DESCRIPTION

Community Health Nursing

TRANSCRIPT

PROBLEM LIST

PROBLEM IDENTIFIED Cough and Colds Fall Hazards Improper Garbage Disposal Seizure
Cigarette Smoking

DATE IDENTIFIED January 15, 2013 January 14, 2013 January 15, 2013 January 14, 2013
January 14, 2013

DATE EVALUATED January 29, 2013 January 29, 2013 January 29, 2013 January 29, 2013
January 21, 2013

SCORE 4.5 4.1 3.6 4.0 2.2

Prioritization of the Problem

A health problem is a situation or condition which interferes with the promotion and/or
maintenance of health and recovery from illness or injury. A health problem becomes a nursing
problem when it can be modified through nursing intervention. After data analysis, the nurse
encounters a number of health problems which cannot be taken up all at the same time
considering the available resources of both the family and the nurse. Considering this situation,
the nurse should establish priorities by ranking the identified problems. There are four criteria for
determining priorities among health problems. These include: Nature of the problem presented-
categorized into health threat, health deficit, and foreseeable crisis; Modifiability of the problem-
refers to the probability of success in minimizing, alleviating or totally eradicating the problem
through nursing intervention; Preventive potential- refers to the nature and magnitude of future
problems that be minimized or totally prevented if intervention is done on the problem under
consideration;

Salience- refers to the familys perception and evaluation of the problem in terms of seriousness
and urgency of attention needed.

Scale for Ranking Family Health Problems According to Priorities Criteria Nature of the problem
presented Scale: health threat- 2 health deficit- 3 foreseeable crisis- 1 Weight 1

Modifiability of the problem Scale: easily modifiable 2 partially modifiable- 1 not modifiable- 0

2
Preventive potential Scale: high 3 moderate- 2 low- 1

Salience Scale: a serious problem, immediate

attention needed-

a problem but not needing immediate attentionnot a felt problemScoring: Decide on a score for
each area. Divide the score by the highest possible score and multiply by the weight. X weight 1
0

Sum up the scores for all criteria. The highest score is 5, equivalent to the total weight.

Cough and Colds Criteria

Computation3/3x1

Actual Score1

JustificationIt is classified as a health deficit because of the actual alteration in the bodys
immune response. Cough and colds signify that there is an ongoing viral and/or bacterial
infection in the body, most particularly in the respiratory system, that we often get from the air
we breathe in. It is easily modifiable since resources are available and feasible such as the
presence of Lagundi plant in the community and the availability of the mother. The possibility of
preventing coughs and colds is high because it can be prevented through proper personal
hygiene, proper nutrition and environmental sanitation alone. The family is recognizing the
problem and needs immediate action because of their observed frequency of visits in

Nature of the problem

Modifiability

2/2x2

Preventive potential

3/ 3x1
1

Salience

2/2x1

0.5

their children. Total Score: 4.5

Fall Hazard Criteria

Computation2/3x1

Actual Score0.6

JustificationIt is classified as a health threat since it is conducive to cause an accident. Upon

observation, the house is situated at the river bank, without any fence that will serve as a barrier
for anyone not to slide off or fall into the deep river just below the bank. It is easily modifiable
since resources are available and feasible such as the woods for fencing. The possibility of
falling can be prevented if river bank is fenced and if the parents will learn about some
preventive measures to prevent accidental falls. The family does not recognize this as a
problem or a felt problem.

Nature of the problem

Modifiability

2/2x2

Preventive potential

3/ 3x1

Salience

0/2x1 Total Score:

0 3.6
Improper Garbage Disposal Criteria

Computation2/3x1

Actual score0.6

JustificationIt is a health threat because the garbage thrown in the river can worsen the
problems of flooding, of which during times of floods, the family and the community as well will
be ones affected for insect-borne illnesses and clouding and contamination of the water supply.
It is easily modifiable since resources are available and feasible in the community such as doing
garbage segregation with the use of available sacks/ cellophanes, and woods, and

Nature of the problem

Modifiability

2/2x2

Preventive potential

3/3x1

Salience

1/2x1

0.5

regularly placing their garbage in a sealed sack or cellophane near the road or highway for
easier collection by the Barangays Garbage Collectors. The problem can be prevented if there
is an appropriate action and compliance to the Barangays waste disposal program from the
family. The family recognized this as a problem but does not need immediate action.

Total Score:

4.1

Seizures Criteria
Computation3/3x1

Actual Score1

JustificationIt is classified as both a health deficit and a health threat because a person of this
illness has already had a lifetime predisposition of attacks yet it can be prevented and/or
managed with medications. Also, it is a health threat because when this attacks, it may cause
fatal injuries to the person. As asked, the child already had 4 episodes of seizure attacks and
the most recent was when we had our duty in the area and according to his parents, the attack
was sudden and was of longer duration. The problem is partially modifiable because it cannot
be totally modified because of the lifetime predisposition of the person who has this disorder,
because the problem with seizure is the brain activity itself. A person of this disorder will
possess it throughout his lifetime, however, the frequency of attacks and the likelihood of falls,
brain injury, airway obstructions and other fatal injuries can be prevented with proper

Nature of the problem

Modifiability

1/2x2

Preventive potential

3/ 3x1

Salience

2/2x1 Total Score:

1 4.0

knowledge and understanding of the seizure precautions. The possibility of preventing or

managing this brain activity disorder is high because the likelihood of incidence or occurrences
can be managed with proper anti-seizure drugs maintenance, eliminating triggering stimuli and
instituting seizure precautions to ensure safety of the child when seizure attaks. The family is
recognizing the problem that needs immediate action.

