PRACTICAL 5 FAMILY HEALTH

NURSING CARE
Structure
5.0 Objectives
5.1 Introduction
5.2 Family Health Nursing Care
5.2.1 Aspects of Fanlily Health Nursing
5.2.2 Points to Remember
5.2.3 Equipment
5.2.4 Procedure

5.3 Recording and Reporting

5.4 Let Us Sum Up

After going through this practical, you should be able to:

.s assess the general condition of the faanily mem1.~ersas well as the socio
cultural environment;
e ~nteractwith the family members to seek their p:irticipation in their care;
Q utilize scientific knowledge and skill in providing care:
e provide need based health education to the family;
e collect relevant infom~ationregarding family background, composition,
utilization of health services;
e identify health problems in the family and help the family to deal with their
prcblems effectively;
e participate in National Health programmes as applicable to the family;
m render guidance and counseling to couples, e.g., Infertile couples;
m render pre-referal services and follow up for the continuity of the care; and
e provide rehabilitative services to the individuals in the family.
8

INTRODUCTION
The family is a primary and basic unit in all societies. It is a group of biologically
related individuals living together and eating from a common kitchen. The family
consists of members of different age groups like infant, toddlers, pre-school, school
going children, adolescents, adults and the elderly.
The family may have various health problems and it is the responsibility of the
Community Health Nurse (CHN) to identify these problemslneeds and assist the
family to deal with their concerns so as to solve their problems, reduce the severity
of the problem and/or to prevent the problems from occurring altogether.
In this practical we shall focus on various aspects of family health nursing care,
equipments, procedure and recording and reporting of care.
Nursing Practices in
Community Health-I FAMILY HEALTH NURSING CARE
Let us begin with aspects of Family Health Nursing.

5.2.1 Aspects of Family Health Nursing

There are various aspects of family care. You need to meet the health care needs
of the family depending upon the age group of family members, their physiological
status, illnesses present etc. The services are comprehensive, promotive, predictive,
preventive, curative and rehabilitative. However, while rendering the care or
planning the care the, following aspects must also be kept in mind:
a) Family Health care gives an opportunity to serve the family as a whole and
not to a particular individual.
b) . If a child in the family is having Diarrhea and other member is having fever,
the care should be provided to both'at the same visit.
c) -Family health knowledge and standards influence the practices of health team
members e.g., If the' family members are ignorant about immunization or
family planning methods, then they need the services and also they need to be
made aware df the importance of the services, what it is? Its methods, and
where these services are available.

d) Family with a low level of health have a negative influence on the community.
e) If the family is not maintaining their personal and environmental hygiene, then
it is not only suffering for themselves but they are capable to spread the
infection and various diseases to the community also.
f) The healthy families enhance the individual development, e.g., if parents are
accepting the small family norm and providing adequate nutrition, care and
support to their children, this will help to bring up healthy individuals in the
community and will set an example for others in the same coinmunity to
follow.

g) Every individual in the family exerts his influence on other members of the
family. e.g., if 3 member in the family is an alcoholic, this affects the children
and spouse also.
h) Good relationship among family members aids in better health care and
acceptance of health team members.
i) In case of Geriatric members in the family and their acceptance by the family
by providing support and warm interaction will enable him to cope well with
the limitations posed by the aging process.

5.2.2 Points to Remember

The following points need to be kept in mind while rendering family health care
nursing:
a) Establish rapport with the family to gain their confidence in you
- Introduce yourself
- Your agency
- Respect their culture and religious practices
- Interact in a professional way and maintain professional relationship
- Maintain confidentiality
b) Family hedth problems are related to the individuals, behaviour, habits and
lifestyles.
cj If family members are not following healthy habits for hygiene and diet etc., Family Health Nursing Care
then family is at risk of getting various air borne diseases and a host of other
diseases.

d) A person in the family may at one time be suffering from more than one
problem, so all the problems need to be dealt effectively.

e) Follow the scientific and nursing principles while performing any activities in the
family.

f) Follow nursing ethics and principles of working in the community.

g) Broad knowledge of the community institutions and resources is needed so as

to optimize the care and deal with the family problems comprehensively.

h) Knowledge of all nursing disciplines in health and illness is essential for

rendering comprehensive care, as,the family is composed of various age groups
of individuals with or without specific problems.

i) Develop a broad understanding of the factors contributing or detrimental to

health and well-being.

j) Render the need based health service to community and provide specific care
to vulnerable aid high risk individualslgroups.

kj Follow a systematic approach in dealing with the families and their needs,
concerns and involve the family in their care.

