Holy Trinity University

Puerto Princesa City, Palawan

College of Nursing

In Partial Fulfillment of Requirements In

Community Health Nursing 1
Related Learning Experiences (RLE)

FAMILY CASE STUDY

Prepared to:
Mrs. Gloria Vanessa Nalica, RN, MSN
Clinical Instructor

Prepared by:
Rodriguez, Anna Rose E.

September-November 2022

1
 TABLE OF CONTENTS

Introduction 3
Family Nursing Care Assessment 4-8
Family Survey
Initial Data Base
Family Health Assessment and Family Nursing Diagnoses
Computation of Priority 9-11
Family Nursing Care Plan 12-17
Summary 18
Bibliography 19

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 Family Case Study | 2022
INTRODUCTION

Community refers to a group of people who interact with each other, it is a social
group determined by geographic boundaries, common values and interest. It functions within
a social structure, exhibits and creates norms, values, and social institutions. (Microsoft ®
Encarta, 2009).
In Community health nursing, one of the two major fields of nursing in the Philippines,
nursing practice in the community means different things to different nurses. Its primary goal is the promotion
and preservation of health of its client that could be in the individual, family, population, group and
community. In community health nursing practice includes nursing directed to individuals, families, groups;
the dominant responsibility is the population as whole. With these, the health of the people is a reflection of the
communities of which they live, play, work and learn. Communities shape the lifestyle that people adopt and
their livelihood of living safe, fulfilling and productive lives.
Our community experience has been founded on the above principle. This exposure did not
only provide an avenue to apply what we have acquired in the classroom but also provided an opportunity to
serve our fellowmen. Because being in the community is more than meeting the requirements in the Related
Learning Experience (RLE), it is being experience the real world, making real memories and rendering service
with competence, conscience, commitment and care.
In order to manage health programs and resources to clients’ need and concerns regarding
their health, community nurses use various techniques. It is our duty to change the neighbourhood into a
unified, self-sufficient group of people. Since the family is the fundamental societal unit, it is crucial to
undertake a family case study to assess the conditions in the home and family to deliver adequate nursing care
and engage in health-related activities.
This paper presents a case of a nuclear family of five (5) members at Purok Unang Lahi,
Barangay Sta. Lourdes, Puerto Princesa City Palawan. As a community health student nurse assigned in the
area, I was given a chance to care for a certain family. After initial survey of the place, I came across to the
Viray family.
The objective of the study is to smooth the progress of putting into practice the concept of
family-oriented nursing care and make certain an organized approach in the delivery of the nursing services to
the families in the community, purposely in the application of the nursing process. It aims to identify the health
problem of a family within the community. As student nurse, I could give and apply some nursing
interventions that are applicable and attainable within the community health services.

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 Family Case Study |2022
CHAPTER 1
Family Nursing Care Assessment

In this chapter, family structures, characteristics, mobility dynamics, social integration, cultural
influences, environment, residence, neighbourhood, and health behaviour are discussed. The demographic
information of each family includes their name, age, sex, civil status, occupation, and level of education, place
of birth, date, monthly income, and date of deworming, weight, and BMI. The parental economic situation,
Physical surroundings, past and present history, as well as the evaluation of the family based on the functional
health patterns are all described in detail.

A. CHARACTERISTICS

In the present case study, the informant of the group was Mr. Arnel A. Viray who’s the
head of the family. Mr Viray mentioned few situations when it comes to their household that
describes the ways they communicate and build relationship within the family. He has a sister
named Analiza Viray who lives in Paranaque, Manila and they are often contacting her by the
means of virtual call, text and call. Every six months his sister went home at Sta. Lourdes
where they originally live with their other siblings and relatives.

The family currently had lives in Purok Unang Lahi, Bgy. Sta. Lourdes for over 8 years
since Mr Viray left Lucena City because of his job. He mentioned that his family has a strong
emotional connection and addresses their problems when necessary. He leads the family
which makes him the authority and rules over the family since he has three (3) daughters
who’s still dependent on them. Together with his wife Mrs Joann Viray, they are the ones
who solves family problems and handles conflict through assessing and providing
understanding. When it comes to division of tasks, he gives their daughter different and fairly
distributed tasks inside the household but especially he prioritizes their safety and emotions.