Cigarette Smoking Criteria

Computation2/3x1
Actual score0.6

JustificationIt is a health threat because this practices or habit precipitates the development of
many respiratory and cardiovascular diseases, such as TB, COPD, Stroke, Hypertension,
atherosclerosis and the like. It is partially modifiable because cigarette smoking is an addicting
practice that is hard to be eliminated in ones system however with strong determination,
motivation and family support, it is not impossible. However, it will take time to be eliminated.
The problem is moderately preventable if addiction to cigarettes at an earlier time will be
achieved. Not a felt problem by the family.

Nature of the problem

Modifiability

1/2x2

Preventive potential Salience

2/3x1

0.6

0/2x1 0 Total Score: 2.2

FAMILY NURSING CARE PLAN

Problem 1: Cough and Colds Date Identified: January 15, 2013 Date Evaluated: January 29,
2013 Family Nursing Problem: Inability to make decisions with respect to taking appropriate
health actions due to lack of adequate knowledge or insights as to alternative actions or home
remedies open to them. Cues: Subjective: "Ubo, Sip-on mao jud na ang permi na problema sa
akong mga anak kay sige ra na sila ug ubhon ug sip-on." Objectives: Youngest son frequently
plays outside with soil or anything he finds under the son. Family eats with bare hands most of
the time. Facial towel used by the youngest son seen to be left anywhere. Youngest son bites
his hand or puts his hand in his mouth oftenly. Home enironment is surrounded with dried leaves
and tiny pieces of cut woods. Youngest son is seen to wipe off his mucus in his face. RR: 32
cpm Goal of Care: Short Term: Within 1 hour of nursing care and management, the family will be
able to: Develop conscious awareness about their felt health problem of cough and colds. Long
Term: Within the two home visits, the family will: Be able to gain knowledge about cough and
colds; Will prevent the reoccurrence or frequency of occurrence of the disease in the future.
Objectives: Short Term: Within 1 hour of nursing care and management, the family will be able
to: Acquire idea and information about the disease including signs and symptoms of the
disease, immediate health care assistance, and preventive measures; Enumerate ways on how
to prevent occurrence of the disease; Long Term: Within the two home visits, the family will be
able to: Utilize resources available in the community in resolving the problem; Demonstrate
alternative ways or remedies available at home. Interventions:

Assess the familys status of personal hygiene. R: Personal hygiene plays a very important role
in the transmission of microorganisms that cause cough and colds. Discuss with the family the
cases and effects, signs and symptoms, common causes, and complications of cough and cold.
R: Understanding the cause, effects, signs and symptoms and complications of cough and colds
helps gain participation and involvement of the family in the care f their sick member. Explain
the importance of proper food preparation, good nutrition, rest and sleep in strengthening ones
resistance against illness, so as to prevent occurrence of cough and colds. R: Strengthened
immune system helps the body fight against infection. Cite ways in eliminating the disease and
limiting the occurrence of transmission by suggesting course of actions such as: Use of
alternative home medications such as Lagundi Syrup, Ginger Tea, Honey and Calamansi Syrup,
and Garlic with Honey Tea; R: These home remedies help provide pharmacologic effects
without the risks of adverse effects compared to over-the-counter drugs, thereby empowering
the family in solving their health problems. Covering mouth of the member with cough and colds
when sneezing or coughing; R: Cough and Colds are transferred via droplets thus covering the
mouth when coughing or sneezing would help prevent transmission. Proper disposal of nasal or
oral discharges. R: To prevent further transmission of the microorganisms through air. Increase
fluid intake and have an adequate rest and sleep. R: To replenish fluid loss and to aid in
loosening the secretions in the respiratory tract. Demonstrate proper personal and
environmental hygiene among all family members such as: Washing hands very often; R: Hand
washing is the one of the most effective ways of preventing transfer of microorganisms.
Cleaning and/or dusting the house as well as the surroundings to prevent acquiring the disease.
R: Dusts, Pollens and allergens are also one of the common causes of cough and colds. Teach
the family how to prepare the Lagundi Syrup, its indication and dosage. R: To help the family
gain skills on how to remedy cough and colds at home thereby empowering them.

Provide information on the health centers in the vicinity for immediate care assistance. R: To
give the family knowledge about the presence of available health services. Evaluate the family.
R: To assess the effectiveness of the care provided. Evaluation: Short Term: Goal met. After 45
minutes of nursing care and management, the family was able to show understanding on the
nature of the disease process, their signs and symptoms, common causes and alternative ways
or home remedies as evidenced by the mother's verbalization of: "Oo, nakasabot nako nganong
magkasipon ug ubo sila, kasagaran diay hinungdan kay virus. Nakat-unan pud nako na maayo
jud na maghugas ug kamot permi, unya kung naay ubhon o sip-on sa amu dapat manampong
para dili makatakod. Dili pud diay maayo ng mupalit ug tambal labina antibiotic sa tindahan o
parmasya, mas maayo pa diay ug maghilada o magbuhat ug halada, paimnon ug dugos akong
mga anak." Long Term: Goal met. After the first home visit, the family was able to utilize
resources available in the community in resolving the cough and colds such as garlic, Lagundi
leaves and honey, doing frequent handwashing as observed and maintaining cleanliness of their
home environment and the family was able to demonstrate active participation during the
Structured health teachings about cough and colds and the actual demonstration on how to
make the lagundi syrup.