A Family Nursing Care Plan on

Family Size Beyond what Family Resources can Adequately Provide, Pneumonia, and Breastfeeding

In Partial Fulfillment of the Requirement in NCM 209 - RLE

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

Submitted to:
Gerald Jay Geronan, RN, RTRP
Clinical Instructor

Submitted by:
Aliganga, Joshua Andrei L. St. N
Bano, Zyclare Dee C. St. N
Dancel, Chris Enola Gay H. St. N
Masion, Hazel A. St. N
Pantoja, Rosaree Mae L. St. N
Rivera, Elaiza Jill M. St. N

BSN 2K - Group 1 - Subgroup 1

February 03, 2021

Scenario:
The Gonzales family lives around Barrio Boulevard. The father is a tricycle driver, while his wife is a vegetable vendor at Bankerohan Public Market. They have eight
children. Anton (13), Jake (11), Lou (9), Reg (8), Marie (6), Sam (5), Jet (4), and Annia (1). Their youngest daughter Annia, is having a hard time breastfeeding. While there 4
years old son Jet is experiencing Pneumonia. Moreover, their family is having a problem in terms of providing their family’s needs due to their big family size.
 FAMILY NURSING CARE PLAN ON FAMILY SIZE BEYOND WHAT FAMILY RESOURCES CAN PROVIDE

Date and Time Health Family Nursing Goal of Care Objectives of Care Nursing Intervention Nurse-Family Resources Evaluation
Cues Problem Problem Contact Required

February 02, 2021 Family 1. Inability to make After nursing After 2 home visits Independent Interventions: Home Visit Material February 04, 2021
@ 7:00 AM size decisions with intervention, of nursing Resources: After 2 home
beyond respect to taking the family will intervention, the 1.) Establish rapport Health Center Visual aids visits, the family
Subjective: what appropriate health be able to: family will able to: visitation of the Pamphlets was able to:
family action due to: Rationale: To gain the trust and family for check on family
● The mother resources -Understand a. Recall the cooperation of the family and the ups planning ● Understan
verbalized, can a. Lack the information patient Family d through
“Lisod man adequatel of/inadequate importance of regarding on Short interview planning verbalizing
kaayo ron y provide knowledge/insi family the 2.) Assess the readiness of the family regarding the chart the
maam, gamay as health ght as to planning. discussion condition of the importanc
ra kaayo threat alternative about family Rationale: To know the willingness family through Human e of family
akong halin sa courses of -Identify planning of the family to listen the use of any Resources: planning.
pagtinda kay action open to solutions on provided by social media The time and ● “Dapat
mahal na ang the family. what actions the student 3.) Assess the level of understanding platforms such effort of both gyud
mga gulay ron b. Fear of shall help nurses of the family regarding the problem as messenger the family planuhon
tas akong consequences them in b. Plan on how or text and the ug tarong
bana sad wala of action, providing to solve Rationale: To obtain baseline student nurse ang mga
kaayoy makita specifically on adequate their information or data mahitabo
nga mga economic resources to financial Financial bago
pasahero consequence. their family. constraints 4.) Explain the following to the family: Resources: manganak
tungod sa with the use Finances for napud, kay
covid.” 2. Inability to provide -Provide of the A. The definition and importance the pait kaayo
● The father a home environment concrete alternative of family planning transportatio nga makita
also conducive to health decisions actions n, and the silang
verbalized, maintenance and when it comes presented Rationale: To have some knowledge materials that nagkalisod
“Naa pa gyud personal to their by the and understanding were used in tungod kay
mi anak nga development due to immediate student creating the di namo
naay sakit inadequate family needs. nurses. B. The possible consequences visual aids, matustusa
niya mahal resources c. Encourage of not having a family pamphlets, n ug
kayong specifically: the family to planning and family tarong
tambal. take Rationale: This will give awareness planning ilang mga
Maong gina a. Financial appropriate to the family if they will not take an chart. kailangan.”
immediate action in solving the
 budget namo actions problem As
ug taman constraints/li especially to verbalized
among kwarta mited the needs of C. The importance of family’s by the
pero kulang financial their size based on their resources couple.
jud para resources children. ● Identify
masaigo sa Rationale: Adequate space could solutions
among tanan. lessen the spread of bacteria such as
Swerte ug finding
makakaon mi D. The importance of hygiene jobs that
ikatulo sa isa could fit
ka adlaw pud. Rationale: Proper hygiene could the skill
Pait kaayo kay deter the spread of microorganisms that the
di namo couple has
mahatag ang 5.) Provide alternative actions in as an
uban solving the family’s financial action to
kinahanglan constraints help them
sa among provide
mga anak.” Rationale: Providing alternative the
actions could help the family in adequate
Objective: solving the problem they faces resources
- Client history they need.
● The mother is a 6.) Encourage practice appropriate ● Have
vegetable decision making. agreed to
vendor. provide
● The father is a Rationale: Having concrete concrete
tricycle driver. decisions helps the family to manage decisions
● A family with 8 their future problems. based on
children. the
7.) Encourage the family to plan in
● Residing in a immediate
providing the needs of the children
small barong- needs of
barong their family
Rationale: Planning is an important
located at
aspect in succeeding
Barrio
Boulevard.
● Underweight Collaborative Interventions:
children
● BMI: 1.) Encourage the family to go to the
 Anton - 17.5
Jake - 17.9 nearest health center
Lou - 18.1
Rationale: Health center could
Reg - 17.0
provide some needs of the family
Marie - 16.9
Sam - 17.3
Jet - 16.5

