DR. YANGA’S COLLEGES, INC.

Wakas, Bocaue, Bulacan

College of Health Sciences

BS Nursing Program

“Family Case Study”

Submitted by:

Mhikkie Herrera

Mae Danielle S. Guballa

BS Nursing II-A

Submitted to

Regie P. De Jesus, MAN

 I. Introduction

Every family in the community has a responsibility in social development. They are the
foundation of every community to enhance the development, support, resources and having
access to all institutions or facilities in the community. The function and responsibility of the
family is to educate themselves and their children to socialize to introduce the values, morals
and be a member in the group of society. Definition of family had been established by the
common perspective as composed of a mother and a father with children that are living under
one roof. These days, many people clarify that family is not just related to each other and have
a linking blood but family is the people who are living in one roof have a common goals, values
and shares interest. All families in a community have a responsibility to be a foundation and
continue the building of family by procreation, especially to interact with other people and to
have a strong and one community. People should be strong and unite to each other by sharing
and exchanging norms that will contribute greatly to the community.

The community health nursing or so called public nurse that are found in RHU and
health care center accompany and introduce the primary healthcare and nursing interventions
that should be implemented in the community setting. They introduce the health education,
health intervention and health services to every individual, family and in a whole community
and this action nurses give a helping hand to every person to aid and prevent those illnesses
that has a solution and also before it becomes morbidity to the community. This community
health nursing helps and practice nurses to be adapt and to be divergent, by this nurses will
know how to build rapport easily with the people and try their practices especially in hospital
setting, community health nursing also helps nurses to identify what are can be the risk factors
of common illnesses that always happen in community and it will helps also on how to give an
action systematically to all the patients. This community health nursing practices and teach all
nurses to understand and accept every individual and family in the terms of their norms, values,
cultures and how families do their life. By knowing their cultures, nurses can formulate
interventions that resources are compatible and sustainable to all families. Community health
nursing should give all the care that are needed by the family and give all this care to all family
without discrimination. Community health nurses identifies the needs, problems of every
individual, family and community, nurses should formulate a health plan that is exact
accordingly to the needs of every people, their functions also is to interprets, create and
implement a nursing plan and provide this buy direct nursing care to all sick, disabled, and well-
being in home, clinic, school and other institutions in community. Nurses should motivate and
escalate every individual and family to participate in educating, planning, and implementing by
themselves by giving health educations and by building rapport it will initiate the family and
individual to develop and promote disease prevention. Nurses in the community should be a
role model for all people by being a good example of healthy living and joining in the members
of the community. This field of nursing combines all the skills of nursing, public health, social
assistance and as part of the community for the improvement of well and conditions in social
and environment and promoting the health and preventing the disease.

Community is composed of people or families that are living in the same area that share
attributes, norms and something in common such as the government, geographic location,
culture and heritage. In the community the basic unit of care is the family, nurses should be
care providers in all families; by providing a continuous and comprehensive care for the families
and emphasizes the promotive and preventive health care. Family case study is an instrument
that uses to identify the health status of every family in community, student nurses assess and
do critical observations to know what are the risks and can be the stress point of health and
understanding this student nurses make a plan intervention to improve the deficiency of family
and give the holistic care which the family needs it. This family case study inform and teach the
family to know how to classify and identify if there is a problem in terms of their health, it can
also help to know what are the things that can be improve and how environment things can be
the source of threat and this family case study will encourage every family to use or have an
access in all health care facility in their community how it is important and how check- ups and
consulting in a doctor important in their health status.

A. Objective

a. Short Term

▪ Student Nurse Centered

After 2 days of home visits, the student nurses shall be able to:
✔ Introduces themselves in the family
✔ Establish rapport
✔ Familiarize themselves in the community
✔ Explain the purpose of home visits
✔ Collect data by interviewing the family members

▪ Client Centered
After 2 days of home visits, the adopted family shall be able to:
✔ Have a trust in the student nurses
✔ Answer and give information without hesitations
✔ Telling to the student nurses if their perspective and
understanding the instruction are same
b. Long Term
▪ Student Nurse Centered

After 4 days of home visits, the student nurses shall be able to:
✔ Identify what are the deficits and can be the threats
✔ Inform the family on what are the threats or can be the
problem achieving the optimum health
✔ Educate the family about the importance of visiting
healthcare center
✔ Implement the nursing interventions and improve the
deficiency identified
✔ Identify and allocate the resources in nursing intervention

▪ Client Centered
After 4 days of home visits, the family shall be able to:
✔ Family accept the suggested health interventions
✔ Understand the purpose of physical assessment and health
interventions
✔ Attain the proper hygiene
✔ Able to understand what nurses explain about the possible
problem and risks in health
✔ Family cooperate with the student nurses when allocating
the resources
 B. Entry, Climate of Acceptance, First Few Words, Number of Home Visit

The student nurses are assigned in Barangay Guyong, Sta. Maria Bulacan. On the first
day, October 21, 2021, Thursday, the student nurses had a tour and to find an applicable family
and familiarize themselves around the area.

October 24, 2021, Sunday morning, the student nurses had a task to search for a family
that is right and fit for their study. Family must be the one that needs help for the health
improvement and accepts all the nursing intervention and health teachings. Student nurses
found that is accommodating, responsive and accepted all the terms and purpose of this family
case study and that is Potato Family.

