S a n Pe d ro C o lle g e

1 2 C . G u sm a n S t., D a va o C ity

Family Case Study

Yvanne Ronald A. Agno
Kevin Van Eric O. Saballo
Roselle E. Anino
Hannah Berry T. Alegado
Phoebe Lyn S. Brusas
Vaugh
W e d n e sd a y , 2 9 S e p te m b e r
INTRODUCT
Vough
 Introduction
“The family is the corner stone of our society.
More than any other force it shapes the
attitude, the hopes, the ambitions, and the
values of the child. And when the family
collapses it is the children that are usually
damaged. When it happens on a massive scale
the community itself is crippled. So, unless we
work to strengthen the family, to create
conditions under which most parents will stay
together, all the rest - schools, playgrounds,
and public assistance, and private concern- will
never be enough”
 -Lyndon Baines Johnson
 Vou g h
 Introduction
 The FAMILY: This is the core and unit of service in Community Health Nursing (CHN).
As student nurses, we focus on the optimum health of the family as a whole and
provide our holistic health teachings as a teaching role of each student nurses,
that imparting information, bombarding those inputs with them and reinforcing
changes in behavior.


 What is family? According to Burgees and Locke, the family is a group of persons
united by ties of marriage, blood or adoption, constituting a single household,
interacting and communicating with each other in their respective social roles of
husband and wife, mother and father, son and daughter, brother and sister and
creating a common culture. This, we would regard as a fundamental description
of a family.


 Where does a family starts? For Winston Churchill, it starts with a young man
falling in love with a girl and no superior alternative has yet been found. Yes,
that may be proper. But in this modern world, family may become more
intricate than just the nuclear basis. Families are too intimate as close tied to
stick with the trouble-free definition. It is more about nurturing one another and
respecting each other’s lives. The family and the home basically is the only Vou g h
place where one truly belongs.
 Introduction
Health: The World Health Organization (WHO) defines


health as a “state of complete physical, mental, and

social well-being and not merely the absence of
disease or infirmity”. And this definition of health was
been clearly modified to include the ability to lead a
“socially and economically productive life”. Individuals
need to function at its optimum level and as its best,
even with such disease and infirmity, if one is able to
manage and tolerate such stressors and continue to
function at the highest possible level he could attain,
the one is considered to be healthy. A family must
indeed be healthy to function properly their role. Thus,
making each member of the family contributes
through role functioning for the welfare, goodness and
effectiveness of the family as unit of service in the
community and basic unit of society. Vou g h
 Introduction
 As student nurses, we are active not only in the hospital set-
up but also in health promotion in the community. We not
only play the roles of providing care, applying nursing
procedures for the practice of our profession but also to
create a big impact through rendering out our health
teachings for them to generate knowledge and acquire in
alleviating such problems occurring in their family and in
the community. We help them to achieve optimum wellness
and provide continuous care for physical and social
environment. It somehow adds to the development of the
nation since there are some people cannot afford private
health services. By means of the community health nurses
and public health centers, health services are now
accessible and affordable. We reach out to the community
in order to be of assistance to them. The only factor that
would probably turn the world around is the client’s volition
and enthusiasm to participate.
Vou g h
 Introduction
This case study focuses on the Basco Family. They belong to the traditional
family structure. Thus, they are a nuclear family. According to Evelyn
Duvall’s family stage, they belong to the family with preschool children.
They have three children. The husband, the head of the family works as a
messenger at BPI while the wife is a full-time housewife. The family is
slightly able to meet the needs for physical survival and security.
 

The reason that the group has chosen the Basco Family as the client for the

case study is first, they are very hospitable and accommodating. Their
willingness was very astounding. They have exhibited enthusiasm when we
were informing them about the things we are going to do for them. They
have appreciated our purpose a lot. They were also able to understand our
situation and presented themselves to help us. Second, through ocular
observation, they are not well-off and that they are living in a non-
conducive environment. Lastly, the group wants to help the family improve
and enhance holistically their lifestyle and activities of daily living.

Vou g h
 Introduction
Through the FNCP’s and implementations that we have
designed, we expect that our client’s overall health
status will improve and alleviate all the problems they
had. And through this case study, we look forward to a
more extensive understanding about the family with a
pregnant mother, not only for our own benefit but also
for the subject of this study.
Finally, we anticipate learning from the student nurses

and the client. That learning may not end at this point;
that this case study will mark the beginning of a new
knowledge that will hopefully pass on through
generations in the field of Community health Nursing.


Vou g h
OBJECTIVE Vough
 General Objective
This study aims to allow the student


nurses to apply the different

concepts, practices and principles of
family health care process.


Vou g h
 Specific Objectives
Specifically, this study aims to:


• Find a family in the area of exposure as our subject for

the case study;
• Establish rapport with the family members and their
significant persons to gain cooperation and trust;
• Gather systematically the pertinent information in
relation to their health status and other significant
matters;
• Present the introduction related to the condition being
studied;
• Formulate specific, measurable, attainable, realistic
and time-bounded objectives;
• Acquire the necessary information about the client
and formulate the family initial database; Vou g h
 Specific Objectives
• Identify the family’s developmental stage and compare the task
attained by the family and expected task to be achieved base
on the theory of Evelyn Millis Duvall;
• Present a comprehensive family genogram and trace the family
web and to make a corresponding legend that will show the
status, hereditary diseases, present and past condition of the
family;
• Rate the family’s coping index to provide a basis for estimating
the nursing needs of the particular family;
• Prioritize the health problems observed upon assessment;
• Formulate therapeutic family nursing care plans on the described
problems;
• Enumerate and give appropriate health teachings to the family
involved;
• Identify the implications of this case study to nursing research,
education and practice; and
• List down the references used in the making of this case study. Vou g h
INITIAL Vough
 Demographic Data
The Basco family is currently living in


a rented house for nine months

already since May of this year. It is
located at Blk. 49 Barangay 21-C,
Piapi Boulevard.


Vou g h
 Family Data
The Basco Family has been living here


in Davao for 33 years already while

in their current house, they only have
9 months length of residency. They
are originally from Davao City. They
are four of them in the family with a
father, mother and two children. The
family is Roman Catholic and they
belong to the Bisayan tribe.
 Vou g h
Family Data
• Name: Basco, Marlou
• Age: 33 years old
• Civil Status: Married
• Position: Head of the
Family
• Educational
Attainment: High
school Graduate

Vou g h
Family Data
• Name: Angelita Ablas-
Basco
• Age: 33 years old
• Civil Status: Married
• Position: Wife
• Educational
Attainment: High
school Level

Vou g h
 Family Data

X
• Name: Basco, Angelito
• Age: Deceased
 • Civil Status: -
• Position: Eldest
• Educational
Attainment: -

Vou g h
Family Data
• Name: Basco, John
Marco
• Age: 5 years old
• Civil Status: Single
• Position: Second Child
• Educational
Attainment: Kinder
2

Vou g h
Family Data
• Name: Basco, Janna
Mae
• Age: 4 years old
• Civil Status: Single
• Position: Third Child


Vou g h
Family Data
• Name: Basco, Jenna
• Age: 2 months
• Civil Status: Single
• Position: Youngest
Child

Vou g h
 Family Data
 The BascoFamily belongs to the Nuclear family structure. They
are Roman Catholic. Mr. Marlou Basco is the head of the
family. He is 33 years old and he was born on March 07, 1976.
He was able to finish high school. He is presently working as a
messenger in Bank of the Philippine Islands or BPI. His wife is
Mrs. Angelita Basco a 30 – year old and was born on March 15,
1979. She has 3 beautiful living children. The couple has been
living together for 5 years. The eldest child unfortunately died
few minutes after giving birth due to over dosage of the
prescribed drug that was taken by Mrs. Angelita during her
pregnancy because she was diagnosed of having weak lungs
during her pregnancy then. John Marco Basco is the second
child and 5 years of age. He was born at July 24, 2004. He is
studying at the Day Care Center as kinder 1 student. The
second child is Janna Mae Basco. She is 4 years old and was
born on July 19, 2005. She is not yet in school but her parents
are planning to send her the next school year. Their youngest
child is Jenna Marie who is 2 month old. She was born on Vou g h
 Family Characteristics
C R IT E R IA STA TU S A D D IT IO N A L IN FO R M A T IO N

