Download - akima fcp1
-
8/7/2019 akima fcp1
1/35
1
Liceo de Cagayan University513%OYG&DUPHQ&DJD\DQGH2UR&LW\'SPPIKISJ2YVWMRK
IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS OF NCM5O1205RELATED LEARNING EXPERIENCE (RLE)
Family Case Study
Submitted by:
Akima Grace R. Matias
Submitted to:
Mrs. Sylvia S. Garcia, RN, MAN
December 17, 2010
-
8/7/2019 akima fcp1
2/35
2
TABLE OF CONTENTS
I Introduction 3
a. Overview of the study 4
b. Scope and Limitation of the Study 4
II Spot Map
a. Narrative
III Family Profile 5
IV Family Health History 7
V Present Health Status 8
a. Nursing Review Chart
VI Integrated Management of Childhood Illness 15
VII Home and Environment 18
a. Housing
b. Water Supply
c. Toilet Facility
d. Kitchen
e. Garbage disposal
f. Drainage System
g. Domestic Animals
h. Food Storage
i. Neighborhood
j. Community Facilities
VIII Family Coping Index 21
IX Schematic Diagram 23
X Family Care Plan 25
XI Actual Implementation 28
XII- Recommendation 30
XIII Evaluation 31
XIV Bibliography 32
XV Appendices 33
-
8/7/2019 akima fcp1
3/35
3
I. INTRODUCTION
A. OVERVIEW OF THE STUDY
Community Health Nursing is a unique blend of nursing and public health practice woven
into a human service that properly developed and applied has tremendous impact on human
well being. Its responsibilities extend to the care and supervision of individuals and families in
their home, in places of work, in schools and clinics. It is one of the basic services of health
departments. The community health nurses, as members of the health team, are expected to
integrate within the context of family health care, the priority programs of the Department of
Health.
Everyone has his own definition of what is a family. The meaning of family is different to
every one of us. All definitions adapt to all families. A universal family is a nuclear family. The family
consists of adults of both sexes who are married the adults have biological children and socializes
them. By socializing their children they are transmitting the culture of their generation to their
children. The family helps bring about harmony and integration in society. Other institutions have
nowadays taken on these functions.
Children are usually the reflection of their parents. They carry on whatever they learn from
their parents onto their own. Children need the love and care from both parents, so they will not
feel incomplete. It takes two to have children, and those two should raise the child together with all
the love they have to offer.
The familys major roles are to protect and socialize its members. Among the many functions
it serves, of prime importance is the role of the family plays in providing emotional support and
security to its members through love, acceptance, concern, and nurturing. In addition to providing
an emotionally safe environment for members to thrive and grow, the family is also a basic unit of
physical protection and safety. This is accomplished by meeting the basic needs of its members:
food, clothing, and shelter. Provision of a physically safe environment requires knowledge, skills,
and economic resources. The adult members through employment secure the economic resources
needed by the family.
Family X is an extended family composed of their own two children and parents of the
wifes side. They live at Zone 3 Baikingon, Cagayan de Oro City. They were renting a house that
cost a hundred per month. The head of the family is a government employee as a construction
worker while the wife is a plain housewife.
I chose this family because they fit the required criteria for the family case study such as
the family income is below eight thousand, family that has a maximum of six members with
childrens age from zero to five years, and with a geriatric member. This family has the income
of six thousand to six thousand five hundred a month; they are six in the family; the wifes
parents, the couple and their two children.
The objective of the study is to smooth the progress of putting into practice of family-
oriented nursing care and make certain an organized approach in the delivery of the nursing
services to the families in the community, purposely in the application of nursing process. It
-
8/7/2019 akima fcp1
4/35
4
aims to identify health problem of a family within the community. As student nurses, we could
give and apply some nursing interventions that are applicable and attainable within the
community health services. Also to offer some health teaching strategies for our clients such as:
1.) Visit the health center in their Barangay as a way maintaining health status of the family.
2.) How the environment affects such problem that the family experiencing and,
3.) How can a member of the family team help the family to deal with such problems?
On the later part the actual implementation and health teachings is given means on
setting up and evaluating the care at the family level. And lastly, to show and document the
array of services that nurses provide at the family level.
B. SCOPE AND LIMITATION OF THE STUDY
This study focuses to the prevention of health problems, and promotion of health by the family
X.
The scopes of this study are as follows:
y The family must be a resident of Zone 3, Baikingon CDOC.
y The family must be assessed and cared for by the student in-charge for at least 6 visits.
y The students must have the consent coming from the family to make them the subject
of the study.
y The scope of the study includes the family members personal and health profile and
spot map of their residence, the chief complain of the family member with a health
problem and the family members, the history of present illness of the member with a
health problem, the nursing assessment, the family coping index, the integrated
management of childhood illness, the family health plans and the actual implementation
of different interventions given to the family.
y The different references were also part of this study, which encompasses the use of the
different community health nursing books, nursing care plan books and other sources
which served as guide throughout the study.
II. SPOT MAP (Narrative)
From the point of reference which is Liceo De Cagayan University, we used a private vehicle
during our travel and paid 50.00 php each student back and forth but when riding a public
utility vehicle, the terminal is situated in the northwest of the cogon market. The fare for adults
is 40.00 php and for students senior citizen is 38.00 php. We did not follow the route of the
public utility vehicle going to Baikingon. We started out travel by passing through the National
Highway and passed by many landmarks such as Makro, RER, and other landmarks that isfamous within the busy streets of the National Highway. We passed through the Bulua gym,
and went straight ahead until we arrived at the bridge of the Iponan River and went straight
ahead again and followed the dusty and rocky roads going to Baikingon. Approximately we
travel about 14 kilometers from the point of reference to the area of destination which is
Baikingon and the travel time is approximately 30-45 minutes. The roads were dusty and some
were well cemented but the travel was worthwhile and enjoying.
