Saint Mary’s University

School of Health and Natural Sciences

Nursing Department

In Partial Fulfillment of the Requirements in NCM 104 RLE

Presented to:

Ms. Josephine Arizala, RN

Submitted by:
Veannie F. Fillag

March 2021
Introduction
A family is a fundamental social group and the basic unit of society sharing the same emotional bond
whether dwelling together or not. They are usually related by blood, marriage or adoption. A family has
different types, functions and characteristics. There are also family developmental stages that each family
experiences. This study identifies the structure of the family including their socio-economic data, house
and environmental condition, and nutritional status. The family’s individual health needs and problems
are also identified together with the nursing interventions.

I. Initial Data Base

1.Family structure, characteristics, and dynamic

Member of the Position in the Relationship to the Civil Age Sex

household Family head of the family Status
Mr. F Father Married 53 Male

Mrs. F Mother Wife Married 50 Female

Child A Child Father Single 24 Male

Child B Child Father Single 22 Female

Child C Child Father Single 19 Female

Child D Child Father Single 17 Female

Member of the Place of Type of Family Dominant family General family

household residence of each Structure members in relationship or
member of the terms of decision dynamics
family making
Mr. F Samoki, Bontoc, Nuclear Mrs. F Overprotective
Mountain of his children.
Province There is sense of
security and
belonging
Mrs. F Samoki, Bontoc, Nuclear Mrs. F Supportive,
Mountain loving and caring
Province for other family
members
Child A Samoki, Bontoc, Nuclear Mrs. F Dependable,
Mountain studious and has
Province temper issues
Child B Samoki, Bontoc, Nuclear Mrs. F Ambitious,
Mountain dependable,
Province obedient, and
conscientious
 Child C Samoki, Bontoc, Nuclear Mrs. F Sympathetic, not
Mountain health conscious,
Province helpful, and
extrovert
Child D Samoki, Bontoc, Nuclear Mrs. F Independent,
Mountain keen,
Province conscientious,
and perceptive

2.Socio- economic and Cultural Characteristics

Member of the Income and expenses
household Occupation Place of Work Income of each Who makes decision
working about family
member expenditure
Mr. F Security Guard DepEd, Poblacion, 12,000 per month Mr. F and Mrs. F
Bontoc, Mountain
Province
Mrs. F Government DepEd, Poblacion, 40,000 per month
worker Bontoc, Mountain
Province
Child A Student NYK-TDG, N/A
Calamba, Laguna
Child B Student Bayombong, N/A
Nueva Vizcaya
Child C Student Bayombong, N/A
Nueva Vizcaya
Child D Student Poblacion, Bontoc, N/A
Mountain Province

3.Home and Environment (Narrative form)

Family owns a three-story concrete building with 2 stories occupied that are enough for the 6 household
members. Each one has a room as there is one master bedroom for parents and four individual bedrooms
for children. The house is located near a canal. The perimeter of the house, specifically on the western
and southern boarders are surrounded by water drainages. These are the passageways of water wastes.
During dry season, the flow of water is limited resulting to pooling of water; hence, the presence of
breeding sites of vectors of diseases. There is no presence of accident hazards within the compound of the
house. For food storage and cooking facilities, the refrigerator is in place and there are cabinets for
storage of kitchen utensils. There are also sealed and separate containers for condiments, rice and other
food items. The water supply of the household comes from the municipal water system and a private
water supplier. Each story of the house has a comfort room with weekly schedule of cleaning.
Biodegradable wastes are used as compost while non-biodegradable garbage are segregated and collected
twice a week as per schedule by the municipal waste disposal unit. For drainage system, there is presence
of septic tank but water waste from sinks flows into the canal.
Moreover, families in the neighborhood belong to different cultures and religion and most are residential
houses. The community has a general hospital and a rural unit, and each barangay has one barangay
health station which is manned by a midwife and a Human Resource Health personnel. There are also
transportation facilities available which include tricycles, jeepneys, private vehicles, and public utility
vehicles that ply to other communities or barangays and to nearby establishment. In terms of
communication facilities, it is done via mobile phones.

