CHAPTER III

Initial Database

This chapter indicates the family structure, characteristics, functions, and

dynamics such as the demographic information of each family member outlining
their names, age, sex, civil status, occupation, educational attainment, position
in the family, religion, and date and birth of place. As well as, descriptions of the
family with regards to their socio-economic status, physical environment, past
and present history and family assessment that is completely conducted based
on functional health patterns.

A. Family Structure, Characteristics, and Dynamics

Member Age Sex Civil Relationsh Occupatio Education Religi
Status ip to the n al on
Head of Attainmen
the Family t

Erwin 51 L M Head N/A High Cathol

Agua School ic
Graduate
Juliet 53 B M Wife Housewif High Cathol
Agua e School ic
Graduate
Clair 29 B M Child N/A College Cathol
Ollyenda ic
Graduate
Colleen 28 B S Child Call College Cathol
Agua Center ic
Graduate
Carlo 27 L S Child Checker College Cathol
Agua ic
Graduate
Clarence 18 L S Child Waiter Undergra Cathol
Agua duate ic
Other
members:

Rusella 7 B S Grandchild N/A Elementar Cathol

Samantha y ic
 Ollyenda
Rain 6 L S Granchild N/A Elementar Cathol
Sander y ic
Ollyenda
Rian Snow 4 B S Grandchild N/A N/A Cathol
Ollyenda ic
Rabia 2 B S Grandchild N/A N/A Cathol
Sama ic
Ollyenda
Raver 1 L S Grandchild N/A N/A Cathol
Storm ic
Ollyenda

B. Socio-economic and Cultural Characteristics

The members of the Agua family speak two languages in their
household; Bicol and Tagalog. Mr. Erwin is a member of PWD that receives
assistance from DSWD each month as needed for his hospital visit for
hemodialysis twice a week. He mentioned that he is grateful of what he
receives as he also gets a benefit from the government assistance in their daily
living expenses. Moreover, with the combination of his three children’s
(Colleen, Carlo, and Clarence) gross monthly income which is almost 10,000
pesos, they are able to sustain their daily living expenses without any
problems.

The monthly income goes to their expenses in the household: first

priority are food, water, and medicine; second priority are electricity, and
study; lastly, transportation, and toys for children.

C. Home and Environment

Upon arriving at the family’s house, outside displays the concrete painted
orange that serves as its trunk, and galvanized iron sheet as their house’s roof.
Small plants outside are seen surrounding their home. There are four
bedrooms; the bigger bedroom is where Mr. Erwin and Mrs. Juliet rests; and
the other rooms are where their children and grandchildren own.

Their restroom is well-cleaned, uses pit-privy as facility and is divided

appropriately away from the other divisions of the house. Drainages are closed.
Waste disposal method uses garbage collection outside of their residence.
 Although the construction of the house is well-constructed, the outside
may cause accidental hazards since it rained, there are puddles formed on
their way out. It may be slippery, if not careful.

D. Health Assessment of each of Family Members

D1. Past and Present Illness
a. Mr. Erwin Agua – Had alcohol addiction in the past which resulted in chronic
kidney failure.
b. Mrs. Juliet Agua – Had frequent alcohol intake in the past but changed her
lifestyle and doesn’t have any illness in the present.
c. All of their children had colds, and fever when they were small, and now
they are away from any diseases.
D2. Family Assessment based on Functional Health Pattern
a. Health Perception-health management pattern
● Mr. Erwin and Mrs. Juliet have unhealthy lifestyles in the past due to
frequent alcohol intake which resulted of acquiring kidney failure of
Mr. Erwin’s body. Due to that, they altered their lifestyle into good,
they avoided drinking alcohol, ate healthy foods, and maintained
adequate sleep.
● They have a strong belief when it comes to medical health teaching.
They avail hospital, clinic, barangay health center, hilot, albularyo,
and herbal medicine as a health resource.
b. Nutritional-metabolic pattern
● The typical food taken by the family are rice, vegetables, meat, and
fishes. They maintain their health by drinking appropriate amounts of
water because they mention that drinking water is one of their
important processes of maintaining health.
● They consume more meat due to having 10 chickens as their source
of food and fun.
c. Elimination pattern
● Bowel and odor problems were not identified.
d. Activity-exercise pattern
● Mr. Erwin is currently receiving hemodialysis, due to that, his
activities are only limited to tolerable ones such as walking. In the
past, he used his bicycle to exercise but he was advised not to, due
to health reasons. The pattern of exercise is regularly roaming
around the house or outside for fresh air. When he’s bored, he plays
games on his phone, or watches television.
 e. Sleep-rest pattern
● Mr. Erwin mentioned that in the past he had some sort of sleeping
problems which resulted in sleep deprivation.
f. Cognitive-perceptual pattern
● Changes of memory, and blurring of vision affected by aging.
g. Self-perception/self-concept
● Mr. Erwin also shared that the changes he had all over the year
might be regretful but he didn’t lose hope and just strived.
h. Roles and relationship
● If there are problems, they deal with perseverance, hopefulness, and
optimism. They talk and pray to God when they feel that their
problem is too heavy to bare.
i. Sexual Reproductive
● Sexual relationship problems were not identified.
j. Coping Stress
● Mr. Erwin mentioned that he had been through several operations
due to kidney failure, and it’s a big challenge for him, may it be
physically, mentally, spiritually, and emotionally as there are changes
that affected him. But he didn’t lose affirmation to himself.
k. Values/belief pattern
● The Agua family have strong faith in God, they see it as an important
principle to value.
l. Values, habits, practices on health promotion
● They have strong belief in health practices as they see it valuable
and as it improves their well-being, just like the situation of Mr. Erwin.

