Professional Documents
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Family Case Analysis 2
Family Case Analysis 2
Angeles City
Presented by:
GROUP 1- BSN III-1
ANO, CARL ELEXER
CALMA, ARIANE CAMILLE
DIZON, REQUELITO
SOTTO, MICHELLE LOUIE
BALILO, NOEL LEONCIO
CABRERA, KRISTINA EDNA
CUYUGAN, MARY ANN
DE JESUS, LUIGI MIGUEL
ESTRADA, FLORENCE ANCEL
LIBRES, MARY ANGELICA TEOFFY
PALCIS, DANIEL
VALENCIA, PRECIOSA
Presented to:
JOANNE MARIE GALANG, R.N.
I. INTRODUCTION
Ogden Nash was basically a humorist, but such quote made a lot of sense. To interpret
it, it must mean that the family is a model which, physical manifestations would include the
presence of a man one calls father, a woman one calls mother, and of course those sons and
daughters running about to get their tasks done as they, undeliberately, grow older. A sleeping
dog or a cat basking on the sunlight at the patio would constitute to the occasional animal he
was talking about. And as for the common cold, generally, this would mean a highly contagious,
self-limiting disease brought about by different strains of viruses with symptoms of sore throat,
runny nose, nasal congestion, sneezing and coughing.
So how did common cold get to associate itself with the family? One would say, its
communicability is the primary factor, yes. Looking beyond the natural scope of things, the
predetermined communicability of the common cold lies on the word, common, not as of the
ordinary, but as of the shared. Usually, in a family, if one child is coming down with a cold,
surely, a sibling will follow, especially if such come from a depressed family devoid of the
advantages of nutrients to keep their immune system on the pink of health. Perhaps Nash was
only trying to imbibe to us the power of family, that even diseases are shared. A loving family is
worth all the riches in the world, for they will always be there for you, no matter what happens.
Ergo, no poor family is too poor if they have a family deeply rooted in love and compassion for
each other.
On a more serious note, In Article 15: The Family, of the 1987 CONSTITUTION OF THE
REPUBLIC OF THE PHILIPPINES: “The State recognizes the Filipino family as the foundation
of the nation. Accordingly, it shall strengthen its solidarity and actively promote its total
development. This reinforces the value of the family in community health nursing, as it plays
mediator between the first and third type of clientele, the individual and the society.
The family, being the crucial entity of the society is also deemed as the critical unit of
care since it is an efficient and accessible avenue for much of the community health nursing
effort. How ironic to say that a family shares a disease to be family! As aspiring nurses, it is the
duty of the researches to at least, be there for the family to reinforce health goals and promote
self-reliance, that it’s a deliberate nature of the family to share, yes, but not illness. Family
Health Nursing is a level of community health nursing practice focused or directed on family as
the unit of care/ client, with health as a goal and nursing as a medium or provider of care.
Family-centered care is the key concept in community health nursing practice.
Family Case Analysis is an instrument utilized by PHN nurses and student nurses alike
in delineating all prevailing problems of the community by centering on the families constituting
it. Home visits are the number one means in order to accomplish this. In here, the family’s
health needs will be assessed and the nurses, or the student nurses, rather, will provide health
teachings and render nursing care to accommodate and address their inadequacies and
liabilities in terms of family life and do something about them.
Before the exposure, the student nurses have a main criteria in choosing a family as a
subject; 1.) Depressed, 2.) Lack knowledge about healthy lifestyle, 3.) At least four members of
the family, 4.) At least have children who are 7 years old and below and the Griffin family suits
are criteria the most. They cannot do health tasks effectively making them at risk with different
health hazards.
A. Objectives
Family assessment begins with a complete health history. It is one of the most effective
ways of identifying existing or potential health problems. History is followed by physical
assessment of family members (Kozier, 2004).
1. BRIAN GRIFFIN
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36 °C
P- 73 bpm
R- 21 cpm
BP- 100/60 mmHg
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen. He can hear and respond when he is asked.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
His nail plates are colorless and have concave curves. They are slightly long and
untrimmed. His nail beds returned to previous state in less than three seconds after pressure
was applied.