4.Health status of each family members (Narrative Form)

Mrs. F and Child B are the only members of the household who had medical history. Mrs. F had surgical
removal of brain tumor (meningioma) 2 years ago last May 31, 2018 and other surgeries such as
cholecystectomy, total abdominal hysterectomy, one cesarean section, and one appendectomy. Child B,
on the other hand, had history of menorrhagia due to hormonal imbalance.
Family’s nutritional assessment shows that Child C is obese; parents and Child B are overweight; and
Child A and D have normal body mass index (BMI). The family’s BMI are as follows: Mr. F- 26.6, Mrs.
F- 27, Child A- 22.5, Child B- 26.5, Child C- 35.43, and Child D- 21.5. Eating habits practiced in the
family include regular meal of vegetables that are eaten either home-grown or locally produced. Meat
products are also locally patronized, except for the occasional purchase of dressed chicken products. Fried
foods, canned goods and processed foods, however are also consumed often.
As for risk factor assessment, there is strong family history of diabetes on maternal side and strong family
history of dyslipidemia on paternal side. Also, Mr. F has high uric acid, high cholesterol and high blood
sugar. There is no physical assessment indicating presence of illness state in the family as a result of
recent cranial CT scan of Mrs. F taken last week yielded negative result for recurrence of tumor.

5.Values and practices on health promotion and maintenance and illness prevention

Values and practices Description

1.Immunization status All members of the family completed
immunization.

2.Healthy lifestyle practices Daily intake of vegetable, usually once a day

during dinner time is observed.
Water intake of 10 liters per day is closely
monitored with about 1.5 liters consumption per
member.
Proper sleep and rest is encouraged with the
family members having an average of 7 ½ hours
sleep from 10pm-6:30am, except for Child C who
oversleeps for 10 hours, sleeping around 1 am
with a waking time of 11 am.
There is an occasional consumption of soft drinks.
Family members are not engaged with vices like
smoking and using illegal drugs, except for
alcohol drinking of Mr. F consuming 500ml beer
3 times a week at night.
3.Adequacy of: All members of the family have adequate rest and
• Rest and sleep sleep of about 7 ½ hours except for Child C who
• Exercise/activities tends to oversleep with an average of 10 hours
• Use of protective measures because of no motivation to wake up since the

4. Use of promotive- preventive health services
pandemic started.
3 out of 6 members (Mr. F, Child A and Child D)
observe daily exercises of cardio, stretching and
weight lifting while the other three (Mrs. F, Child
B, and Child C) have irregular exercises of cardio.
There is adequate use of protective measures in
children with them having complete childhood
vaccination. Strict compliance with health
protocols to prevent from getting infected with
COVID-19 virus is also observed. These practiced
preventive and protective measures include the
use of face mask and face shield, proper hand
hygiene and display of hand and feet disinfectants
outside the home.
Parents believe in spacing of children as
evidenced by the 2-3 year gap between the birth
of each child.
Children are highly encouraged to seek early
consultation and do preventive measures before
any ailments get worse such as drinking water
right after taking sweets, access to flu vaccine,
and adhering to community health protocols
during a pandemic. In addition, all family
members have a daily consumption of vitamin C
500mg once a day in the evening for additional
protection of immunity. Parents are also taking
Centrum Silver supplements daily every after
evening meals and is very much compliant with
their maintenance medication. They have an
annual physical/medical check-up as part of their
work requirements including complete blood
works.
Handrails are installed in every stairway to
prevent accident
Hand bars are also installed in bathrooms to
prevent further accidents as Mrs. F has balancing
problems

II. Scale for Ranking/ Criteria in Identifying the Problem

PROBLEM 1: Inadequate exercise as a health threat

CRITERIA SCORE WEIGHT

I. Nature:

Health Deficit (HD) 3 1

Health Threat (HT) 2
Foreseeable Crisis (FC) 1
II. Modifiability
 Easy 2 2
Intermediate (Moderate) 1
Not modifiable 0
III. Preventive Potential