- Client Display
● The
surroundings
are dirty and
not suitable for
living.
● Food shelves
shows instant
noodles and
canned goods
● They are not
well groomed.
● Some of their
children are
wearing
ripped clothes.
● Parents show
uncertainty
while asked
about
providing the
needs of their
children.
● Hesitation
noted in both
parents while
asked about
family
planning.

FAMILY NURSING CARE PLAN ON PNEUMONIA

 Date and Time Health Family Nursing Goal of Care Objectives of Care Nursing Intervention Nurse-Family Resources Evaluation
Cues Problem Problem Contact Required

February 02, 2021 Pneumonia 1. Inability to After nursing After 2 days of Independent Interventions: Home Visit Material February 04, 2021
@ 7:00 AM as a health recognize the interventions: nursing interventions, resources: After 2 home
deficit, problem due to: the family will be able 1.) Establish rapport with the family Health Center Powerpoint visits, the family
Subjective: caused by a. Lack of - the family will to: visitation of the presentation was able to:
● Mother the knowledge be able to have a. Gain Rationale: This is to gain the family’s family for check and other low ● Give
verbalized “tulo inflammatio and adequate knowledge trust and cooperation; and will promote ups cost materials definition
na siya ka n of air understanding knowledge and and open communication with the family that will serve about
adlaw sacs due to about the understanding understandin Short interview as visual aids pneumoni
gikalintura, ni bacterial health about g about the 2.) Obtain the patient’s vital signs regarding the needed during a and its
taas pa gyud infection. condition, Pneumonia Pneumonia; condition of the the complicati
samot karon” such as; such as its Rationale: To obtain baseline family through demonstration ons and
● Mother nature of the - provide the nature, information of the patient the use of any and health managem
verbalized “ disease, it’s necessary severity, social media teachings ent
ginaubo ug sip severity and preventive complications 3.) Apply Tepid Sponge Bath to the platforms such regarding the ● Conduct
on pa jud na other measures to and patient as messenger disease such interventio
siya mao kada complications, minimize its management or text as its ns and
gabii mag lisod and spreading b. Carry out Rationale: Since the patient has fever, prevention and procedure
ug tulog management necessary TSB will help decrease his management of the sick
maglisod lagi - provide the interventions temperature family
daw siyag 2. Inability to give proper and Human member
hinga” adequate nursing management procedure of 4.) Position the patient in a semi- resources: ● Minimize
● Mother care to the family over the care towards fowler’s position Time, the spread
verbalized “luya member suffering disease the disabled cooperation of the
kaayo siya unya from pneumonia or sick family Rationale: This position would help and effort of disease
gamay ra pa jud a. Lack of - maintain a member the patient to breath properly and the family, the through
kaayog gina knowledge on home c. Minimize the better nurse and proper
kaon” how to carry environment spread of community hygiene
● Client out the conducive for disease to 5.) Teach the patient to perform ● Perceive
verbalized appropriate health other siblings Diaphragmatic breathing Financial phome
“wala koy gana procedure of maintenance d. Perceive resources: remedy in
mukaon o care and and personal home remedy Rationale: Since the patient has an Cost for decreasing
mutindog” treatment development. in decreasing increased RR and has a fast breathing, transportation the clients
b. Limited and the client’s this will help him to relax and have a and visual aids fever and
Objective: inadequate fever and rate normal respiration rate respiration
- Vital Signs resources due of respiration rate
● BP: 110/70 to financial e. Give 6.) Assess the family’s readiness to ● Verbalize
● Temp: 38.5 C constraints importance to listen to the health teachings the
● CR: 105 bpm preventive preventive
● PR: 107 bpm 3. Inability to minimize measures Rationale: To determine whether they measures
● RR: 45 bpm the spread of disease such as are interested to start the discussion or of the
within the family due proper not infection
- Client History to lack of knowledge hygiene. ● Utilize the
● Fever for the f. Seek help in 7.) Assess the knowledge of the family health
last 3 days referred regarding the present health problem community
● Cough and barangay resources
Cold for 3 days health Rationale: To know what the family regarding
centers and needs to know, or further learn the
- Medications other health disease
● Paracetamol community 8.) Educate the family on the following: and other
● Amoxicillin resources problems
1. What Pneumonia is, sign and
- Laboratory symptoms, further
● Chest X Ray complications when left
● Complete Blood untreated, and how it easily
Count spread

