The family lives in a small two-room house in a congested area. The father works as a carpenter while the mother previously worked but stopped due to her pregnancy. They have 6 children between the ages of 1 to 10. Some of the children have health issues like cough, colds, and wounds. The family struggles financially and has poor sanitation in their home and surroundings, which threatens their health. Managing the children's illnesses and improving their living conditions are priorities.
The family lives in a small two-room house in a congested area. The father works as a carpenter while the mother previously worked but stopped due to her pregnancy. They have 6 children between the ages of 1 to 10. Some of the children have health issues like cough, colds, and wounds. The family struggles financially and has poor sanitation in their home and surroundings, which threatens their health. Managing the children's illnesses and improving their living conditions are priorities.
Original Description:
nursing family assessment from tophill, lahug, cebu city.
The family lives in a small two-room house in a congested area. The father works as a carpenter while the mother previously worked but stopped due to her pregnancy. They have 6 children between the ages of 1 to 10. Some of the children have health issues like cough, colds, and wounds. The family struggles financially and has poor sanitation in their home and surroundings, which threatens their health. Managing the children's illnesses and improving their living conditions are priorities.
The family lives in a small two-room house in a congested area. The father works as a carpenter while the mother previously worked but stopped due to her pregnancy. They have 6 children between the ages of 1 to 10. Some of the children have health issues like cough, colds, and wounds. The family struggles financially and has poor sanitation in their home and surroundings, which threatens their health. Managing the children's illnesses and improving their living conditions are priorities.
Place of Residence: Tophill. Lahug A. STRUCTURE AND CHARACTERISTICS MEMBERS OF THE FAMILY RELATION TO THE HEAD DATE OF BIRTH AGE SEX CIVIL STATUS RELIGION OCCUPATION INCOME OTHER SOURCES OF INCOME EDUCATIONAL BACKGROUND PLACE OF BIRTH O.A Head 12.16.1978 30 M Married Catholic Carpenter Php 290.00/day
None Grade 6 Cebu M.J.A Wife 09.10.1980 29 F Married Christian Housewife None Washwoman Grade 4
Negros occidental
J.A
Son 11.27.1998 10 M Single Christian Student None None Grade 2 Cebu
J.A
Daughter 10.2.2000 8 F Single Christian Student None None Grade 3 Cebu
N.J.A
Daughter 09.15.2002 7 F Single Christian Student None None Grade 1 Cebu
J.A
Son 10.17.2004 4 M Single Christian - None None None Cebu
J.K.A
son 02.2.2008 1 M Single Christian - none none none Cebu
TYPE OF FAMILY STRUCTURE: The family has a nuclear type of family structure FAMILY MEMBER WHO DECIDES ON MATTERS IN HEALTH CARE: Both M.J and O decide on health care matters and whenever they need medical assistance. GENERAL FAMILY RELATIONSHIP (PRESENCE OF ANY OBVIOUS/READILY OBSERVABLE CONFLICT BETWEEN MEMEBERS) : The children of M.J. and O are observed to be always quarreling with each other but not on serious matters. Most of their misunderstandings are caused by toys and food. M.J and her children also verbalized that M.J. and O have conflicts every time O comes home not in the mood and drunk. B. SOCIO ECONOMIC AND CULTURAL CHARACTERISTICS INCOME AND EXPENSES O is a carpenter and earns Php 290.00/day while M.J. was a washwoman but stopped for a while due to her pregnancy. O and M.J were able to provide their children of their basic needs. The family is able to eat three times a day and sometimes can be able to provide snacks in the afternoon. The clothes of some of the couples children are observed to be already worn out but were still usable and appropriate for their respective gender (dress for the daughter and shorts and shirts for the boys). The couple is able to provide their family with a house to live in. in terms of decisions on money matters, O gives his salary to his wife and M.J will be the one who will budget the money which can meet the familys basic necessities such as food, clothes, school supplies and the like. EDUCATIONAL ATTAINMENT OF EACH MEMBER Both M.J and O were not able to finish studying because of financial problems. O was able to graduate elementary while M.J stopped attending school when she was in her 4 th grade. Three of their children are currently studying i n a school near their home. J1, the eldest is still in his second grade since he had failures in some of his subjects that needed him to re-enroll to grade 2. J2 on the other hand is in her 3 rd grade and was an honor student when she was in grade 2. NJ is in his 1 st grade while the rest of the family members are staying at home. ETHNIC BACKGROUND AND RELIGIOUS AFFILIATION M.J. was born in Negros Occidental while O is from Cebu. O is a roman catholic and M.J is a Christian. Both of them decided and agreed to have their children baptized as Christians. On Sundays, both M.J and O goes to colon to attend Christian mass. They dont bring their children with them since they are not still discipline enough with their behavior and actions.