Highly 3
Moderate 2 1
Low 1
IV. Salience of the Problem

Problem needing urgent attention 2

Problem not needing urgent attention 1 1
Not a felt problem 0

PROBLEM 2: Hypertension related to hypercholesterolemia and genetic predispositions as a

health deficit

CRITERIA SCORE WEIGHT

I. Nature:

Health Deficit (HD) 3 1

Health Threat (HT) 2
Foreseeable Crisis (FC) 1
II. Modifiability

Easy 2 2
Intermediate (Moderate) 1
Not modifiable 0
III. Preventive Potential

Highly 3 1
Moderate 2
Low 1
IV. Salience of the Problem

Problem needing urgent attention 2 1

Problem not needing urgent attention 1
Not a felt problem 0

PROBLEM 3: Presence of breeding sites of vectors of diseases as a health threat

CRITERIA SCORE WEIGHT

I. Nature:

Health Deficit (HD) 3 1

Health Threat (HT) 2
Foreseeable Crisis (FC) 1
 II. Modifiability

Easy 2 2
Intermediate (Moderate) 1
Not modifiable 0
III. Preventive Potential

Highly 3 1
Moderate 2
Low 1
IV. Salience of the Problem

Problem needing urgent attention 2 1

Problem not needing urgent attention 1
Not a felt problem 0

PROBLEM 4: Faulty eating habits as a health threat

CRITERIA SCORE WEIGHT

I. Nature:

Health Deficit (HD) 3 1

Health Threat (HT) 2
Foreseeable Crisis (FC) 1
II. Modifiability

Easy 2 2
Intermediate (Moderate) 1
Not modifiable 0
III. Preventive Potential

Highly 3 1
Moderate 2
Low 1
IV. Salience of the Problem

Problem needing urgent attention 2 1

Problem not needing urgent attention 1
Not a felt problem 0

PROBLEM 5: Alcohol drinking as a health threat

CRITERIA SCORE WEIGHT

I. Nature:

Health Deficit (HD) 3 1

Health Threat (HT) 2
Foreseeable Crisis (FC) 1
 II. Modifiability

Easy 2 2
Intermediate (Moderate) 1
Not modifiable 0
III. Preventive Potential

Highly 3 1
Moderate 2
Low 1
IV. Salience of the Problem

Problem needing urgent attention 2 1

Problem not needing urgent attention 1
Not a felt problem 0

III. List of Health Problems according to priorities

HEALTH PROBLEM SCORE

Inadequate exercise as a health threat 4.67
Hypertension related to hypercholesterolemia 2.17
and genetic predisposition as a health deficit
Presence of breeding sites of vectors of diseases 3.67
as a health threat
Faulty eating habits as a health threat 4.34
Alcohol drinking as a health threat 3.34

PROBLEM 1: Inadequate exercise as a health threat

Criteria Computation Score (With Justification

1. Nature of the Problem
2. Modifiability
3. Preventive Potential
computation)
2/3 x 1 0.67 The problem is a
health threat
2/2 x 2 2 The problem is easily
modifiable. The
members with
abnormal BMI can
gradually get involved
with various physical
activities given the
right motivation and
guidance.
3/3 x 1 1 The problem is highly
preventable. This
could be done by
choosing to walk
instead of using public
utility transports and
conscious efforts to
 maintain at least three
to five times weekly
exercise.
4. Salience of the 2/2 x 1 1 The problem needs
Problem immediate attention
because lack of
physical activity leads
to chronic diseases.
TOTAL 4.67

PROBLEM 2: Faulty eating habits as a health threat

Criteria Computation Score (With Justification

1. Nature of the Problem
2. Modifiability
3. Preventive Potential
4. Salience of the
Problem
TOTAL
computation)
2/3 x 1 0.67 The problem is a
health threat
2/2 x 2 2 The problem is easily
modifiable. The
family just needs to
alter feeding habits.
2/3 x 1 0.67 The problem is
moderately
preventable. Although
this could be done by
simply reducing
excessive intake of
fatty foods, canned
goods, and processed
foods, it will be a
gradual process as
they became used to
it.
2/2 x 1 1 The problem needs
immediate because if
this is pursued, the
family is at risk for
cardiovascular
diseases, especially
that the family has
genetic
predispositions.
4.34

PROBLEM 3: Presence of breeding sites of vectors of diseases as a health threat

Criteria Computation Score (With Justification

computation)
1. Nature of the Problem 2/3 x 1 0.67 The problem is a

2. Modifiability
3. Preventive Potential
4. Salience of the
Problem
TOTAL
health threat
1/2 x 2 1 The problem is
moderately
modifiable. The canal
is permanent and
cannot be covered;
hence, the problem
can only be solved by
observing cleanliness.
3/3 x 1 1 The problem is highly
preventable. This
could be done by
regular cleaning of the
canal for improved
sanitation.
2/2 x 1 1 The problem needs
immediate attention
because if not
addressed, it will
contribute to incidents
of vector diseases like
chikungunya, dengue
fever, malaria, and
others
3.67