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B. SOCIOECONOMIC AND CULTURAL CHARACTERISTICS

The family communicates with each other and other people by using Tagalog. The
family can read and write in language. Mr. Viray mentioned that he has a good
connection with his family, friends and other relatives but when it comes to his neighbour
and other people, he is not too open for them since he is not confident around them and
doesn’t have a good communicating skills as he had mentioned. Mr. Arnel mentioned that
he and his family was once a Roman Catholic but now they are practicing being
Christian. He also mentioned that they participates in church services where his daughters
are part of the choir. Mr Viray graduated with the degree in Business Management and he
was once a fast food staff and a promo dicer in Manila. We observed that their financial
resources and capacity is enough for them in order to provide their basic needs. But there
is no assurance for the stability of their resources since they are self-employed and
doesn’t know when to have a commission in catering and delivering of foods. As a family
bonding and leisure time, they play badminton, basketball, watches TV shows, and
movies.

Mrs Viray mentioned that they believes in folk diseases especially “binat” because
she experienced it herself after each time she gave birth to her daughters. She said that
when she experiences “binat”, they boils and drink “buko juice” as medicine on what she
experiences after she gave birth.

C. FAMILY ENVIRONMENT

As we observed the surroundings and environment of the family, that they some
underlying health risks regarding to their sewage system, pests control, and other issues.
Their house is big enough to accommodate the five (5) of them. We observed that their
house was semi-concrete but some parts of the house was made with light materials and
some are old that are not enough to make them safe and protected from strong winds and
heavy rains. Their waste disposal is near water resources that may cause health risks. I
observed that they have many pets like ducks, chicken, and dog that doesn’t have
separated space for them to secrete their waste that attracts many insects like flies and
mosquitos.

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 They also have bottles and containers near their house that have stocked water that is
infested and being lay eggs of mosquitos and other insects. They are located in rural area
that is far from streets and traffics that are also safe from crowded and noisy areas.

D. FAMILY HEALTH AND HEALTH BEHAVIOR

The family are going on trips spending overnight trips and doing activities outdoor.
When it comes to their disease prevention, the family observes for symptoms, progress of
sickness and provides home remedies like herbs present in their backyard if it is not too
serious but when it comes to urgent and medical attendance, they consults healthcare
professionals usually the BHWs in their Health Care Centres immediately to prevent the
worsening of underlying or present illness.

PAST AND PRESENT ILLNESS

a. Arnel A. Viray – Her wife Mrs Joann Viray mentioned that Mr Viray experienced
early manifestation of appendicitis and UTI (Urinary Tract Infection) but it didn’t
become worst because they consult it immediately and also drinking lots of fluids
help to ease what he feels. We also checked his blood pressure which is 120/80 and is
normal.
b. Joann P. Viray – Mrs Viray mentioned that she doesn’t have present illness but we
observed and checked her BMI that she’s obese. She mentioned that their family on
her side had a history of high blood pressure. We also had a chance to check her blood
pressure which is 110/80 and is also normal.
c. Amelija P. Viray – Mr Viray mentioned that there are no present illness to her
because we didn’t had a chance to meet their daughters to check their vital signs.
d. Ivon Jade P. Viray – Mr Viray also mentioned that Ivon Jade is a bit small for her
age and as we checked her weight according to the details her father had given was
that she is underweight. We didn’t had a chance to check her vital signs also because
we didn’t meet her and we had limited time.
e. Merry Criss P. Viray – Mr Viray mentioned that his youngest daughter bigger than
him and has a greater difference of weight compared to her siblings and according to

6
 our computation of her BMI, it is normal. Estimated 8 months ago, she experienced
mild flu but didn’t become serious.