NUTRITIONAL STATUS
Age: 32 years old
Height: 168 cm
Weight: 63 kg
Formula:
Body Mass Index (BMI) = Weight in kilograms (kg)
Height in meter squared (m2)
= 22.5
Interpretation:
Healthy Weight
Legend:
BMI Table
( Based on Asia-Pacific Obesity Guidelines )
Underweight < 18.5
Healthy Weight 18.6-22.9
Overweight > 23.0
At risk 23.0-24.9
Obese I 25.0-29.9
Obese II > 30.0
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . He can hear and respond when he is asked.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
His nail plates are colorless and have concave curves. They are still slightly long and
untrimmed. His nail beds returned to previous state in less than three seconds after pressure
was applied.
2. Lois Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.5 °C
P- 75 bpm
R- 17 cpm
BP- 110/80 mmHg
General Appearance and Mental Status:
During the assessment, Lois Griffin was wearing a white shirt and pink pants. Her hair is
tied up, She is cooperative, coherent and oriented to person, place and time. She has a steady
gait and shows no difficulty in speaking. She also exhibits thought association and has a sense
of reality. She has no difficulty recalling past and present events. She stands 155 cm and
weighs 52 kg.
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. She has moist mucous membranes and her palpebral
conjunctiva is pink in color. Her pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen. Her hearing in her right ear is slightly impaired but she was able
to respond when asked.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are long and untrimmed.
Her nail beds returned to previous state in less than three seconds after pressure was applied.
NUTRITIONAL STATUS
Age: 45 years old
Height: 155 cm
Weight: 52 kg
Formula:
Body Mass Index (BMI) = Weight in kilograms (kg)
Height in meter squared (m2)
= 21.6
Interpretation:
Healthy Weight
Legend:
BMI Table
( Based on Asia-Pacific Obesity Guidelines )
OBSTETRICAL HISTORY
Lois Griffin has two children . She delivered them both via Normal Spontaneous Delivery.
She delivered her first child at a secondary level hospital in Angeles City while her second child
was delivered by a midwife ( home delivery ). Her first child didn’t reach full term and she had
eclampsia during the delivery of her first child. She was also given antihypertensive drugs which
were taken sublingually for elevated blood pressure. Her second child reached full term. She
has been pregnant and has given birth two times- G2P2 ( T1P1A0L2 ).
HISTORY OF PAST ILLNESS
According to Lois Griffin, she had Chickenpox and sore eyes during childhood. No
interventions were made to manage these. For episodes of fever, she took Paracetamol. She
also had eclampsia during the delivery of her first child and she was given antihypertensive
drugs for elevated blood pressure which were taken sublingually.
Vital signs:
T- 36.8 °C
P- 78 bpm
R- 20 cpm
BP- 110/70 mmHg
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. She has moist mucous membranes and her palpebral
conjunctiva is pink in color. Her pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . Her hearing in her right ear is slightly impaired but she was
able to respond when asked.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are long and untrimmed.
Her nail beds returned to previous state in less than three seconds after pressure was applied.
3.Meg Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.3 °C
P- 89 bpm
R- 22 cpm
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, with discharges in minimal amount and no discolorations are
present at the surface of eyelids. Lids close symmetrically. She has moist mucous membranes
and her palpebral conjunctiva is pink in color. Her pupils constrict when looking at near objects
while they dilate when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . She can hear and respond only through movements.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. Discharges in minimal amount were
noted and there is the absence of nasal flaring. Also, no nodules and masses were noted upon
palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. A small wound was found on her right knee.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are slightly dirty and
untrimmed. Her nail beds returned to previous state in less than three seconds after pressure
was applied.
NUTRITIONAL STATUS
Age: 4 years old
Height: 88 cm
Weight: 9 kg
Vital signs:
T- 36.5 °C
P- 85 bpm
R- 24 cpm
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, with no discharges and no discolorations present at the surface
of eyelids. Lids close symmetrically. She has moist mucous membranes and her palpebral
conjunctiva is pink in color. Her pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . She can hear and respond only through movements.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and
there is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. A small wound was found on her right knee.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are trimmed and short. Her
nail beds returned to previous state in less than three seconds after pressure was applied.
4. Stewie Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.2 °C
P- 90 bpm
R- 20 cpm
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . A small wound was found at the lower pinna of his left ear. He
can hear and respond through head movements.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities. Wounds are present on both lower extremities and right hand.
Fingernails
His nail plates are colorless and have concave curves. They are dirty and untrimmed.
His nail beds returned to previous state in less than three seconds after pressure was applied.
NUTRITIONAL STATUS
Age: 3 years old
Height: 88 cm
Weight: 10 kg
Vital signs:
T- 36 °C
P- 81 bpm
R- 20 cpm
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . He can hear and respond through head movements.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities. Wounds are present on both lower extremities and right hand.