First Home Visit ( October 24, 2021, Sunday)

Sunday afternoon, the student nurses knocked on the door and Mrs. Patata
Potato welcomed us with a smile and said “pasok at maupo kayo”, her child Pringles Potato is
found outside playing with her friends and Mrs. Potato called Pringles to greet us. Mrs. Potato
warmly welcomed them in their home and offered a seat. Before the student nurses ask and
give the purpose of this study, the student nurses introduced themselves first and ask how was
their days pass, after building and establish rapport by asking open- ended questions they asked
Ms. Bernardo “Pwede po ba kayo ma interview? Para po ito sa case study.” and Ms. Bernardo
replied “Pwede naman”. Using the open- ended questions to Ms. Bernardo It will help to gain
trust and be able to exchange information easily.

After introducing themselves, Mrs. Potato also introduced herself and her child, which is
Pringles. Mrs. Potato is a single mother of two children but her eldest daughter is currently
studying in Manila and living with her grandmother and she said that they visit when her eldest
child does all the activities. Before the student nurses started the interview, they informed the
family about the home visit.
 After talking about their life, I was able to interview Mrs. Potato about their life and
health status, environmental and sanitation status and other information that had been asked.
The mother answers the question without hesitations and sometimes she asks if her
understanding is right into the concept that is being asked. On the first day, the interview went
well and finished it right away, before they said goodbye, they informed Mrs. Potato that I will
go back to next Sunday and say what action we will do.

Second Home Visit ( October 31, 2021, Sunday)

1:00 pm, they arrived at the home of the Potato family. Pringles is doing her module
because she is in a modular mode of her learning and passes it every week. Mrs. Potato
greeted them with a smile and told them to sit. The student nurses continue the interview
because there are some questions that still have no response and the mother answers it
properly. After they interviewed Mrs. Potato, they also asked Pringles for the family coping
index and explained every statement properly so she could understand and know what answer
she would give to them.

The student nurses also performed physical assessment but Mrs.Potato is the one they
are able to assess and only the head and neck, but before they started they said first what will
be the actions that they will do so Mrs. Potato will not hesitate to cooperate. They cannot
perform physical assessment to Pringles because she and her cousins are doing their modules.
Before they left, they told Mrs. Potato that they will be back and continue the physical
assessment to her and her child Pringles.

Third Home Visit ( November 11, 2021, Thursday)

Around 2:00 pm, the student nurses arrived at the home of Potato Family, they greet
them as they say good afternoon to Mrs. Potato and Pringles. They are in their living room
watching television and Mrs. Potato is also busy with her phone but when they greet them she
welcomes them and offers them a seat. Pringles is just watching television with her cousins
because their relatives are just nearly living in their house.

The student nurses explained first to Mrs. Potato and Pringles that they will assess them
physically and will perform FANCAP assessment and continue the assessment from last week.
Everything is fine while doing the physical assessment and the family is cooperating with them
when the student nurses said they need to do something like that to be able to assess and
know if there is a problem. The physical assessment was done nicely, they got thankful to them
for the participation that they got and again before they left them, they said that they will be
back and ask some questions and do some interventions.

Fourth Home Visit ( November 20, 2021, Sunday)

Around 2:00 pm, the student nurses arrived at the home of the Potato Family and did
what they usually do. They already did the physical assessment for the family and are now
starting to assess the home of the family regarding the materials of the household and the
water facility. The family is fine with all the measurements of the house and answers all the
student nurses’ questions. Also, as it is their 4th visit, Pringles is now friendly with the student
nurses and shares that she also wants to be a nurse someday. The student nurses also bought
merienda for the family as a token of appreciation for the cooperation of the family throughout
the whole visit. The student nurses told the family that they will be back after evaluating all the
assessments and planning all the interventions to be implemented to the family.
 II. Family Constellation

NAME AGE ORDINAL SEX EDUCATIONAL PRESENT HEALTH

STATUS STATUS
POSITION

Ms. Patata Potato 39 years Mother Female High school Ms. Liezel is wearing a
old black shirt and black
Graduate shorts while brown
hair is tied, she is
watching television.
When they assessed
her, all findings are
normal but her five
teeth have cavities and
eight teeth are pulled
out because she said
that she is planning to
have a denture. Her
nails in hand and toe
are clean, she has nail
polish because she has
tools for manicure and
pedicure.

Vital signs:

PR- 66bpm

RR- 18 cpm

T- 35.9 °C

BP- 101/61mm/hg

BMI- 19.1 (normal)

Pringles Potato 10 years Daughter Female Elementary Pringles was wearing a

old green dress as usual
clothes for everyday
 and playing with her
cousins, she has black
hair and a thin girl. Her
nails have some dirty
parts, even her
toenails. Through the
physical assessment
they found that her
lower teeth are the
most affected of the
cavities. Her hair is a
bit messy because they
are playing with her
cousins and she has
some scars in her legs.