Observabl We weren’t able to ask Mr. Basco about Before, Mrs. Basco has part
e conflicts
their usual conflicts since he needs to go time job as a sales lady at
between
family to work. However, Mrs. Basco, his wife is Korean store in Uyanguren.
members the one who openly shared about their Through this, she can help her
family issues. She told us that they are husband to provide additional
arguing mostly about money. Since the income to support their needs.
salary of Mr. Basco is sometimes not But since she got pregnant she
enough to sustain and provide the needs needs to stop the work in
of the family. When this problem exists, order to prevent complications
both couples would talk about the matter during pregnancy. Last
and would come up a mutual decision to December 24, 2009 she gave
solve such conflict. Mr. Basco has the birth to a lovely baby girl
responsibility to hand the money to his named Jenna. And still not able
Vough
 Family Characteristics
C R IT E R IA STA TU S A D D IT IO N A L IN FO R M A T IO N
C h a ra cte ristic T h e y h a ve in fo rm a l co m m u n ica tio n A s sta te d b y M rs. B a sco ,
s of to w a rd s e a ch o th e r b u t n o t to th e th e y w illo n ly b o rro w ce ll
co m m u n ica ti e xte n t th a t th e y b lu rt o u t b a d & fo u lp h o n e a n d a sk fa vo r to
on w o rd s e sp e cia lly w h e n th e y a re te xt fro m th e ir clo se
h a vin g a n a rg u m e n t. T h e y d o n ’ t n e ig h b o r in ca se o f
h a ve ce ll p h o n e fo r d ista n ce e m e rg e n cy .
co m m u n ica tio n a n d e m e rg e n cy
p u rp o se s.

Vou g h
 Family Characteristics
C R IT E R IA STA TU S A D D IT IO N A L IN FO R M A T IO N

In te ra ctio n W h e n it co m e s to fa m ily in te ra ctio n s, If th e ch ild re n co m m it

p a tte rn s o u r g ro u p o b se rve d th a t th e y a re so m ista ke s, th e fa th e r w ill
am ong clo se a n d it se e m s th e y a re co n te n te d ta lk to h is ch ild re n a n d
m e m b e rs w ith w h a t th e y h a ve . T h e p a re n ts so m e tim e s sp a n k th e m .
d iscip lin e th e ir ch ild re n in a p ro p e r w a y . T h is is th e w a y th e y
T h e y w a n t to b e re sp e cte d b y th e ir d iscip lin e th e ir ch ild re n .
ch ild re n . In te rm s o f fa m ily b o n d in g , th e T h e ch ild re n ca llth e ir
fa m ily sp e n d s th e ir sp a re tim e o n ly in p a re n ts m a m a & p a p a .
th e ir h o u se w a tch in g t. v . sh o w s. T o
tig h te n th e ir fa m ily b o n d in g , th e y
so m e tim e s g o to P e o p le ’ s P a rk a n d
M a g sa ysa y P a rk . T h e m o th e r is th e o n e
w h o sp e n d s m o st o f th e tim e w ith h e r
ch ild re n sin ce h e r h u sb a n d is w o rkin g
fro m M o n d a y to S a tu rd a y . O n ly S u n d a y
is h is d a y -o ff. Vou g h
 Nutritional Status
Fa m ily M e m b e rs W e ig h t H e ig h t R e su lts NO RM AL
RANG E 2
B a sco , M a rlo u 6 5 kg 1 .7 0 m N =2 2 . 4 9 20-25 kg/m
kg / m 2
53kg 1.50m N=24.44 kg/m2 19.8-26 kg/m2
Angelita
John 19kg 1.07m N=16.60 kg/m2 14.4-20.2 kg/m2
Marco
Janna 14.5kg 1.00m N=14.50 kg/m2 12.6-17.9 kg/m2
Mae
Jenna 5kg 0.46m
Marie

Vough
 Nutritional Status
• All of the family members we have assessed in getting the
nutritional status because of the time availability of the
family members coincide with the time we have done
gathering our data for this assessment.
• Mr. Marlou Basco has a weight of 65kg and a height
of 1.70m. His BMI result is N=22.49 kg/m2 which
interpret as normal.
• Mrs. Angelita Basco has a weight of 55kg and a
height of 1.50m. Her BMI result is N=24.44 kg/m2 which
interpret as normal.
• Jhon Marco has a weight of 19kg and a height of
1.07m. His BMI result is N=16.60 kg/m2 which interpret
as normal.
• Janna Mae has a weight of 14.5kg and a height of
1.00m. Her BMI result is N=14.50 kg/m2 which interpret
as normal. Vou g h
ACTIVITIES OF DAILY LIVING

Vou g h
 Sleeping Pattern
 The entire family has an average of 6-8 hours
of sleep per day. The Family usually retires
to bed at between 8:00-10:00 p.m. after
they watch TV shows. Their wake up time
depends upon the members of the family.
For Mr. Marlou and Mrs. Angelita, they
usually wake up at 4:00 a.m – 4:30 a.m. as
Mr. Marlou will go to work at 6:00 am and
Mrs. Angelita will prepare food for the
family. Their children will wake up at 6:00
am in preparation for school. The whims of
retiring and getting up of the family
members are dependent on each individual. Vou g h
 Eating Pattern
• The family is able to eat three times a day.
As we ask them of their 24 hour dietary
recall, their usual breakfast is dried fish or
fried fish.
• Mr. Basco has enough income fitted only for
their basic needs like food. Mrs. Basco
reported that even though they cannot
provide for house resources like
appliances, they try to make sure that
they will prioritize the nutritional status of
their family as evidence on the Body Mass
Index which all results were normal.
 Vou g h
 Diatary Habbits
Breakfast
Lunch
Dinner Tinolang
February
Bread,
Fried fish,
milk,
isda
18rice Dried
February
champorado,
fish19
fish, and
rice
milo Fried
February
Rice and
fishdried
20
and rice.
fish,
(Thursday)
milo
and juice.
rice.
or coffee. and
(Friday)
rice.
coffee. soup. milk,
legume (Saturday)
milo or coffee.

Vough
 Leisure Time Activities
Watching TV shows and the children play


jolen outside the house after their

school. They also spend time listening
to music and also taking time in
chatting with neighbors. The kids are
free to play outside the house but they
are always reminded not to play with
harmful objects such as sticks, wires
etc. Sometimes if there is extra money,
they also go to amusement parks and
malls. These are the activities that
promote relaxation to the entire family.Vou
Vou g h
 Monthly Family Income
Members
of the EducationalOccupation Nature of Work Place of Monthly
family w/ Attainment work income
1income
) Marlou High schoolMessenger An employee who
Basco graduate of BPI delivers bills P4,800
(father) of BPI clients
directly to
their offices or
homes

Vou g h
 Monthly Family Income
The family’s breadwinner is the father


who is Mr. Marlou Basco. He is a high

school graduate who works as a
messenger of BPI. He is an employee
who delivers bills of BPI clients
directly to their offices or homes here
in Davao City. He earns
approximately P4,800 monthly.
 Vou g h
FAMILY HEALTH STATUS

Vou g h
 Mr. Marlou Basco
 When we interviewed Mr. Marlou, he said that
he didn’t experience any serious illness
when he was young. He also verbalized
that he had a complete immunization during
his childhood. He experienced common
illnesses such as colds, cough and fever. He
can consume at least 3-5 sticks per day of
‘Fortune’ cigarettes. These results served as
evidences for presence of a health threat.
He mentioned that their family on his
mother’s side has a past health history of
hypertension. He is also hypertensive.
 Vou g h
 Mrs. Angelita Basco
Mrs. Angelita just recently gave birth a


live baby girl via Normal

Spontaneous Vaginal Delivery last
December 24, 2009 namely Jenna
Marie. She also verbalized that she
had complete immunization during
her childhood and she didn’t
experience any serious illness when
she was young. She experienced
common illnesses such as colds, Vou g h
 John Marco Basco
As verbalized by the mother and


through observation, John Marco

experienced cough, colds and fever.
Also he is presently experiencing
colds and cough that’s why her
mother verbalized that there is a
need for medical consultation.


Vou g h
 Janna Mae Basco
Presently, Janna Mae experiences


cough and colds. That’s why her

mother verbalized that there is a
need for medical consultation.

Vou g h
 Jenna Marie Basco
She is 2 months old and she was just


recently immunized with BCG, DPT,

OPV and Hepatitis B. Fortunately
Jenna has not yet experience any
illness.