RELATIONSHIP OF THE FAMILY TO LARGER COMMUNITY M.J. attends some of the activities implemented by the Barangay Health Workers such as immunization, garbage disposal and the like. Because of her present condition, she seldom participates in the activities since their house is far from the location of the programs. M.Js family has a good relationship with their neighbors and is willing to help whenever anyone is in need. C. HOME AND ENVIRONMENT The family is living in a two (2) room house and is beside the house of M.Js sister. The house is just enough for the family. In the presence of J1s wound (matag-tiki) on his gluteus, he stayed on the room of his parents while the rest are currently staying on the other room which also served as the familys dining room and living room. Breeding sites of insects and rodents such as uncovered pails with water and stagnant canals were observed in their surroundings. Thei r kitchen is situated at the side of the entrance of their house. They use wood for cooking. They dont have refrigerator to store their food so they see to it that there will be no leftovers. I n some cases, they just cover their food with plastic plates and store it at the side near the sink which is reachable to the dogs and cats. They get their water from their neighbor and pays Php 50.00 for 10 gallons, Php 3.00 for one pail. They have their own bathroom but is still under construction. They use empty sacks to cover their toilet. They have pour-flush type of toilet facility. They throw their garbage far from their house and where there are no more houses and just leave it there. KIND OF NEIGHBORHOOD The family is settled in a congested slum area. The houses are situated side by side. SOCIAL AND HEALTH FACILITIES AVAILABLE The Barangay hall and health center is far from their house. They seldom avail medications from the health center since they find it too far from their house but M.J had the effort to go on prenatal visits. COMMUNICATION AND TRANSPORTATION FACILITIES AVAILABLE The familys mode of transportation is just public vehicle or they just walk to save money. Whenever they need to call, the f amily just borrows the cellular phone of M.Js sister.
D. HEALTH STATUS OF EACH FAMILY MEMBER MEDICAL AND NURSING HISTORY J.K was hospitalized because he fell from their four-stepped stairs and luckily, he didnt experience any complications. J2 had a tetanus toxoid shot because she was wounded by a rusty metal on her right foot. Three of M.Js children are currently experiencing cough and colds and health teaching was done to help alleviate the illness. J1 had a deep wound with abscess/pus on his right gluteus. NUTRITIONAL ASSESSMENT The family was not observed with dehydration, underweight, overweight or any kind of malnutrition. DEVELOPMENTAL ASSESSMENT None of the family has any problem with their development. No one is mentally retarded or had any problems with their learning abilities. M.J verbalized that all of their children learned how to walk at approximately 1-1 years old. PHYSICAL ASSESSMENT INDICATING PRESENCE OF ILLNESS STATES Productive cough and mucosal secretions were observed in M.Js three children. Wounds were also noted on J.K and J3s scalp and legs and the deep wound of J1. E. VALUES AND PRACTICES ON HEALTH PROMOTION/MAINTENANCE AND DISEASE PREVENTION J1 and J3 were not able to be immunized with measles while the rest of the children had BCG, DPT, Hep B and measles. M.J. cannot recall if she had received any immunization during her childhood. She didnt know if her husband has also been immunized. The family takes in multivitamins daily whenever they have money to supply. They usually go to sleep at around 8 in the evening and wakes up at 6-7 am. F. CLASSIFICATION OF HEALTH PROBLEMS HEALTH DEFICIT HEALTH THREAT FORESEEABLE CRISIS Cough and colds Deep wounds Poor environmental sanitation Family size beyond family resources can adequately provide Pregnancy
G. HEALTH PROBLEMS ACCORDING TO PRIORITIES
COUGH AND COLDS
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION 1. Nature of the problem 2. Modifiability of the problem
3. Preventive potential
4. Salience of the problem 3/3x1 1/2x2
3/3x1
1/2x1 1 1
1
0.5
3.5