Vitals signs:

PR- 86 bpm

RR- 19cpm

T- 36.8 °C

BP- 80/50 mm/hg

BMI- 14.08
(underweight)

III. HEALTH ASSESSMENT (IPPA-CEPHALOCAUDAL)

A. Physical assessment
 Name: Mrs. Patata Potato

AREA TO ASSESS TECHNIQUE SKILLS FINDINGS

HEAD Inspection Inspect skull for The size of her head is

shape, symmetry, size normocephalic which is
in proportion to body normal and it is
and position symmetrical to her body

SKULL Inspection and Palpate with finger There is no any masses,

Palpation pads beginning in lesions, and redness in her
frontal area and skull through the
continuing over observations and there is
parietal, temporal, no also palpated any
and occipital areas for masses
contour, masses,
depressions, and
tenderness

FACE Inspection Inspect facial features Her facial features are all
for expression, shape, normal and symmetrical,
and symmetry of eyes are symmetrical to
eyebrows, placement each other even the
of nose, eyes, and eyebrows, the placement
ears of the nose is fine and her
ears are also symmetric
and there is no lesions and
redness but she has one
scar in her forehead

EYES AND VISION Inspection Inspecting eyes for Her eyes are not
symmetry and protruding and they are
position. symmetric to each other
and her eyes are
symmetric to her ears

Inspection Inspecting the Through the inspection

eyelids/ Bulbar the eyes of the patient is
conjunctiva for normal, there is no any
erythema and any discharge and redness
 discharge. around it and her eyelids
are pinkish

Inspection Inspecting the sclera The sclera of the client

and if the eyes are in appears white with some
socket and inspecting visible blood vessels but it
cornea is normal, her cornea is
shiny and the iris is visible
also. The sclera has no
abnormalities like
jaundice.

Inspection Inspecting the pupil, The size of her pupil is

its size and response 4mm and it is equal to the
to the light and opposite pupil. The
accommodation PERRLA of the client is
normal, her pupil reacts
when the light directed it
to the pupil it means it
constricts and
accommodates to the
light.

Inspection Inspecting the Both eyes are coordinated

ExtraOcular simultaneously when the
Movement or 6 penlight moves it
Cardinal of Gaze clockwise and when the
(Cranial Nerve III, IV, penlight moves near her
& VI ) nose, her eyes coordinate.

EARS AND HEARING Inspection Inspecting the Her ears are normal,
external ear, there’s no any lesions,
symmetry, auricles, masses, redness and
color and any tenderness, the color of it
discharge is fair to her skin color, the
auricles are aligned to the
cantus of the eye and
especially there is no any
discharge.
 inspection Inspecting the The patient is able to
whispered voice test repeat what I’ve said
when I whisper
(CRANIAL NERVE VIII)

Palpation Palpating the external When her ear is palpated,

ear, mastoid process there’s no pain reported
and moving up and and when her ear is
down the ear moving up and down, no
discharge are noted and
the mastoid process is
clear which means no
lesions or even tenderness

NOSE AND SINUSES Inspection Inspect the nose for Her nose is symmetric to
symmetry, deformity, her face, no discharge
flaring or reported and no redness,
inflammation and masses and lesions
discharge from the reported, the patency of
nares and examine her nostrils are normal,
the patency of each she is able to inhale and
nostrils (CRANIAL exhale without hinder like
NERVE 1), and the clog formation and
inspecting the nasal her nasal septum is in the
cavity middle.

Palpation Apply gentle upward Upon the palpation in her

pressure on frontal nose, there’s no
and maxillary areas tenderness and pain
avoiding pressure on reported and in the
the eyes sinuses theirs is non-
tender air filled cavities.

MOUTH Inspection Inspecting the lips, Her lips is in pinkish color

gums, teeth, tongue and even the mucosa, the
floor and sublingual gums of the client is also
pinkish and firm and no
receding gums, the teeth
of the client is not
complete because there
are some teeth that are
 already pulled out and she
has a five tooth that has
cavity and needs to fill in
and she has also plaque,
her tongue is pinkish and
have some whitish color in
the surface area and the
sublingual veins are
prominent on the floor of
mouth. No pain, lesions
and redness reported.

Inspection Doing the The gag reflex of the client

examination for is intact and normal
cranial nerve 9 and

10- Gag Reflex

FACIAL AND NERVE Inspection Inspecting the cranial Upon the assessment of
nerve 7 by doing close this cranial 7, she’s able to
eyes tightly, opening do this all without the
the mouth, smile and pain reported and did all
puff out cheeks the facial expressions
easily

NECK Inspection Inspecting the neck The neck of the client is

for symmetry, lumps symmetric and it is in the
visibility and jugular middle, there’s no lumps
distention visible and jugular veins
are also not visible. No
lesions, masses, redness
and tenderness reported

Inspection Inspecting the trachea The trachea of the client is

and note for position in the midline position and
it is palpable.

Palpation Palpate lymph nodes There is no lymph nodes

and instruct client to palpated
relax and flex neck
 slightly forward

Palpation Palpating the carotid The pulse of carotid artery

artery of the client is normal and
intact when palpated it
one- by- one

Auscultation Auscultation in When the carotid artery

carotid artery are auscultated it is
normal and there’s no
hum reported but it is
normal findings due to the
normal jugular venous
flow

THORAX AND LUNGS Inspection Asses shape and The thorax of the client is
symmetry, movement symmetrical even the
of chest wall with breathing motion and has
deep inspiration and no masses, there’s no
full expiration and difficulty in breathing, and
inspecting the spine any obstruction or
abnormalities are none
and the spine of the client
is straight and no
abnormalities. There’s no
also noted a barrel chest

Palpation Palpate thoracic There’s no tenderness and

expansion at 10th rib lesions noted in the
by placing thumb posterior and anterior
close to clients spine chest of the client and
and spread hands when palpating for thorax
over thorax and expansion, the findings
palpate for lesions or are normal, it expands and
areas of pain meets my both thumb in
midline when on
expiration.