- Client Display Rationale: Knowledge and awareness

● Fast breathing on a specific disease may help the
● Stridor sound is family to prevent it from spreading, and
heard during to avoid further threats that can
inspiration possibly occur
● Flaring of
nostrils 2. Management on the symptoms
● Yellow sputum of the disease such as TSB
is evident and Diaphragmatic Breathing
● Chest
Indrawing is Rationale: To help treat the disease’s
seen during symptoms such as fever and fast
inspiration breathing
● Shivering is
 evident 3. Importance of preventive
● Client is weak measures such as washing of
and pale hands, and covering of mouth
when sneezing or coughing

Rationale: This will the deter the

spread of viruses, bacterias, and other
microbes from spreading

4. Advantages and importance of

health insurance

Rationale: Health insurances helps

cover medical expenses for injuries
and illnesses

9.) Ask if they understood the health

teachings

Rationale: To know if they understood

the health teachings, and if they have
clarifications or further questions

10.) Advice to separate the patient

from his siblings especially to the ones
younger than him

Rationale: Since the disease may

spread easily especially to his younger
siblings

11.) Recommend the herbal medicine

such as SLK Syrup

Rationale: Herbal medicine is

affordable and SLK Syrup can help
with the patient’s cough and cold
 Dependent Interventions:

1.) Administer 5 mL Paracetamol

Syrup (250 mg/5mL) as prescribed

Rationale: To treat the patient’s fever

2.) Administer 15mL of Amoxicillin

(250mg/5mL) as prescribed

Rationale: Amoxicillin is the

recommended first-line drug of choice
in the treatment of pneumonia

Collaborative Interventions:

1.) Facilitate the family regarding its

capability in utilizing the health
community resources

Rationale: This may financially help

the family

2.) Encourage the family to visit health

centers

Rationale: For follow-up check up,

and management of the disease

BREASTFEEDING
 Date and Time Health Family Nursing Goal of Care Objectives of Care Nursing Intervention Nurse-Family Resources Evaluation
Cues Problem Problem Contact Required