Fingernails
His nail plates are colorless and have concave curves. They are dirty and untrimmed.
His nail beds returned to previous state in less than three seconds after pressure was applied.
In terms of decision making, whether heath care-related or not, it is Brian Griffin who
usually do it, although he still considers the suggestions and preferences of Lois, his wife.
EXPENSES AMOUNT
Food Php6000
Clothing and other expenses 2000
Electricity 200
Water 250
Total: Php8450
D. Working Hours
Brian Griffin is the breadwinner of the household. He works from 6 am to 10 pm, 16
hours a day, Mondays to Saturdays. He is given a lunch and a dinner break, where he goes
home to eat around 12-1pm and 6-7pm, respectively.
E. Ethnic background and Religious Affiliation
Brian is a Kapampamangan native, whilst Lois is an Illongga woman. The family’s
religion is Roman Catholic, so very few restrictions are being implemented, almost negligible.
According to Lois, they attend the Holy Mass during Sundays.
J. Housing Condition
The Griffin family lives in a one-bedroom semi-concrete shack. Sheets of boards from
Brian’s previous employer were topped against each other to form the walls of the humble
bungalow. In the front yard, one can see a table where dining takes place. Plants and flowers
stand on the right corner. For protection, they lined their lot with a simple dark blue picket fence.
The receiving area for guests is the front porch. The bedroom has the largest area in the house
with wooden bed and a television for entertainment purposes. Immediately on the left is the
kitchen devoid of cooking facilities as Lois cooks occasionally using charcoal outside the house.
In there, one can find plates and utensils for cooking and eating. The toilet facility is at the back
of the house.
According to the National Building Code of the Philippines (2000) the minimum size of
room required for human habituation individually is 3.5 square meters (adult) and 1.5 square
meters (child). For information regarding the adequacy of living space, the student nurses
measured each room’s total fixtures area and subtracted it from total floor area. Afterwards, the
available living space (resulting value) is less 3 square meters (1.5 sqm each) because of Meg
and Stewie, the children in the family. Then, the remaining space will be divided among the 2
adults in the family.
The total available space is 16.92 sq m, which is minus 3 square meters as required by
Meg and Stewie. The resulting value is 13.92 which is further divided by the 2 adults in family
who are Brian and Lois, comprising of 6.96 sqm per adult family member. Ergo, the family has
adequate living space.
As for adequacy of ventilation, the total window area should be at least 10% of the total
floor area. The house has only one window, measuring only 0.27 sqm. The total floor area is
16.92. This measurement didn’t make it to the 10%. This goes to show that the house is under
poor ventilation.
For the lighting conditions, the family use incandescent bulbs as their source of light
during evenings. However, inadequacy in daytime lighting is very evident, as there is only one
window and the walls of their house are not painted, adding to the dark feel of the atmosphere.
Sleeping arrangements constitute of the one bedroom they all sleep in. Brian and Stewie
sleep on a mat on the floor, whilst Lois and Meg occupy the bed they have. Both of which are
quite hard on the back as there is no mattress available.
The family is aware of the presence of vermin like cockroaches. Buzzing mosquitoes at
night are also of a common occurrence.
Last month, their front porch was burned because of the cooking facility left unattended.
Such would then be a big fire hazard as an evidence of a history of fire has occurred.
Their drainage system is located on the other side of the road. Its type is of open and
flowing nature. The garbage disposal container is sack and it is covered. Garbage collectors get
their household garbage twice a week.
Current
> Mrs. Lois Griffin is fully aware of the
knowledge problem as she has mentioned the following
Family
Resources
statement during the interview:
“si meg nung kamakailan lang nagsuka ng
SN Resources bulate”(meg vomited a worm just recently)
Community
Resources > The family has manpower resources
that enable them to easily bring their
children to the barangay health center for
proper management.
Problem# 5 Family size beyond what family resources can adequately provide:
Inadequate Family Resources
Actual
Criteria Computation Justification
score
The problem is a health threat, inadequacy
of the family resources to suffice their daily
1. Nature of the needs may result to serious health problems
2/3 x 1 .67
problem if not corrected e.g. malnutrition which is
now actually evident in the family since the
children are all underweight.
