COMMUNITY HEALTH NURSING RLE

PART A. INITIAL DATA BASE

I. FAMILT CHARACTERISTICS:
A. What is the type of family structure?
Nuclear Single - Parent
 Extended Others (specify)
B. What is the type of family based on authority?
Patriarchal
 Matriarchal
C. Who makes decisions regarding health care? Mother ( AUNTIE
D. What is the present family relationship?
with conflicts between members
 without conflicts between family members
E. Activities of daily living:
1. Sleeping pattern: 11PM
Retiring/getting up hours: 8AM
Nap during the day: 1PM-3PM
Do members sleep together: NO( they
have their own bed)
2. Eating pattern
How many meals each day? 3X a DAY
Who appears overweight? ME
Who appears underweight? NONE
3. Leisure time activities
How does each member spend leisure hours?: ALL
Is it appropriate for the sex and age group? : YES
What is the effect on the family?: GOOD RELATIONSHIP
Any joint activity for leisure?: YES, (KARAOKE&COOKING)

II. FAMILY INFORMATION

Head of the family: Mother (AUNTIE)
Address: 4210 Diamond St. Que Balag Valenzuela
City
Members of the household: 14

NAME RELATION TO THE AGE EDUCATIONAL ATTAINMENT

HEAD
Emma Espejo Auntie( Guardians) 47 Graduated College with a Degree
Alex Choi Husband 61 Graduated College with a Degree
Melvin Espejo Siblings 30 Graduated College with a Degree
Calvin Arevalo Step-son 25 Graduated College with a Degree(hindi
pa nakapag take ng board)
Hans Espejo Anak 22 Still in College
Aidan Choi Anak 17 Still in SHS
Aia Espejo Pamangkin 17 Still in SHS
Elizer Frank Ambala Pamangkin 22 Still in College
Joyce Bumagat Cousins- Father Side 32 Under Grad
Levy Marin Cousins- Father Side 29 Graduated College with a Degree
/avg 1
 Justin Cruzado Pamangkin 23 Still in College
3 Kasambahay Boss 50+ Under Grad
Joana Dela Cruz Pamangkin 21 Still in College

/avg 2
 III. SOCIO-ECONOMIC AND CULTURAL FACTORS
A. Income

NAME OCCUPATION PLACE INCOME /

MONTH
Emma Espejo Company Owners Ad Asia Miltilink inc., Que 500,000
(ADVERTISING) Balag, Valenzuela City
Alex Choi Company Owners Ad Asia Miltilink inc., Que 500,000
(ADVERTISING) Balag, Valenzuela City
Melvin Espejo Accountancy Ad Asia Miltilink inc., Que 30,000
Balag, Valenzuela City
Joyce Bumagat Advertising Ad Asia Miltilink inc., Que 25,000
Balag, Valenzuela City
Levy Marin Advertising Ad Asia Miltilink inc., Que 25,000
Balag, Valenzuela City

1. Does the working family member meet the basic necessities?

 Yes No
2. Who makes decisions regarding money matters?: BOTH, (Guardians)
3. Religious affiliation: Catholic
4. What roles does the family play in the community?: Tumutulong, Join in Organization

IV. ENVIRONMENTAL FACTORS

A. Housing
1. Ownership
Owned
 Rented
Rent-Free Others (specify)
2. Construction materials used
Light
Mixed
 Strong
3. Living space
 Adequate Inadequate
4. Sleeping arrangement: Each has their own Bed
5. Adequacy in furniture
 Adequate Inadequate
6. Water source
Private
 Public
Potability?
7. Food storage
 Refrigerator Jars/container Others (specify)
8. Cooking facility
 Electric stove Firewood _____ Charcoal
 Gas Stove Kerosene ___________ Others (specify)
9. Drainage facility
 Open drainage Blind drainage None
10. Toilet facilities/type

/avg 3
  Flush type Overhung latrine Bored-hole latrine
Water-sealed latrine Open-pit privy _______ Closed-pit privy
Pail system None _______ Others (specify)
11. Garbage disposal
Open Dumping
 Picked up by garbage collector
Burial in pit
Open burning
Hog feeding
Composting
Others(specify)
12. Domestic Animals
Type Number Where Kept
Truck BODY#17 Dumpside Brgy.Lingunan Valenzuela City