CHAPTER IV
Family Background

A. Family History
Family Agua is composed of 11 members. The head of the family is
Mr. Erwin, 51. His wife is Mrs. Juliet, 53. They have four children; the eldest
is Clair Ollyenda, 29; middle children are Colleen, 28, and Carlo, 27; the
 youngest child is Clarence, 18. Mr. Erwin’s eldest child; Clair Ollyenda have
five children; Rusella Samantha, Rain Sander, Rian Snow, Rabia Sama, and
Raver Storm.

Mr. Erwin is a former president of Gawad Kalinga. Now, he’s a

member of the PWD community, and receiving benefits from DSWD for
hemodialysis two times a week.

Since birth, Mr. Erwin resided in Gawad Kalinga; he later received

their current house as a gift from Kiko Pangilinan’s proposed project.

B. Data Base of the Respondent

The respondent upon the interview is Mr. Erwin Agua in the family.
NAME: Erwin Agua
AGE: 51
GENDER: Male
ADDRESS: Zone 1, Gawad Kalinga, Barangay Del Rosario, Naga City,
Camarines Sur.
RELIGION: Roman Catholic
OCCUPATION: None
CIVIL STATUS: Married
NATIONALITY: Filipino
NO. OF CHILDREN: 4
EDUCATION ATTAINMENT: High School Graduate
ESTIMATED MONTHLY INCOME: None
NAME OF WIFE: Juliet Agua

C. Family Tree

D. General Household Data

1. No. of children: 9
2. List of household members: 11

Member Statu Occupati Se Educational Religio Position Imm.

s s on x Attainment n in the Statu
Family s
Erwin M N/A L High School Catholi Head COM
Agua Graduate c
 Juliet M Housewife B High School Catholi Wife COM
Agua Graduate c
Clair M N/A B College Catholi Child of COM
Ollyenda Graduate c the Head
Colleen S Call B College Catholi Child of COM
Agua Center Graduate c the Head
Carlo S Checker L College Catholi Child of COM
Graduate c the Head
Clarence S Waiter L Undergradua Catholi Child of COM
te c the Head
Rusella S N/A B Elementary Catholi Grandchi COM
Samanth c ld of the
a head
Ollyenda
Rain S N/A L Elementary Catholi Grandchi COM
Sander c ld of the
Ollyenda head
Rian S N/A B N/A Catholi Grandchi COM
Snow c ld of the
Ollyenda head
Rabia S N/A B N/A Catholi Grandchi COM
Sama c ld of the
Ollyenda head
Raver S N/A L N/A Catholi Grandchi COM
Storm c ld of the
Ollyenda head