-
8/7/2019 akima fcp1
5/35
5
III. FAMILY PROFILE
Head of the familyName : R. B
Position in the family : Husband
Gender : Male
Age : 25 years old
Civil status : Married
Birth date : May 27, 1985
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation : Construction Worker
Monthly income : Php 6000
Mother
Name : J. N
Position in the family : Wife
Gender : Female
Age : 24 years old
Civil status : MarriedBirth date : May 8, 1950
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation : Housewife
Monthly income : None
Grand father
Name : A. N
Position in the family : Grandfather
Gender : Male
Age : 63 years old
Civil status : Married
Birth date : August 31, 1947
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation : None
Monthly income : None
-
8/7/2019 akima fcp1
6/35
6
Grand mother
Name : N. Y
Position in the family : Grandmother
Gender : Female
Age : 57 years old
Civil status : Married
Birth date : July 12, 1953
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation : None
Monthly income : None
Son
Name : M. B
Position in the family : Son
Gender : Male
Age : 4 years old
Civil status : Child
Birth date : August 31, 2006
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation :None
Monthly income : None
Daughter
Name : M. B
Position in the family : Daughter
Gender : Female
Age : 3 years old
Civil status : Child
Birth date : August 14, 2007
Birth place :Cagayan de Oro City
Citizenship : Filipino
Religion : Roman Catholic
Occupation : None
Monthly income : None
IV. HEALTH HISTORY
Mr. R. B
-
8/7/2019 akima fcp1
7/35
7
Mr. R. B is 25 years old and currently resides in Zone 3, Baikingon, Cagayan de Oro City.
He works as a construction worker whose income is just enough for their family. He was
delivered through a Normal Spontaneous Vaginal Delivery. According to Mr. R. B he had
completed his immunization. He does not have any food and drug allergies. And he cant
remember anyone from his parents and grandparents having serious illnesses that he might
inherit. He cannot recall of having any serious illnesses in the past six months. But he
remembered of having cough and colds due to climate change. He left it untreated without
taking any medications. He was never been confined nor brought to a hospital for treatment.
Mrs. J. B
Mrs. J. B is 24 years old and a plain housewife. Her menarche began when she was 13
years of age. Her 2 children were delivered at Health Center through Normal SpontaneousVaginal Delivery (NSVD) with no complications noted during the course of pregnancy, labor, and
delivery. She had prenatal checkups at the Barangay health center. She was able to breastfeed
her children. According to Mrs. J. B she was not been confined to a hospital before and nor
experienced any serious illness. Just like her husband she only experienced cough, and colds,
which were just treated by self-medication, such as over the counter drugs.
Mr. A. Y
Mr. A. N is 63 years old and resides in Zone 3, Baikingon. He has a hearing problem and
first noticed it when he was in high school it was from his mother side and due to due to the
financial constraints his disease was not able to treat his illness. He had been hospitalized in JR
Borja Hospital for his hypertension and was given Captopril for his home medication but due to
the side effects like dizziness he stops taking the medication.
Mrs. N. Y
Mrs. N. Y is 57 years old and an old resident of Baikingon. She had 2 children and
delivered them through a Normal Spontaneous Vaginal Delivery. She was not able to recall any
past illnesses and was never been hospitalized or brought for treatment. She denied of having
any heredofamilial disease. But she recalled of having cough and colds few weeks prior to our
visit.
Child M. B
M. B is 4 years of age and the eldest child in the family. He was born in the health
center through a Normal Spontaneous Vaginal Delivery. He was normal and had no
complications noted. He was also completed his immunization. And was never been brought to
the hospital or experienced any serious illnesses. According to his mother he experienced fever,
cough, and colds days prior to our fist assessment. He was treated with paracetamol for 2 days.
Child M. B
-
8/7/2019 akima fcp1
8/35
8
LEGEND: Day 1 Day2 Day3 Day4 Day5 Day6
M. B is 3 years old and resides in Zone 3, Baikingon. She is the youngest in the family
and was delivered through a Normal Spontaneous Vaginal Delivery in the Health Center. She
had completed her immunization and was never been brought to the hospital for treatment.
Like her brother she also experienced cough and cold but without fever. She was not able to
take any medications according to her mother.
V. PRESENT HEALTH STATUS
Part A.
Father
During the visit, Mr. R.B was warm to touch and the vital signs are within normal range.
He doesnt show any signs of being sick. He is participative and cooperative. He is an
occasionally drinker.
Mother
During the visit, Mrs. J.B was warm to touch. Her upper teeth are lacking. She has no
vices. She was also participative and cooperative to us during our visit. She also doesnt have
any chronic disease and medications maintain.
Grandfather
During the visit, Mr. A.Ys BP was 130/80mmHg, and it is already in the pre-hypertensive
stage, and he stated that when he is at work or doing something strenuous, he feels a sudden
neck pain, and when he goes to the health center, his BP rises to 140/100 mmHg. He is
maintaining medications before but had stop taking captopril lately because he feels
drowsiness. He said that it started when he was still 25 years old and because he was smoking
at least 1 pack of cigarette a day, and is not physically active, he was not surprised to have this
illness.
Grandmother
During the visit, Mrs. N.Y was not sick and doesnt show any signs of being sick, she is
very cooperative and responsive. She is well and doesnt have any vices; she is also not
maintaining any medications for a chronic disease.
Children
During the visit, their children were having colds, and the eldest was the first who got
it and passed it to the youngest. It started last November, and their mother said its because of
the climate change. They were not taking medicines for it, because their mother said its only
normal for their age, she will just give her children more water and soup in meals. They dont
have any vices yet for their still child.