Vou g h
 Immunization Status
3.) Jenna
21Child
John
Janna
’s name
Marco
Mae
Marie CBCG CDPT
2doses COPV
2doses CHEP. B XCMEASLES
Basco

Legend:
C- Complete X- Not immunized √- Done

Vou g h
 Immunization Status
• There are three children in the Basco family.
Each child has taken such immunization for
the goodness of their health.
• John Marco, the eldest child has 1 BCG, 3
DPT, 3 OPV, 3 HEPA B and 1 MEASLES
immunization and is considered a fully
immunized child.
• Janna Mae has 1 BCG, 3 DPT, 3 OPV, 3
HEPA B and 1 MEASLES immunization and is
considered a fully immunized child.
• Jenna Marie the youngest child has 1 BCG,
2 DPT, 2 OPV, 3 HEPA B and no MEASLES
immunization and she is not considered a Vou g h
HOME AND ENVIRONMENT

Vou g h
Flooring
• Brown- Kitchen
• Gray-
Sleeping/Eating
Area
• Violet-Door
• Sky Blue- Windows

Vou g h
 Total Floor Area
2.31m
• TFA = (length of
the house’s floor)
x (width of the
house’s floor)
3.15m

•
= (2.31m) x (3.15m)
= 7.28sqm

•
Vou g h
 Total Window Opening
0.72m • TWO = (length in
meters) x (width
in meters)
= (0.66m) x (0.76m)
0.66m

= 0.50sqm x

2windows
= 1.00sqm

•
Vou g h
 Door Opening
0.68m
• Door Opening =
(length of the
door) x (width of
the door)
1.07m

= (1.07m) x (0.68m)

= 0.73sqm

Vou g h
 Ventilation
• Ventilation = • Scale:
(TWO/TFA) x 100 20% - satisfactory /

= (1.0032sqm + good ventilation

0.73sqm) / 18-19% - fair

(7.28sqm) x 100 17% below – poor

= 13.07%
ventilation
= Poor Ventilation
•
•
Vou g h
 Comparison of TFA and TSR
Number of family
 Client Multi- Purpose room Single-Purpose room

Adult 3sq.m 2.50sq.m

members currently Children 1.5sq.m 1.26sq.m
Infant 0 0
living in the house: 4


Category of members:
adults (2) children (2)
Room Category: Multi-

Purpose room
•

Vou g h
 Comparison of TFA and TSR
 Computation:
Adult: 3sq.m x 2 adults = 6sq.m

Child: 1.5sq.m x 2 children = 3sq.m

Infant: 0 x 1 = 0sqm

TSR = 6sqm + 3sqm = 9sqm

TFA = 7.28sqm

7.78sqm<9sqm = overcrowded

Condition: TFA > TSR = not overcrowded

 TFA < TSR = overcrowded

Vou g h
 Comparison of TFA and TSR
The Family rents a house where they are currently


residing. The house is a mixed type; it’s made up of

the combination of wood and cement. Their house is a
multipurpose room with two windows and one door.
The length of their house measures 2.31m and the
width is 3.15m resulting to a TFA of 7.28sqm. They
have two windows measuring 0.50sqm each resulting
to a TWO of 1sqm. The door’s length is 1.07m and has
a width of 0.68m resulting to a Door Opening of
0.73sqm. Their TSR is 9sqm and their TFA is 7.28sqm.
Because of this, they are overcrowded. We divided the
TWO by the TFA and multiplied to 100 resulting to
13.07% ventilation. Normal vent is 17%. So, they have
poor ventilation in their current house.

Vou g h
 Comparison of TFA and TSR
• As soon as we entered the house of our client, we observed
that the family has the following appliances: 1 TV and 1
small electric fan. We also noticed that there is a small
multi-purposed room with only 1 small bulb light as their
light. They don’t pay their electric and water bills since
its part of the money that they’re paying for their rent.
• Their garbage is being dumped in a place in their barangay
where garbage men collect the trash daily.
• Their toilet system is water sealed latrine, a toilet similar to
flush type but without the flushing system. Their source
of water is Davao City Water District.
• They do not have a gas stove; they only use charcoal for
cooking. Finally, we noticed that they have a hazardous
environment because of the sharp objects such as
knives, nails and other dangerous object lying anywhere
inside their house.
Vou g h
 Health and Health Practices
The family has no specific principle or


practice with regards to infirmity.

They don’t believe in the healing
powers of quack doctors. If they
experience colds, cough or fever,
they seek medical advice from the
barangay health worker or go to the
health center.
Vou g h
ENVIRONMENT

Vou g h
 Kind of Neighborhood
Since the family is living in a community


where houses are built close to each

other, it’s expected that almost
everyone knows each other and are
close to each other. The neighborhood’s
environment is quite dirty because
trash, spit and left over food are seen
everywhere. Almost all houses are at
risk for fire hazards since most of the
houses in barangay 21-C are made of
wood. The presence of rats and other
rodents are also noticeable. Vou g h
 Social and Health Facilities
Available
The community has a Health Center


where they could have their

immunizations done, pre-natal check
up, dental and health check up. The
Health Center is so accessible to
them since it’s strategically located
in a place near to everyone.

Vou g h
 Communication and
Transportation Facilities
Almost everyone in barangay 21-C have


cell phones. So, it is the basic means of

communication in the community aside
from personally speaking to the person.
For their transportation, tricycles are
the basic means of transportation in
barangay 21-C because it’s cheap,
easily accessible and travels faster than
walking. Jeepneys could also be used
when trying to go to other places
outside the community.
Vou g h
 Awareness to Comunity
Organization
The family is aware of some


organization in the community such

as the GKK and the Barangay
Officials, but they aren’t members of
any of these organizations. In fact,
the family isn’t even aware and
involved in any activities in their
community.
 Vou g h
FAMILY
DEVELOPMENTAL Vou g h
Level Ideal Actual

Family with °Adjusting to the - The family are

Preschool Children costs of family life budgeting their
  money for the
different expenses
every month.
 
°Adapting to needs - The eldest child
of preschool is Kinder 1 and goes
children to to school at the
stimulate growth Piapi Day Care
Vou g h
Level Ideal Actual

°Coping with - The parents are

parental loss of adjusting to the
energy and privacy high energies of
the children. They
constantly play
without ceasing.
They also want to
cling always to
their parents
leaving them with
less privacy.
Vough


 Based on their classification, the Basco

family belongs to the family with preschool
children. The developmental tasks at this
stage are adapting to the critical needs and
interest of preschool children in stimulating,
growth-promoting ways and coping with
energy depletion and lack of privacy as
parents.
 Through our observation, all of these
developmental tasks were evident in the
Basco Family. This is a good sign that the
family is responding really well to family life.
They have been adjusting and coping to the
different tasks under the criteria. Thus, each
new development crisis necessitates new
adaptations and imposes new Vough
GENOGRAM
Vou g h
 Tiborcio Basco, Carmelita Basco, 60 Rosalita, 58 Nicolas Ablas, 59
60 X
X

Jhong Basco, 28 Marlou Basco, Angelita,30

Rita Basco, 25 33

Angelito Basco, John Marco Basco,

Janna Mae Basco, 4 5 Jenna Basco, 2mo
X (still birth)

Legend:
Hypertension Male
X deceased Female
Vaugh
 Genogram
The genogram shows the three


generation of hereditary disease

from the grandfathers and
grandmothers of our client Janna Mae
Basco. Janna’s grandmother,
Carmelita Basco has hypertension
and so does her father.


Vough
ECO-MAP
Vough
 MARKET

Legend :
Rarely
ou
Often
lita

a Mae SCHOOL
John
o
Vough
 Eco-map
• As shown above, the family specifically Mrs.
Basco usually goes to the market where their
basic needs are being brought. Since the
family do not have refrigerator to store their
perishable, thus explain the frequent trip to
the market.
• Furthermore, Mr. and Mrs. Basco submits their
selves along with their children for any
services offered in the health center such as
free vaccinations and medicines, they utilize
the services being offered at the health
center. However, Mr. Carlos and Mrs.
Rosalitatend to drop by at the health center
when certain medical conditions are being Vough
 EcoMap
• The family is considered to be a member
of the Roman Catholic Church, however, they
does not involve themselves in any activities
related to their religion such as attending the
so called “kasaulugan” during Saturdays.
Nonetheless, Mr Mr. and Mrs. Basco are trying
to find time to attend the activities structured
by their religion.
• The family sometimes goes to Gaisano
Mall or People’s Park to relax and enjoy when
there is extra money.
• Mr. Basco always go to work every
weekdays, his son John Marco is attending
daycare every morning. Vough
 Admission: February 20, 2010

FAMILY
Vou g h
9 ADMISSION DISCHARGE
CATEGORIES RATING JUSTIFICATIO RATING JUSTIFICATION
N
1. Physical 3 - Some family 3 -Still, some family
Independence members are able members are able to move
 to move in and out independently. But, Jenna
 of bed and some is still too young to take
 weren’t able to care of herself.
 take care of
 grooming -Manage common

3 - Can carry out 3 illnesses fairly. The
2. Therapeutic some treatments mother encourages the
Competence such as managing children to drink lots of
fever by taking water when having cough
“BIOGESIC” and and give them
can only do “BIOGESIC” when they
exercise sometimes have fever.

