing

problems but they cannot do something about it due to

inadequacy of income. But those environmental problems

were tend to sustain by cleaning their backyard

The mother verbalized “nag-aaway kmi minsan, wala ako asahan sa sweldo niya, hindi

yon nagbibigay para sa bayarin dito sa bahay kaya

minssan umuutang na lang ako sa amo ko para pambayad

sa rental ng bahay”. As we observed from the

verbalization of the mother, it only shows that their children

are only relying to her

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Application of the Principles of General hygiene.

Fair

incomes, household chores and other payments.

As we observed, the mother was able to instruct their children to take a bath

everyday but the children were not able to do it properly.

They have dirty nails because they are playing outside and

sometimes they do not performing handwashing.

XI. RECOMMENDATION

FamilyEvery individual has different emotional reaction in terms of their conditions. Through

this we would like to recommend the family to practice a healthy environment by cleaning their backyard to prevent acquiring of vector borne diseases since they already it to their two children. Also their hygiene; they should be taught about the proper hand washing before and after meals and proper bathing to prevent further complications. They should have proper storage of food and water. The emphasis of this is to maintain a clean drinking water and food which is greatly stressed to prevent bacteria and other microorganisms that may jeopardize their health. Finally the Family should impose proper disposal of waste products from them to prevent harmful insects and other pest for this may become their breeding grounds.

College of Health Sciences and Sero Elementary SchoolTo have an illness is a serious public health problem. Most of the people die because of

the food borne and air borne diseases. The most victims are the children and older adults who suffer from gastrointestinal infections. We would like to recommend the College of Health Sciences to double their implementations of health promotion when conducting health education to different schools. This health education should be effective and comprehensive to the pupils so that they can apply what they have learned.

Barangay Health Center The main concern of the public health nurse is the prevention of diseases, prolonging life,

promoting health and efficiency through organized community effort. We would like to tap the Barangay Health Center to facilitate more programs that regards to the sanitation and other health promotion activities that will greatly encourage them to stand on their own since self-reliance is the ultimate goal of the community health nursing. Furthermore, we recommend the Barangay Health Center to have an effective health education to the community so that it would be possible that people would apply what they have learned. We are hoping that they make facilities in the center available to render quality care.

Government The environmental health services of the department are responsible for the promotion of

healthy environmental strategies. The programs will help towards the elimination and control of environmental factors that causes disease transmission to the people of the community. The collaboration from government agencies is important is disease prevention and promotion of health of the members of the family. We would like to catch the attention of the government agencies responsible for the health and livelihood of the residence of this country.

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community health nursing

Documents

years old

focus of health

roman catholic bisaya

family structure

family major

health condition

quality of health

health deficits