Part B. Nursing system review chart
-
8/7/2019 akima fcp1
9/35
9
PHYSICAL ASSESSMENTName:A.Y
Vital Signs:PR:76bpm/78/72/76/78/78 RR:20cpm/22/20/24/22/20;
BP:130/80mmHg/130/90/140/90/130/90/130/90/140/90;Temp:36.5C/36C/37.2/37/37.2/36.4 Height:56 ft ; Weight: 65 kg
EENT:[ X ] blurred vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ X ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [ ] teeth
Assess eyes ears nose throat for abnormality [ ] no problem
RESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest
[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum
[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored[ ] wheezing [ ] pain [ ] cyanoticAssess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ X ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [] No problem
GASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problem
GENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problem
NEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ ] hot [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ X ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [X] No problem
Blurredvision(firstvisit upto
lastvisit)
Hardofhearing
BP:
130/80mmHg,130/90,
mmHg,140/90mmHg,13
0/90mmHg,130/90mmH
g
Joint pain
-
8/7/2019 akima fcp1
10/35
10
PHYSICAL ASSESSMENT
Name: N.YVital Signs:PR: 80bpm/76/72/74/72/78 ; RR20: 18cpm/20/22/20/18/ ; BP: 90/70mmHg/90/70/
100/70/90/70/90/70/9070 ; Temp: 36.2C/ 36.5/36.8/37.2/37/37.2 ; Height: 52 ; Weight: 37kgEENT:[ ] impaired vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [] teeth
Assess eyes ears nose throat for abnormality[x]no problem
RESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored[ ] wheezing [ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [x] No problem
GASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problem
GENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problem
NEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ ] hot [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [X] No problem
Skin warm
to touch,
skin warm
to touch
-
8/7/2019 akima fcp1
11/35
11
PHYSICAL ASSESSMENTName: J.BVital Signs:PR: 86bpm/82/82/86/86/84; RR: 22cpm/20/18/20/20; BP:100/90100/80/100/90/110/80/100/80/11080 Temp:
37.3C/36.5C/37.2C/37/36.8/37;Weight: 40kg Height: 52EENT:[ ] impaired vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [ X ] teeth
Assess eyes ears nose throat for abnormality [ ] no problemRESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored[ ] wheezing [ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [x] No problemGASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problemGENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problemNEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ X ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [ ] No problem
Upper teeth
lacking
Skim warm
to touch,
Skin warm
to touch
-
8/7/2019 akima fcp1
12/35
12
PHYSICAL ASSESSMENTName: R.BVital Signs:PR: 88bpm/90bpm/86bpm/92/88/86 ; RR: 24cpm/20cpm/22cpm/20/22/22; BP: 120/90mmHg/ 110/90mmHg/ 120/90mmHg/110/80/120/80/110/80 ; Temp:
37.4C/36.8C/36.3C/37.2/36.5/37.2 ; Height: 57 Weight: 64klsEENT:[ ] Impaired vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [] teeth
Assess eyes ears nose throat for abnormality[x]no problem
RESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored
[ ] wheezing [ ] pain [ ] cyanoticAssess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [x] No problem
GASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problem
GENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problem
NEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ X ] hot [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [ ] No problem
Skin
Warm to
touch,
Skin
Warm to
touch,
Skin
Warm to
-
8/7/2019 akima fcp1
13/35
13
PHYSICAL ASSESSMENTName: M.Y (eldest)Vital Signs:PR: 94bpm/90bpm/90bpm/92/88/96 ; RR: 24cpm/20cpm/22cpm/20/22/22; BP: noneTemp: 37.2C/36.9C/36.5C/36.3/37.4/37.2 ; Height: 3ft Weight:12kg
EENT:[ ] Impaired vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [] teeth [ X ] Colds
Assess eyes ears nose throat for abnormality[x]no problem
RESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored[ ] wheezing [ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [x] No problem
GASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problem
GENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problem
NEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ X ] hot [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [ ] No problem
Colds
Skin
warm to
touchSkin
warm to
touch,
Skin
warm totouch
-
8/7/2019 akima fcp1
14/35
14
PHYSICAL ASSESSMENTName: M.Y (youngest)Vital Signs:PR: 9obpm/94bpm/96bpm/92/90/96 ; RR: 24cpm/22cpm/20cpm/20/22/22; BP: noneTemp: 37.2C/37.3C/36.5C/37.4/36.5/36.6 ; Height: Weight:
EENT:[ ] Impaired vision [ ] blind [ ] pain redden [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [] teeth [ X ] Colds
Assess eyes ears nose throat for abnormality[x]no problem
RESP:[ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough[ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum[ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored[ ] wheezing [ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern, breath sounds, and comfort[x] No problem
CARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses[ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] pain, Assess heart sounds, rate rhythm,Pulse, Blood Pressure, circ., fluid retention, comfort [x] No problem
GASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing, bowel sounds, and comfort[x] No problem
GENITO URINARY AND GYNE[ ] pain [ ] urine colour [ ] vaginal bleeding [ ] hematuria[ ] discharge [ ] nocturia, Assess urine frequency, control,Colour, odor, comfort, gyne bleeding, discharge [x] no problem
NEURO:[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,Grip, gait, coordination, orientation, speech[x] No problem
MUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ X ] hot [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [ ] cool [ ] deformity[ ] wound [ ] rash [ ] skin colour [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis[ ] diaphoretic [ ] moist
Assess mobility, motion, gait, alignment, joint function Skin colour, texture, turgor, integrity [ ] No problem
Colds
Skin
warm to
touch,
Skin
warm to
touch,
Skin
warm to
-
8/7/2019 akima fcp1
15/35
15
VI. INTEGRATED MANAGEMENT of CHILDHOOD ILNESSES
Childsname:M. B Age: 51 months oldSex:Male Weight:12 kilogram Temp: 36.5C, 36.7C,37.2C, 36.9CASK: What are the childs problems? Cold
Initial visit? _____ Follow-up visit? _
_
ASSESS CLASSIFYCHECK FOR GENERAL DANGER SIGNS
NOT ABLE TO DRINK OR BREASTFEEDVOMITS EVERYTHINGCONVULSIONSABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN
YES__NO
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? Yes_ No_For how long?
y Count the breaths for one minute. _21_breaths per minute. Fast breathing?y Look for chest indrawing?y Look and listen for stridor.
