- * 4 5 ? Ifillment of Related Learni ig Experie » HEALTH CARE II J ) a x 4 \ : jf & y wv, subi f \ | \ BaSman, Nadfifia ; Castillo, Ethel Joy " Celso, Ritzy Re Ecenas, Gellyn * Detiy, Menilo Jr. Espatio, Daphne GraVi. vil. vill. xl. xt, xi, Introduction Spot Map Family Profile Health History Present Health Status Integrated Management of Childhood Illness Home and Environment Family Coping Index Schematic Presentation of the Health Problem Family Health Plan Actual Implementation Evaluation & Referrals Documentationsayae ae as lnveoduction The family is, or should be, the primary unit of health care. It is very important social institution that performs two major functions - reproduction and socialization. The structure, functions, and process of the individual family unit influence and are influenced by the health status of the individuals in the family and the health of the family unit. Family undergoes an ongoing evolution in structure, function, and process. This is true both for the family as an institution in society and for changes throughout their life cycle. Change enables the family to continue to play a viable role in society. It is generally considered as the basic unit care in community health nursing for many reasons. It may contribute knowingly or unknowingly to the development of health and nursing problems of its members. However, it also performs health-promoting, health-maintaining and disease-preventing activities. In many cases, the family is the locus of decision-making on health matters. It is the source of the most solid support and care to its members, particularly to the young, the elderly, the disabled and the chronically ill. [Lise M. Stevens, M.A., Writer] Community is a body of people having common rights, privileges, or interests, or living in the same place under the same laws and regulations; a group of people sharing common geographic boundaries and common values and interest. Community health purpose and goals are realized through the application of a series of steps that lead to a desired result. The nursing process is central to all nursing actions; it is very essence of nursing applicable in any setting, in any frame of reference and within any philosophy. Its uniqueness will depend on the best application of nursing and public health skills to family and community problems. Family Care is a care program being given to a family within the community. As a comprehensive and flexible care service system, Family Care strives to foster people's independence and quality of life, while recognizing the need for interdependence and support. [Published in JAMA: October 24/31, 2001].Parnily Profile FATHER Name: __ Rolyn Abedencia Age: 31 years old Birthday: 04/25/1977 Sex: Male Civil Status: Married Religion: Roman Catholic Nationality: Filipino Address: Zone 6, NHA- Kauswagan,CDOC Occupation: Helper Height: 5’2” Weight: 68kg Educational attainment: High school undergraduate Monthly income: 4,000 pesos/month MOTHER Name: _ Analyn Abedencia Age: 24 years old Birthday: April 19,1984 Sex: Female Civil Status: Married Religion: Roman Catholic Nationality: Filipino Address: Zone 6, NHA- Kauswagan,CDOC Occupation: Housekeeper Height: 148cm Weight: 80 pds. Educational attainment: High school undergraduate Monthly income: NoneELDEST CHILD Name: Angel Abedencia Age: 4 years old Birthday: December 31, 2004 Sex: Female Civil Status: Single Religion: Roman Catholic Nationality: Filipino Address: Zone 6, NHA- Kauswagan,CDOC Height: 100.cm. Weight: 22 pds. YOUNGEST CHILD Name: —_ Ranny Abedencia Age: 1 year old Birthday: October 02, 2007 Sex: Male Civil Status: Single Religion: Roman Catholic ; Filipino Address: Zone 6, NHA- Kauswagan,CDOC Height: 76cm Weight: 10 pds.