NAME AGE RELATIONSHIP VITAL IMMUNIZATI NURSING PRESENT

TO THE HEAD OF SIGNS ON HISTORY MEDICAL
THE FAMILY STATUS HISTORY
BP= Covid vaccine:
VIRAY, 38 Head of the family 120/80 Fully vaccinated Early None
ARNEL A. (Pfizer) manifestation
of
appendicitis
and UTI
Covid vaccine:
VIRAY, 39 Spouse BP= Fully vaccinated None None
JOANN P. 110/80 (Pfizer)
Covid vaccine:
VIRAY, 17 Daughter N/A Fully vaccinated None None
AMELIJA P. (Pfizer)
Covid vaccine:
VIRAY, IVON 16 Daughter N/A Fully vaccinated None None
JADE P. (Pfizer)
Covid vaccine:
VIRAY, 15 Daughter N/A Fully vaccinated Mild flu None
MERRY CRISS (Pfizer)
P.

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Family Health Assessment and Family Nursing Diagnosis

First Level Assessment Cues Identified Family Nursing Diagnosis

A. Home and Environment
 Structural safety- made  Ineffective protection due to
of light and old materials lack of awareness in their
 Pest and vermin control- environment and
presence of mosquito larva surroundings.
stocked in used bottles and  Inability to provide a home
containers environment which is
 Presence of mosquito conducive to health
larva: Presence of maintenance and personal
mosquito larva on stagnant development due to: lack of
water stocked in garbage inadequate awareness of the
bottles and containers. importance of home
environment improvement.
 Ineffective protection due to
lack of awareness in their
environment and
surroundings.

Second Level Assessment Cues Identified Family Nursing Diagnosis

A. Inability to recognize the
presence of the problem
 The Viray Family’s home
has a poor structural safety  Inability to resist risks of

and sanitation when it destruction and risks due to

8
 comes to .pest and vermin structural safety measures.
control.  Inability to recognize the
 Lack of attention on how underlying health risks due
to clean their surroundings to lack of attention to their
especially when it comes environment.
to animal excreta.
 Lack of adequate attention
in promoting healthy
environment.
B. Lack of knowledge on underlying
health risks and illnesses
 Risk for developing heart
 Mrs Viray mentioned that
diseases.
her family had a hereditary
and that her environment
may promote this risks.
 Risk for developing
 Mrs Viray mentioned that dysfunctional
his husband had early gastrointestinal motility
manifestation of
appendicitis and UTI that
has a risk to be developed.

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 CHAPTER 2

Prioritization of Family Nursing Diagnosis

Computation of priority

1. Problem: Structural safety is low

Computation Actual Justification
Score
1. Nature of the 2/1x1 2 We foresee that due to their
problem structure and materials, this
may cause accident hazards
to the family.
2. Modifiability 2/1x1 2 For the family, this may be
of the modified easily since they
problem have a capacity or enough
resources to prevent
underlying hazards.
3. Preventive 3/2x1 1.5 It has a high preventive
potential potential if the materials
were replaced.
4. Salience 2/2x1 1 We didn’t receive any denial
and verbal statement that
they ignore this problem and
told us that their house is
safe enough for the family.
Total 6.5

2. Problem: Pest and vermin control is low

Computation Actual Justification
Score
1. Nature of the 2/1x1 2 We foresee that due to their
problem surroundings, this may cause
various diseases like
hantavirus and spotted fever
to the family.
2. Modifiability 2/1x1 2 For the family, this may be
of the modified easily since they
problem have enough knowledge
about controlling and

10
 cleaning their surroundings.
3. Preventive 3/1x1 3 It has a high preventive
potential potential if they have
separate area for animal
waste.
4. Salience 2/2x1 1 We didn’t receive any denial
and verbal statement that
they ignore this problem but
we observed that they are
aware of the problem.
Total 8

3. Problem: Presence of breeding and resting sites of mosquitos

Computation Actual Justification
Score
1. Nature of the 2/1x1 2 We foresee that due to their
problem surroundings, this may cause
dengue fever/virus to the
family.
2. Modifiability 2/1x1 2 For the family, this may be
of the modified easily since they
problem have enough knowledge
about cleaning and removing
stagnant water in garbage
containers and bottle that is
present in their surroundings.
3. Preventive 3/1x1 3 It has a high preventive
potential potential if they are aware
and cleaning their
surrounding always.
4. Salience 2/2x1 1 We didn’t receive any denial
and verbal statement that
they ignore this problem but
we observed that they are
aware of the problem.
Total 8