No Pneumonia:Colds
DOES THE CHILD HAVE DIARRHEA? Yes___ No
For how long? ___days
Is there blood in the stools?
y Look at the childs general condition.
Abnormally sleepy or difficult to awaken?
Restless or irritable?
y Look for sunken eyes.
y Offer the child fluid. Is the child:
Not able to drink or drink poorly?
Drinking eagerly, thirsty?
y Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds)?
Slowly?
No Dehydration
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) Yes__ No_
Decide Malaria Risk
y Does the child live in malaria area? No
y Has the child visited a malaria area in the past 4 weeks? No
If malaria risk, obtain a blood smear.
y Look or feel for stiff neck.
y Look for runny nose.
+ Pf Pv - Not done
y For how long has the child had fever? __days
y If more than 7 days, has fever been present every day?
y Has the child had measles within the last 3 months?
Look for signs ofMEASLES
y Generalized rash and
y One of these: cough, runny nose. Or red eyes.
If thechild hasmeaslesnoworwithin thelast 3 months:
y Look for mouth ulcers
If yes, are they deep and extensive?
y Look for pus draining from the eye
y Look for clouding of the cornea.
Decide Dengue Risk: Yes__ N o_
_
If dengue risk, then ask:
y Has the child had any bleeding form the nose or gums or in the vomitus or stools?
y Has the child had black vomitus or black stool?
y Has the child had abdominal pain?
y Has the child been vomiting?
y Look for bleeding from nose or gums
y Look for skin petechiae.
y Feels for cold and clammy extremities.
y Check capillary refill ___seconds.
y Perform tourniquet test if child is 6 months or older and has no other signs and has fever for
No Fever:
No Malaria
-
8/7/2019 akima fcp1
16/35
16
y More than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No_
y Is thereearpain?
y Is thereeardischarge?
If yes, forhowlong? ___days
y
Look forpusdraining from theeary Feel for tenderswelling behind theear.
No Ear Infection
THEN CHECK FOR MALNUTRITION AND ANEMIA
y Look for visible severe wasting.
y Look for edema of both feet
y Look for palmar pallor.
Severe palmar pallor? Some palmar pallor?
y Determine weight for age
Very Low? Yes, underweight.
No Anemia but
underweight
CHECK THE CHILDS IMMUNIZATION STATUS completely immunized
Record lost _________
(Date)
CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or older
Is the child six months of age or older? Yes_
_ NO__
_March 2007
Has the child received Vitamin A in the past six months? Yes__ No_
Vitamin A needed
today
Yes_
No__
ASSESS CHILDS FEEDING ifchild has ANEMIA OR VERY LOW WEIGHT orless than 2
yearsold.
y Do you breastfeed your child? Yes___ No____
If Yes, how many times in 24 hours? ___ Times. Do you breastfeed during the night? Yes___
No__
y Does the child take any other food or fluids? Yes__ No___
If Yes, what food or fluids? Rice, vegetables, fish. And meat. Water, juice, coke
How many times per day? 3 times. What do you use to feed the child? Spoon ,fork, plate
If very low weight for age: How large are servings?10-15 spoons per meal
Does the child receive his/her own serving? Yes
__ who feeds the child and how? child himself
y During the illness, has the childs feeding changed? Yes __ No___
If yes, how? Decrease
Feeding Problems:
ASSESS OTHER PROBLEMS: none
IMCI MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS
Childsname:M. B Age: 39 months oldSex: Female Weight:15 kilogram Temp: 37.2C_
ASK: What are the childs problems? NoInitial visit? _____ Follow-up visit? _
ASSESS CLASSIFYCHECK FOR GENERAL DANGER SIGNS
NOT ABLE TO DRINK OR BREASTFEEDVOMITS EVERYTHINGCONVULSIONSABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN
YES__NO
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? Yes_ No
_For how long?
y Count the breaths for one minute. _27_breaths per minute. Fast breathing?y Look for chest indrawing?y Look and listen for stridor.
No Pneumonia:
DOES THE CHILD HAVE DIARRHEA? Yes___ No__For how long? ___daysIs there blood in the stools?
y Look at the childs general condition.Abnormally sleepy or difficult to awaken?Restless or irritable?
y Look for sunken eyes.y Offer the child fluid. Is the child:
No Dehydration
-
8/7/2019 akima fcp1
17/35
17
Not able to drink or drink poorly?Drinking eagerly, thirsty?
y Pinch the skin of the abdomen. Does it go back: Very slowly (longer than 2 seconds)?Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) Yes__ No_Decide Malaria Risk
y Does the child live in malaria area? Noy Has the child visited a malaria area in the past 4 weeks? No
If malaria risk, obtain a blood smear.y Look or feel for stiff neck.y Look for runny nose.
+ Pf Pv - Not doney For how long has the child had fever? __daysy If more than 7 days, has fever been present every day?y Has the child had measles within the last 3 months?
Look for signs ofMEASLESy Generalized rash andy One of these: cough, runny nose. Or red eyes.
If thechild hasmeaslesnoworwithin thelast 3 months:
y Look for mouth ulcersIf yes, are they deep and extensive?
y Look for pus draining from the eyey Look for clouding of the cornea.
Decide Dengue Risk: Yes__ N o
_
If dengue risk, then ask:y Has the child had any bleeding from the nose or gums or in the vomitus or stools?y Has the child had black vomitus or black stool?y Has the child had abdominal pain?y Has the child been vomiting?y Look for bleeding from nose or gumsy Look for skin petechiae.y Feels for cold and clammy extremities.y Check capillary refill ___seconds.y Perform tourniquet test if child is 6 months or older and has no other signs and has fever fory More than 3 days.
No Fever:No Malaria
DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No_y Is thereearpain?y Is thereeardischarge?