Percussion Palpating the Air filled lungs of the client

posterior thorax is a resonant sound.
 Auscultation Auscultating the The breathing sounds are
posterior thorax of normal
the client

CARDIOVASCULAR Inspection Inspecting the chest if The chest of the client has
have a heaves or lift no any heaves or visible
pulses

Auscultation Auscultating the areas There’s no any murmurs

of anatomic aortic, and abnormal sounds
pulmonic, tricuspid, heard
and mitral

ABDOMEN Inspection Inspect the skin The skin in the abdomen

integrity, and shape of the client is fair into her
overall skin color and no
masses, lesions and
edema are noted but she
has scars in her abdomen
because she gave birth to
her two daughters in
cesarean section

PERIPHERAL AND Inspection Inspect for any lesions Upper extremities of client
MUSCULOSKELETAL in upper extremities, is normal, the color is
motion of the fingers, same to her skin color
(UPPER EXTREMITIES) and inspect for drift which is fair, there’s no
any lesions, edema and
redness noted, the motion
of the fingers are normal
there’s no any hand
deformities noted, and
when the client tried to
extend her arms and close
her eyes his arm didn’t
move upward which
means normal and she has
scars in her both arms due
to the when she is cooking
 Palpation Palpate the radial and The radial and brachial
brachial artery, test artery of the client pulses
for the strength by is normal , her resistance
squeeze and pulling also is intact when trying
the hand, and grading to pull her hand and in the
the crepitus crepitus when feeling the
movement of the elbow is
also normal and when
flexing and extending her
upper extremities there’s
no pain verbalize.

PERIPHERAL AND Inspection Inspect for any lesions The lower extremities of
MUSCULOSKELETAL in lower extremities, the client has no lesions,
raising the foot, edema and she have a 16
(LOWER inspect also the toe scars in her knee and tibia,
and toenails anterior portion of her
EXTREMITIES)
foot and fibula part of his
lower portion, her toe has
also a scar

Palpation Palpate the popliteal, The pulse in popliteal,

posterior tibia, posterior tibia and
anterior part of the anterior part of the foot is
foot, and check for intact and the pulse is
edema, and Babinski normal, the Babinski reflex
reflex of the patient is normal
her toenails react when
the thing use in her
posterior part of the foot,
and there’s no signs of
edema

SKIN, HAIR AND Inspection Inspecting the skin The skin color of the client
NAILS color, hair, and nails is brown color and fair to
his body, her hair has
already a white hair and
also her hair is distributed
equally and her is clean
 Palpation Check for the capillary The capillary refill of the
refill in both hands client is normal within 2
and toes and check seconds her blood is
for skin turgor already back or refill in
both hands and toe and
the skin turgor, her skin
snaps rapidly back to its
normal position.

Name: Pringles Potato

AREA TO ASSESS TECHNIQUE SKILLS FINDINGS

HEAD Inspection Inspect skull for The size of her head is

shape, symmetry, size normocephalic which is
in proportion to body normal and it is
and position symmetrical to her body

SKULL Inspection and Palpate with finger There are no any masses,
Palpation pads beginning in lesions, and redness in her
frontal area and skull through the
continuing over observations and there is
parietal, temporal, no also palpated any
and occipital areas for masses but she has a 3
contour, masses, mole in her scalp.
depressions, and
tenderness

FACE Inspection Inspect facial features Her facial features are all
for expression, shape, normal and symmetrical.,
and symmetry of eyes are symmetric to
eyebrows, placement each other even the
of nose, eyes, and eyebrows, the placement
ears of the nose is fine and her
ears are also symmetric
 and there are no lesions
and redness but she has
one scar in her forehead.

EYES AND VISION Inspection Inspecting eyes for Her eyes are not
symmetry and protruding and they are
position. symmetric to each other
and her eyes are
symmetric to her ears

Inspection Inspecting the Through the inspection

eyelids/ Bulbar the eyes of the patient is
conjunctiva for normal, there is no any
erythema and any discharge and redness
discharge. around it and her eyelids
are pinkish

Inspection Inspecting the sclera The sclera of the client

and if the eyes are in appears white with some
socket and inspecting visible blood vessels but it
cornea is normal, her cornea is
shiny and the iris is visible
also. The sclera has no
abnormalities like
jaundice.

Inspection Inspecting the pupil, The size of her pupil is

its size and response 4mm and it is equal to the
to the light and opposite pupil. The
accommodation PERRLA of the client is
normal, her pupil reacts
when the light directs it to
the pupil which means it
constricts and
accommodates to the
light.

Inspection Inspecting the Both eyes are coordinated

ExtraOcular simultaneously when the
Movement or 6 penlight moves it
Cardinal of Gaze clockwise and when the
 (Cranial Nerve III, IV, penlight moves near her
& VI ) nose, her eyes coordinate.

EARS AND HEARING Inspection Inspecting the Her ears are normal,
external ear, there’s no any lesions,
symmetry, auricles, masses, redness and
color and any tenderness, the color of it
discharge is fair to her skin color, the
auricle are aligned to the
cantus of the eye and
especially there is no any
discharge.