5. Problem: Lack of knowledge on underlying health risks and illnesses

Computation Actual Justification
Score
1. Nature of the 2/1x1 2 We foresee that the
problem hereditary hypertension in
the family of Mrs Viray she
may developed and also Mr
Viray which had an early
manifestation of appendicitis

11
 and UTI.
2. Modifiability 2/1x1 2 For the family, this may be
of the modified easily since they
problem are aware of the illnesses and
they immediately consults if
the symptoms progresses.
3. Preventive 3/1x1 3 It has a high preventive
potential potential if because they are
aware and focuses to a
member of the family when
there is present illness.
4. Salience 2/2x1 1 We didn’t receive any denial
and verbal statement that
they ignore this problem but
we observed that they are
aware of the problem.
Total 8

Community Problems According to Priority

1 Structural safety is low 6.5
2 Pest and vermin control is low 8
3 Presence of breeding and resting sites of 8
mosquitos
4 Lack of knowledge on underlying health risks 8
and illnesses

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 CHAPTER 3
Family Nursing Care Plan
Health Family Nursing Nursing Nursing Nursing Type of Resour Evaluation
Problem Diagnosis Care Care Actions Nurse- ces
Goal Objectives Family Needed
Contact
.
-To raise STG: -Assess -Home Human STG:
-Ineffective the -After their visit once Resour At the end
protection due to awarenes nursing surround a week ces: of nursing
Structural lack of s of the intervention ings as -Time intervention
Safety is awareness in family , the family well as -Interview and s, the family
Low their when it will be able their method coopera was able to
environment and comes to to recognize structural tion of state what
surroundings. their the problem safety. the are the
surround they can see student problems
-Inability to -Assess
ings. with regards nurses they can see
provide a home the
to their and the and
environment -To perceptio
house’ family. experienced
which is educate n of the
structure regarding to
conducive to the family -Skills
and also in their
health family with of the
their structural
maintenance and when it regards student
surrounding safety.
personal comes to to the nurses
s.
development their underlyi to LTG:
due to: lack of safety -The family ng finish -After
inadequate with will be able effects of the task nursing
awareness of the regards to know and structural effectiv intervention
importance of to their understand safety to ely by s, the family
home house’ what are the their assessin was able to
environment structure. possible health. g and acknowledg
improvement. health risks health e the
that they -Discuss teachin possible
may the g. health
encounter possible problems
due to their health Structur from their
house’ risks and al structural
structural hazards safety safety and
safety. the needs how it

13
 problem financia would
LTG: may l and affect them.
-At the end cause. efforts
of the in order -The family
intervention to was able to
, the family provide state the
will be able adequat ways how
to prevent e they
accidental respons prevented
hazards by e to the accidental
changing proble hazards
the m. regarding to
structures their
and structural
materials of safety.
their house.

-The family
will be able
to recognize
and
understand
the value of
structural
safety of
their house
in order to
provide
them safety.

Health Family Nursing Nursing Nursing Type of Resource Evaluatio

Problem Nursing Care Goal Care Actions Nurse- s n
Diagnosis Objectives Family Needed
Contact

Pest and -Ineffective -To raise STG: -Assess -Home Human STG:
vermin the -After their visit once Resource At the end
protection
control awareness nursing surroundin a week s: of nursing
is low due to lack of of the intervention gs as well -Time interventi
family , the family as their -Interview and ons, the
awareness in method
when it will be able pest and cooperati family
their comes to to recognize vermin on of the was able
their the problem control student to state
environment
surroundin they can see nurses what are
and gs. with regards -Assess and the the
to their the family. problems
surroundings.