1/2 x 2 1 The problem is partially modifiable as
2.Modifiability of the reflected by the criteria being considered:
problem
> The family has a current knowledge of the
Current problem, as Mrs. Lois was able to verbalize
knowledge this problem during the interview when the
Family Resources Student Nurses asked her of what are their
problems in their house
SN Resources "...haaay syempre mahirap ang buhay
Community ngaun kaya pera ang pinakaproblema
Resources namin” (of course with the increasing
financial problem, money is our main
problem) as verbalized by Mrs. Lois.
FAMILY METHOD OF
INTERVENTION RESOURCES
CUES NURSING OBJECTIVES RATIONALE FAMILY EVALUATION
S REQUIRED
PROBLEM CONTACT
S> “Ayaw nila -Inability to ,ake SHORT TERM: - Assess for -to know past Home visits Time & effort of After 1-2 hours of
mag tsinelas pag decisions with After 1-2 hours of history of medical history the family and home visit, the
naglalaro” respect to taking home visit, the parasitism the student members of the
appropriate family will nurse. family shall have
O> health action due enumerate ways -Determine factors -to identify enumerated ways to
-The Children are to to prevent associated to contributing prevent parasitism
not wearing their misconceptions parasitism parasitism factors
slippers when or erroneous
playing outside. information -Discuss the -to provide health
LONG TERM: importance of teachings that At the end of the 5th
-The father and At the end of the having good will let them home visit, the family
his children have 5th home visit, the personal hygiene. maintain a good members shall have
untrimmed and family will personal practiced measures
dirty fingertips practice hygiene. to prevent parasitism
and toenails. measures to and identify support
prevent -Give health -to provide groups in the
-improper hand parasitism and teachings general comfort community
washing when identify support regarding different and clean body.
eating. groups in the practices on good
community personal hygiene.
-Perform usage of
the fork and
spoon when
eating.
Problem # 4 HEALTH THREAT: UNHEALTHY LIFESTYLE HABIT: POOR PERSONAL HYGIENE
FAMILY METHOD OF
INTERVENTION RESOURCES
CUES NURSING OBJECTIVES RATIONALE FAMILY EVALUATION
S REQUIRED
PROBLEM CONTACT
S> Ø -Inability to take SHORT TERM: -Assess for signs -to know health Home visit Family SHORT TERM:
O> appropriate After 2 hours of of poor personal threats resources: The family shall have
-The members health actions home visits, the hygiene -open to new verbalized
are seen wearing due to: family will information and understanding about
dirty clothes -lack of adequate verbalize -Determine factors -to know factors involvement of the importance of
knowledge understanding associated with contributing to nursing good personal
-The members of regarding proper about the poor personal health threat interventions hygiene to their
the family have hygiene importance of hygiene health
long and dirty -inadequate good personal Student nurses
fingernails and financial hygiene to their -Discuss the -to provide health resources:
toenails resources to health importance of teachings that -Time & effort to
avail proper having good will let them explain proper LONG TERM:
-The members of hygiene practices personal hygiene. maintain a good hygiene The family shall have
the family has and resources LONG TERM: personal practices and demonstrated
dirty skin as a At the end of the hygiene. adequate maintainance of
sign of not taking 5th home visit, the knowledge good personal
a bath family will -Give health -to provide about the hygiene and applied
demonstrate teachings general comfort diseases in a health teachings
maintenance of regarding different and clean body. poor personal given as evidenced
good personal practices on good hygiene by taking a bath
hygiene as personal hygiene. everyday, and proper
evidenced by cleanliness in their
taking a bath -Discuss the -to provide a bodies.
daily and wearing following: presentable look.
comfortable
clothing, trimmed -Instruct them to
fingernails and take a bath at
toenails. least once a day.
-Instruct them to -to minimize the
frequently wash occurrence of
hands and cross infection
trimmed and parasitism.
fingernails &
toenails.
Problem #5: Family size beyond what family resources can adequately provide: Inadequate Family Resources
S> Inability to Short term: Establish To gain trust Home Visit Family resources: Short term:
sustain their After 1-2 hrs of rapport with the and cooperation Understanding The members of
O> The group basic needs due home visit, the family of the family. and cooperation the family shall
found out that the to lack of family family will be able members. of the family. have identified
total monthly resources and to identify ways ways to properly
budget of the failure to have a on how to Compute for Provides Student nurses budget their
family is high paying job. properly budget the family comparison of resources: monthly income.