Palpation Palpating the external When her ear is palpated,

ear, mastoid process there’s no pain reported
and moving up and and when her ear is
down the ear moving up and down, no
discharges are noted and
the mastoid process is
clear which means no
lesions or even
tenderness.

inspection Inspecting the The patient is able to

whispered voice test repeat what I’ve said
when I whisper.
(CRANIAL NERVE VIII)

NOSE and SINUSES Inspection Inspect the nose for Her nose is symmetric to
symmetry, deformity, her face, no discharge
flaring or reported and no redness,
inflammation and masses and lesions
discharge from the reported, the patency of
nares and examine her nostrils are normal,
the patency of each she is able to inhale and
nostrils (CRANIAL exhale without hinder like
NERVE 1), and the clog formation and
inspecting the nasal her nasal septum is in the
cavity middle.
 Palpation Apply gentle upward Upon the palpation in her
pressure on frontal nose, there’s no
and maxillary areas tenderness and pain
avoiding pressure on reported and in the
the eyes sinuses theirs is non-
tender air filled cavities.

MOUTH Inspection Inspecting the lips, Her lips is in pinkish color

gums, teeth, tongue and even the mucosa, the
floor and sublingual gums of the client is also
pinkish and firm and no
receding gums, the teeth
of the client is not
complete because there
are some teeth that are
already pulled out and she
has a five tooth that has
cavity and needs to fill in
and she has also plaque,
her tongue is pinkish and
have some whitish color in
the surface area and the
sublingual veins are
prominent on the floor of
mouth. No pain, lesions
and redness reported.

Inspection Doing the The gag reflex of the client

examination for is intact and normal
cranial nerve 9 and
10- Gag Reflex

FACIAL NERVE Inspection Inspecting the cranial Upon the assessment of

nerve 7 by doing close this cranial 7, she’s able to
eyes tightly, opening do this all without the
the mouth, smile and pain reported and did all
puff out cheeks the facial expressions
easily.

NECK Inspection Inspecting the neck The neck of the client is

 for symmetry, lumps symmetric and it is in the
visibility and jugular middle, there’s no lumps
distention visible and jugular veins
are also not visible. No
lesions, masses, redness
and tenderness reported.

Inspection Inspecting the trachea The trachea of the client is

and note for position in the midline position and
it is palpable.

Palpation Palpate lymph nodes There is no lymph nodes

and instruct client to palpated
relax and flex neck
slightly forward

Palpation Palpating the carotid The pulse of carotid artery

artery of the client is normal and
intact when palpated it
one- by- one

Auscultation Auscultation in When the carotid artery

carotid artery are auscultated it is
normal and there’s no
hum reported but it is
normal findings due to the
normal jugular venous
flow

THORAX AND LUNGS Inspection Asses shape and The thorax of the client is
symmetry, movement symmetrical even with the
of chest wall with breathing motion and has
deep inspiration and no masses, there’s no
full expiration and difficulty in breathing, and
inspecting the spine any obstruction or
abnormalities are none
and the spine of the client
is straight and no
abnormalities. There’s no
also noted a barrel chest
 Palpation Palpate thoracic There’s no tenderness and
expansion at 10th rib lesions noted in the
by placing thumb posterior and anterior
close to clients spine chest of the client and
and spread hands when palpating for thorax
over thorax and expansion, the findings
palpate for lesions or are normal, it expands and
areas of pain meets my both thumb in
midline when on
expiration.

Percussion Palpating the Air filled lungs of the client

posterior thorax is a resonant sound.

Auscultation Auscultating the The breathing sounds are

posterior thorax of normal
the client

CARDIOVASCULAR Inspection Inspecting the chest if The chest of the client has
have a heaves or lift no any heaves or visible
pulses

Auscultation Auscultating the areas There’s no any murmurs

of anatomic aortic, and abnormal sounds
pulmonic, tricuspid, heard
and mitral

ABDOMEN Inspection Inspect the skin The skin in the abdomen

integrity, and shape of the client is fair into her
overall skin color and no
masses, lesions and
edema are noted but she
has two scars in her
abdomen

PERIPHERAL AND Inspection Inspect for any lesions Upper extremities of client
MUSCULOSKELETAL in upper extremities, is normal, the color is
motion of the fingers, same to her skin color
(UPPER EXTREMITIES) and inspect for drift which is fair, there’s no
any lesions, edema and
redness noted, the motion
 of the fingers are normal
there’s no any hand
deformities noted, and
when the client tried to
extend her arms and close
her eyes his arm didn’t
move upward which
means normal and she has
seven scars in her both
arms due to the physical
activity like playing.

Palpation Palpate the radial and The radial and brachial

brachial artery, test artery of the client pulses
for the strength by is normal , her resistant
squeeze and pulling also is intact when try to
the hand, and grading pulled her hand and in
the crepitus crepitus when feeling the
movement of the elbow is
also normal and when
flexing and extending her
upper extremities there’s
no pain verbalize.

PERIPHERAL AND Inspection Inspect for any lesions The lower extremities of
MUSCULOSKELETAL in lower extremities, the client has no lesions,
raising the foot, edema and she have a 16
(LOWER inspect also the toe scars in her knee and tibia,
and toenails anterior portion of her
EXTREMITIES)
foot and fibula part of his
lower portion, her toe has
also a scar and her
toenails has a dirt
underneath of it and
when raising her foot
there’s no any pain
associated.
 Palpation Palpate the popliteal, The pulse in popliteal,
posterior tibia, posterior tibia and
anterior part of the anterior part of the foot is
foot, and check for intact and the pulse is
edema, and Babinski normal, the Babinski reflex
reflex of the patient is normal
her toenails react when
the thing use in her
posterior part of the foot,
and there’s no signs of
edema.