If yes, forhowlong? ___days
y Look forpusdraining from theeary Feel for tenderswelling behind theear.
No Ear Infection
THEN CHECK FOR MALNUTRITION AND ANEMIA
y Look for visible severe wasting.y Look for edema of both feety Look for palmar pallor.
Severe palmar pallor? Some palmar pallor?y Determine weight for age
Very Low? Yes, underweight.
No Anemia normalweight
CHECK THE CHILDS IMMUNIZATION STATUS completely immunizedRecord lost _________
(Date)
CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or olderIs the child six months of age or older? Yes_
_ NO__
_ June 2008Has the child received Vitamin A in the past six months? Yes__ No_
Vitamin A neededtodayYes_No__
ASSESS CHILDS FEEDING ifchild has ANEMIA OR VERY LOW WEIGHT orless than 2yearsold.
y Do you breastfeed your child? Yes___ No____If Yes, how many times in 24 hours? ___ Times. Do you breastfeed during the night? Yes___No__
y Does the child take any other food or fluids? Yes__ No___
If Yes, what food or fluids? Rice, vegetables, fish. And meat. Water, juice, cokeHow many times per day? 3 times. What do you use to feed the child? Spoon ,fork, plateIf very low weight for age: How large are servings?1.5 cups per mealDoes the child receive his/her own serving? Yes
__ who feeds the child and how? child herselfy During the illness, has the childs feeding changed? Yes __ No___
If yes, how? Decrease
Feeding Problems:
ASSESS OTHER PROBLEMS: none
-
8/7/2019 akima fcp1
18/35
18
VII. HOME AND ENVIRONMENT
A. HOME AND ENVIRONMENT
HOUSING
They rent their house with a 100php a month, constructed with woods and their roof
made of nippa. The area of their house is not enough to occupy six persons because the
limited space that the house has. They only have one room that is used by the couple
for sleeping while the grandparents utilized the space outside the room which is also
used as the dining area during meal time together with their grandchildren. The house is
not thoroughly clean and things are not properly arranged due to limited space, they
dont have drainage. But still, the house is not hazardous because it doesnt have a
stairs and other unfinished construction. The distance to the neighbor is very near
because they are just renting and constructed their using the firewall of the neighbor as
their wall.
B. WATER SUPPLY
The source of their drinking water is from their own faucet and sometimes there is no
water, because they are just tapping water from the neighbor. They store it in a 4 liter
water container with cover. Regarding the source of the drinking water it is considered
as not safe since they were not practicing proper boiling of the water before consuming
C. TOILET FACILITIES
-
8/7/2019 akima fcp1
19/35
19
The family doesnt have their own toilet and they are using the neighbors CR and two
families are using it, and the type is water-sealed, and it is located at the back of their
house, approximately 10 meters. The toilets odor is not that offensive
D. KITCHEN
They have a dirty kitchen inside their house and is located at the side of their house.
They are using wood for cooking rice and vegetables in a small pot. They store their left
over foods in the plastic container and just on top the table.
E. GARBAGE DISPOSAL
The Yanez family was disposing their garbage by means of burning it all in their
backyard. The government facilities that were assigned on collecting the garbage were
not able to reach the barangay area thats why the community decided to just burn all
their garbage. The family was not practicing garbage segregation before burning them.
-
8/7/2019 akima fcp1
20/35
20
F. DRAINAGE SYSTEM
The Yanez family does not have any drainage system in their house surroundings; the
draining water just goes directly to the soil ground outside their house.
G. DOMESTIC ANIMALS
The family has a dog and a derby chicken. The dog is tied under their sink, partly inside
the house, and defecates and urinates where he is tied, the family just bury the dogs
feces and cover the urine with soil. The derby chicken is the head of the familys pet; it
is tied inside their house.
H. NEIGHBORHOOD
The familys house is located across the barangay hall, the distance of each house is
very close, and some are built with only one wall apart. The families in that specific
place are already very familiar with each other. The house is very near from the health
center, approximately 100 meters away.
I. COMMUNITY FACILITIES
The house is very close to the barangay hall, approximately 30 meters away. It is also
very near to the school where their kids studied which is the beside Baikingon
Elementary school, the school also located the barangay covert court where in all
community program are being conducted. The health center also is very accessible
because of its distance; it is just a 100 meters away from their house.
-
8/7/2019 akima fcp1
21/35
21
VIII. FAMILY COPING INDEX
The objective of this indicator is to present a benchmark for approximating thenursing needs of a particular family, thus Family Coping Index. It is the coping capacityand not the underlying problem that is being rated, and it is designed to record family
rather than individual coping capacity. In public health nursing, the family cannot beseen only as a factor that affects health; rather, the family is the patient.
Legendary:5 Complete competence
3 Moderate competence1 No competence
9 Areas ofNursing
Concerns
Rating Justification Statement
1. PhysicalIndependence 5
The members are all able to move without assistanceand difficulty. They do their activities of daily livingwithout aid. They are independent in moving aboutand using their musculoskeletal system but there isone member of the family with abnormalities in thephysical independence (Mrs. A.Y).
2. TherapeuticCompetence
3 The parents are aware on what to do if a memberfells ill. Although, the distance of the health center isnear but because of financial problems that's whythey cannot provide enough and/or appropriateinterventions. The parents are aware of their lapsesin therapeutic competence. They are aware of theirfinancial difficulties, which is the primary reason fornot having or following the appropriate procedure ortreatment, having appliances and even enoughclothes for the children.
3. Knowledge ofHealth Condition
3 The mother is knowledgeable on salient health issuesand responsibilities. Yet due to financial problems,health issues are overlooked. But as a mother sheconsiders immunization as essential for her childshealth. Immunization of the children was complete.
4. Application ofPrinciples of
General Hygiene
3 . The family sleeps well but sometimes they dont eatnutritious foods. Their source of water is from faucet
which is only available at the barangay hall. They donot practice sterilization or healthy habits in foodstorage and preparation. Even though aware ofhygienes importance, the family does not practicegood hygienic skills. Yes they take a bath everydaybut their source of water for bathing and washingclothes are from barangay hall water source and isnot available sometimes., eating habits andmaintenance of healthy lifestyle are not taken intoconsideration that much.