(iiss ofa uy ‘Tho objectives of this Family © Study are to give people better choices about the services and supports available to meet thelr needs, Improve people's access to services, improve the overall quality of the family care system by focusing on achieving peopl health and social outcomes, to identify their major Ilnesses and somehow provide Intervention on identified problems, to allow us to develop our ideas on hollstle primary fective health care in discussion with a family in thelr home setting, and create a cos family care system for the future, Seuba ain) Uieitun ‘The study is only limited to the days of consignment at Zone 6 NIA Kauswagan, ayan de Oro City and employing 8 hours each day from eight in the morning to three in the afternoon, The study focuses only to the problems experienced by the Abedencia family. ‘The identified interventions arc limited only for short-term treatment. The student used only the resources available within the family. ‘The study comprises the spot map of the area, profile of each member of the family, health history of the family members, present health status of the family members, home and environmental condition of the family, family coping index, integrated management of childhood illness of the family member less than § years old, schematic presentation of the health problem, family care plans, actual implementation of the care plans, referral and evaluation of interventions rendered.2 ri el 0 A health history is a comprehensive look at the family member's medical history including information such as existing diseases, previous health problems, injuries, medications and surgical procedures that were assessed during the health care providers’ visit. <4 Mr. Rolyn Abedencia (Hus! Fat! Mr. Rolyn Abedencia, a 31 year old man, was born in Negros Accidental, through normal vaginal delivery at home assisted by a “manghihilot” in their community. He is the 5th child among seven siblings of Mr. and Mrs Neurecio Abedencia. He is recently a helper. Mr.Rolyn’s income is not enough for the family's daily needs, most especially to his youngest child's needs. As a head of the family, he has to double his time in working for he was the only one earning money for the family. Mr. Rolyn encounters a “crisis” in living that really contributes to his health and to the family as a whole. According to his wife, Mrs. Analyn, he mentioned to her that he had not completed his immunization. Fortuitously, he doesn't have any allergies. Furthermore, Mrs. Analyn denied that no one from Mr. Rolyn’s parents and grandparents had serious illnesses that he might inherit. She further stated that for the past six months, Mr. Rolyn only had common cough and colds and said that as long as he can bear it he won't neither consult nor visit a physician because again of financial constraints and believes that it’s just a waste of time and prefers to work, work and work. Regarding his regular diet, he favored eating raw fish. He doesn’t have any problems about having allergies of any food, or drugs. wt b ia (Wife/Mot! Mrs. Analyn Abedencia, 24 years old who was also born through normal vaginal delivery at home assisted by a “manghihilot’in Zone-6 NHA, Kauswagan, Cagayan de Oro City. She is the 2nd child of Juliet and Alejandro Dela Pefia. She verbalized that no one fromher family that had serious illnesses that she might inherit. Regarding her immunization, she did not experience any kind of vaceinations. She currently has 2 offspring and during her pregnancies, she had regular prenatal check-ups. The couple makes use of the oral contraceptives as their family planning, method. As regi fever and cough and colds. rds to her health for the past six months, she experienced minor ilinesses such as ¢ preferred on treatment managed by herself in dealing with for these minor illnesses because according to her, going to the health center to consultation would entail time, effort and unerringly, it would add more expenditure in cases when the needed medication for minor illnesses is not readily availabl has no known food and drug allergy. ‘4 Angel Abedencia Born on the 31 of December 2004 in Northern Mindanao Medical Center, Cagayan de Oro City, Angel, 4 years of age, was delivered through caesarian delivery in Northern Mindanao Medical Center, assisted by a doctor. She is the eldest among the 2 siblings of Mrs. & Mrs. Abedencia. According to her mother, she completed all her immunizations in their local health center at NIA- Kauswagan. She had no history of hospitalization; neither received blood transfusion nor had undergone surgery. Her mother claimed that Angel has no known allergies to any food or drugs, and is being breastfed upon demand the past 2years. “# Ranny Abedencia Born on the 24 of