ST.

PAUL UNIVERSITY DUMAGUETE

COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

Initial Data Base for Family Nursing Practice

1. Family Structure. Characteristics and Dynamics

Name of Family Member Position in the Family Relationship Age Sex Civil Status Religion Educational

(Members of the household) to the head of the Attainment

family

Charles Patrick Q. Head of the Husband 36 M Married Roman College

Go family catholic graduate

Lady love Mother Wife 34 F Married Roman College

mazhalah G. Go catholic graduate

Reshia marianelle Only child Child 13 F Single Roman Grade school

G. Go catholic graduate

2. Socioeconomic

INCOME and EXPENSES

Occupation Place of Income of Adequacy to Who makes the

each working meet the basic decisions about money
Name of Family Member Work member necessities

Mr. C. G. investor home 15k- Capable _

20k/mon to meet
th the basic
necessitie
s

Mrs. M. G. Registered home 13k- Capable The one who

nurse 18k/ to meet decides about
month the basic the money
necessitie
s

Miss. R. G. _ _ _ _ _

3. Home and Environment

1. Housing

A. Adequacy of living space

- the house is made of concrete and wood. a typical house for a province like negros
oriental. the house and lot were owned by the grandmother of the father. the house has
only 2 windows and can’t sustain ventilation needed by the family.

B. Sleeping Arrangement
 ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

- 2 bedrooms 1 for the main bedroom (parents’ room) and 1 bedroom for their daughter.
they all sleep on a bed with bedframe with clean sheets

C. Presence of breeding or resting sites of vector of disease ( eg. Mosquitoes, roaches, files etc.

- the pest ive notice are that there are cobwebs on the ceiling. there where mosquito at the
living room. there also small rats and possible insects get it in from their windows because
it is not screened.

D. Presence of accident hazard

- on the walls of the house there’s some crack that can be seen inside the house and it
collapse if there’s an earthquake will occur. they stated that if there’s a storm their ceiling
start to drip some water that can be hazardous it may wet the wirings of the house that can
be led to start a fire since their house partially made by wood.

E. Food storage and cooking facilities

- the family use gas stove for cooking. the food they usually eat fried fish or chicken with
vegetables that they will buy to the near market. when it comes to storing their food, they
have a shelve that’s on the floor and not properly close. they also have refrigerator for
storing the fish, chicken, vegetable and etc.

F. Water supply, ownership, potability

- the main supply of water is coming from water district. this is where they use for bathing
washing clothes, washing dishes, for cooking. they pay their own water bills

G. Type of toilet facilities, ownership, sanitary condition

- they have their own toilet but it wont properly flush

H. Garbage /refuse disposal-type, sanitary condition

- they put their trash in a trash bag and place it outside every morning on Wednesday when
there’s a trash collector.

I. Drainage System-type, sanitary condition

- they have their own drainage system where all their human waste flow. the sorrounding
are clean and there is no sign of foul odor

2. Kind of Neighborhood, eg. Congested or slum

-the house in the community is not congested. they are spaced adequately. most of their
neighbors are just relatives.

3. Social and Health facilities available ( Health Center, Basketball court . gym, etc)

- they have a basketball court in the area and 2 chapels for christians and for roman catholics.
there is also a near market where they buy their food.

4. Communication and Transportation facilities available

 ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

- the family does not own any transportation; they just ride a tricycle or jeep to go to their
destination. sometime they just walk when they need to buy food which is just near to their
house.

4. Health Status of each Family Member

1. Medical and nursing history (Past, current .significant illnesses) or beliefs and practices
conducive to health and illness.

A. Mr. C. G. was diagnosed pancreatitis back on 2020 he told me that the reason he was
diagnosed pancreatitis is due to always eating fast food like jollibee, mcdo and etc. currently
today mr. Go is back to healthy state and eating healthy foods and started to do some home
exercise. mr. Go stated that they don’t have significant illnesses.

B. Mrs. M. G. according to her, she is healthy they do home exercise every morning like yoga.
she told me that her family has hypertension so including her, to maintain her blood pressure
she does some breathing exercise and yoga and pair with healthy foods.

C. Ms. R. G. is still 13 years old she was shy and I wasn’t able to interview her but according to
her father that their daughter is always drinking lots of milk and having a proper meal
everyday. their daughter doesn’t have any signs of health problems.

2. Nutritional assessment (especially for vulnerable or at risk members)

a.  Anthropometric data: measures of nutritional status of children-weight, height, mid-

upper arm circumference; risk assessment measures for obesity : body mass
index(BMI=weight in kgs. divided by height in meters2), waist circumference (WC:
greater than 90 cm. in men and greater than 80 cm. in                women), waist hip
ration (WHR=waist circumference in cm. divided by hip circumference in cm. Central
obesity: WHR is equal to or greater than 1.0 cm in men and 0.85 in women)
b. dietary history specifying quality and quantity of food or nutrient per day
c. Eating/ feeding habits/ practices
3. Developmental assessment of infant, toddlers and preschoolers
- DOH National Center for Health Promotion (NCHP)

4. Risk factor assessment indicating presence of major and contributing modifiable risk
factors for specific  lifestyle diseases

- hypertension, elevated blood lipids/ cholesterol, obesity, diabetes mellitus, inadequate

fiber intake, stress, alcohol drinking, and other substance abuse.

5. Physical Assessment indicating presence of illness state/s (diagnosed or undiagnosed by

medical practitioners)
-

6. Results of laboratory/diagnostic and other screening procedures supportive of assessment

findings.
-2
5. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

1. Immunization status of family members

- three members of the family are completely immunized from infancy. (Measles Vaccine, oral
polio vaccine and tetanus vaccine)
2. Healthy lifestyle practices. Specify.
 ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

- doing exercise every morning, Drink Water and Stay Hydrated, and Limit Sugared Beverages,
Get Enough Good Sleep.
3. Adequacy of:
a. Rest and sleep
- they have enough rest and sleep.

b. Exercise/activities
- does physical activities everyday.
c. Use of protective measure-e.g. adequate footwear in parasite-infested areas; use of bed
nets andprotective clothing in      malaria and filariasis endemic areas.
- in terms of safety measures everyone in the family has the knowledge of safety since
the wife is a nurse. they use footwear when inside the house. they do not use any bed
nets instead they bed sheets since their house is mosquito free.
d. Relaxation and other stress management activities
- during their day off they just watch some movies, enjoy their family time and play
games either using cellphone or playing outdoors.

4. Use of promotive-preventive health services

- The family takes advantage of the city's preventive and promotion health care services. Preventive
health services are more prevalent in the area than promotional health services. Family planning and
the practice of safe sex are promoted in preventive health services, particularly for the corona virus
and vaccinations, but also in promotional health services.

GENOGRAM:
 ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

PHOTO GALLERY

Please attach some picture of your actual interview as well as the evidences that will support your family
nursing problems.

leaking ceiling

shelve on the floor that wont shut propely

ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
First Semester, 2021-2022

Cracks on the wall