-
8/7/2019 akima fcp1
22/35
22
5. HealthAttitudes
3 The parents are concerned about the health of themembers of the family yet they do not participateactivelyin maintaining optimum health due to financial
constraints. Also, the family lacks informationregarding healthy lifestyle and healthful ways towardimprovement of life. Parents, as much as possible,want to protect their children from any harm butthen, they lack money and information for them tocarry out the right health care for the family.
6. EmotionalCompetence
5 The family are competent enough emotionally. Theycan manage their own problems and also handlestress just like any other family does. The parents
take responsibility their only child and to theirextended family. They also discipline and teachalways their children the morals of life. The familylives harmoniously at home. Even though conflictsarise, they really see to it that they would discusseach concern in a calm manner.
7. Family Living 3 There is high concern within the family, especiallywith regards to their interrelationship with others.The parents discuss decision- making. The child is not
yet open for suggestion to decision-making since theyare still young and difficult to comprehend theircurrent situations. Others respect individualrelationships of each member of the family Decision-making is shared among its members except onyoung member. Each has his or her own part or rolein the family, which is well respected.
8. PhysicalEnvironment -
3 The familys house space is not good enough for thefamily.They cook their food inside their housewherein they just use earthly pot and used wood asfuel. They live in a place wherein its not congestedbut then the distances between their neighbours arenot that so far from each other. The houseenvironment is not fitted for them , because of thepresence of pests and accident hazards in theircommunity. Also their house is in poor condition, thatthey can possibly acquire serious diseases. Their food
storage is unsanitary. Though it is covered with cloth,sometimes insects and other small animals couldcrawl inside the dish organizer.Having a earthy pot used for cooking inside thehouse is really a fire hazard because some of the coalfire might come in contact with their wood wall.
9. Use ofCommunityFacilities
3 The mother is aware of the available resources in thecommunity, both in health and education. But theycannot utilize the health facilities due to busy doinghousehold chores. They go to the health center ifneeded.
-
8/7/2019 akima fcp1
23/35
Family Health
Schematic Presentation of Family Health Proble
Mother seldom attends
community meetings and
gatherings in thezone.
Political
Socio-Cultural Factors Biological Factors
Economic
Income: Php 6,000/month
Father: Construction Worker
Mother: Housewife. She doeshousehold chores and takes care The familys knowledge
about some service providedby the barangay healthcenter is limited only.Financially unstable family, the
couples income is not enough to
support the small family as a
Foreseeable Crisis.
Health threat: the
to performing
practices in dealin
-
8/7/2019 akima fcp1
24/35
Biological Factors
Genetic Physical
*Poor Personal Hygiene*Hypertension Paternal side
There is a possibility that their
offspring will acquire the
disease.
The family is prone of havingdiseases.
Genetic Hypertension as a
Health Threat
Poor Personal Hygiene as a
Health Threat
-
8/7/2019 akima fcp1
25/35
Environmental Factor
Housing H2O H2O Toilet
The house was
not well
constructed.
There drinking
water is not
sterilized
They have a
communal
toilet.
There source
of water is
through a
faucet found in
the barangay
hall.
The family is
unable to
maintain good
hygiene
The family is
prone to accidentsThey have the
possibility of
acquiring water
borne diseases
They have less
privilege to use
the toilet
Health Threat:
*Accident hazard:
Presence of sharp and pointed objects*Fair home and environmental sanitation and condition:
Inadequate living space
Polluted water supply
-
8/7/2019 akima fcp1
26/35
Priority number 1:
CUES
HEALTH
PROBLEM
FAMILY NURSING
PROBLEMS
GOAL OF
CARE
OBJECTIVES OF
CARE
INTERVENTION
MEASURES
Subjective
igo-igorapudangkita
saakobana,dili judsiya
ina.ana ka daku pang
suportasapamilya as
verbalizedby themother
Objective:
Income P6,000 per
month
Presence of
Low family
income as a
foreseeable
crises
Inability to provide
home environment
conducive to health
maintenance and
personal
development due
to:
y Inadequate
family
resources,
specifically:
y Financial
constraints/limit
ed financial
resources
At the end of
3 days of visit,
The family will
find enough
resources
that could
sustain family
health needs.
At the end of
nursing
intervention the
family will Identify
ways to utilize
family income
wisely and earn
money from extra
work.
y Encouraged the fam
to find additional way
to earn money.
y Encouraged family
prioritize needs. Foo
should always b
available especially f
their child.
y Encouraged the fam
to minimiz
unnecessary
spending like buyin
junk foods.
Family Care Plan
-
8/7/2019 akima fcp1
27/35
CUES
HEALTH
PROBLEM
FAMILY
HEALTH
PROBLEM
GOAL OF
CARE
OBJECTIVES OF CARE INTERVENTIONS
MEASURE
M
O
FA
C
SUBJECTIIVE:
Sa reservoir rame didto
sa barangay ga kuha ug
tubig para imnon as
verbalized by the client
OBJECTIVE
Unboiled
drinking
water
Un cleaned
drinking
water
container
Unsafe
drinking
water as
health
threat
Inability to
recognize
possible
health
threats
on unsafe
source of
drinking
water and
practices
At the end of
3 days the
family will be
able to obtain
necessary
measures to
prevent
acquiring
diseases
from the
unsafe
source of
drinking
water and
practices.