October 2007 in Cagayan de Oro City, Ranny, one year of age, was also delivered through caesarian delivery in Northern Mindanao Medical Center, assisted by a doctor, He is the youngest among the 2 siblings of Mrs. & Mrs. Abedencia, According to his mother, he already completed all his immunizations in their Local Health Center. He has had no history of hospitalization; neither received blood transfusion nor had undergone surgery. His mother claimed that Ranny has no known allergies to any food or drugs, and is being breastfed until now.NURSING SYSTEM REVIEW CHART Name Vitat Signe: Date: March 01,2009 __ Putse___T0.bom_8°._120.90nmMia_Temp._37.1.6_Meight_52._ Weight_ssia__ eent 1 kenpaired vision blind pain | hard of Nearing reddened drainage gums. deat buming edema lesion teeth Ansoas eyes, ears nose, throat for Abnormalities. no problem, RESP: ‘asymmetnc tachypnea ‘apnea res cough barrel chest bradypnea ‘ehalow / thonchi -eputum diminishes Dyspnea cyanotic orthopnea Iabored wheezing cyanotic, : pain ‘Assess respi rate, rhythm, depth, pattem, Breath sounds, comfort xno CARDIO VASCULAR ‘antrythmia tachycardia) numbness diminished pulses edema x Fatigue © pain leregutar bradycardia |) murmur tingling ” absent pulses ‘Assess heart sounds, rate hythm, puis, blood Pressure, cic.. uid retention. Comfort 10 problem GASTRO INTESTINAL TRACT xno problem GENITO-URINARY and GYNE pain © urine color : vaginal bleeding ‘Assess mobilty, motion, gait, alignment, joint function « « ‘thin color, texture, turgor, integrity‘) ne problem Place an (X) in the area of abnormaity. {—> Blurringss of Vision on Both Eyes wi wiNURSING BYBTEM REVIEW CHART Name. Nate March 01, 2000, Vital Signe: Pulao’ een 100 on Weight _ 43a 1 dna vison (blind palin far of ‘reddened | drainage | gum) dat ‘burning || edema \Feslon toatl ‘Aanoas eyes, earn n080, throat for Abnormalities no problem Rear: Yagymmetii | tachypnen ‘¢60ugh pnen halo | onc sputum Cidiminiahod ‘Dyspnea | cyanotic ee omthopnea | labored Dry kin intoanity_——— | J wheezing | cyanotic Aunoas reap rate, rhythm, depth, pater, Breath sounds, comfort 1 no problem ‘CARDIO VASCULAR Vntythmia tachycardia | numbness | diminished pulses: edema (Fatigue pain (regular bradycardia | murmur {tingling absent pulses ‘Assess heart sounds, rat rythm, puis, blood a Pressure, cc. fd retention, Comfort x no problem GASTRO INTESTINAL TRACT {bese | detention (macs 1) dysphagia ily pain ‘Aasess abdomen, bowel habits, awallowing, ‘Bowel sounds, comfort 10 problem GENITO-URINARY and GYNE pain urine color | vaginal bleeding ihermeturia discharge: noctoria ‘Assess urine frequency, contro, color, odor Comfortigyn-bleeding, lacharge x _ no problem NEURO (“paraiysie( stuporous | unstendy |) selzuros Hethargi | comatose (vertigo tremors | confused vision grip ‘Assess motor function, sensation, LOC, strength, | Grip, galt, coordination, orientation, apeech, Y v .N0 problem MUSCULOSKELETAL and SKIN Xtching |) appliance stifness | potechiae [hot drainage prosthesis ( swelling ' ‘feslon (| poor turgor! coo! deformity (wound (ash (skin color (fushed ) atrophy "1 pain ecchymosis J dlaphoretic | molst “ ‘Assess mobility, motion, galt alignment, joint function «+ ‘kin color, texture, turgor, Integrity no problem : | | ‘ichysaahos on both lous. in Place an (X) in the area of abnormality7 4 ng ww QO, 1 mn Prasent rhe) Slats Mrs, Analyn Abedencia jnvs: (March 01, 2009) uC 92 bpm Resplratory rate Vita ‘Temperatu Pulse rate 21 epm Blood Pressure: 110/70 mmily, Height: 148 cm Weight: 80 pds, Mrs, Analyn Abedencla has no known allergies for foods and drugs. She doesn't If into vi practice involving herscl cers & using. oral contraceptives for farnily planning, Mr. Rolyn Abedencia Vital Signs: (March 01,2009) ‘Temperature: 36.9" C Pulse rate: 95 bpm Respiratory rate: 18 epm Blood Pressure: 100/70 mmlig Height: 5°2 ft. Weight: 60 kg. Mr. Rolyn Abedencia maintains a healthy diet with no known food and drug allergi He only drinks alcoholic beverages & smokes occasionally, Ne has no complaints regarding, her health. He usually practices proper bowel elimination.Angel Abedencha Vital Signa: (March 04, 2009) Heart Rate: 91 bpm Respiratory: 27 epm ‘Tomperatin Height: 100.em Weight: 22 puts. Angel recently had a non « productive cough upon conducting the proponent’s last she had the cough for 1 week already and took advantage of visit, According to her mother the effect of "Kalabo" to cure her cough, Angel was a healthy kid and she was active & Jolly Hons & usually practices healthy Hfestyle by during our visit. She has complete immuniz cating lols of frults & vegnles, Ranny Abedencia Vital Signs: (March 01, 2009) 98 bpm Heart Ra Respiratory: 27 epm ‘Temperatu 376-0 Weight: 10 pus During the group's 6 days of a ed during the 6th ment, Ranny was newly a healthy kid and he was active & jolly during our visit. He day of our visit. R nny wa practices proper bowel elimination. According to his mother, he received complete immunization & she also mentioned that Ranny has no food & drug alleHe EA Date A «hy March 04, 2009 1, Home: a, Ownership () Owned () Rented (¥ ) Rent-free b, Construction mate LC) Light (¥) Mixed () strong, ©. Number of rooms loeping: | for sl di. Lighting facilities: (7 ) Electricity () Kerosene ( ) Others (specity) ¢. General sanitary condition: fair santtaty condition 2, Water Supply a, Drinking water Source () private (+) public Distance from hou ithin the community proper Storage () none (direct from faucet or pipe) (¥ J jar or can with faucet () Jar or galloon without faucet (J others (specity) 3. Kitchen 4, Cooking facility () Electric Stove ()Gas stove ( v )Firewood/Charcoal b, Sanitary condition: poor sanitary condition ©. Drainage facility () Close Drainage ( v ) Open Draining () Blind Drainage () None 4. Refuge or Garbage Disposal a, Reuse and Garbage 1,) Container ( ) covered ( v ) Open () None 2.) Method of Disposal () Hog feeding () Composition (¥) Open dumping — () Incineration(¥) Open burning () others (specify) () Burial in pit b. Toilet 1) Type None () Antipolo System (Pail System (v) Water-sealed ()Open pit privy () Flush type (Closed pit privy () Others (specify) ()bored-hole latrine () Overhung latrine 2.) Distance from house: Inside the house 3.) Sanitary condition: poor sanitary condition S. Domestic Animals Kind Number Where Kept chicks 12 outside the house dog 1 inside the house The Community in General a. General sanitary condition They have fair environmental sanitation. b. Housing congestion: ( v) Yes Q)No c. Recreational facilities talking. d. Availability of health care facilities (Describe briefly) Accessible within 50 meters away from homeHousing The family is currently living in their house for rent & free and not their own lot. Their house is constructed made from low cost materials. With 4 members of the family, they all share in spaces as one. There were several health threats that were identified. Among these were: nails that are left not fully hammered & unclean backyard. Foods were also visible placed on the dining table, and left-over were not covered and not properly kept and there were presence of flies around, Water supply They buy water for their source of drinking. Faucet-water is used in cleaning their utensils and articles, and using deep well as for washing their clothes. Found in the backyard, the family is storing uncovered water in a container. This is exactly perceived as a threat for mosquito - related diseases to the family. Toilet The toilet is a pail system with stacks of pail with water placed at the sides. The room is also dark with poor ventilation. Sanitary condition Environmental sanitary condition rarely in poor condition since the garbage is open dumped and they practice open burning, The house was located near the deep well. They also keep their clothes in the room without cover. Garbage/refuge disposal The family does open dumping and burning of garbage’s. Since there was no consistent garbage collection, they just burned their garbage’s, which is harmful to the environment.Drainage system ‘The family has open-drainage system and they don’t usually check the drainage and irvig Kind of neighborhood The majori fe, They just leave it as is and burn it, yy of the families in the neighborhood was low-income earners but is very friendly and accommodating. They are relatives with their neighbors. The only problem is ss of their surrounding: cl they lack concern as to the that they don’t maintain the cleantin appropriate ways in their