IV. Subjective Cues and Data and Family Nursing Problem

Subjective Cues and Data Family Nursing Problem

Mother verbalized, “Wala na kasi yung dating Inadequate exercise as a health threat
common time para sa family exercise sana”
Mother verbalized, “Yung BP namin ng asawa ko Hypertension related to hypercholesterolemia and
nananatili sa 130/90-140/100” genetic predisposition as a health deficit
Mother verbalized, “Hindi papayagan ng Presence of breeding sites of vectors of diseases
barangay na takpan yung kanal kasi doon as a health threat
dumadaloy yung tubig papunta sa tubig
irigasyon.”
Mother verbalized, “Napapadalas na din yung Faulty eating habits as a health threat
pagkain namin ng mga delata, hotdog at mga
pritong pagkain kasi yun ang mga madaling
lutuin”
Mother verbalized, “Itinatago ng asawa ko ang Alcohol drinking as a health threat
pag-inom ng redhorse pero nahuhuli”

V. Family Nursing Care Plan

Health Family Goal of care Objective of Intervention Expected

Problem Nursing Care of problem Outcome
Problem
Subjective Altered After the After 1 week Determine the GOAL MET
Data: nutritional nursing of community possible
“Wala na kasi status related intervention, exposure, the barriers to the After 1 week
yung dating to lack of the members members will planned of community
common time physical will be able to be able to: exercise or exposure, the
para sa family activity have an activity members were
exercise sana.” increased State the able to:
knowledge and importance Design a long-
Objective understanding and benefits of term exercise State the
Data: of the benefits physical program. importance
Mrs. F- BMI of exercise or activities or and benefits of
of 27 physical exercise Allow and physical
-body structure activities encourage activities or
is mesomorph Engage in the patient to exercise
planned adopt an
Child B- BMI exercise exercise Engage in the
of 26.6 program routine that planned
-body structure involves 45 exercise
is mesomorph Increase minutes of program
gradually the exercise five
Child C- BMI performance times per Increase
of 35.43 of the planned week. gradually the
(obese) activity or performance
-body structure exercise Recommend of the planned
is endomorph keeping a activity or
Improve record of exercise
Exercises only physical activity on the
when they feel functioning of exercise Improve
like doing it the body program as it physical
advances to functioning of
more complex the body
activities

Explain the
importance of
exercise in a
weight control
program

Encourage
involvement
on active
forms of social
activities

Intervention of Problem

Nursing Intervention Method of Nurse-Patient Resources

 Contact
Determine the possible barriers Home Visit Manpower resources such as
to the planned exercise or time and effort
activity Pamphlets

Design a long-term exercise

program.

Allow and encourage patient to

adopt an exercise routine that
involves 45 minutes of exercise
five times per week.

Recommend keeping a record of

activity on the exercise program
as it advances to more complex
activities

Explain the importance of

exercise in a weight control
program

Encourage involvement on
active forms pf social activities

Health Family Goal of care Objective of Intervention Expected

Problem Nursing Care of problem Outcome
Problem
Subjective Inability to After the After 1 week Assess the GOAL
Data: recognize the nursing of community family’s PARTIALLY
“Napapadalas value of intervention, exposure, the knowledge and MET
na din yung balanced diet the family will family will be understanding
pagkain namin due to lack of be able to able to: of balanced After 1 week
ng mga delata, knowledge and practice and diet of community
hotdog at mga time for proper maintain a Discuss the exposure, the
pritong food balanced importance of Discuss the family was
pagkain kasi preparation nutrition/diet balanced importance of able to:
yun ang mga nutrition proper
madaling nutrition Discuss the
lutuin” Identify importance of
healthy foods Demonstrate balanced
Objective necessary for healthy ways nutrition
Data: good nutrition of food
Four members preparation Identify the
of the family Enumerate healthy foods
are overweight alternative and Advise patient necessary for
and obese with healthier ways to measure good nutrition
abnormal BMI of food food regularly
of the preparation Enumerate the
following: Inform the alternative and
Mr. P- 26.6 Demonstrate consequences healthier ways
Mrs. F- 27 appropriate of poor of food
Child B- 26.5 selection of nutrition preparation
Child C-35.43 meals or menu
planning Educate Demonstrate
Lots of stock toward the patient about appropriate
of canned goal of weight adequate selection of
goods stored reduction nutritional meals or menu
in the cabinet intake. A total planning
Start plan permits toward the
Lots of stock practicing the occasional goal of weight
of processed observance of treats reduction
foods in the appropriate
refrigerator amount of
food intake
1 liter of oil
consumed for
a week