14
 -To surrounding perception they can
educate the especially of the -Skills of see and
-Inability to
family the pest and family the experienc
provide a
when it vermin with student ed
home
comes to control. regards to nurses to regarding
environment
their safety the finish the to their
which is
with -The family underlying task structural
conducive to
regards to will be able effects on effectivel safety.
health
their to know and their y by
maintenance
surroundin understand health by assessing LTG:
and personal
gs, pest what are the pest and and -After
development
and vermin possible vermin. health nursing
due to: lack
control. health risks teaching. interventi
of inadequate
that they -Discuss ons, the
awareness of
may the Pest and family
the
encounter possible vermin was able
importance of
due to their health control to
home
house’ risks and requires acknowle
environment
structural hazards adequate dge the
improvement.
safety. the attention possible
problem and health
LTG: may solutions problems
-At the end cause. because it from their
of the may pest and
intervention cause vermin
, the family serious control
will be able diseases. and how it
to prevent It will would
underlying require affect
health risk immediat them.
and diseases e
to be attention -The
developed and family
by exposure preventio was able
in pest and n to to state
vermin. avoid the ways
serious how they
-The family illnesses prevented
will be able and future
to recognize problems illnesses
and . and health
understand problems
the value of that may
their health cause by
in exposure pest and
with pest vermin.
and vermin.

15
Health Family Nursing Nursing Nursing Type of Resources Evaluati
Problem Nursing Care Goal Care Actions Nurse- Needed on
Diagnosis Objectives Family
Contact

Presence -Inability -To raise the STG: -Assess -Home visit Human STG:
of awareness of -After their once a week Resources: At the
to provide
breeding the family nursing surroundin -Time and end of
and a home when it intervention gs as well -Interview cooperatio nursing
resting comes to , the family as their method n of the intervent
environme
sites of their will be able awareness student ions, the
mosquito nt which is surroundings. to recognize in nurses and family
s the problem eradicatin the family. was able
conducive -To educate they can see g the to state
to health the family with regards presence -Skills of what are
when it to their of the student the
maintenanc comes to nurses to
surrounding mosquitos problems
e and their safety especially in their finish the they can
with regards eradicating surroundin task see and
personal to their effectively experien
the presence gs.
developme surroundings, of by ced
especially in mosquitos. -Assess assessing regardin
nt due to: eradicating the and health g to their
lack of the presence -The family perception teaching. exposure
of mosquitos. will be able of the to
inadequate to know and family Exposure mosquito
awareness understand with to .
what are the regards to mosquitos
of the possible the requires LTG:
importance health risks underlying adequate -After
and effects on attention nursing
of home problems their and intervent
environme due to their health by solutions ions, the
exposure pest and because it family
nt with vermin. may cause was able
improveme mosquitos. serious to
-Discuss diseases. It acknowl
nt. LTG: the will edge the
-At the end possible require possible
of the health them their health
-
intervention risks and time just problems
Ineffective , the family hazards to clean from

16
 protection will be able the and their
to prevent problem remove exposure
due to lack
underlying may pile of to
of health risk cause. garbage mosquito
and diseases that and it
awareness
to be promotes would
in their developed the affect
by exposure presence them.
environme
in of
nt and mosquitos. mosquitos. -The
family
surroundin -The family was able
gs. will be able to state
to recognize the ways
and how they
understand prevente
the value of d future
their health illnesses
in exposure and
with health
mosquitos. problems
that may
cause by
their
exposure
to
mosquito
.

Health Family Nursing Nursing Nursing Type of Resources Evaluati

Problem Nursing Care Goal Care Actions Nurse- Needed on
Diagnosis Objectives Family
Contact

Underlyin -Risk for -To raise the STG: -Assess -Home Human STG:
g health developin family’s -After their visit once resources -At the
risks g hearth awareness nursing surrounding a week needed: end of
(Hyperten regarding intervention, s as well as -Time and nursing
diseases.
sion and their the family the factors -Interview cooperatio intervent
GI tract -Risk for will be able that may method n of the ions, the
underlying
problem) developin health risk to state what promote student family
g that may are the underlying nurses and was able
dysfunctio developed. problems health risks. the family to state
nal they can involved what are
gastrointes -To educate foresee -Assess the in the possible
the family on regarding perception study. problems
tinal
what are the underlying of the they can
motility possible health risks. family -Skills of foresee