area. Most of the houses in the of promoting cleanliness community are also small for the size and number of people who live in it, Social and Health facilities available The Health Center has personnel (public health nurse, midwife, barangay health workers) who facilitate the schedule of health services offered like immunization, family planning, consultation, and others, Few of the people have televisions and radio, which play importance for them to be updated on important news report and entertainment.réunly Cov 1) laa AREAS SCALE JUSTIFICATION 1. PHYSICAL INDEPENDENCE 5 [The couple is able to move about, get out | abitity to move about, get out f bed, and perform activities of daily {bed and perform daily living. No one in the family is physically tivities impaired to not be able to gain physical independence. [2. THERAPEUTIC COMPETENCE 3 |Couple was taught good treatment L includes procedure or Jmethods but was not able to fully apply treatment prescribed knowledge the health teachings. to condition f | . KNOWLEDGE OF THE 3 [The family does have the knowledge that CONDITION certain health problem occurred in any concerned with the particular the member of the family health conditions that is the [But sometimes they were not aware of the| loccasion of care. lunderlying cause and its possible ‘omplication if an illness will not be treated immediately. |t. APPLICATION OF PRINCIPLES 4 [the couple knows about the importance lOF GENERAL HYGIENE lof good nutrition and adequate rest but Sateen reer as not able to apply it because of lieicuen financial restraints but still they can eat egetables were they get good nutrientsf. neaLTH arriTuDE |. the way the family feels about }neath care in general Fhe couple is open regarding teachings on ealth, in general. The problem lies on the pplication of the teachings. ls. EMOTIONAL COMPETENCE |- maturity and integrity with which the members of the family lare able to meet usual stresses land problems of life and to plan for a happy and fruitful living |The couple helps one another and lupports each other during stressful tuations and when problems arise. 17. FAMILY LIVING | how well the family members |get along with another in an interpersonal relationship 5 fhe couple has a harmonious relationship }with each other. They live on the elements] f peace, love, and understanding. |. PHYSICAL ENVIRONMENT | concerned with the home ‘ommunity and the work lenvironment as it affects family ealth Environment sanitation is not so good. |The family don’t segregated garbage can. |The area/home is not so clean. They had a| \good source of water and practiced good anitation at home. )p. USE OF COMMUNITY FACILITIES | degree of the family use and hwareness of available ‘ommunity facilities for health leducation and welfare to lphysician i [The family is able to utilize facilities and is fable to recognize what are their needs in the community in a minimal way. Legend: (1-2 no competence, 3- moderate competence, 5- complete competenceYu vy i) — “ si =; —S- Environmen I 1 i i No Unclean Dusty House made proper kitchen; surroun of garbage unwashed d-dings combustible disposal plates materials + +. i Gartagewas | [_¥0 eet ! scattered proper i around the drainage breeding vo house places like ous Open container I Easy members. transmission of harmful vector within family Health Threat: ¥ ronmental Risk Improper garbage disposal; Presence of breeding places of insects and rodents; Poor personal hygiene; Health Deficit: Insect mosquito bite, colds and coughSocial [eres eee Behavioral | Economic | Political Culture Low educational Poor information 4 attainment: campaign of the a Father: High School health care services Dilated Undergraduate general Mother: High school T preventive Undergraduate | measures, Does t not look for The mother is medical Father has on and not active in assistance in off income zonal activities. presence of illness 4 UI fe nse “The monthly pacers | nie Php utilization of water: drinking without boiling ¥ Typel Health Threats: Low Family Income; Poor Home and environment, malnutrition Health Deficit: Cough, Mother's DM Possible to the Continue of Wrong Practices (oe Health Threats: Poor Hygiene, Poor home and environmentPsychological I Low Self- esteem