P8,250.00 which their monthly expenses and data and Skills,
gives every income. salary. determines knowledge, time, Long term:
member a deficiency in effort and The members of
monthly Long term: financial status. motivation of the the family shall
allowance of At the end of the Assess the students. have maintained
P2,062.50. It is 5th home visit, the family’s sources Provides practice
not enough for family will be able of income. baseline data measures to
the family’s to find ways on and determine prevent fire
everyday needs. how to earn extra other possible hazards.
income sufficient sources.
to the needs of Provide the
the family. family Provides
information on creativity in the
different family and
methods of raising extra
earning an income.
extra income.
Encourage
the family to To allow
engage in money for daily
activities that needs and to
would promote save extra
livelihood such money.
as planting
vegetables.
Explore ways
on proper To maximize
budgeting and the money
possible extra earned by the
sources of parent.
income.
Problem #6: Presence of Accident Hazard: Fire Hazard
S> “Nasunugan Inability to make Short term: Assess for the history of To obtain Home Visit Time and effort Short term:
kami nung Jan. decisions with After 1-2 hrs of the event. baseline data. of the student The members
31.” As reported respect to taking home visit, the nurses and the of the family
by Lois appropriate members of the Determine factors which To family. shall have
health actions family will can contribute to the determine enumerated
O> presence of due to enumerate occurrence of such. contributing measures to
damaged inaccessibility of measures to factors. prevent fire
improvised roof appropriate prevent fire hazards.
resources for hazards.
care specifically Enumerate ways to To prevent Long term:
cost constraints Long term: prevent fire hazards: occurrence of The members
or economic/ At the end of the fire hazards. of the family
financial 5th home visit, Establishment of shall have
inaccessibility the members of safe cooking maintained
and failure to the family will facilities. practice
comprehend the maintain to measures to
nature/ practice Objects which can prevent fire
magnitude of measures to contribute to its hazards.
the problem. prevent fire occurrence should
hazards. be properly
stored.
Careful utilization
of objects/
equipment that
can cause fire
hazards.
Problem #7.5 Poor Environmental Sanitation: Lack of Food Storage Facilities
Method of
Problem
Nursing Family Resources Expected
Cues Analysis Objectives Rationale
Interventions Contact Required Outcome
S: Ø Inability to Short term: >Establish raport >to gain trust Home visits Family Short term:
recognize the After 2 hours of Resources: The family shall
O: presence of the nursing >Assess Food >to obtain baseline data >plates and have verbalized
>The Family problem due to: intervention the Storage Facilities plastic food understanding on
has no family will covers the importance of
refrigerator >Inadequate verbalize >Discuss to the family >to develop awareness to the proper storage of
>They don’t knowledge understanding on the possibilities of family about the prevention Student food
have cabinet about the the importance of contaminating the and intervene about it nurse’s
for food consequence of proper storage of food if not properly resources: Long term:
storage the problem food stored. >time and The family shall
> Leftover effort with the have complied
foods were >Inadequate Long term: >Explain the possible >to increase their awareness cooperation with the health
left on the financial After 1 of home consequences and that this could bring about and teaching given on
table in a resources to visit, the family complication they complication to their health. participation proper food
plate with avail food will comply with may acquire from of the family storage..
cover storage facilities the health contaminated food and student
teaching given due to improper nurse.
on proper food storage
storage.
>Encourage covering >to prevent easy spoilage
of food properly with and contamination of the
plates or any foods
appropriate
Problem #7.5 Poor Daytime Lighting Condition
Method of
Problem
Nursing Family Resources Expected
Cues Analysis Objectives Rationale
Interventions Contact Required Outcome
S: Ø Inability to Short term: >Assess lighting >to obtain baseline data Home visits >Knowledge Short term:
provide a home After 1 hour of condition and The family shall
O: environment nursing communicatio have verbalized
>Upon which is intervention the >Allow the family to >to assess family’s n skills of the understanding on
entering the conducive to family will verbalize some ways compliance on the health student nurse the health
house it was health verbalize to improve their teachings given teaching given
quite dark maintenance understanding on source of lighting >Participation regarding the
and there due to the health and importance of
was inadequate teaching given >Identify with the >to include the family in acceptance of adequate lighting
insufficient family resources regarding the plans to alleviate poor planning and increasing family
number of specifically: importance of lighting awareness members Long term:
light bulbs adequate lighting The family shall
>Financial >Instruct the mother >to provide enough light >time and have
>Use of 2 constraints/ Long term: to keep the door open effort with the demonstrated
incandescen limited financial After 3 of home during daytime cooperation implementation of
t lights resources visits, the family and the means the
will demonstrate >Encourage mother >to provide enough light participation identified such as
>Hard to >Limited implementation to open the widows of the family opening windows
read when physical of the means the and remove and student
inside the resources identified such as obstruction such as nurse.