17
-Impaired health regarding the student regardin
home problems that -The family their health nurses to g
maintenan can be caused will be able and finish the underlyi
by underlying to know the livelihood. task ng health
ce
health risks. possible -Discuss to effectively risks.
health the family by
-To provide problems that the possible assessmen
knowledge to can be caused health t and
the family on by underlying problems in health LTG:
what they can health risks. underlying teachings. -After
do or practice health risks. nursing
to prevent LTG: - intervent
underlying -At the end of Underlyin ions, the
health risks. the g health family
intervention, risks was able
the family requires to
will be able immediate acknowl
to at least attention edge the
lessen and since it possible
prevent the will cost health
underlying them problems
health risks. financially from
because it underlyi
-The family may be ng health
will be able severe and risks.
to understand developed.
the -The
importance of family
having was able
enough to state
knowledge the ways
and to lessen
understandin and
g in prevent
underlying the
health underlyi
problems. ng health
risks.

18
 CHAPTER 4
Summary

In Bgy. Sta. Lourdes, Purok Unang Lahi, there lives the family of Mr and Mrs Viray.
This family is considered as a type of nuclear family which consists of five (5) members
inside the household. Mr Viray is the one who decides and distributes task for his children
since they are all girls. His family had a strong bond that is strengthened by their
imperfections, trials, and successes in life together.

The family of Mr Viray resides in Bgy. Sta. Lourdes, Purok Unang Lahi, Puerto
Princesa City for 8 years. Their house is made of concrete and light materials that has 2
bedrooms enough for them to keep them safe. The source of income of the family comes
from the catering they had made through orders and to be delivered in Ospital ng Palawan
according to Mr Viray. Mr Viray formerly works in a fast food restaurant and a promo dicer
in shopping malls when he doesn’t have a family yet. The family enjoys from their strong
bonds together especially to their daughters.

Moreover the source of water for the family is NAWASA. The family’s overall safety
and drainage is safe. The often participates in barangay activities since the barangay doesn’t
informs them sometimes. The family of Mr Viray has an underlying health risks because of
their surroundings, pest and vermin control, the presence of mosquitos that may cause serious
illnesses to their family according to our observation. Furthermore, Mrs Viray mentioned that
her side of family has a history of hypertension and Mr Viray recently experienced early
manifestation of UTI and appendicitis. A nursing care plan is formulated to address different
problems that are being identified. However, the family has a capability to improve their way
of life. There are still the opportunity to improve their wellbeing and provide a home
environment for their personal development.

The goal of the student nurse is to recognize family nursing issues, which was only
partly accomplished due to limited time. The student nurse, along with the family, especially

19
Mr and Mrs Viray who is openly received us and allowed us to be interviewed needs nursing
intervention regarding their surroundings and health. As a student nurse, I wanted to help
them and change their lifestyle to improve and allow them to have knowledge by giving them
some teaching, advice, inspiration and encouragement. Mr and Mrs Viray are already
oriented towards helping them to be healthier and have a healthy surrounding.

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Microsoft ® Encarta, 2009. The definition of community. Retrieved November 1, 2022, from
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Daisy Jane Antipuesto, R.N M.N. (2009, July 9). Concept of family. Retrieved November 1,
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Approved NANDA Nursing Diagnosis List 2018-2022. Class 2 Gastrointestinal function.

Retrieved November 6, 2022, from googleclassroom.com Nursing Diagnosis

Matt Vera, R.N. (2014, January 29). Family Nursing Care Plan: Assessment and Diagnosis
in Family Nursing Practice, Retrieved November 1, 2022, from nurselabs: Family Nursing
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Uploaded by hahah1130. (n.d.). Family Nursing Problem Prioritization. Retrieved November

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Uploaded by Roy Francis Cordero. All about Nursing: CHN. Computation of prioritization.
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