SKIN, HAIR AND Inspection Inspecting the skin The skin color of the client
NAILS color, hair, and nails is brown color and fair to
his body, her hair some
lice when it inspected and
also her hair is distributed
equally and her nails has
some dirt in the
underneath of fingernails
both in hand and toe

Palpation Check for the capillary The capillary refill of the

refill in both hands client is normal within 2
and toes and check seconds her blood is
for skin turgor already back or refill in
both hands and toe and
the skin turgor, her skin
snaps rapidly back to its
normal position.

B.FANCAP Assessment of each member

Name: Mrs. Patata Potato

FLUID Color of skin and skin Her skin color is brown and
condition fair to her overall body and
there’s no present of lesions,
 edema, redness, and
tenderness and she has scars
in her upper and lower
extremities

AERATION Breathing Her breathing is normal and

her respiratory rate is 18 cpm

NUTRITION Under or overweight Her BMI is 19 and that is

classified as normal

COMMUNICATION Can they make own needs she can make their own needs
especially for her daughter

ACTIVITY Level Now she here activity is doing

household chores her
occupation in parlor

PAIN Under reported There’s no pain reported

ELIMINATION Normal and amount Her elimination is regular and

with a specific time schedule.

SOCIALIZATION Self- worth and self- Before they live here in

interaction Bulacan she always talking or
bond with her friends in
Manila but now she just chat
it in theu social media

Name: Pringles Potato

FLUID Color of skin and skin Her skin color is brown and
condition fair to her overall body and
there’s no present of lesions,
edema, redness, and
tenderness and she has scars
in her upper and lower
extremities

AERATION Breathing Her breathing is normal and

 her respiratory rate is 19 cpm

NUTRITION Under or overweight Her BMI is 14 and that is

classified as underweight

COMMUNICATION Can they make own needs She still child and when she
needs something she says it
first to her mother and ask
some permissions in and
when it comes to other
people she still shy to make a
talk or ask some questions

ACTIVITY Level During this pandemic she

always play with her cousins
and sometimes she answer all
her modules.

ELIMINATION Normal and amount She said that her elimination

is always after she eats
because she felt that it needs
to be excreted and in one day
sometimes she eliminates
three times.

SOCIALIZATION Self- worth and self- She used to interact with her
interaction playmates, cousins and
relatives but when in other
people she still confuse and
shy

IV. SOCIO ECONOMIC, CULTURAL AND ENVIRONMENTAL ASSESSMENT

A. Type of Family
 The Potato Family is identified as a Single Parent Family. Single Parent Family is defined
as a family in which a parent brings up a child or children alone, consisting of a parent/caregiver
and one or more dependent children without the presence and support of a spouse or adult
partner who is sharing the responsibility of parenting. Mrs. Potato is separated from her first
husband when her eldest daughter is still in her womb and her second husband, they separated
when Pringles is 1 year old. Since then Mrs. Potato is living with her mother and she helps it for
the living expenses.

B. Dominant Family Member/s in terms of decision-making especially to health care

In terms of decision- making, the family of Ms. Bernardo is Matriarchal which the full
authority is on her because she has two daughters and she wanted to take care of them and
grow them properly. She was the one who had authority when it came to the weekly and
monthly budget in their house like the bills and budget for the food. Sometimes she still asks for
the permission and advice from her mother and sometimes her mother has authority in other
things. When it comes in to health, Ms. Bernardo is dominant. She always thinks about the
health status of her two daughters, they have completed all the vaccines and they have a
personal pediatrician and always go ahead in hospital when her two daughters need medical
assistance. Sometimes her eldest daughter has authority when it comes to her school activity
and what she wants about her degree and course in her studies.

C. Source of Income and Expenditures

For the Potato Family, their source of income is from the mother and sometimes she
borrowed money from her friends and mother. Her monthly income is 10,000 pesos from her
work as a salon worker, sometimes she makes a graham cake and sells it, and also offers service
from house to house doing the client’s manicure and pedicure. Her eldest daughter also sells
graham balls back when she’s in senior high school. The 10,000 pesos was divided and allotted
to the bills that need to be paid like electricity and water bills, for the food they also allotted a
money for it. She also buys ready to eat canned goods and instant noodles to have stock and
she also buys vegetables, fish, meat and fruits. For the medical assistance, she doesn’t allot
money for this, but when there’s need a medical assistance from her daughter they
immediately call ambulance in their barangay and send them in public hospital in Manila, now
that they are living here in Bulacan her daughter or even her didn’t experience immediate
medical assistance because it is just a colds and cough that can be treated in the home with the
over the counter medicines.

D. Working Hours

Before the pandemic hit, Mrs. Potato has eight to nine hours work in parlor from 9:00 am to
7:00 pm so her youngest daughter which is Pringles, she leaves it in her mother so she could be
able to work, right now that still pandemic she has no work that’s why her attention is focus on
her daughter to take care of it. Sometimes to have an income she does home service and she
also brought her daughter to the house of her client.

E. Ethnic Background

The Potato Family was born and raised in Manila, but they are now living here in
Barangay Guyong Sta. Maria Bulacan, their culture is more integrated with the culture and
norms from the mother of Ms. Bernardo and also they are now living nearby with their
relatives. They are all Roman Catholic, sometimes they go to church to attend the mass but
sometimes they can’t go to the church because of some time and things are not compatible to
attend.
 F. Significant Other’s Roles in the Family Life

The significant person that always helps their family is the mother of Mrs. Potato and
sometimes the sister of them that are now living in another country. Her mother works at a
barangay hall in Manila and gave them some money for their budget and the sister of her
mother sometimes gave her also money for her daughters.