I Lack of Motivation I Lack of Knowledge in importance of general preventive and curative measures I Affected ability to cause change Health Threats: Poor Hygiene, Poor Home and environment Health Deficit: cough. Mother's DM Type1 Biological t Physical I Poor Personal Hygiene I Prone to diseases/illnesses Health Threats: Poor Hygiene, Poor home and environment, Malnutrition, Faulty eating habits, improper garbage disposal Health Deficit: Cough; Insects/Mosquito bitesPg oF + UNSAFE WATER SOURCES Criteria___| Computation | Actual score Justification Nature ofthe | 2/3X1 28 Tis a health threat. Problem Modifiability of | 2/2X2 2 Health resources are available the Problem to solve the problem. Preventive 3/3X1 1 Unsafe water sources should be Potential prevented. Salience of the Problem Total score 32/3 * POOR HOUSE AND ENVIRONMENT SANITATION Criteria Computation | Actual score Justification Nature of the 2/3X1 23 Itis a health threat. Problem Modifiability of 2/2X2 2 Available interventions and the Problem ways to solve the problem. Preventive 3/3X1 1 Infectious diseases can be Potential eliminated and prevented. ‘Salience of the Problem Total score 32/3 * NO PROPER GARBAGE MANAGEMENT Criteria [ Computation | Actual score Justification | Nature of the 2/3X1 23 Itis health threat. |___ Problem Modifiability of | 2/2X2 2 ‘Available ways and intervention the Problem to solved the problem. Preventive 3/3X1 1 ‘Communicable diseases can be Potential minimized. Salience ofthe | 2/2X1 1 Needing immediate attention Problem Total score. 42/3antily Care Plan “ Ang kaon namo ga- depende sa sweldo sa akong bana”, as verbalized by Mrs. Analyn Abedencia Objectives: Lack of food ‘supply * Low income * Socioeconomic problem Altered health mi tenance related to | Abedencia family wil ineffective fami be able to: coping and inadequate | resources, a. plan and execute positive health maintenance; b. adapt and work towards positive heap tenani examination or interview b. Evaluate for substance use/abuse c. Assess knowledge level regarding effects ‘of smoking, alcohol and drug use. 4d. Provide information about family health care needs. e. Health teaching regarding hygiene, nutrition, medication and coping strategies. Cues Family Health Plan of Intervention/impleme Evaluation Diagnosis Care/Objectives ntation Atthe end of 6 days | a. Conduct a physical _| At the end of 6 days, the Abedencia family was able to optimistically acknowledge the health care providers’ health teachings that were imparted and verbalize positive health maintenance and ability to cope adequately with existing situation.Cues Co — Planof =—_ Intervent ition/impleme EvaluationHEALTH FAMILY METHODS No garbage can) containers GOALOF | OBJECTIVES —_| INTERVENTION | OF NURSE- | RESOURCES CUES | pRoBLEM | pacorcas | CARE OF CARE MEASURES —_| FAMILY REQUIRED | EVALUATION CONTACT Subjective: | Improper | 1. tnabilty to After nursing 4. Provide Home Time and effort | At the end of 6 week of “wala garbage properly intervention the | teachings about of both the assessment, the family disposal as | segregate and fami the corect ways nurse and the | will able to classify the a health dispose due to to: in garbage family. type of waste and they will threat. lack of demonstrate | a. Identify and _| segregation able to practice the proper awareness on | correct ways of | classify types of method of waste proper waste | garbage waste as 2. Exucate the management. dispo: disposal biodegradable and | familljabout the isks afd effects appreciate the jodegradable. i importance of gatbage b. Practice proper Objective: disposal. method of waste management. Scattered garbage outside their a housepill Mal Nui Cu ea Cues Nursing Objectives Nursing Interventions Rationale ‘Subjective: “ Giubo akong anak, pero wlay plema."as verbalize by Mrs. Abedencia(Angel’ s mother). Objectives: + Persistent cough without sputum production. + Respiratory Rate: 24 bpm + Non— productive Sputum Ineffective airway clearance related to persistent ineffective cough without sputum production. At the end of 2 hrs. The client will be able to verbalize understanding of cause & therapeutic management. a. Auscultated lung, as needed such as wheezing may indicate increasing airway