-It is a health deficit and demands immediate attention -The resources and interventions are not available to the family. The family chooses not to take medications because they dont have enough money to avail medications -transmission of illness can be prevented if it is managed well as soon as possible -the mother recognizes the problem but she didnt attend to the problem immediately
DEEP WOUND CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION 1. Nature of the problem
2. Modifiability of the problem
3. Preventive potential
4. Salience of the problem 3/3x1
2/2x2
3/3x1
2/2x1 1
2
1
1
5 -It is a health deficit since the client experienced the illness and is vulnerable for infection -The nurses and familys resources are available. The nurse can help in treating the wound through wound dressing. The mother gives medication to the infected person -Infection can be prevented if the problem is attended well like giving proper medications and wound dressing -the mother recognizes the problem and seek immediate attention
POOR ENVIRONMENT CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION 1. Nature of the problem
2. Modifiability of the problem
3. Preventive potential
4. Salience of the problem 2/3x1
2/2x2
2/3x1
1/2x1 0.6
2
0.6
0.5
3.7 -it is a health threat since this can possibly cause diseases and illness like dengue -the family and the nurse have enough resources to prevent the occurrence of illnesses/diseases caused by poor sanitation
-the family is not the only one contributing to the problem
-the problem was recognized by the family but they didnt take any immediate action to their condition
FAMILY SIZE BYOND FAMILY RESOURCES CAN ADEQUATELY PROVIDE CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION 1. Nature of the problem
2. Modifiability of the problem
3. Preventive potential
4. Salience of the problem 2/3x1
2/2x2
3/3x1
2/2x1 0.6
2
1
1
4.6 -it is a health threat since the family can no longer provide the basic necessities thus the members cannot have proper nutrition that can lead to illness -The nurses and familys resources are available to solve the problem. The nurse can help in budgeting the resources of the family -The possibility of increasing family size is reduced through the use of contraceptives like abstinence, condom, rhythm, pills and the like. -the family recognizes it as a problem and believes that it needs immediate attention and ensures that the sixth pregnancy will be the last
PREGNANCY CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION 1. Nature of the problem
2. Modifiability of the problem
3. Preventive potential
4. Salience of the problem 1/3x1
1/2x2
3/3x1
1/2x1 0.3
1
1
0.5
2.8 -it is a foreseeable crisis since pregnancy needs attention to the health of both the mother and the baby. Also, it needs financial expenses -The nurses resources and intervention are available but the familys resources are not to solve the problem
-complications associated with pregnancy can be highly prevented if utmost attention is given to the health of the mother -the family recognized it as a problem since this could add up to their expenses but they dont find it to be needing immediate attention
H. RANKING OF PRIORITIES
1. Deep wound as a health deficit5 2. Family size beyond family resources can adequately provide as a health threat4.6 3. Poor environmental sanitation as a health threat3.7 4. Cough and colds as a health deficit3.5 5. Pregnancy as a foreseeable crisis2.8
UNIVERSITY OF SAN CARLOS COLLEGE OF NURSING FAMILY NURSING CARE PLAN HEALTH PROBLEM FAMILY NURSING PROBLEMS GOAL OF CARE OBJECTIVES OF CARE NURSING INTERVENTIONS METHODS OF NURSE-FAMILY CONTACT RESOURCES REQUIRED EVALUATION Cough and col ds as a heal th defi ci t
Subjecti ve cues: nah, gpang.ubo ni si l ang tulo ay. Usahay naai tambal, usahay wal a. Depende kung naai kwarta as verbal i zed by the mother
Objecti ve cues Producti ve cough Average amount i n sputum Cl ear- yel l owi sh i n col or Mucosal secreti ons noted >i nabi l ity to provi de adequate nursi ng care to the si ck, di sabl ed, dependent, or vul nerabl e at ri sk member of the fami l y due to: - Lack of /i nadequate knowl edge about the di sease/heal t h condi ti ons (nature, severi ty, compl i cati ons, prognosi s and management) >fai l ure to uti l i ze communi ty resources for heal th care due to: After the nursi ng i nterventi on , the fami l y wi l l be abl e to el i mi nate the cough and col ds and wi l l prevent the recurrence of the di sease i n the future.