G. Health Habits/ Beliefs

Family Bernardo still believes in “hilot and pagtatawas”, when her daughters have some
sickness or fever and they usually consult there when they have “pilay”. Mrs. Potato also
believes that it is important for her children to have a complete immunization and she fulfilled
it and sometimes they go to the barangay hall when there is a free check-up and they consult
there. Mrs. Potato also got a family planning method which is the implant but she has already
removed it from the hospital where she got it because it has some side effects on her. She gave
birth to her daughters in Fabella Hospital and when her daughters needed urgent medical
assistance she immediately sent an ambulance and sent them to Jose Reyes also in Manila.

H. Family’s Involvement in Community Activities

The Potato Family, back when they lived in Manila they participated in every activity and
program that was formulated by the barangay institution like when there was a free
consultation, fiesta and when there was an announcement from their barangay captain. But
now that they are living here in Bulacan and also it is still pandemic that’s why they are not yet
trying to participate when they have a program.

I. Family’s Utilization of Community Resources

 The Potato Family is satisfied with the facilities and how the facilities are very
convenient to go to the school, barangay and the health center are just in one place. For Mrs.
Potato is very helpful because when she needs something in barangay, she will not waste time
and money for transportation to go to the school or to fetch Pringles if face to face is already
happening.

J. Housing Condition

The house of Mrs. Potato are made out of solid materials. It has a floor of 5.89 m x 3.63
m, so the total floor area of their house is 21.38 sqm2. There are just two living there but
sometimes her eldest daughter sleeps there when she visits Bulacan and is free from her school
activities. When the TSR and TFA computed it shows that they are crowded in their house but
they are just two members which is Mrs. Potato and her child Pringles. TSR is greater than TFA
where 21.38 sqm2< 23 and Ms. Bernardo said that their house is fine for them.

Their house contains one bedroom only, when they are going to sleep, they share one
bed. They have appliances like television and DVD players and when entering their house, their
living room and kitchen are in one place. Their house is also ventilated because their windows
are two and it is big. They also have washing machines and dryers for their clothes. When they
are going to eat, they just sit on their wooden sofa and use the mini table in front of it. Their
light is poor because there is only one for living room, kitchen and the other one light is their
bedroom.

Adequacy of Living Space

FORMULA:

TFA (IN SQM) = LENGTH OF THE HOUSE x WIDTH OF THE HOUSE

5.89 m x 3.63 m= 21.38 sqm2

 TSR = NUMBER OF HOUSEHOLD MEMBERS x CORRESPONDING SPACE
REQUIRED FOR THAT MEMBER

CONSIDER:

ADULTS (13 Y/O AND ABOVE) = 15 SQM

CHILDREN (1 Y/O TO 12 Y/O) = 8 SQM

INFANTS (BELOW 12 MONTHS) = 0 SQM

COMPARE THE TFA (TOTAL FLOOR AREA) WITH THE TSA (TOTAL SPACE REQUIREMENT)

CROWDED IF: TFA < TSR

NOT CROWDED IF: TFA > TSR

TFA = 21.38 sqm2

TSR = 1(15) + 1 (8)

= 15 + 8

= 23

INTERPRETATION: TFA< TSR = (CROWDED)

K. Food Sources, Storage and Cooking facilities

Mrs. Potato go to the wet market of Sta. Maria Bulacan sometimes every week or when
they don’t have food stocks. She usually buys vegetables, fish, eggs and meat but it's just
sometimes because she said that pork and beef are too pricey and she also buys in grocery
stores instant foods like canned goods and instant noodles. She always cooked and prepared
the food for the two of them. Their kitchen is just small, it contains only a one burner stove,
sink, plates, spoon and fork, and also a cup and glass. They have a refrigerator that is used for
the storage of their food and they also sell ice for five pesos. For the snack of her daughter she
also buys a pack of biscuits and powder juice and prepares it for her.

L. Water Supply

The family is categorized in Level III: Sta. Maria District Water. They have a faucet in
their sink and in their comfort room. They use this for taking a bath and washing dishes. For
their drinking water, it has a mineral station nearby and Ms. Benardo always orders three
containers so she has stocks of drinking water.

M. Toilet Facility

The Potato Family has their own comfort room. It is located within their kitchen area.
The toilet is devoid of water carriage and it has good sanitation, the toilet bowl is clean and no
excrement wastes found, the smell is not stinky and not too good, just an exact smell for the
restroom.

N. Drainage System

The drainage system of Potato Family is an open type for their kitchen, it is located
outside their house. The side of their house is a vacant lot and full of grass and the tube where
their waste from food and dishes are just flowing and they just rent a person to make a
longitudinal pit that is directed to the canal of their community. But in their comfort room is a
closed type because it is directed to the main canal of their community.

O. Social and Health Facilities Available

 The family benefits from the services offered by the barangay health center back when
they are lived in Manila, where her children got fully immunized, doing some free consultations
and got a free transportation through ambulance when they are going to the hospital, now
here in Bulacan when she and her niece want to get a consultation because it is pregnant it
needs cedula and needs to pay three hundred pesos that’s why they didn’t go in health center
but instead they consult in private ob- gyne clinic and also that was pandemic and the staff in
charge there said that the doctor and midwife is not available.