CHAPTER V
Family Coping Index

CRITERIA IDEAL ACTUAL RATI JUSTIFICAT

NG ION
1. Physical Is involved Families 5 Family
Independ with the are able to members are
ence ability to freely free to move
move move around.
around, to without
get out of pain or
bed, to take inconvenie
care of daily nce doing
hygiene, basic
walking etc. actions.
2. Therapeuti Involves all Strictly 5 Family has
c procedures follows strong
Compete or medical motivations
nce medications advice or drive to
prescribed from follow
for the profession medical
treatment of als. advice.
illness, such
as
prescription
drugs,
appliances,
dressing,
exercises,
stress relief,
diet plans,
etc.
3. Knowledg Associated Have 5 Knows about
e of with the adequate basic
Health specific knowledge knowledge of
Condition health about their certain
condition and loved health
that gives one’s conditions
rise to health such as flu,
treatment, condition fever,
such as the hypertension
awareness , etc.
of the
disease or
the inability
to
comprehend
 the
communicab
ility of
illnesses and
the mode of
transmission
.
Recognizing
the general
pattern of
development
of newborn
infants and
basic
physical care
needs of
infants.
4. Applicatio Concerned Family 5 Members are
n of with family members knowledgeab
Principles action in the have le about the
of relation to adequate importance
General preserving knowledge of hygiene.
Hygiene family of the
nutrition, importance
ensuring of hygiene.
adequate
rest and
relaxation for
family
members,
implementin
g accepted
precautionar
y measures
(immunizatio
n, medical
assessment,
safe home-
making in
relation to
food storage
and
 preparation).
5. Health Primarily Mr. Erwin 5 Family
Attitudes concerned receives members
with the way treatment have strong
the family because beliefs of
feels about he believes medical
health care that practices as
in general, adequate they are
including care and immunized,
preventive knowledge follows
services, of medical
health care profession advices, and
and public als helped inquire about
health him to be health
measures. better. conditions.
6. Emotional It has to do Family 5 Members
Compete with the members especially
nce maturity and freely Mr. Erwin
integrity with expresses and Mrs.
which the concerns. Juliet deals
members of with their
the family family
are able to problems
cope with maturely.
the usual
stress and
problems of
life, and to
plan for a
happy and
fruitful life.
The extent to
which
individuals
recognize
the
appropriate
disciplines
enforced by
their own
family and
culture.
 Developing
the
responsibiliti
es and
decisions of
the
individual.
An
eagerness to
meet
sensible
responsibiliti
es, to accept
fortitude
adversity, to
consider the
needs of
others as
well as one’s
own.
7. Family Concerned I observed 5 They talk
living about the closeness comfortably
interpersonal of the and address
or group family concerns
aspect of members with caution,
family life. and
Members of rationality.
the family
get along
with each
other, the
ways in
which they
make
decisions
that affect
the family,
the extent to
which they
support each
other and do
things as a
 family, the
degree of
respect and
affection,
and the way
in which they
organize the
household
finances.
8. Physical Concerned Family is 4.5 They act as
Environm with the strict with soon as they
ent home, expelling are
community concerns concerned.
and work that are
environment harmful for
as it affects the
family members.
health.
House
conditions
such as
accident
hazard
pressure,
screening,
plumbing,
system,
cooking
facilities,
privacy,
community
levels
(deteriorated
neighborhoo
d, presence
of social
hazards,
pests),
school
transport
and
accessibility.
 9. Use of Degree of Members 5 They uses
Communi use of the are aware resources in
ty family and and avails their
Facilities awareness resources. barangay to
of the know their
community condition.
facilities
available for
welfare and
education.

CHAPTER VI
Typology of Nursing Problem

CUES OR DATA FAMILY NURSING PROBLEM

Subjective Data: - Activity Intolerance.
“Nagdidialysis ako ta igwa akong
helang sa kidney”
- Risk side effects of hemodialysis:

a. Excess fluid volume.

Objective Data:
b. Sepsis.
Swelling in the limbs
c. Muscle Cramps.
d. Weight loss or gain.
e. Hypotension/ Hypertension.
 CHAPTER VII
Prioritizing Problems

FAMILY PROBLEM NO.1 – Chronic Kidney Failure

Criteria Computation Actual Justification
Score
1. Nature of 3/3 x 1 1 It limits
the Problem movement and
mobility.
2. Modifiabilit 2/2 x 2 2 Condition can
y of the be improved
Problem through
hemodialysis.
3. Preventive 3/3 x 1 1 It would be
Potential preventive with
a good
lifestyle.
4. Salience of 2/2 x 1 1 Needs urgent
the Problem action because
of dysfunction
of kidney.
TOTAL SCORE 5

CHAPTER VIII
Family Nursing Care Plan

Health Family Goal of Objective Intervention Plan

 Methods of
Nursing Nursing Resourc
Nurse
Problem Care of Care Interventio e
Problem Family
n Required
Contact
- Chronic - Activity - After - After the - Observe -Health -BP, and
Kidney Intolerance nursing nursing physical teaching thermom
Disease as . intervention, intervention, activity and during home eter.
health the family the family mobility visit
deficit. will be able will be able level of the rotations.
- Risk side to verbalize to: client.
effects of the methods
hemodialy of reducing
sis: activity a. Verbali - Note
intolerance, ze and weight,
ideal food demon heart rate,
a. Excess intake strate BP,
fluid maintenanc the temperature
volume. e, and the metho .
risk effects, ds of
b. Sepsis. signs and reduci
c. Muscle symptoms ng - Monitor
Cramps. of activity the
hemodialysi intoler effectivenes
d. Weight s. ance. s of the
loss or b. Share treatment.
gain. the
e. signs
Hypotensio and -Inform the
n/ sympt client about
Hypertensi oms if the signs
on. client and
have symptoms
risk of having
effect the side
of effects after
hemod dialysis.
ialysis.
c. Client
must -Encourage
identify the client to
the perform
ideal engaging
type of activities
mainta that are
ining tolerable.
food
intake.
-Educate
about the
adequate
food intake.

-Note for
shortness of
breath,
dizziness,
muscle
pain,
fatigue, and
general
weakness.