Intervention of Problem

Nursing Intervention Method of Nurse-Patient Resources

Contact
Assess the family’s knowledge Home Visit Manpower resources such as
and understanding of balanced time and effort
diet Pamphlets
Visual aids and low-cost
Discuss the importance of supplies for demonstration
proper nutrition

Demonstrate healthy ways of

food preparation

Advise patient to measure food

regularly

Inform the consequences of poor

nutrition

Educate patient about adequate

nutritional intake. A total plan
permits occasional treats

Health Family Goal of care Objective of Intervention Expected

Problem Nursing Care of problem Outcome
Problem
Subjective Risk for After the After 1 week Discuss with GOAL MET
Data: vector-borne nursing of community the family how
“Hindi diseases due to intervention, exposure, the breeding After 1 week
papayagan ng presence of the family will family will be grounds for of community
barangay na breeding sites be able to able to: various exposure, the
takpan yung of vectors of understand the insects, and family was
kanal kasi diseases benefits of Recognize the explain the able to:
doon maintaining a causes of seriousness of
dumadaloy clean breeding sites the diseases Recognize the
yung tubig environment such as to they can causes of
papunta sa conducive to prevent transmit breeding sites
tubig health occurrence of such as to
irigasyon.” disease Discuss the prevent
importance occurrence of
Objective Become aware and purposes disease
Data: and more of proper
During one knowledgeable sanitation Become aware
local outbreak about the and more
2 years ago, importance of Cite the causes knowledgeable
the Local proper and prevalence about the
Health Unit sanitation of these importance of
conducted a unwanted proper
surveillance on pests around sanitation
the kinds of the home
mosquitoes
present in the Explore with
area. The the family
identified are ways of
Culex and implementing
Aedes sanitation
albopictus
types of Plan with the
mosquitoes. family a
regular
Pooling of cleaning
water in the schedule to
canal avoid pooling
of water in the
canal

Intervention of Problem

Nursing Intervention Method of Nurse-Patient Resources

Contact
Discuss with the family how Home visit Manpower resources such as
breeding grounds for various time and effort
insects, and explain the Pamphlets
seriousness of the diseases they Visual aids and low-cost
can transmit supplies for demonstration

Discuss the importance and

 purposes of proper sanitation

Cite the causes and prevalence

of these unwanted pests around
the home

Explore with the family ways of

implementing sanitation

Plan with the family a regular

cleaning schedule to avoid
pooling of water in the canal

VI. Summary, Conclusion, and Recommendation

The family’s type of structure is nuclear with no concerns on social relations. The home and environment
of the family has also no issues, except for the presence of breeding sites of vectors of diseases.
However, on the assessment of health status and practices of health promotion and illness prevention, the
family is posed with a variety of problems, specifically on the nutritional status and the risks associated
with them.
The family has been identified with four health threats and one health deficit. Among these identified
problems, the top priorities are as follows: inadequate exercise, faulty eating habits and presence of
breeding sites of vectors of diseases. Necessary interventions were given and SMART goals were
presented. After a week of community exposure, all identified goals were met, apart from faulty eating
habit problem wherein its goals are only partially met.
Maintaining a clean home and environment is not enough for safety and protection from any illnesses or
dangers in life. Physical, as well as other aspects of health, must also be given attention in order to attain
an optimal holistic health. It is maintaining a balanced internal and external environment that promotes a
better welfare of individuals.
Lastly, the family is recommended to maintain an exercise schedule and regular cleaning of the
surroundings and to practice alternative and healthier ways of food selection and preparation.

VII. Appendices (Documentation)