After nursi ng i nterventi on, the fami l y wi l l be abl e to: a. Acqui re adequate i nformati on about the di sease i ncl udi ng si gns and symptoms of the di sease, i mmedi ate heal th care assi stance and preventi ve measures
1. Di scuss wi th the fami l y the causes, si gns and symptoms and compl i cati ons of cough and col ds. 1.1 col d-acute i nfl ammati on of the mucous membrane of the upper passages 1.2 causes: i ntake of col d food seasonal changes i mproper di gesti on of food 1.3 s/s: runni ng nose/bl ocked nose sneezi ng sore throat congesti on headache l ow fever l oss of appeti te l ethargy i nsomni a 1.4 compl i cati ons ear i nfecti ons si nus i nfecti ons bronchi ti s pneumoni a 1. Home visit 2. Lecture 3. discussion Manpower: Student nurse Family/client Manhour: Time and effort of family and student nurse Materials: Visual aids
-fai l ure to percei ve the benefi ts of heal th care/servi ces
b. Be aware on how to reduce the chances of spreadi ng communi cabl e di seases to other fami l y members
c. Identi fy l ow cost home remedi es for cough and col ds
d. Choose and perform 2. provi de adequate knowl edge on the vari ous ways of mai ntai ni ng cl eanl i ness i n thei r surroundi ngs 2.1 ways: hand washi ng taki ng a bath everyday di spose garbage properl y
3. expl ai n the i mportance of proper food preparati on, good nutri ti on, rest and sl eep i n strengtheni ng ones resi stance agai nst i l lness so as to prevent the occurrence of cough and col ds 3.1 i mportance prevent someone from getti ng si ck prevent cross contami nati on prevent from spreadi ng the di sease heal th promoti on and di sease preventi on
4. gi ve the fami l y some home remedi es for cough and col ds 4.1 remedi es SLK Lagundi l eaves Bl ack pepper and gi nger Garl i c (boi led wi th sugar) Chi cken soup(col ds)
5. Hel p the cl i ent i denti fy appropri ate remedy to be used correctl y the remedy chosen e. Uti l i ze communi ty resources avai l able i n resol vi ng the condi ti on experi enced
f. Verbal i ze understandi n g of proper sani tati on and the remedi es and preventi ve measures of the condi ti on 6. Assi st cl i ent i n prepari ng the chosen remedy
7. Ci te ways i n el i mi nati ng the di sease and l i mi ti ng the occurrence of transmi ssion through medi cati ons and al ternati ve medi ci nes and preventi ve measures such as coveri ng the mouth when sneezi ng or coughi ng and proper di sposal of oral and nasal di scharges
8. Eval uate the fami l ys understandi ng regardi ng proper sani tati on and preventi ve measures of cough and col ds
HEALTH PROBLEM FAMILY NURSING PROBLEMS GOAL OF CARE OBJECTIVES OF CARE NURSING INTERVENTIONS METHODS OF NURSE-FAMILY CONTACT RESOURCES REQUIRED EVALUATION Presence of breedi ng si tes of vectors of di seases
Subjecti ve cues:magpundo man mi ug tubi g kai wa man mi amo.ang tubi g, ang uban wai takub.. nah cana pud among canal ai y pwerte cadaghan ug l amok as verbal i zed by the mother
Objecti ve cues uncovered pail wi th water observed stagnant canal noted unfi ni shed l aundry noted unwashed di shes noted >i nabi l ity to provi de a home envi ronment conduci ve to heal th mai ntenance and personal devel opment due to: -i gnorance of the i mportance of hygi ene and sani tati on -l ack of knowl edge regardi ng preventi ve measures of i l l nesses and di seases After the nursi ng i nterventi on , the fami l y wi l l be abl e to eradi cate the presence of these unwanted si tes of vectors causi ng di seases and therefore wi l l mai ntain a home envi ronmen t conduci ve to heal th.