February 02, 2021 Faulty 1. Inability to After nursing After 2 days of Independent Interventions: Home Visit Material February 04, 2021
@ 7:00am feeding recognize the interventions; nursing interventions, Resources: After 2 home
techniques presence of the family will be able 1.) Establish Rapport Health Center Visual aids visits, the family
Subjective: practices possible - The family to: visitation of the was able to:
● The mother specifically complication especially Rationale: It helps to establish good family for check Human
verbalized, ineffective due to lack of the mother 1. Gain interpersonal relationships, and this ups Resource: ● Have an
“Nurse ang breastfeedi knowledge. will have knowledge can open many doors for you to Time and additional
baby nako dili ng appropriate about understand the client. Short interview effort of the knowledge
man siya ka 2. Inability to knowledge breastfeeding regarding the student about
tarung og dede provide about , its 2.) Take the vital signs condition of the nurse and breastfeed
saakoa, putol- adequate breastfeeding importance family through the family ing
putol iyang nursing care to toward the Rationale: To know the current the use of any
pagtutoy.” the sick due - The mother infant’s condition and to prevent further social media Financial ● Verbalize
to: will be able to nutrition, and complication noticed platforms such Resource: understan
● “Gamay ra ang a. Lack of provide the complications as messenger Cost for ding of the
mugawas na understanding proper that may 3.) Evaluating the ability of the or text transportation proper
gatas ma’am. about the management arise if not patient and the family to listen to and visual aids breastfeed
Tas usahay problem over the properly done health teaching ing
rami makakaon b. Inadequate problem 2. Perform the
sa isa ka adlaw knowledge in proper way of Rationale: To know if they are able ● Demonstra
ma’am kay carrying out - Both the breastfeeding to start the conversation and if they te
daghan biya mi the mother and are prepared to listen. techniques
tas pila ray appropriate infant will be to manage
income sakong management able to achieve 4.) Educate the family on the following: breastfeed
bana. Daghan effective 1. What breastfeeding is, and ing
pud kaayo kog breastfeeding complications that may arise if problems
atimanon not taken properly by the infant
maam”, as ● Infant
verbalized by Rationale: manifest
the mother. signs of
2. The on the proper positioning adequate
of the baby and good feeding
● “Di pud kaayo attachment intake
 siya
makatarong ug Rationale: Correct positioning and
supsup ma’am. latch on techniques can prevent nipple
Mag dede siya soreness and allow the baby to obtain
pero ginabuy- enough milk
an ra gyapon
niya”, the 3. On proper holding and lining of
mother added. the baby. Making sure the
baby’s head and body are
Objective: facing the mother.

- Vital Signs: Rationale:

● Temp: 36°C 4. Advantages and

● RR:39bpm Disadvantages of breastfeeding

- Client History Rationale : Advantages and

disadvantages of breastfeeding
● Previous history encourages a mother to breastfeed her
of breastfeeding baby, to provide with best nutrition and
failure to reduce the risk of infection, etc.

- Client display: 5. How to enhance the flow of

milk by massaging the breast
● Observable or make the infant burp. Then
sign of switch to another breast if the
inadequate infant's swallowing slows down
infant intake
(decrease in Rationale: Inadequate milk supply can
number of wet lead to early weaning.Massaging the
diapers) breast can stimulate milk production.
● Infant crying at Infants should breastfeed from both
the breast breasts.
● Resistant
latching 5. ) Recommend monitoring number of
● Infant is not well infant’s wet diapers
attached
● Infant’s chin Rationale: To assess hydration and
 doesn't touch promote wellness
the mother’s
breast 6.) Encourage frequent rest periods,
● Mouth is sharing of household chores or
minimally childcare
opened
● More areola Rationale: To limit fatigue, facilitate
visible below relaxation at feeding times and to
than above the develop skills of adequate
mouth breastfeeding.
● Low weight for
age 6 kg, 66 cm
7.) Encourage mother to increase fluid
intake.

Rationale: It helps to produce milk

needed for breastfeeding.

8.) Remain with the mother and infant

during several feedings

Rationale: To pinpoint any problem

areas

9.) Encourage exclusive breastfeeding

Rationale: Bottle feedings can

interfere with the infant's desire to
breastfeed.

References:
Agabao, J., Rosete, R., & Nonato, L. (2015, September 8). 107051970 a-family-case-study. Slideshare. Retrieved February 4, 2021 from https://www.slideshare.net/home
workping7/107051970-afamilycasestudy

American Lung Association. (2020, October 23). Pneumonia Symptoms and Diagnosis. Retrieved February 03, 2021 from https://www.lung.org/lung-health-diseases/lung-diseas
e-lookup/pneumonia/symptoms-and-diagnosis

Family Planning: A Global Handbook for Providers. 2018 World Health Organization and Johns Hopkins Bloomberg School of Public Health. Retrieved February 4, 2021 from
https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf?sequence=1

Jewell, T., (2018, September 25). Healthline: What is Diaphragmatic Breathing? Retrieved February 04, 2021 from https://www.healthline.com/health/diaphragmatic-breathing

Personal hygiene. (2020). Healthdirect. Retrieved February 6, 2021 from https://www.healthdirect.gov.au/personal-hygiene#:%7E:text=Good%20personal%20hygiene%20is

%20one,spreading%20diseases%20to%20other%20people.

Stoppler, M., (2019, October 25). MedicineNet: Pneumonia. Retrieved February 03, 2021 from .com/pneumonia_facts/article.htm#:~:text=Pneumonia%20is%20a%20lung%20dis
ease,causes%20pneumonia%20is%20Streptococcus%20pneumoniae