At the end of nursing
intervention the family will
be able to:
a.) Filter first the
water from the
reservoir
b.) recognize the
importance of
boiling drinkingwater first before
consuming
c.) Clean the
drinking water
container
regularly and
cover it properly
d.) Avoid exposing
the container to
sun light rays to
prevent
formation of
algae
1.) Encourage thefamily to filter the
water by using,
such as: clean
clothes, water
filterer
2.) Educate the
family to boil
water for 10 to
15 minutes
3.) Inform the familyto use clean and
well cover
container
4.) Instruct them to
place the
container in a
place that cannot
easily seen by the
sunlight
H
V
-
8/7/2019 akima fcp1
28/35
Priority number 3:
CUES
HEALTH PRBLEM FAMILY NURSING
PROBLEMS
GOAL OF
CARE
OBJECTIVES OF
CARE
INTERVENTION
MEASURES
Subjective:
y Grabe jud ang
basura dani,
gasunogon
nako para ma
kuhaan
Objective:
y Garbage isscattered
around the
house
y The backyard is
infested with
flies
Improper garbage
disposal as a
Health Threat
Inability to provide a
home environment
conducive to health
maintenance and
personal development
due to:
a. frustration felt
caused bythe recent
natural
calamity
b. Inadequateknowledge of
the
importance
of hygiene
andsanitation.
After nursing
intervention,
the family will
improve their
means of
disposing
garbage.
After nursing
intervention, the
family will be able
to:
a.) recognize that
improper garbage
disposal is a health
hazard and is
unfriendly to the
environment
b.) consider other
means of garbage
disposal
1. Discuss with the
family the importance
of proper garbage
disposal
2. Discuss alternative
ways in disposing
garbage.
3. Discuss the threat
that vectors such as
flies could pose to their
health.
4. Encourage the
family to rise above
the calamity they
encountered
-
8/7/2019 akima fcp1
29/35
29
IX. ACTUAL IMPLEMENTATION
First Visit
During my first day of visit, I introduced myself to the family, stated the purpose &
duration of visit, and established good rapport with them. I interviewed the family with regardsto the names, birthdays, educational attainment, occupation, monthly income, religion, and
heredo-familial diseases of the family. We took their vital signs and were able to do physical
assessment. Unfortunately I wasnt able to interview and take the vitals of the head of their
family since he was with his job.
We gave partial health teachings regarding proper hygiene as well as sanitation. The family
was able also to understand the teachings. I also examined the weight of their children and
assess with the use of IMCI.
Second visit
I still could not see any changes in the family since the house was still untidy, their
children were wearing dirty clothes and havent taken a bath yet, so again we told the family
that they need to have their house clean if they want to have a clean environment, free from
any diseases. The mother was encouraged to provide a food that are nutritious like vegetable
and fruit and avoid junk foods.
I also imparted additional health teachings with regards to management of the grand
fathers disease condition we stressed out the importance of avoidance of caffeine beverages
and smoking cessation. Also I taught pt on boiling lemon grass as alternative regimen for his
HPN.
Third visit
I was able to see some changes with regards to the surroundings of the family. Grasses
were cut very short in frontage and the mother cleaned the house. As I continue to inspect
every detail of the house, its fulfilling to the part of the student nurse that they were listening
and willing to cooperate in fulfilling the objectives of this care study.
I was able to stay long with the family and unfortunately I wasnt able to meet the head
of the family because of the same reason. And I instructed them again to go to the health
center to avail free medication, regular check- up and prenatal check up then I invited them to
attend our culminating activity.
Fourth Visit
I provided health teachings related to environmental sanitation and how to fix their
garbage by not throwing it anywhere or burning them up because it can affect the respiratory
system of the residents and specially the young children that are playing near their house. I
associated learning to them behind the importance of environmental sanitation and the benefits
that will gained towards the proper disposal of their garbage. I also evaluated them with the
activities that were given during the culminating activity and the essential knowledge and skills
that would help the family generate an income; we did not stayed for long and bid farewell to
the family leaving them with teachings that would uplift their lifestyle.
-
8/7/2019 akima fcp1
30/35
30
Fifth Visit
I instructed the family to conscious enough in food handling because they have a higher
risk for diseases because of improper food handling. Even they dont have enough utensils to
provide enough food for the family as well as to keep their food safe from any foreign vectors
that could bring bacteria that may contaminate the food during the course of cooking. Also the
person cooking the food must also be aware of the cleanliness of his/her hands because he/she
is directly involve with the food, in other words hes the one holds, prepares and cooks the food
for everybody. These factors can affect to the consistency of the food and its patency to be
safe enough and to be consumed.
Sixth Visit
I ended our last visit with a productive one, were we gathered all the necessary
teachings for the family. I provided them with knowledge pertaining the disease that may
occur in each of the family member. I explained the causes of diarrhea and how to prevent and
how to cure it when one of them has it. We taught the client about making a homemade
oresol. We taught the family the ways of making it, by using a tablespoon of salt, 8 teaspoon
of sugar and one liter of sugar. We explain the importance of the homemade oresol and the
means of using it, also we included the important thing about this regimen that it can be only
be effective with the span of 24 hours and if the diarrhea is still present, the family must make
a new mixture to replace the fluids and electrolytes that were lost during the excretion of the
feces. We also gave health teachings to the management of their domestic animals and the
disadvantages that the family could acquire if they dont properly anticipated the risk for freeing
their pets and it could provide a big problem to each member of the family if they dont tie
them up and secure them in an area away from their children and to the other residents.
X. RECOMMENDATION
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:
y The family should maintain a healthy and clean environment. They must clean their
surroundings to avoid the presence of vectors of diseases.
y The family should also maintain proper hygiene such as taking a bath regularly, trimming
their nails, frequent changing of clean clothes especially when come in contact with filthy
objects or experienced wetness of the back, refraining from walking barefooted, brushing of
teeth frequently, and proper and regular hand washing.
y They must also reorganize their cooking practices in terms of food preparation and handling
as well as keeping their kitchen utensils in a covered storage to avoid getting it
contaminated by insects or pests. In addition to that, they should also cover their food
storage.