Vou g h
 ADMISSION DISCHARGE
9 RATING JUSTIFICATION RATING JUSTIFICATION
CATEGO
RIES
3. 3 - Has some general 5 -Has fully understood the concept of
Knowledge knowledge about their cleanliness & sanitation. They have been
and Health health and sanitation
Condition and is only partially well-informed. They were able to keep
informed. Has not their house clean.
understand fully
because of low
educational attainment

4. 3
- Takes a bath only 5
once a day. Does not -Family members already are taking a
Applicatio
wash hands regularly bath twice a day & they wash hands
n of
regularly.
Principles
of
General

Vou g h
9 ADMISSION DISCHARGE
CATEGORIES RATING JUSTIFICATION RATING JUSTIFICATION

5. Health 5 
Understands and 5 -The family still
Attitudes recognizes the understands and
need for medical recognizes the need for
care during medical care during
illnesses. When illnesses. Ma’am Angelita
the mother was ensures that Jenna
still pregnant, she Marie has complete
goes to the health immunization to prevent
3 3
center for diseases.
6. Emotional
prenatal visit.
Competence
-Family is doing
-The family is still
fairly well. The
somewhat immature. Only
mother sometimes
the parents are capable
acts immature
of making decisions and
because she
handling problems within
giggles a lot when
family.
being asked about Vough
9 ADMISSION DISCHARGE
CATEGORIES RATING JUSTIFICATIO RATING JUSTIFICATION
N
7. Family Living 3 - Family gets 3 -Though the family
along but has is trying to adjust
problem living together,
adjusting to
there is still a
maintenance of
open
problem in
communication. maintaining open
Husband is only communication.
available at
Sundays and
rarely gets day
offs. No cell
phones for
constant and
easy
Communication
Vough
9 ADMISSION DISCHARGE
CATEGORIES RATING JUSTIFICATIO RATING JUSTIFICATION
N
8. Physical  1 - House is in 3 -Even though the
Environment   poor condition   house has inadequate
    with inadequate   living space, the house
    living space and now has good
  poor environmental
    environmental   sanitation. It is now
sanitation.   clean.
9. Use of 5   5  
Community - When the -Still, the mother
Facilities mother was still regularly goes to the
  pregnant, she health center for the
goes to the scheduled vaccinations
Health Center of Jenna Marie. John
regularly for Marco also goes to the
Prenatal Check- Day Care Center in the
up. The eldest barangay.
child goes to Vough
Physical Assessment

Vou g h
Physical Assessment
General Survey :
Our client is Jana Mae A. Basco a 4-year old female. On February 20,2010, we had
conducted a thorough physical assessment on her. She had just finished taking a bath.
She was well-groomed and neat. Has an mesomorphicbody built with height of 100.33 cm and
weight of 14kgs. Has an erect posture with coordinated movements. No signs of distress.
Cooperative. Responds appropriately to the situation. Talks clearly and is
understandable.

Vital Signs :
T= 36.3 0C
PR= 75 bpm
RR= 18 cpm
CR=78 bpm

Skin Assessment :
General uniformity. No edema. Moderate moisture. Uniform temperature on both hands and
feet. Good skin turgor.

Hair Assessment :
Evenly distributed. Silky and resilient.No infection and infestations. Variable amount of
body hair.

Vou g h
Nails Assessment :
Has a convex shape and with no clubbing. Smooth fingernail and toenail texture. Pinkish
and has an intact epidermis. Capillary refill time of 2 seconds. Well trimmed finger and
toe nails.

Skull and Face Assessment :

Normocephalic with symmetr ical facial features. No edema and hollowness noted.
Symmetrical facial movements. No presence of nodules or masses.

Eye Structure Assessment :

E yebrows evenly distributed and skin intact. Equal and outward curl of eyelashes.
Eyelids intact with 17 blinks per minute bilateral. Palpebral conjunctiva has pinkish-
peach color with minimal blood vessels visible. Bulbar conjunctiva are clear with few
underlying blood vessels. White sclera visible. Upon palpation of lacrimal duct, no edema
or tenderness noted. Shiny and smooth cornea. Pupil is black in color, equal in size and
3mm in diameter. Illuminated pupil constricts(direct response). Non-illuminated pupil
constricts(consensual response). Aligned and coordinated eyes.

Visual Acuity Assessment :

Has good visual acuity.

Vou g h
Ears Assessment :
Color is same as facial color and auricles are symmetrically aligned with outer canthus.
Elastic and firm auricles. Presence of cerumen in the external ear. No difficulty
hearing.

Nose Assessment :
Symmetrical external nosewith no flaring. No tenderness and no lesions. Pinkish with
nasal catarrh. Nasal septum intact and maxillary and frontal sinuses non-tender.

Mouth and Oropharynx Assessment :

Symmetric contour of outer lips. Has the ability to purse lips. Pinkish and moist inner
lips and absence of skin lesions. No lumps and excoriations on tongue noted. Tongue in
midline. No swelling and redness noted on salivary duct. Light pink and smooth soft
palate. Lighter pink and more irregular texture of hard palate. Uvula in midline of soft
palate. Pink and smooth posterior wall of oropharynx. Tonsils pink, smooth and with no
discharge. Grade 1+ tonsils. Present gag reflex.

Assessment of the Neck :

Muscles equal in size and head centered. Coordinated and smooth movements with
no discomfort. Equal strength of muscles. Lymph nodes not palpable. Trachea on central
placement in midline of neck. Thyroid gland not visible upon inspection. Upon palpation,
lobes are small, smooth, centrally located and rises freely with swallowing

Vou g h
 Lungs and Thorax :
Transverse to anteroposterior diameter is 1:2 in ratio. Symmetrical chest
expansion observed. Spine aligned and no deformation noted. Not in respiratory distress.
Skin is intact. Chest wall intact, no tenderness and no masses noted upon palpation.
Bilateral and symmetrical vocal fremitus. Absence of adventitious sounds such as
crackles wheezing. Breathing pattern is regular with a respirstory rate of 18 cycles per
minute. With clear breath sounds on both lung fields noted upon auscultation.

Heart and central Vessels :

Point of maximal impulse was heard on the left midclavicular line at the 5th
intercostal space with 78 beats per minute. No abnormalities of the heart rate noted. No
murmurs were heard during auscultation of the cardiac rhythm.

Carotid Artery :
Symmetrical pulse volumes, full pulsations, thrusting quality noted. No sound heard
during auscultation.

Jugular veins :
Veins are not visible, its presence indicates advanced cardiopulmonary disease.

ral Pulses :
c pulse volumes and bilaterally full pulsations noted upon palpation except for carotid pul

Vou g h
 Peripheral Veins :
No distended veins at lower limbs. limbs not tender and symmetrical in size.

Peripheral Perfusion :
Skin color is pink, skin temperature not excessively warm or cold, no edema and has
moist skin texture during inspection. Using Buerger’s test in the limbs and lower limbs,
original color returned after 15seconds and 10 seconds respectively.

Breast and axillae :

Breasts are not yet mature. Not yet developed secondary sex characteristics. No hair
in axilla. No foul odor.

Abdomen :
Skin uniform in color. Flat abdomen. No enlargement noted. Umbilicus is clean
without any discharges, foul smelling odor, and signs of inflammation. Has 20 bowel
sounds per minute.

Musculoskeletal System :
Muscles equal in size. No contractures or deformities. No tremors noted. Firm and
tonic muscles with smooth, coordinated movement. Active movement against full resistance.

Vou g h
Bones:
No skeletal deformities. No edema or tenderness noted upon palpation.

Joints:
No swelling. Joints move smoothly.

Neurologic Assessment :
Oriented. RLS-GCS of 1/15.