house during (e.g. bulbs) opening windows curtains
daytime
Problem #10: Poor Ventilation due to Economic/ Cost Implication
FAMILY METHOD
NURSING RESOURCES
CUES NURSING OBJECTIVES RATIONALE OF FAMILY EVALUATION
INTERVENTIONS REQUIRED
ANALYSIS CONTACT
S> Ø > poor SHORT TERM: >Discuss to the >To analyze and Home Visits >knowledge and SHORT TERM:
ventilation due After 1 hour, the family the realize the ideas communication GOAL MET,
O>the house has to low salience family will be able importance of regarding the skills of the After 1 hour, the
only one window of the problem to verbalize having good matter nursing students. family will
measuring to 60cm x >lack of understanding ventilation verbalized
45cm or 0.27m2 adequate about the >Participation understanding
such measurement knowledge of importance of >Explain the >For the family to and Acceptance about the
is less than 10% the importance having adequate possible become aware of of family importance of
requirement posited of proper ventilation and consequences of the possible members having adequate
by national building ventilation. consequences if having poor consequences ventilation and
code of the having poor ventilation >Time and effort consequences if
Philippines as The ventilation. of the student having poor
total Floor area is >Provide health >To provide nurse and the ventilation.
16.92 m2 LONG TERM: teachings about the knowledge and family.
After the 3 days of significance of realize the benefits
>it is quite warm home visit, the adequate of having adequate LONG TERM:
inside the house. family will be able ventilation ventilation GOAL MET, After
to demonstrate the 3 days of home
techniques on how >encourage to >To allow passage visit, the family
to improve proper Remove of air inside the demonstrated
ventilation. unnecessary house. techniques on how
obstruction which to improve proper
are contained in the ventilation.
windows.
Initial Final
Category Justification
1 3 5 1 3 5
1. PHYSICAL
INDEPENDENCE Initial:
The Family has moderate physical
This category is concerned
independence ask evidenced by the
with the ability to move about,
to get out of bed, to take care mother Is able to provide the family
of daily grooming, walking, need on basic needs such a s food
etc. Note that it is the family
preparation nurturing of the children,
competence that is
measured- even though an grooming and the like, but still the
individual is independent, if mother still lack some more information
the family is able to
to proper render this care, because at
compensate for this. The
family is important-hence, if times the children are still important.
the focus of care is poor, for Final:
instance, if the mother is After the health teachings and
giving care to a handicapped
child that she shared with interventions given by the student nurse
other members of the family, the mother’s physical independence
the independence might be increase to an efficient level AEB she
considered incomplete. The
was able to maintain her children
causes of independence may
vary however. Lack of hygiene.
independence in the family
may be due to actual physical
incapacity, the inability of
“know-how”, the willingness or
fear of doing necessary tasks.
2. THERAPEUTIC Initial:
COMPETENCE
Initially the family has very low
therapeutic competence, as the mother
This category includes all the does not necessary manage the illness
procedures or treatment
of the members in the family, she lacks
prescribed for the care of
illness, such as giving information on “How to” do such
medications and using procedure, the family relies on OTC
appliances, dressings,
drugs.
exercises, and relaxation and
special diets.
Final:
On the final visit, After giving all the
necessary intervention to correct them
previous believe and practices the
family was able tom increase their
therapeutic competence. This was
supported by the mother as she readily
responds to the question given by the
student nurse regarding certain
situation.
3. KNOWLEDGE ON
HEALTH CONDITION
Initial:
Upon assessing the family
This category is concerned
with the particular health knowledge about certain disease,
condition that is the occasion condition especially those of common
for care, knowledge of the
diseases. The mother was able to
disease or disability,
understanding of responds on some of the question but
communicability of diseases still lack of knowledge on how to
and modes of transmission,
properly manage such diseases.
understanding of general
Final:
patterns of development of a
newborn baby and the basic Upon final visits with the health
needs of infants for physical teachings given and reinforcement of
care and tender loving care.
the knowledge, the family was able to
verbalize on how to manage these
disease in case it happen to occur in
their family.