sesistance. b. Assisted client to assume position of comfort , e.g. elevate head of bed c. Kept environmental pollution to a minimum, e.g. dust, smoke and feather pillows. d, Increased fluid intake to 3000 mi/day within cardiac tolerance; provide warm liquids. Recommend intake of fluids between, instead of during meals. a. To note and document significant change in breath sounds. b. To facilitate respiratory function by use of gravity. respiratory reactions that can trigger onset of acute episode. d. Hydration helps decreased the viscosity of secretive facilitating expectoration, Using warm liquids may decrease bronchospm. Fluids during meals can increase gastric distension and pressure on the diaphragm. At the end of 2 hrs. The able to verbalize understandin g of cause & therapeutic management.‘viel Inula several home visitations, we were able to thoroughly a ment, we observed { oss the family as a An at the status of each member. During, our a whole, as well as health family has very litte knowledge with regards to Interventions that contributed to thelr all their needs, To addres ne family has low Income to accommod: family health statu ngs regarding, family planning, this problem, our interventions consist mostly. of health te: ss of thelr drainage. And we also rbage, and maintaining the cleanin in order for them to meet their dally added some points in acquiring additional Income needs, Another problem that we Identified was Inadequate living space. During our home ommodate them. There visit, we immediately noticed that thelr living space could barely living is very congested which Is no longer conducive to health maintenance, We educated the family about Importa pace ce of maintaining sanitary home/environmental condition, Another health threa vectors. ‘To reduce the risk of acquiring vector-borne diseases, we emphasize was the presence of breeding sites of Insects, rodents, and other id the importance of proper environmental sanitation such as regular cleaning of the surroundings, disposing of extra containers, emptying soft drinks, empty can of paint, banana stalks, leaves and trash lying around the house that could accumulate stagnant waters. We encouraged then covering their water containers, which could be possible breeding grounds for mosquitoes and flies. Another health problem we detected was sanitation was not properly observed during handling and preparation of food. Also, thelr nutritional intake was unhealthy. We to prepare foods that are nutritious such as green and lealy encouraged the family den. And we explain to them the importance of vegetables, which are also planted in their gi proper hand washing or keeping the hands clean during preparation of food, having a clean and sanitary kitchen and the proper storage of leftover food. We also encouraged them to put drainage near their kitchen to avoid risk of infection from them and the! ir chi‘At the end of 6 days of interaction and observation of the Abedencia family, the student was able to obtain necessary information, such as the family background and history, and the family health condition, which facilitated in the plan of care that was rendered to the family. Interventions that were community based were given to treat the health deficit and health threat to the family. The family was able to learn some health teachings regarding nutrition and how to maintain it and the proper preparation of herbal plants through the microteaching. With the information given, the family was able obtain and know the importance of health promotion and illness prevention. Environmental factor is also one of the features that contributed to the problems of the family. The proper hygiene was greatly stressed to eliminate harmful microorganisms to the body. Reverrals ‘The family is referred to the health center in NHA- Kauswagan. This referral can help since they have existing health deficit and health threats that would hamper their health condition, This referral will help the family in preventing diseases, and at the same time maintaining and promoting good health. In the other hand, referral is also for the immediate response and intervention for the sick member of the family. This will help the sick member a lot in the recovery of the illness.