Vou g h
Cranial Function Physiologic Actual Test Done Result
Nerve Function
I - Olfactory Sensory Smelling
 We instructed the patient Identification of mild
to close her eyes, smell, aromas:
and identify the different She was able to
mild aroma we which we identify mild aromas
will be placing near her like that of the sweet
nose candy and soap.
II - Optic Sensory Transmit visual We checked the patient’s Rosenbaum test:
information to the near vision through The patient was able
brain; Rosenbaum test (asked the to read at 14 cm
patient to read at a distance
distance of about 14 cm) Visual Fields:
and we checked for her The patient has a good
visual fields as well. peripheral vision.
III - Oculomotor Motor Innervates levator We asked the patient to Extraocular movements:
palpebrae superioris, follow the penlight we are All the extraocular
superior rectus, medial holding in every direction muscles were functioning
well and she was able to
rectus, which we will be pointing and we follow the penlight on 6
collectively perform also assessed for the directions
most eye movements, pupil reaction of the eyes Pupilreaction:
inferior rectus, and of our patient. The patient’s pupil was
inferior oblique briskly reactive to light,
constricts when looking at
near objects, and dilates
to far objects

Vou g h
Cranial Function Physiologic Actual Test Done Result
Nerve Function
IV-Trochlear Motor Innervates the We asked the patient to Extraocular
movements:
superior oblique follow the penlight we All the extraocular
muscle, which are holding in every muscles were
functioning well
depresses, rotates direction we will be and she was able to
laterally (around the pointing follow the penlight
optic axis), and on 6 directions

V-Trigeminal Both intorts

Receivesthe eyeball
sensation We used a light object Blink reflex:
Our patient was
from the face and like cotton to check for able to elicit
innervates the the blink reflex of the active blinking
muscles of patient by touching the reflex
Light and deep
mastication sclera of the eye and sensation:She was
also we assessed the able to detect light
patient’s ability to touch and
detect light differentiate it with
touch/sensation by a deep touch
wiping a wisp of cotton
on the patient’s
forehead Vou g h
Cranial Function Physiologic Actual Test Done Result
Nerve Function
VI - Abducens Motor Innervates the
 We asked the patient Extraocular
lateral rectus, to follow the movements:
which abducts the penlight we are All the
eye holding in every extraocular
direction we will be muscles were
pointing and we also functioning well
observed the and she was able
directions of her to follow the
gazes penlight on 6
directions
Direction of
Gaze:
The patient was
able to gaze
laterally.

Vough
Nerve Function
VII - Facial Both Provides motor
 We asked our patient Facial Movements:
innervations to the to smile, raise her Our patient was
muscles of facial eyebrows, frown, puff able to smile,
expression and out her cheeks, close raise her eyebrows,
stapedius, receives her eyes tightly. And, frown, puff out her
the special sense of we asked the client to cheeks and close
taste from the identify various her eyes tightly.
anterior 2/3 of the tastes like little Identification of
tongue, and provides amount of sugar, salt tastes:
secretomotor and a sip of her Our patient was
innervations to the calamansi juice with able to identify
salivary glands her eyes closed sweet & salty
(except parotid) and tastes
the lacrimal gland
Cranial Function Physiologic Actual Test Done Result
Nerve Function
VIII - Sensory Senses around, We checked for the Hearing Acuity:
Vestibulococ rotation and gravity ability of the patient The patient was
hlear (essential for to hear spoken words able to hear us and
balance and the words we had
movement) spoken like “Ma’am”,
“Excuse Me”, and
“Smile” as
evidenced by her
appropriate
responses
IX - Both Receives taste from We asked the client to Tongue movements:
Glossopharynge the posterior 1/3 of move tongue from side Our patient was
al the tongue, provides to side and up and able to move tongue
secretomotor
innervations to the down from side to side,
parotid gland up and down
Motor innervations to

the stylopharyngeus
(essential for tactile ,
pain, and thermal
sensation)
Cranial Function Physiologic Actual Test Done Result
Nerve Function
X - Vagus Both Supplies branchiomotor We observed the patient’s Speech:
innervations to most speech for hoarseness Our patient’s voice is
laryngeal and not hoarse
pharyngeal muscles
Controls muscles for

voice and resonance and

the soft palate

XI - Accessory Motor Controls muscles of

 We asked the client to Shoulder resistance:
the neck and overlaps shrug her shoulders Our patient was able
with functions of the against the resistance to resist the force of
vagus from our hands and to turn the hand on both
her head to side against shoulders
our resistance Face resistance:
Our patient was able
to resist force of the
hand on every other
side of the face
Cranial Function Physiologic Actual Test Done Result
Nerve Function
XII - Motor Provides motor We asked the client to Tongue movements:
Hypoglossal innervations to the protrude her tongue at The patient was
muscles of the midline by saying able to protrude
tongue and other “aahhh” then move it tongue at midline,
glossal muscles side to side then moved it side
Important for to side
swallowing (bolus
formation) and
speech articulation.
 Finger’s to Nose and to the nurse’s
finger:
 When instructed to touch her nose and to touch the nurse’s
fingers alternately, she is able to perform it rapidly.
 Finger to Fingers:
 Can perform rapidly, able to touch fingers consistently.

 Pain Sensation:
 Can determine if the object used for testing is dull or sharp. (Tip of
the ballpen for sharp and the cover of the ballpen for dull)
 Kinesthetic Sensation:
 Can determine her finger’s position if it is up or down.

 Vough
 Muscle strength:
 Sternocleidomastoid
 - She was able to turn her head strongly when I tried to push it.
 Trapezius
 - Able to shrugs her shoulder strongly against my resistance.
 Deltoid
 - She can raised her both arms strongly against resistance.
 Biceps
 - Able to flex her arms against my resistance.
 Triceps
 - She can extend her arms strongly when I tried to push it.
 Hip Abduction
 - Can abduct her leg to the side strongly against resistance.
 Hip Adduction
 - Can adduct her legs back to the position against my resistance.


Vough
 IMCI Assessment
• No pneumonia, cough or cold
•
PRIORITIZATION OF
HEALTH PROBLEMS
Vou g h
TOP 10 PROBLEMS
Problem Score
Walking Barefooted 4 1/6
Pointed/Sharp Objects 4 1/6
Poor Personal Hygiene 4 1/6
Tobacco/Cigarette Smoking 4 1/6
Lack of Food Storage Facilities 2 5/6
Family Size beyond what Family Resources Can Adequately Provide 2½
Inadequate Living Space 2½
Poor Lighting and Ventilation 2½
Family History 2 1/3
Fire Hazard 1
K
 10 Health Problems
•Fire
Hazard
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 It is a threat against
the family’s safety and
2. Modifiability of the 0 /2 x 2 0 welfare
Not modifiable
. because it
Problem is impossible to change
the structure of the
house because they are
just renting.
3. Preventive Potential 1 /3 x 1 1/3 Future problems cannot be
totally prevented. They can’t
4. Salience 0 /2 x 1 0 restructure
Not perceivedtheashouse . Only
a problem
renting
or social concern of the
family.
Total Score 1

Vou g h
Inadequate Living Space
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 It poses a threat to the
inadequacy of space for
the family members.

2. Modifiability of the 0/2 x 2 0 Not modifiable because of

Problem the lack of financial
resources.

3. Preventive Potential 1/3 x 1 1/3 Problems cannot be totally

alleviated be cause of
financial constraint to
rent a bigger space.
4. Salience 1/2 x 1 ½ Not needing immediate
attention as believed by
the family.

Total Score 1 1/2

Vou g h
Family History
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 Hypertension imposes a
threat to the health of
the family members
especially the father.

2. Modifiability of the 2/2 x 2 2 The problem can be

Problem potentially managed by
avoiding triggering
factors of increase in HBP.

3. Preventive Potential 1/3 x 1 1/3 Low preventive potential

because of passiveness of
the client. And
hereditaryillnesses can’t
4. Salience 0/2 x 1 0 The family
totally be most especially
eradicated .
the husband does not see
HPN as a problem.
Total Score 21/3
Vou g h
Pointed / sharp objects
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 It would be harmful
especially to the children
and be a cause of an
accident.

2. Modifiability of the 2/2 x 2 2 Can be modified easily

Problem because the thing to be
done is to cover or hammer
protruding nails.

3. Preventive Potential 3/3 x 1 1 The problem is not that

difficult to handle. Knives
can b e kept and nails can
4. Salience ½ x 1 1/2 Not needing. immediate
be hammered
attention as believed by
the family.

Total Score 4 1/6

Vou g h
oor lighting & ventilation
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 Contribute to difficulty
of breathing and blurring
of visions.

2. Modifiability of the 0/2 x 2 0 Not modifiable because it

Problem is impossible to aid about
poor ventilation because
it involves renovation of
the house.
3. Preventive Potential 1/3 x 1 1/3 Low preventive potential
because they are just
renting. They can’t do
4. Salience ½ x 1 1/2 Is not the major
renovation on theconcern
of the family
ventilation . because of
financial aspects and they
are a lot of problems to
solved.
Total Score 1 1/2

Vou g h
ck of food storage facilities
Criteria Rating Actual Score Justification
1. Nature of the Problem 2/3 x 1 2/3 It could be the cause of
death due to poisoning
which is a big threat.