-
8/7/2019 akima fcp1
31/35
31
y The family should also be advised to not wait for the ailment to become severe before
seeking medical help.
y The family must also be educated and follow the proper preparation of herbal medicines as
it was presented during the mothers class.
y The family should persevere to perform proper waste segregation and disposal of their
garbage as it was presented during the mothers class.
y The family should be aware that organizations in the community are open and present for
their problems to be addressed properly.
yThey should be encouraged to verbalize their concerns with regard to the community so
that resolutions can be made.
XI. EVALUATION
Although some short comings were not thoroughly anticipated during the care of the
family as well as referral was not very successful due lacks of time, still were able to care to the
concerned family.
There were no difficulties encountered as to the family members attitude because they
were participative and accommodating throughout the care rendered to them. In the client care
process, several interventions were done as well as health teachings. This includes the
appropriate care for the disease conditioned, information drive or further research and
education which concerns of health care and health related conditions. As well as other health
tips were emphasized to the concerned family, these were discussed as to anticipate the care of
the individual and the family as a whole.
During the termination phase, the family said their thanks for the health teachings that
were imparted to them. The objectives of this study was met, related factors that affected the
familys health was identified. Referral and appropriate interventions was provided to the family.
The objectives of the study were successfully met; health promotion and prevention of disease
was implemented as part of this study. As part of the implementation Proper referral and
interventions were done.
Poverty exists everywhere and although there are a lot of factors to consider, the
attitude of a person is really important. Poverty pushes these people to live into that type of
life status. The lack of income and financial constraints puts health as the lowest priority in
their day to day living exposing them to risk to different kinds of diseases.
It was total different experience on my part to be exposed in the Community and all its
actuality and candidness, learning the intricacies of community health nursing was more
worthwhile and full of appreciation. Previously we have one-sided view about nursing care, but
everything was changed soon after we grasped the idea of community nursing. This fact made
us realized that although the period covered for our exposure is inadequate if we truly want to
render effective health service, yet we could evaluate everything that transpired as within
satisfactory. We admit that the client who is subject of our study made all things possible for
us to learn what we need to know and what we supposed to gain in the field of community
nursing.
-
8/7/2019 akima fcp1
32/35
32
XII. BIBLIOGRAPHY
Maglaya, Araceli(2004). Nursing Practice in the Community. 4th edition. Argonauta
CorporationMarikina City
IMCI (Integrated Management of Childhood Illness) Chart Booklet. 2009 edition.
Sr. Jimenez, Carmen (2008). Community Organizing Participatory Action Research
(COPAR) for
Community Health Development. C& E Publishing, Inc. Quezon City
Cuevas, Frances Prescilla (2007). Public Heath Nursing in the Philippines. 10th
edition. C& E Publishing, Inc. Quezon City
-
8/7/2019 akima fcp1
33/35
33
XIII. APPENDICES
FAMILY HEALTH PLAN
y Inadequate living space
Criteria Computation Actual score Justification
Nature of theProblem
2 / 3 X 1 0.67 It is health threat that does notdemand immediate action
Modifiability of theProblem
0/ 2 X 2 0 Increasing the living space will requirequite a financial expenditure. Thefamilys resources are presently notadequate considering the other
problems.PreventivePotential
3 / 3 X 1 1 Increasing the living space willy reduce possibility of transferability
communicable disease, e.g(scabies)
y provide privacy to membersy provide bigger space to allow
adequate movements whenperforming housework
Salience of the
Problem
1 / 2 X 1 0.5 The family recognizes this as a health
threat but not needing an immediateaction
Total score 2.17
y Improper Garbage Disposal
Criteria Computation Actual score Justification
Nature of the
Problem2 / 3 X 1 0.67 It is health threat that requires
immediate action.
Modifiability of theProblem
2 / 2 X 2 2 The problem is easily modifiablebecause the student nurse can help the
family understand and explore wayshow to properly dispose their garbagewastes to keep environment clean.
PreventivePotential
3 / 3 X 1 1 This problem can easily be prevented ifthe family will be encouraged andmade them realized the importance ofproper garbage disposal.
Salience of theProblem
0 / 2X 1 0 The family does not recognize theexistence of the problem
Total score 3.67
-
8/7/2019 akima fcp1
34/35
34
y Family size beyond what family resources can adequately
Criteria Computation Actual score Justification
Nature of theProblem
2 / 3 X 1 0.67 It is a health threat
Modifiability of theProblem
2 / 2 X 2 2 Current knowledge, interventions andresources are available to solve theproblem.
PreventivePotential
3 / 3 X 1 1 The possibility of increasing the familysize is reduced; the available familyresources can be utilized to encouragegrowth promoting experiences formembers.
Salience of the
Problem
1 / 2 X 1 0.5 The family perceives it as a serious
problem needing attention to ensurethat the last pregnancy will be the lastone.
Total score 4.17
y Unsafe Drinking Water
Criteria Computation Actual score Justification
Nature of the
Problem
2 / 3 X 1 0.67 It is a health threat
Modifiability of theProblem
2 / 2 X 2 2 Current knowledge, interventions andresources are available to solve theproblem.
PreventivePotential
3 / 3 X 1 1 The problem can be easily prevented ifthe family will be reminded with thesterilization method.
Salience of theProblem
0/ 2 X 1 0 The family does not recognize theexistence of the problem
Total score 3.67
y Inadequate water supply
Criteria Computation Actual score Justification
Nature of theProblem
2 / 3 X 1 0.67 It is a health threat
Modifiability of theProblem
2/ 2 X 2 2 The family does not have adequateresources to solve the problem.Inadequacy of water supply is a barrierto achievement of good personal
hygiene which is very important.PreventivePotential
3 / 3 X 1 1 The problem can be highly prevented ifthe family will exert more effort ingetting for water resources that isreadily available near their house.
Salience of theProblem
0/ 2 X 1 0.5 The family perceives it as a problembut does not see the problem asneeding immediate action.
Total score 4.17 The family does not recognize the
existence of the problem
-
8/7/2019 akima fcp1
35/35