After nursi ng i nterventi on, the fami l y wi l l be abl e to: a. Acqui re knowl edge on the i mportance of proper sani tati on especi al l y at home
b. Identi fy vectors and possi bl e breedi ng si tes
1. Assess the clients home for breeding sites and proper sanitation/hygiene 2. Discuss to the family the importance of proper sanitation 2.1 reduce the numbers of microorganisms such as bacteria and viruses 2.2 reduce transmission of communicable and infectious disease 2.3 maintenance of health 2.4 promote health 2.5 prevent diseases and illnesses 3. explain to the client/family what vector is and its different types and breeding sites 3.1 vectors- described as any agent that transmits a disease organism 3.2 examples include: bedbugs cockroaches flies lice mosquitoes rat fleas 3.3 breeding sites include old tires clogged canals Home visit Lecture discussion Manpower: Student nurse Family/client Manhour: Time and effort of family and student nurse Materials: Visual aids
c. Enumerate methods/ techni ques to eradi cate the breedi ng si tes of vectors of di seases
d. poi nt out possi bl e breedi ng si tes of vectors of di seases e. choose from the methods/tec hni ques gi ven to use at home to eradi cate breedi ng si tes f. perform the methods correctl y g. verbal i ze thei r understandi n g of the i mportance of proper plastic wrappers plants with large leaves
4. familiarize to the client some techniques and methods to eradicate breeding sites 4.1 use of mosquito/fly trap 4.2 use of mosquito repellent 4.3 use of mouse traps 4.4 proper sanitation of the environment
5. help client in assessing their home for possible breeding sites
6. assist client/family in choosing the appropriate techniques to be used
7. guide the client in performing the chosen methods/techniques
8. evaluate what the family has learned and assess how they feel about the activity
sani tati on and i ts effects to humans heal th
HEALTH PROBLEM FAMILY NURSING PROBLEMS GOAL OF CARE OBJECTIVES OF CARE NURSING INTERVENTIONS METHODS OF NURSE-FAMILY CONTACT RESOURCES REQUIRED EVALUATION Heal th seeki ng behavi ors for heal th mai ntenance and promoti on rel ated to the need to i ncrease i ntake of nutri ents and cal ori es during pregnancy
Subjecti ve cues: gamay raman keu cog caon nya sad coi vi tami ns usahay cai wai kwarta pero adto ko sa heal th center para prenatal as verbal i zed by the mother
Objecti ve cues: 9 months pregnant Average type of body >i nabi l ity to recogni ze the presence of the probl em due to: - l ack of i nadequate knowl edge regardi ng the proper nutri ti on duri ng pregnancy >i nabi l ity to make deci si ons wi th respect to taki ng appropri ate heal th acti on due to: -i naccessibility of appropri ate resources speci fi cally cost of constrai nts or economi c/fi na nci al i naccessibility >fai l ure to uti l i ze communi ty resources due After the nursi ng i nterventi on , the cl i ent wi l l be abl e to demonstrat e changes i n her di et as mani fested by proper food sel ecti on and achi eved proper bal anced di et by acqui ri ng the needed nutri ents duri ng pregnancy
After nursi ng i nterventi on, the cl i ent wi l l be abl e to: a. Verbal i ze understandi n g on the i mportance of proper di et especi al l y duri ng pregnancy
b. Enumerate foods to be i ncl uded i n her di et as wel l as i mportant nutri ents
c. Pl an the desi red meal s wi th proper bal anced di et sui tabl e for 1. assess cleints attitude towards eating and her diet during pregnancy 2. educate the client regarding the proper diet and its importance during preganancy
3. educate the client about the vitamins and minerals that are essential during her pregnancy 3.1 protein 3.2 calcium 3.3 iodine 3.4 iron 3.5 carbohydrates 3.6 vitamin A 3.7 vitamin C 3.8 vitamin D 3.9 Folic Acid 3.10 Water 4. Plan with the client her desired meals through providing her a chart or the food pyramid as her guide toward/on what foods she should prepare 5. Instruct client to avoid caffeinated Home visit Lecture discussion Manpower: Student nurse Family/client Manhour: Time and effort of family and student nurse Materials: Visual aids
to: - l ack/i nadequa te knowl edge of communi ty resources for heal th care pregnant women
d. Appreci ate the i mportance of prenatal check- ups/vi si ts
e. Be aware of the compl i cati on associ ated wi th pregnancy f. Recogni ze the presence of heal th care faci l i ties i n thei r barangay that coul d hel p her attai n proper heal th duri ng pregnancy beverages. Caffeinated beverages may decrease the appetite and will make the client feel full easily 6. Instruct client to avoid junk food 7. Instruct client to follow the required number of servings. Too much or too little could bring about complications 8. Encourage client to maintain diet throughout pregnancy and puerperium 9. Assess clients views on prenatal check-ups/visits 10. Assess if client had prenatal check- ups/visits 11. Discuss to the client the importance of prenatal check-up for both mother and baby 12. Explain to the client the complications of pregnancy 13. Instruct client to seek medical attention if client experienced high risk pregnancy complications
14. Encourage client to recognize the presence of their health care centers and the facilities available that could help them learn more about proper nutrition/health during pregnancy