2. Modifiability of the ½ x 2 1 Partially modifiable

Problem because of lack of
financial resource like
buying a refrigerator or
other containers. But,it
3. Preventive Potential 2/3 x 1 2/3 can be modifiable
Moderate preventive
.
potential because base on
their financial status.

4. Salience ½ x 1 1/2 They usually buy ready

made foods and it is
usually consumed.

Total Score 2 5/6

Vou g h
Cigarette / tobacco smoking
Criteria Rating Actual Score Justification
1. Nature of the 2/3 x 1 2/3 Tobacco smoking would lead to lung
Problem complications so it’s a big threat to
the bread winner of the family.

2. Modifiability 2/2 x 2 2 Easily modifiable because it can be

of the Problem eradicate through simple counseling
and therapeutic approach.

3. Preventive 3 /3 x 1 1 High preventive potential especially

Potential with a person which is not really
involved in smoking and it can easily
be prevented. The father is the only
one smoking.
4. Salience ½ x 1 ½ The family are not aware about the
consequences of secondary smoking but
the family knows the disadvantages of
smoking alone.

Total Score 4 1/6

Vou g h
 Walking barefooted
Criteria Rating Actual Score Justification
1. Nature of the 2/3 x1 2/3 It promotes threat to health due to
Problem high risk for contamination and
injury.
2. Modifiability 2/2 x 2 2 Easily modifiable problem and it can
of the Problem be solved easily suck purchasing
sleepers.
3. Preventive 3 /3 x 1 1 High preventive potential and to
Potential superficial problem and problems are
easily prevented.

4. Salience ½ x 1 1/2 Rated 1 for social concern because

this problem for the family would not
make them dying.

Total Score 4 1/6

Vou g h
Poor personal hygiene
Criteria Rating Actual Score Justification
1. Nature of the 2/3 x 1 2/3 When there is untidiness, dieases can be easily
Problem acquired.
2. Modifiability 2/2 x 2 2 Easy modifiable and interventions can
of the Problem be render easily such medical hand
washing.

3. Preventive 3 /3 x 1 1 High preventive potential problem

Potential because the root of the problem are
easily identified.

4. Salience ½ x 1 1/2 Not needing immediate attention as

believed by the family and too
dependent on government program.

Total Score 4 1/6

y Size beyond what family resources can adequately provide .

Criteria Rating Actual Score Justification

1. Nature of the 2/3 x 1 2/3 It is a health threat because it poses a
Problem risk in providing for the needs of the
members. Financial problems arise.

2. Modifiability ½ x 2 1 Partially modifiable because the family

of the Problem could still apply family planning or the
couple could plan the number of children
they really want to have without
compromising their financial stability.

3. Preventive 1/3 x 1 1/3 Low preventive potential because base on

Potential the monthly salary which is P4, 800, it is
impossible to provide all their needs
especially now, commodities are expensive.

4. Salience ½ x 1 1/2 Their social concern is one because they

are still being passive about it, though
they already knew that indeed it is one of
their problems.

Total Score 2 1/2

Top 5 prioritized health
problems
1 . Walking barefooted

2 . Pointed / sharp objects

3 . Poor personal hygiene

4 . Cigarette / tobacco smoking

5 . Lack of food storage facilities

NURSING
Vaugh
 Roselle E. Anino, St. N

WALKING BAREFOOTED
FE B R U A R Y 2 0 , 2 0 1 0 @  9 : 0 0 A M

Vaugh
 Cues
Subjective:
• “Ana jud na sila gang, magtiniil” , as
verbalized by the patient
 

Objective:

• walking without slippers

• with long nails which is not properly
trimmed
• dirty sole
Vaugh
 Family Nursing Problem
• Unhealthful lifestyle and personal
habits/practices specifically :
Walking barefooted or inadequate
foot wear as health threat

Vaugh
 Family Health Problem
• Inability to make decisions with
respect to taking appropriate
health action due to: failure to
comprehend the nature/magnitude
of the problem
•

Vaugh
 Goal of Care
• At the end of nursing interventions,
the family will be able to practice
proper foot care and foot hygiene.

Vaugh
 Objectives
At the end of nursing interventions, the family


would be able to:

• identify the importance of proper foot care,
foot hygiene and foot wear for sustaining
healthy foot;
• follows hygienic and other interventions
such as proper foot wear to maintain skin
integrity and prevent infection;
• demonstrate optimal foot hygiene as
evidenced by intact, pink, smooth,
hydrated and warm skin, intact cuticles
and skin surrounding nails. Vaugh
 Nursing Interventions
1. Establish rapport with our client and apply therapeutic
communication.
® To facilitate trust and cooperation

2. Provide client information on how to manage foot care and

foot hygiene
® To prevent potential foot problems.

3.Discuss the risk for infection and impaired skin integrity

related to walking barefoot

® For the client to be able to gained knowledge

4. Explain thoroughly nursing interventions that will help the

client to maintain healthy foot care practices

5. Instruct the patient to wear slippers every time they go

outside the house

® To avoid contracting athlete’s foot and other infections Vaugh
 Nursing Interventions
6. Render health teachings such as wearing correctly
fitting size of shoes neither restrict the foot nor rub on
any area
®To prevent corn and calluses.

7. Encourage client wash the feet daily and dry them

well especially between the toes, trim nails and make

use of creams or lotions
® To moisten the skin that reduces dryness.

8.Give positive remarks or compliments

®To enhance self-esteem

9. Ensure that responsible individual are wearing

slippers especially the parents

® They serve as role models for children to follow
Vaugh
 Methods of Family Contact
• Home visit

Vaugh
 Resources
• Human Resources, time and effort of
the nurse and family
• Teaching aid

Vaugh
 Evaluation
 “GOAL MET”
  
 March 05, 2010
 @
 9:00am


At the end of nursing interventions, the family was able to:
• identify the importance of proper foot care, foot hygiene and foot
wear;
• follows hygienic and other interventions such as proper foot wear
to maintain skin integrity and prevent infection;
• demonstrated optimal foot hygiene as evidenced by intact, pink,
smooth, hydrated and warm skin, intact cuticles and skin
surrounding nails. Vaugh
 
 Yvanne Ronald A. Agno St.N

POINTED/SHARP OBJECTS
FE B R U A R Y 2 0 , 2 0 1 0 @  9 : 0 0 A M

Vaugh
 Cues
Subjective:
• “Ah kanang mga lansang daan naman na
diri,katong bago pami nagrent” , as
verbalized the wife
 

Objectives:

• presence of nails in the floor

• protruded nails on the wall
• protruded sharp parts of the wall (made up
of wood) Vaugh
 Family Nursing Problem
• Accident hazard: pointed/sharp
objects as a health threat

Vaugh
 Family Health Problem
• Inability to make decisions with
respect to taking appropriate
health action due to low salience of
the problem

Vaugh
 Goal of Care
• At the end of nursing interventions
the family would be able to
enhanced social concern towards
safety precautionary measures

Vaugh
 Objectives
At the end of nursing interventions, the family


would be able to:

• Identify pointed and sharp objects as a health
threat
• Verbalizes3-5 steps to eradicate pointed and
sharp objects
• Demonstrate accurately preventive steps or
actions to eliminate pointed/ sharps object
such as:
• wearing foot ware like slippers;
• Daily general cleaning;
• Vaccination of Tetanus toxoid. Vaugh
 Nursing Interventions
1. Assess the level of understanding of the client.
*to know anticipatory measures on how to interact with the

client
2.Discuss the nature and magnitude of the problem

*knowing the nature and magnitude of the problem would

open the client for any nursing interventions

3.Explain the significance of having a hazard free environment

*to encourage the family to participate in nursing

interventions
4. Discuss the dangers of improper storage of sharps and

pointed objects.
*to emphasize said problem

5. Encourage the family to remove protruded nails and

pointed objects if possible. Vaugh

 Nursing Interventions
6.Advice the parents to cover the protruded nails which are not
removable.
*to protect family from injury

Advice parents to instruct children to keep away from object

*children are hyperactive in playing, this is o prevent them from

harm and injuries

7. Advice parents to instruct children to keep away from object

*children are hyperactive in playing, this is o prevent them from

harm and injuries

8.advice the family to have daily general cleaning

*to avoid presence of pointed/sharps object

9. Advice the parents to wear always slippers especially their

children.
*Slippers would lessen the incidents of stepping sharp objects which

causes injury Vaugh


 Methods of Family Contact
• Home visit
• Group Aproach

Vaugh
 Resources
1. Human Resources:
 - Time and effort of the student
and the family
2. Financial Resources:

 -Money for transportation

Vaugh
 Evaluation
 “GOAL MET”
 March 05, 2010 @ 9:30am


At the end of nursing interventions the family was able to:
Identified pointed and sharp objects as a health threat; “ Maka-tetanus diay ng

mga lansang noh. Cge lang himuon naku to tanan.” As verbalization by the
wife.
Verbalized 3 steps to eradicate pointed and sharp objects;

 1.“Bukbukon nako ni ug martilyo kung madala ning naglabaw na mga

lansang” as verbalized of the wife.
 2. “ Ang dili madala tabunan nalang naku ni ug kahoy napud or fly
wood” as verbalized by the wife.
 3. “Lagi, kumpleto maning mga bata ug ako basta bakuna ug ako” as
verbalized by the wife.
c. Demonstrated accurately preventive steps to eliminate pointed/sharps object

such as; wearing foot ware like slippers, daily general cleaning, vaccination of
Tetanus toxoid.
Vaugh
 
 Hannah Berry Alegado, St.N

POOR PERSONAL HYGIENE

FE B R U A R Y 2 0 , 2 0 1 0 @  9 : 0 0 A M

Vaugh
 Cues
Subjective:


•  “ Pasensya namo ha….baho pa baya mi. Wla pa man gud

mi kaligo.” As verbalized by Ma’am Angelita


Objectives:


• Excessive sweating of the family members

• Faint odor from the mother’s axilla
• Unpleasant odor from father’s mouth
• Nails untrimmed
• unclean clothes
• hair is unkept
• Fingers & feet are dirty
Vaugh
 Family Nursing Problem
• Unhealthful lifestyle and personal
habits/practices; Poor personal
hygiene as a health threat

Vaugh
 Family Health Problem
• Inability to make decisions with
respect to taking appropriate
health action due to: Low salience
of the problem and condition

Vaugh
 Goal of Care
• At the end of nursing interventions
the family will be able to realize
and explain the importance of good
personal hygiene

Vaugh
 Objectives
At the end of nursing interventions,


the family would be able to:

• Identify the importance of personal
hygiene.
• Appreciate the benefits of practicing
good personal hygiene
• Return demonstrate the general
practices of proper personal
hygiene. Vaugh
 Nursing Interventions
1.Recognize with the family factors that contribute to poor personal
hygiene
®To identify causes of poor hygiene.

2. Encourage joint decision making between the nurse and the family

to handle the problem.

®To encourage the family’s participation.

3.Explain the importance of practicing good personal hygiene

®To promote awareness of its significance

4. Discuss with the client the effects of poor hygiene

®To inform about the consequences of not caring for personal

hygiene.
5. Encourage to take a bath regularly at least twice a day.

®To facilitate cleanliness

6. Encourage to rush teeth at least three times a day

®To facilitate fresh breath and clean teeth

Vaugh
 Nursing Interventions
7. Encourage to clean and wash perineal area regularly.
®To prevent infection

8. Wash hands regularly especially before and after eating

®To prevent the spread of microorganisms

9. Encourage to cut nails at least once a week.

®To prevent accumulation of dirt underneath which cause

diseases.
10. Demonstrate the appropriate ways of good personal

hygiene such as:

a. taking a bath

b. brushing teeth

c. washing hands

11. Return demonstrate the different techniques taught.
Vaugh

 Methods of Family Contact
• Home visit
• Group Approach

Vaugh
 Resources
1. Human Resources:
 - Time and effort of the student
and the family
2. Financial Resources:

 -Money for transportation

Vaugh
 Evaluation
 “GOAL MET”
 March 05, 2010 @ 9:30am


At the end of nursing interventions the family was able to:
-verbalized the importance of having good personal hygiene. “Kailangan dyud

manlimpyo sa lawas para makaiwas sa sakit.:

-verbalized appreciation.

“Mas mayo dyud diay kung mag-alaga dyud sa atong lawas kada isa.”

 

-family member were able to take a bath twice a day, brush teeth thrice & wash

hands regularly.
-family has clean & trimmed nails.

-family members have a presentable appearance.

 Hannah Berry Alegado, St.N



Vaugh
 Kevin Van Eric O. Saballo, St. N

TOBACCO/ CIGARRETE
SMOKING
FE B R U A R Y 2 0 , 2 0 1 0 @  1 0 : 0 0 A M

Vaugh
 Cues
Subjective:


• “Dili man jud naku malikayan gang uy. Dili magbaba tulo ka
sticks nga fortune akoang mahurot usaka adlaw..”as
verbalized by Mr. Basco.
• “Sige gud siya naga sigarilyo, makaubos gud na siya ug tulo
usahay makaabot ug lima nga stick sa isa ka adlaw” as
verbalize by Mrs. Basco


Objective:


• consumed not less than 3-5 sticks of fortune cigarettes per

day
• yellowish teeth noted
• bluish discoloration of lips
Vaugh
• smoking during the conversation
 Family Nursing Problem
• Unhealthful lifestyle and personal
habits/practices due to cigarette
smoking as a health threat

Vaugh
 Family Health Problem
• Inability to recognize the presence of
condition or problem due to lack of
or inadequate knowledge about
cigarette smoking.

Vaugh
 Goal of Care
• After the nursing intervention the
family specifically, Mr. Basco will be
able to lessen the consumption of
cigarette from 3 to 2.

Vaugh
 Objectives
At the end of nursing interventions, the


family will be able to:

• identify at least 2 of harmful effects
cigarette smoking such as cancer
and ;
• appreciate the benefits of preventing
the use of cigarette;
• identify at least 3 substitute for
cigarette such as candies, lollipop and
Vaugh
gums.
 Nursing Interventions
• Discuss with the family the:
– The nature of the problem*to promote
awareness and know how the patient view
the situation or the identified problem
– The effects and possible complication of
cigarette smoking
– The effect and possible complication that
may appear on passive smokers
• Identify situations that trigger the urge to
smoke. *avoiding the certain situation
may or will reduce the urge to smoke
Vaugh
 Nursing Interventions
• Encourage the family specially Mr. Basco to:
– Have a support person or group *someone you can call for
those times when you feel like you are having a weak
moment and might smoke a cigarette
– Keep candies, Toothpicks, sunflower seed or Lollipops
handy *it can be used as a substitute for cigarette
– Use diversionary activities such as eating candies, gums or
food*
– Brush his teeth regularly *reduce the presence of tartar
– To buy food instead of buying cigar *
– Client to remind their children not to smoke and what are
the effects of smoking*to encourage their children not to
smoke
• To smoke away from other person if smoking cannot be avoided*to Vaugh
avoid second hand smoking
 Methods of Family Contact
• Home visit

Vaugh
 Resources
• Human resources: time, and effort of
the nurse and the family
• Financial resources: Fare for
transportation
• Teaching aids

Vaugh
 Evaluation
 “GOAL MET”
  
 March 05, 2010
 @
 9:30am


At the end of nursing interventions, the family was able to verblize:



• “duha nalang na sticks ang nahurot nako gahapon…plano na gani

nako magundang na ko pagsigarilyo” as verbalized by Mr.
Basco.
• “kanser,ubo na dugay mayo”
• “mas maayo jud ang dili na mag sigarilyo para makalikay sa sakit
”
• “pwede kendi, lollipop ug bubble gum ang pwede ipuli sa Vaugh
pagsigarilyo” 
 Phoebe Lyn S. Brusas, St. N

LACK OF FOOD STORAGE

FACILITY
FE B R U A R Y 2 0 , 2 0 1 0 @  1 0 : 0 0 A M

Vaugh
 Cues
Subjective:


• “Lage, wala mi butanganan para sa among pagkaon

kay wala man pud gud mi ref gang’’, as verbalized
by Mrs. Angelita Basco.
•
Objectives:


• -no water container;

• -observable leftover food with presence of ants;
• -grocery items such as milk, noodles and condiments
are unkept at one side near the sink;
• -no refrigerator or cabinet for food storage purposes.
Vaugh
 Family Nursing Problem
• Poor home condition specifically lack
of food storage facilities as a health
threat.

Vaugh
 Family Health Problem
• . Inability to provide home
environment conducive to health
maintenance due to: limited
physical resources such as lack of
food storage facilities.

Vaugh
 Goal of Care
• At the end of nursing interventions,
the family would be able to
recognize the importance of proper
storage of food for health
maintenance. Thus, take
appropriate actions to solve the
existing problem.

Vaugh
 Objectives
At the end of nursing interventions, the family would be
able to:
 1. enumerate at least two effects of unprotected
and non-stored food such as:
 a. possible contamination of other substances
or microorganisms;
 b. easy spoilage of food.
 2. appreciate the benefits of having proper food
storage facilities.
 3. demonstrate proper ways of storing food such
as:
 a. placing in properly sealed containers;
 b. labeling the containers; Vaugh
 Nursing Interventions
1. Assess the salience of the family regarding the presence of the problem.
®to know whether the family think it as a problem or not

2. Inform them about the existing problem.

® to promote awareness about the problem

3. Explain to the family the good effects of proper storing of food such as:

a. prevention of rapid spoilage;

b. possible contamination may be avoided.