4. APPLICATION OF
PRINCIPLES OF GENERAL Initial:
HYGIENE In terms of application of principles
This is concerned with family of general hygiene the family has an
action in relation to idea on how to properly do the
maintaining family nutrition,
procedure they also have the
securing adequate rest and
relaxation for family members knowledge on the importance of
and carrying out accepted completing the EPI program
preventive measures such as
immunizations, medical
appraisal and safe Final:
homemaking habits in relation After health teaching were given
to storing and preparing food. appropriate intervention, during the final
visit the family is now knowledgeable on
properly do the procedures, application
of procedure in general of its
importance.
5. HEALTH ATTITUDES
Initial:
This category is concerned
The family has a bright idea about
with the way the family feels
about health care in general, health are, only they do not know how
including preventive services,
to improve and practice this activity
care of illness and public
health measures.
Final:
The final visits the family has able to
verbalize the health teaching render,
eg. It is important to address antibiotics
about health care must be definitely to
the health centre for clarification
6. EMOTIONAL
COMPETENCE
7. FAMILY LIVING
9. USE OF COMMUNITY
FACILITIES
Initial:
This category has to do with
the degree to which family Initially, the family does not have
members know about and the enough knowledge on what are the
wisdom with which they use
available programs in the community
available community
resources for health, that they could avail, though they have
education, and welfare. The some ideas of the barangay programs.
coping ability does not
indicate the level of the need
for services, but rather the Final:
degree to which they can During the final visit, after the
cope when they must seek dissemination of the barangay
such aid.
programs that they could avail
especially of that health related, the
family is now knowledgeable of this and
has developed interest on these
programs.
VIII. LEARNING DERIVED
I personally learned the importance of the family in the society, as the basic unit of the
society, it is important to maintain the health of the family. Comparing the family with the human
body, as when one part of the body is infected, later on the whole body will be affected
systemically, just like with the family and society, when a family is considered ill, later on the
society will be systemically affected.
I also learned the importance of good communicating skill. With the absence of a good
communicating skill the student nurse will not be able to establish rapport with his/ her client,
thus affecting the assessment process, making the problem identification and prioritization be
difficult, thus, altering the maximum care you may give to the family.
Assessment is the very crucial part of doing the family case analysis, with all the data
that you will gather throughout the assessment process, there you will derived the problems you
will intervene to correct this problems.
The most important thing that a student nurse must have is the initiative, time, effort, and
patience, without those things you will not be able to gather all the information you need, the
client’s cooperation and compliance is also a vital ingredients for the success of making a family
case analysis.
Finding a family was hard, and the intolerable heat was unnerving, and didn’t help at all. It was
quite of a feeling of hopelessness and lose that we weren’t able to find a family on the first day,
or let me rephrase that, “a SUITABLE family…” The first foster family we had was so depressed
that we ourselves weren’t sure if we could help them. The mother wasn’t also much of a reliable
source of information for she must have mental problems based on her words and actions. Our
second foster family- the Griffin family, was really nice and accommodating. They were an
inspiration to us, especially Mother Lois. She always has this hopeful note in her words that
everything will be all right when the time comes, and despite the fact they are poor, that wouldn’t
hinder her to always wear a smile and face the world with happiness and courage.
In making the FCA for the second time, it was a real reinforcement of establishing rapport with
the family as we have to visit them for two weeks. Perhaps, it was hard for them to treat us like
we weren’t a bother at all; as of course, people always have better things to do. Still, I’ve
learned the value of kindness and optimism through them, beyond physical examinations,
problem identification and priority setting. However trite this may sound, I can say that
somehow, God has made the family an instrument so I will bear in mind the fact that some
families have real problems, and I was chosen to try to do something about them.
Requelito A. Dizon Jr
Family Case Analysis is not just about accomplishing the paper but it involves more of
indulging or integrating yourself into the life of the family you adopted so that you personally
discover problems which will allow you to do your nursing role.
The student nurses have learned that a Family Case Analysis entails hard work.
Thorough assessment is truly important to identify the problems of the family with appropriate
nursing interventions.
Through the student nurses’ exposure to various families, they also learned that
community health nurses, are the key persons in the provision of comprehensive and
continuous family health care. Thus, a genuine concern and proper coordination is needed for
the efficacious delivery of care.
After being immerse in this kind of activity, there are many thing that I have learned
about life. Upon on what we have witness on the family that we had encountered. Life is not that
easy. You must make some effort in order to survive. It’s not the material things, the fame,
fortune and power that makes us completely happy, but the thought of having helped someone
who is in great need of us. We honestly haven’t been happier that we are right now, because of
the pleasure we have knowing that we have helped people in our own little way.
