Chapter V

Nurse in Family

Learning Objectives
After completed this chapter, students will be able to:
- know about family nursing

A. Family
Definition
Family is a word that conjures up different images for every individual and groups, and
the word has evolved in its meaning over time.
Types of Traditional Family
1. Nurclear family (husband, wife, children)
2. Dyad family (husband, wife)
3. Single parent (parent, children)
4. Single adult (an adult)
5. Extended family (nuclear family, other family members such as aunt, uncle,
grandparent, etc)
6. Middle-aged or elderly couple (parents who live without their children)
7. Kin-network family (some families who live together or closely, using some facilities
together i.e. kitchen, bathroom)
Types of Non-traditional Family
1. Unmarried parent and child family
2. Cohabitating couple (adults who live together)
3. Gay and lesbian family
4. Foster family (adopt children to unite)
B. Nurse’s Role in Family
1. Executor: to give treatment
2. Educator: to identify the need, determine objectives, develop, plan, and conduct
nursing education so family can do healty behaviour.
3. Counselor: to give a counseling to individual or family.
4. Collabolator: to do a collaboration in coping with family problem.
C. Studying family nursing
Purposes
- To get information about client’s condition
- To determine nursing problem and client’s health
- To assess client’s health condition
- To make a decision
Components
1. Data of Family Introduction
o Head of family (i.e. What is your head family’s name?)
o Address (i.e. Where do you live)
 o Family composition (i.e. Can you tell me about your family composition?With
whom do you live?)
o Type of family
o Cultural background (i.e. what is your family nationality? What is your family
ethnicity?
o Religion (i.e. what is your religion?)
o Social status (i.e. can you tell me about your family condition?)
o Family recreation (i.e. do your family travel a lot? Do your family go on vacation
regularly?)
2. Development data and family history
o Development data
Children’s age and development
How old is your first child?
What s/he can do now?
How old is your second child?
How far s/he develop/grow?
o Family history
How old are you?
Do you or did anyone in our family have any long-term health problems, like heart
disease, diabetes, kidney disease, bleeding disorder, or lung disease?
Do you or did anyone in our family have any health issues like high blood
pressure, high cholesterol, or asthma?
Does anyone in our family have any other serious illnesses, such
as cancer,  stroke, Alzheimer's/dementia, genetic birth disorder, or osteoporosis?
How old were they when they were diagnosed?
Are their illnesses under control? How are/were they treated?
What countries did our relatives come from?
Did our late relatives have health problems? What were the issues and when were
they diagnosed?
How old were they when they died?
What were the reasons for their deaths?
3. Environment Data
o Types of society
Do you live in rural or urban society?
What kind of ocupancy do you live?
Is sanitation good?
How about waste?
o Demography characteristics
Can you tell me about your neighbor’s social status?
Do you know about your neighbor’s ethnicity?
Could you please telling me about your neighbor’s livlihood?
What language do your community use daily?
o Geographical family mobility
 How long do you live in your current address?
Where do you live before?
Do you usually gether with your family?
How do you interact with your neighbor?
Do you join certain activities in community?
o Supporting family system
Who gives help, support and counseling in the family?
Does your family have any relationship with health services or agencies?
4. Data about Family Structure
o Communication pattern
How does your family communicate?
How does your family listen to other family members’ idea?
How do you feel when communicating with your family?
o Strength of family structure
Who takes a decision in the family?
How important taking a decision is?
o Role structure
Would you like to tell me about position of each member of your family?
Is there any conflict in your family about position and role?
How do you feel in playing your role in the family?
Is your and other family members’ role flexible?
o Family Values
What cultural values does your family follow?
Who earns for living in your family?
What is your family’s future orientation?
What is your family’s hobbies?
Does your family become the guardian of other family members’ health?
How important the values for your family?
Is there any conflict between values in your family?
How does family values affect your family’s health?
5. Data about Family Function
o Affective
Do family members feel about other’s need in the family?
Do family members care about one another?
Do family members support one another?
o Socialization
How does your family dicipline members?
Do your family member give reward and sanction?
Do your family members give and get love one another?
How does your family train otonomy and dependency?
o Health treatment
How does your family behaviour toward health?
How does your family implant health values?
 How consistent does your family follow health values?

Activity 5.1
Make a conversation between nurse and patient related to one of those components!

D. Physical Examination
1. Inspection
The process of observation, a visual examination of the patient’s body parts to detect
normal characteristic or significant physical signs
2. Palpation
Involves the use of the sense of touch. Giving gentle pressure or deep pressure using
your hand is the main activity of palpation
3. Percussion
Involves tapping the body with fingertips to evaluate the size, borders, and
consistency of body organs and discover fluids in body cavities.
4. Auscultation
Listening to sounds produced by the body

Activity 5.2
Mention what activity you do for each case listed below!

Activity Technique
1. Examining patient’s respiratory
2. Inspecting the mouth and throat
3. Asking patient to stand up to find whether there is scoliosis
or not
4. Pressing her middle finger of non‐dominant hand firmly
against the patient’s back. With palm and fingers remaining
off the skin, the tip of the middle finger of the dominant hand
strikes the other, using quick, sharp stroke
5. Observing the color of the eyes
6. Observing the movement of air through the lungs
7. Testing deep tendon reflexes using hammer
8. Checking the tender areas with her hand
9. Pressing abdomen deeply to check the condition of
underlying organ
10. Preparing a good lighting, then he observes the body parts

E. Useful expression
Implementation step
Explaining what you are going to do immediately
• Now I am going to … press/examine (parts of the body i.e artery, cheeks, neck,
stomach, etc) gently
• It’s time for me to…
• Now I want to…
Instruction
• Would you…?
• Now I want you to…
remove + your… wig
put off hairpieces
• Please + rise your eyebrows
frown your forehead
smile
puff your cheeks
shrug your shoulder
flex your neck with chin toward
bend your neck, with ear toward shoulder
take a sip of water from this glass

Activity 5.3
Make a conversation about acts in assessing head, face and neck!