13. The Community in General

a.Sanitary condition
 Fair Good Poor
Provide brief description: Good Sorrounding

b.Neighborhood (housing congestion)

Yes
 No
c. Presence of Breeding Sites of Vectors of Diseases:
Yes; Specify
 None
d. Recreational facilities: GOODS
e. Availability of Health Care Services and its facility ( Describe briefly) : There’s a near Barangay Health
Center
f.Distance of house to the nearest health care: 3S Center, Ugong 500 meters
HEALTH MEDICAL HISTORY
NAME PAST ILLNESS DIAGNOSED / ILLNESS STATE HEALTH ACTION
UNDIAGNOSED TAKEN
Alex Choi Diabetes UNDIAGNOSED NO Lifetime Medication
Elizer Frank Ambala Situational Syncope DIAGNOSED ADMITTED ICU/Lifetime
Medication

V. VALUE PLACED ON PREVENTION OF

DISEASE Vaccinations

NAME- AGE COMPLETE INCOMPLETE

vaccines
ALL FAMILY MEMBERS COMPLETE

Other preventive practices employed by the family:

/avg 4
 Sources of Health Care:
Health Center Government Hospital
 Private Hospital Others (specify)

Surveyed by _________________________ Date ______________________________

PART B.

Identify At Least 3 Health Problems Of The Family, Or If None, Identify The Family'S Promotive Or Preventive Practices.

FAMILY HEALTH PROBLEMS. / TYPOLOGY OF HEALTH PROBLEM

(WELLNESS STATE , HEALTH DEFICIT,HEALTH THREAT,
(IF NONE, FAMILY’S PROMOTIVE OR FORESEEABLE CRISIS)
PREVENTIVE PRACTICES.)

OBESITY HEALTH DEFICIT

PART C.

Prioritizing / Scaling Of The 3 Identified Health Problems Or Promotive Practices Of The Family.

HEALTH PROBLEM : Obesity

CRITERIA COMPUTATION ACTUAL JUSTIFICATION

SCORE
NATURE OF THE 2/3 1 It is a health threat that must be addressed immediately in
PROBLEM order to avoid negative consequences.

MODIFIABILITY 1/2x2 1 Interventions are feasible but the resources are limited
OF THE
PROBLEM
PREVENTIVE 2/3x1 1 Moderate since hospitals does really provide
POTENTIAL
SALIENCE 1/2x1 0.5

TOTAL 3.5

TOTAL
Part D.
Family Nursing Care Plan (FNCP)

/avg 5
 FAMILY GOALS & Nursing Method of Family- Resources EVALUATION
NURSING OBJECTIVES OF Intervention Nurse Contact Required
DIAGNOSIS CARE

Inability to Upon completion of Introduce a 1. Home Visit 1. Time effort The materials or
make the nursing comprehensive 2. Observation with resources
decisions interventions, the education to participatio required include
with respect family will acquire the family n of the the following:
to taking comprehension regarding the family and Publication
appropriate regarding the application of student materials such as
health action diseases and appropriate nurse. informative
due to fear of treatment plans. eating brochures, printed
consequences The family will also behaviors: 2. Health infographics, and
of action, have the capacity to a. Encourage Teachings. pamphlets
specifically implement the family to
emotional or measures aimed at break bad Financial
psychological assisting the family habits such as resources for food
consequences member who is eating dinner and expenses, for
experiencing late, skipping exercise materials
health-related meals, and or workout
challenges. The eating too fast. programs,
consideration that b. Encourage medical
follows the client's the family to consultation with
desired manner of reevaluate physicians and
care is also factored their choice of psychiatrists, and
in during the meals and for transportation
decision-making avoid and
process. These unhealthy miscellaneous
interventions are foods such as expenses
categorized based junk foods,
on specific health soft drinks, Manpower
concerns. and foods resources such as
Objectives: heavy in sugar time and effort of
and fat. the nurse,
During c. Teach the healthcare
interventions the family to specialists, and
family will: choose a the family.
a. Verbalize what healthy meal
are the different plan by
appropriate eating advising them
behaviors and their to go for leafy
importance. green
b. Practice a healthy vegetables and
lifestyle by healthy
following a healthy sources of
diet plan, protein.
maintaining healthy
eating patterns, and
normal BMI values.
c. Be more active in
performing daily
physical activities.
/avg 6
/avg 7