Doing a Family Case Analysis proved that theories are not enough to have the courage
to face all the trials in life. Basically, it was an experience that served as an eye opener for the
student nurses to deeply feel the true impact of poverty. This activity also served as an
opportunity for them to enhance their critical thinking and socialization to understand and
somewhat abate a family’s certain condition.
Through interacting with the family we adopted, I’ve implied different nursing
interventions taught to us, we had health teachings to promote health and prevent
illness, and also we cleaned the environment together with them to maintain proper
management of the surroundings.
In the community, we are able to meet the health needs of the people in our own
little ways; we are able to help them even in small ways. With that, I have learned that
nursing is not just a profession taught to gain income rather it is giving compassion and
service to our countrymen. I also learned a lot in the different techniques on how to
establish rapport to families and how to teach them regarding family planning, proper
hygiene and prevention of communicable diseases. I’ve learned that many of us are
lacking knowledge regarding promotive and preventive measures to maintain good
health, so it is indeed necessary for us nurses to render care and give appropriate
interventions and management for them to achieve health.
To sum it all up, in my exposure in the community, I’ve learned so much on how
to be a competent community health nurse through the experiences I had.
-Florence Ancel Estrada
I realized the importance of having a stable job in order to adequately provide the
individuals needs of family members. It is also equally important to plan on how many
children that the couple could support with their present resources. I have also
pondered on the family’s situation which made me thankful n where I am right now.
Discrimination aside, I appreciate the efforts of my parents in providing me all that they
could give for me to have a better future. It has been seen by our group how the
children are undernourished and how inadequate their housing condition is. This has
made me realize the implications on what could happen if a family would not be able to
meet their individual needs. The children are always the one who suffers greatly for their
health and education are always compromised with such poor condition. It must be
responsibility of both parents to give their best in supporting their children. I have been
and still fortunate that parents had given me the opportunity to be educated even
though they are having difficulties in working. This made me realize that as a student
nurse. I could help change the community by exerting efforts to educate the families on
how to improve their condition amidst the lack of financial resources. It is true, indeed
that the primary responsibility in shaping an individual’s value of health comes from their
own families.
Being a PHN is also like handling a patient in a hospital, the only difference is that you
handle the whole family itself that you adopted. And the main goal is not just curing the
patient but also helping the family in preventing other potential problems that may arise,
and to also help them in coping from the instances in this fast paced world.
Daniel T. Palcis
Community Health Nursing is not a simple act or Nursing service rendered by either Registered
Nurses or Student Nurses. The primary objective of community Health Nursing in a large sense
is to promote the primary level of prevention, Health promotion, and also continuation of Health
care from the Hospital.
Community Health Nursing provides awareness and knowledge regarding the current
health situation of he community. As student Nurses, and as members of the health care team,
our responsibility is to promote and provide quality care. Even if we are still student nurses, we
already have the capacity to change, manipulate or improve the health situation of the
community. We should always take part and take in to consideration all of the nursing tasks that
we perform. Student nurses should love their craft or the art of nursing per se in order to provide
efficient nursing care.
The community health should be one of the primary objectives of a nurse. A healthy
mind and body contributes to the over-all heath of a person. As student nurses we should
always take part and never ignore the current over-all status of the community because a
healthy community also reflects the health service provided by the health sectors or providers.
Preciosa C. Valencia
IX. SOCIOGRAM:
This chapter illustrates graphic representation of the several home visits made, including
the interactions of the student nurses with the families, the assessment, planning, interventions
and evaluation done.
Legends:
Home Satisfaction
Entrance
Small Garden
Door
Window
Cooking Area
Wall
Comfort
ComfortRoom
Room
Backyard/Garden
Griffin family’s humble abode Entertainment corner
Interview with Mother Lois The comfort room where laundry is done
Cookware devoid of cooking facility Homemade cooking facility using charcoal or wood
Wound Dressing Vital signs taking
Untalan, A. Concepts and Guidelines in COPAR. 1st ed. Manila: Educational Publishing House,
2005.
Maglaya, A. Nursing Practice in the Community. Marikina City: Argonauta Corp., 2004.
Cuevas, F. et. al. Public Health Nursing in the Philippines. 10th ed. Philippines:
2007
http://wisdomquotes.com
http://psychology.about.com/od/theoriesofpersonality/ss/psychosexualdev.htm
http://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htm
Handouts from:
Primary Health Care II (2007-2008)