5.2.3 Equipment
As per the health care needs of the family various procedures in the home should be
demonstrated and taught to the family members so that it become easier for the
family to carry out the care more conveniently in the home even in the absence of
the health worker. Make use of available resources at home for providing care.
Many common articles and supplies of daily use are often available in the homes
which you can improvise in the home situation for carrying out the nursing care.

You may perform and teach various procedures and use the various articles such as.

For Hydrotherapy
- Bowls/basins
- Towels of different sizes
- Cold water

- Clothes for the client

For Steam ~nhalation

- Kettlelwide mouth lota

- Towel
- Hot water
- Vicks/Tulsi leaves

You can perform certain procedures with the'use of Public health bag
(refer Practical 6). Some of the procedures performed in home setting are
oivpn hplnw
Nursing Practices in (The articles requlred for these procedures are carried in the public health bag).
Community Health-I
Recording TPR
Giving hydrotherapy
Recording BP
Steam inhalations
Urine analysis for sugar, alburnin
Assessment of Antenatal mother
Assessment of children of various ages
Personal Hygiene - Sponge bath
Care of mouth, back hair, nails, foot

Administration of medicines
Administration o f , Sub cutaneous iiijection, e.g. Insulin administration
Administration of intra muscular injection, e.g. Neurobion, etc.
Eye irrigation
e ORS Therapy
Minor dressings
Conducting home deliveries
Care of new bom
'Care of post natal mother
Demonstration of Breast feeding
Preparation of Weaning food items
Rendering first aid in case of injuries, bites and stings

5.2.4 Procedure
You should plan to do the procedure as per the identified need of the family and
perform the procedure with the use of public health bag. Make use of resources
available in the home with the permission of the family. Let us take an example of
one procedure, i,e., taking oral temperature as given below.
Recording Oral Temperature
Spread newspaper over a hard surface of the floorltable or charpoy.
Place the public health bag on it.
Open the bag arid .remove hand washing articles such as soap and towel.
' ,'i
. .. . " '

Wash hands aid.$lace the soap, soap dish and towel, on it.
Remove Thermometer with case (this can be procured from the family in
case they posses it).
Clean the thermometer with cotton swabs, bowl, Paper bag.
Shake tbe thermometer to bring mercury to the low level below 95 degree
 Rinse thermometer under running water or pour the water and dry it, by using Family Health Nursing Care '
cotton swab from bulb to stem.
Take the oral temperature for 2 minutes.
Remove the thermometer, wipe with cotton swab using rotatory movements
. .
from the stem to bulb.
Read &e mercury at the eye level in the thermometer.
Clean the thermometer with soap swab and wash well under running water,
dry it with cotton and place in its plastic containerlcase.
Replace articles in the public health bag.
Dispose off the used soiled articles, swabs and paper bag by burning it.
Wash hands well with soap ind water.
Replace Soap with soap dish and hand towel.
Record the findings in your Dairy. I..
\

Fold the newspaper and place it in the outer pocket of the public health bag.
th
Explain the family about the findings and further action.

5.3 RECORDING'ANDREPORTING
It is very importdnt for you as a Community Health Nurse to maintain records
and reports after home visit. You have to record the procedures and effectiveness
of care and services rendered (for details of recording and reporting refer
Practical 8).
As per the policy and standing instruction you need to maintain:
a) Registers of the Community profile.
b) Population statistics.
c) Eligible couples.

d) Record of MCH Services Ante-natal Mothers, Confinement, Infants,

preschoolers.
e) Immunization records.
f) Family planning records.

g) Record on sicknesses, specific health problems.

h) Records of implementation of National Health programmes as applicable in the

community area.
Individual Health Records
ANC
Infant cards
, Preschool child card
Immunization cards
Specific disease cards - Tuberculosis
- Leprosy etc.
Nursing Practices in Maintaining Diary
Community Health-I
You should carry the diary with you daily during home visits and record immediately
your activities in the diary. This recording should include the assessment of the
famigy, health status, procedures performed, health teaching and advices given,
health problems identified, referrals, follow up and continui~ of care. Overall
response of the family to care and teaching, acceptance of the health worker,
outcome of the care, plans for future visits and care. Any problems experienced
need to be reported to the supervisors.

Activity
Plan a family visit and carry' out the nutritional assessment of a school going child of
8 years of age. A sample of a nutritional assessment format is given in Appendix V.
Guidelines
Name of the Family/Community
Place
Date and Time

Signature

5.4 LET US SUM UP

In this practical you have learnt about family health care nursing. This practical has
helped you to assess the condition of the family, identify their needs, render health
care services, perform home procedures, give health education and evaluate your
care. You have learnt to identify the needs of various age groups in the community
and family and provide comprehensive services. Need of family identification and
timely actions by the health care team members will go a long way to prevent
complications and promote the health and welfare of the family and community at
large.