® to provide information about the benefits of proper food storage.

4. Enumerate ways and means on how to improve food storage such as :

a. placing food in clean and properly sealed containers:

b. labeling the containers according to use.

® to prevent contamination

Vaugh
 Nursing Interventions
5. Instruct the family to cover drinking containers with caps or clean
plastic or cellophane which can be sealed by rubber bands.
® to ensure it is clean and is safe to drink

6. Encourage the family to wash and clean the containers from time to

time.
® this promotes health maintenance and wellness

7. Persuade the family to find other ways in storing food.

® resourcefulness and creativity are also solutions on the existing

problem.
8. Encourage the client to buy food enough only for the meals.

® to prevent food wasting and spoilage since they don’t have

refrigerator
9. Instruct parents to put food containers away from children’s reach.

® to avoid accidental spilling and food wasting Vaugh

 Methods of Family Contact
• Home visit

Vaugh
 Resources
1. Human resources: Time and effort
of the nurse and the family.
2. Financial resources: fare for

transportation and money for the

grocery items
3. Teaching aids

Vaugh
 Evaluation
 “GOAL MET”
 March 05, 2010@ 9:30am


1. enumerated two effects of unprotected and non-stored food such as:
 a. possible contamination if not properly sealed and kept;
 b. easy spoilage of food.
2. “ Bitaw no..dapat jud diay nato ibutang sa limpyo na butang anan ug

kanang nay taklob ang pagkaon para dili madapuan ug mga ok-ok ug
langaw . Para makaiwas pud ta sa sakit”, as verbalized by Mrs.
Angelita Basco.
3. demonstrated proper way of storing food such as:

 a. the condiments, milk and noodles are placed inside a

container with cover;
 b. labeled the containers as for the salt, vinegar and sugar.
 c. provided container for the leftovers. Vaugh
Implications Of The
Study
o r e ve n t w h ich is th e ca se . It p ro vid e s a syste m a tic w a y o f lo o kin g a t e ve n ts,
co lle ctin g d a ta , a n a lyzin g in fo rm a tio n a n d re p o rtin g th e re su lts. T h u s, th is
ca se stu d y is d ire cte d to w a rd s a co m p re h e n sive stu d y m a d e o f th e fa m ily to
b rin g a fu lle r u n d e rsta n d in g o f th e n e e d e d n u rsin g ca re to th e m . T h is stu d y
ca n a lso b rin g a b o u t im p ro ve m e n t in th e fie ld o f N u rsin g e d u ca tio n , N u rsin g
Pra ctice a n d N u rsin g R e se a rch .

N u rsin g e d u ca tio n is fo cu se d o n te a ch in g th e kn o w le d g e a n d skills th a t

w o u ld e n a b le a n u rse to p ra ctice in th e h o sp ita l se ttin g . It is co n tin u a lly
re vise d to m e e t th e n e e d s o f n u rse s w o rkin g in a ch a n g in g e n viro n m e n t. A s
stu d e n ts in a h e a lth d iscip lin e , w e ca n u se th is stu d y a s a n e d u ca tio n a l to o l.
T h is ca n se rve a s a g u id e in d o in g a co m p re h e n sive re vie w o f th e clie n t, th e
p ro b le m s, e fficie n t in te rve n tio n stra te g ie s a n d fa cto rs th a t a ffe ct th e
o u tco m e o f th e p ro b le m s.

A p p a re n tly , N u rsin g Pra ctice a s w e a ll kn o w is flexib le a n d d yn a m ic . It

ca n ch a n g e a n d im p ro ve d u rin g th e co u rse o f tim e . T h e im p lica tio n s o f th is
ca se stu d y in N u rsin g Pra ctice is th a t, it ca n h e lp in clin ica l d e cisio n m a kin g
a n d ca n a ssist in se le ctin g a p p ro p ria te in te rve n tio n s. It re a lly m a ke s g o o d
se n se to im p le m e n t a n e w in n o va tio n in th e im p ro ve d p ra ctice se ttin g .
h a p p e n e d a s it d id a n d w h a t m ig h t b e co m e im p o rta n t to lo o k a t m o re
exte n sive ly in fu tu re re se a rch . C a se stu d y is a lso d e fin e d a s a re se a rch
stra te g y , a n e m p irica l in q u iry th a t in ve stig a te s a p h e n o m e n o n w ith in its re a l
life co n text. T h is stu d y ca n b e a va lu a b le so u rce o f d a ta fo r re se a rch . T h e
m a jo r g o a lo f n u rsin g re se a rch is to im p ro ve clie n t ca re .

T h e u ltim a te g o a l o f a n y p ro fe ssio n is to im p ro ve th e p ra ctice o f its

m e m b e rs so th a t th e se rvice s p ro vid e d to its clie n t w ill b e m a xim a lly
e ffe ctive . A p ro fe ssio n se e kin g to e n h a n ce its p ro fe ssio n a l sta tu re strive s fo r
th e co n tin u e d d e ve lo p m e n t o f a scie n tific b o d y o f kn o w le d g e fu n d a m e n ta l to
p ra ctice . T h e e m e rg e n ce o f su ch a b o d y o f scie n tific kn o w le d g e ca n b e
in stru m e n ta l in fo ste rin g a co m m itm e n t a n d a cco u n ta b ility to th e
p ro fe ssio n ’ s clie n ts.

A b o ve a ll, th is stu d y is co n d u cte d fo r th e im p ro ve m e n t o f ca rin g a n d

m a n a g in g ch ild h o o d illn e sse s to re d u ce th e m o rta lity a n d m o rb id ity in
ch ild re n u n d e r 5 ye a rs o ld . T h e co m m u n ity -IM C I is to exp a n d a cce ss a n d th e
co n tin u u m o f ca re fro m clin ics to h o u se h o ld / co m m u n itie s. T h is a lso fo cu se s
o n th e co m m u n ity -b a se d in te rve n tio n s to im p ro ve n e w b o rn a n d ch ild h e a lth .
T h e co m m u n ity -IM C I h e lp s a sp ira n t n u rse s to fa cilita te a ctu a l a sse ssm e n t to
ch ild re n w ith p o o r h e a lth co n d itio n s. T h u s, th ro u g h p ro p e r cla ssifica tio n w e
ACKNOWLED
Ackn ow ledg em en t...
“ O n g o in g re se a rch is e sse n tia l fo r th e g ro w th o f th e
p ro fe ssio n ” . T h u s, th is fa m ily ca se stu d y w o u ld n o t b e a
su cce ss if it w e re n o t fo r o u r d e a r C lin ica l In stru cto r, M r.
Q u irin o U n tu a Jr.. H e h a s p a in sta kin g ly g u id e d u s in e ve ry
ste p o f th e w a y. H e is a g re a t m e n to r a n d te a ch e r. B ig
th a n ks to o u r Pra cticin g C lin ica l In stru cto r, M s R u ffa
T h e re se M a e E n riq u e z fo r h e r co n tin u in g su p p o rt,
g u id a n ce a n d e n co u ra g e m e n t.
 
W e w o u ld like to th a n k o u r g re a t p a re n ts w h o co n tin u a lly
sh o w e d th e ir lo ve a n d su p p o rt. T h e y h a ve b e e n ve ry
co n sid e ra te a n d u n d e rsta n d in g th ro u g h a ll th o se
stre ssfu ln ig h ts.
Ackn ow ledg em en t...
W e w o u ld like a lso to th a n k o u r sp o n so rs: S TA R kid s
Tu to ria l C e n te r, A n in o a n d B ru sa s re sid e n ce a n d th e S a n
Pe d ro C o lle g e Lib ra ry fo r m a kin g th is ca se stu d y
p o ssib le .
 
A n d m o st o f a ll, w e w o u ld like to th a n k th e A lm ig h ty
Fa th e r fo r g u id in g u s, e n lig h te n in g u s a n d p ro te ctin g u s
fro m a ll h a rm . H e h a s b e e n w ith u s fro m th e ve ry
b e g in n in g . W e o w e th is re m a rka b le b le ssin g to H im .
 
To a ll th o se w h o w e re n o t m e n tio n e d b u t co n trib u te d a
lo t to th is su cce ss, o u r d e e p e st g ra titu d e a n d th a n ks to
a llo f yo u . T h a n k yo u ve ry m u ch !