P. Communication and Transportation Facilities

Mrs. Potato has a cellphone so she uses this to communicate with her mother and also to her
eldest daughter, and when she’s going to the market, needs to buy something and needs to
pass the module of her daughter she used to rent a tricycle for transportation.

V. PROBLEM IDENTIFICATION
 A. List of Problem Identified

No. Problems Identified Score Rank

1 Presence of vector of diseases e.g. mosquitoes, flies,

roaches

2 Presence of Pediculosis

B. Priority Setting

Problem#1: Presence of vector of diseases eg. mosquitoes, flies, roaches

Criteria Computation Actual Justification

Score

1. Nature of the ⅔x1 .67 The problem is considered to be a

 Problem health threat since it predisposes
the family to acquire vector borne
diseases such as Dengue,
leptospirosis, and the like.

2. Modifiability of 2/2 x 2 2 The problem is highly

the Problem modifiable as evidenced by the
following criteria observed:

Current
knowledge > The family has a current
knowledge of the problem as
Family
resources during the interview the Mrs.
Potato was able to verbalize
SN
Resources the presence of the problem

Community
Resources
“ Marami talagang lamok
dito sa’min nabili kami lagi ng
pang- spray pero meron pa
ding lamok at karamihan
malalaki yung mg lamok kaya
masakit at siguro dahil din sa
bukid sa gilid ng bahay at
maraming damo kaya di
nawawala agad.”

> The family's manpower and

physical resources are
available AEB the family's
willingness to cooperate and
 comply with the Student
Nurses health teachings and
as verbalized by Mrs. Potato
they have insecticides such as
Baygon which they use to
eradicate those insects.

> The Student Nurses are well

informed and knowledgeable
about vector borne diseases
and the management to be
done to prevent the
occurrence of these diseases
and on how to eradicate those
rodents and insects, thus
making them enable to impart
these knowledge to the family,
another thing is the Student
Nurses willingness to help the
family to minimize if not to
eradicate this problem.

3. Preventive ⅔x1 .67 Prevention of these vectors

Potential has a moderate potentiality as
reflected by the criteria the
Severity Student Nurses have
Duration observed:
 The problem is not yet severe
Current
Manage since no one in the family was
ment affected by the problem, the
High- risk rodents bit no one, and no one
Group
has acquired any of the vector
borne diseases.

>The problem has existed for a

long time ago, this has existed
for approximately 5 years as
Mrs. Potato said that at first it
didn’t have any pests before
they moved into their new
home and then these pests
just suddenly settled.

The family has a current

management on the problem,

(“Kapag nakikita namin ay

bumibili na agad kami ng
pangspray, mahirap na baka
yung mga lamok na yan ay
may dalang Dengue ") as
verbalized by Mrs. Potato upon
interview.
 > Mrs. Potato and Pringles
were both at risk to be
affected by the problem, since
they both live in the same
house.

4. Salience of the 2/2 x 1 1 Prior to the interventions and

Problem health teachings, the family
has already viewed this as a
problem, which needs
immediate action.

TOTAL SCORE : 4.34

Problem #2: Presence of Pediculosis

Criteria Computation Actual Justification

Score

1. Nature of the 3/3 x 1 1 Pediculosis is considered to be a

Problem health deficit brought about by
the infestations of these
parasites wherein they feed
themselves by getting the
nutrients from the host. In the
Potato’s family’s case, Pringles is
the one who had a pediculosis.

2. Modifiability of 2/2 x 2 2 The Potato Family’s problem

the Problem regarding Pediculosis has a high
modifiability status as reflected
Current by the following criteria below:
Knowledg
> The family has a current
e knowledge about the problem as
Family Mrs. Potato was able to
Resources
verbalized the existence of this
SN problem as evidenced by the
Resources
statement below:
Communi
ty “Napansin ko yan na nagkuto
Resources
sya simula nung napapadalas
ang paglalaro nyan sa labas, pag
gabi kating kati ang ulo nya at di
makatulog”

> The family has manpower

resources that the family can use
to minimize Pringle’s lice by
removing them; the family also
has a tiny spaced comb or so
called “SUYOD” that they use to
remove Pringles lice.

>The student nurses knowledge

and initiative will enable the
student nurses to provide health
education for the family on how
to minimize if not eradicate their
problem regarding pediculosis
such as the use of shampoos
that kill the lice.

3. Preventive ⅔x1 . 67 After the student nurses have

Potential considered the criteria on
 determining the Preventive
Severity
Potential of the Potato Family’s
Duration
problem on Pediculosis, it shows
Current that the problem has a moderate
Manageme
nt preventive potential as evidenced
by the following criteria.
High- Risk
Group
> The problem is considered to
be below the severe level since
Pringles has the only one that is
infected by lice infestation.

> The problem is approximately

existing for almost 2 years, as
reported by Mrs. Potato:

“matagal at nahawa lang talaga

siya sa kapitbahay at sa pinsan
niya dahil lagi silang
magkakalaro “.

> The family has current

management on the problem as
Mrs. Potato removes Pringle’s
lice whenever she has free time.]

> Mrs. Potatoes are the high- risk

person, as these parasites are
easily transferred from one
person to another.

4. Salience of the ½x1 .5 > Prior to the student nurses’

 Problem interventions Mrs. Potato was
aware of the problem but does
not need immediate action.

TOTAL SCORE: 4.17

1.

2.

3.
VI. FAMILY NURSING CARE PLAN (in order of priority)