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Assessment Data Base

This document appears to be a form for recording information about a family as part of a nursing assessment. It includes sections for documenting demographic and health information, values and practices related to health, identified health conditions and problems, and a nursing care plan. The form will be used to gather data on a family's characteristics, health status, beliefs and behaviors to develop a tailored nursing care plan addressing their identified needs.

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Romeo Avecilla Cabral
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207 views

Assessment Data Base

This document appears to be a form for recording information about a family as part of a nursing assessment. It includes sections for documenting demographic and health information, values and practices related to health, identified health conditions and problems, and a nursing care plan. The form will be used to gather data on a family's characteristics, health status, beliefs and behaviors to develop a tailored nursing care plan addressing their identified needs.

Uploaded by

Romeo Avecilla Cabral
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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IBULACAN STATE UNIVERSITY CITY OF MALOLOS COLLEGE OF NURSING FAMILY SERVICE AND PROGRESS RECORD NAME OF FAMILY: ADDRESS:

I-SUMMARY/ SIGNIFICANT FININS OF ADB A-DEMOGRAPHIC/ SOCIO-ECONOMIC,CULTURAL AND ENVIRONMENTAL CHARACTERISTICS FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS/ RELATIONAL PATTERN MEMBERS OFHOUSE MEMBERSNOTCURRENTLY HOLD LIVING WITH LIVING WITH FAMILY FAMILY SOCIAL/ CULTURAL CHARACTERISTICS HOME AND ENVIRONMENT

B-HEALTH STATUS
HISORY OF PRESENT/ CURRENT OR PAST SIGNIFICANT ILLNESS

NUTRITIONAL ASSESSMENT

DEVELOPMENTAL ASSESSMENT

RISK FACTOR ASSESSMENT

PHYSICAL ASSESSMENT

RESULT OF DIAGNOSTIC

C- VALUES, HABITS ,PRACTICES ON HEALTH PROMOTION AND DISEASE PREVENTION


BELIEFS / PRACTICES IMMUNIZATION STATUS ANTENATAL REGISTRATION/ FAMILY PLANNING LIFESTYLE PRACTICES AWARENESS OF COMMUNITY/ DOH HEALTH PROGRAM

HEALTH CONDITION AND PROBLEM SHEET HEALTH CONDITION AND PROBLEM FAMILY NURSING PROBLEM SUPPORTING DATA CUES DATE IDENTIFIED RESOLVED ACTIONS/ TAKEN, RESPONSES AND EVALUATION OUTCOMES

FAMILY NURSING CARE PLAN HEALTH CONDITION FAMILY NURSING PROBLEM OBJECTIVES OF NURSING CARE PLAN OF INTERVENTION EVALUATION PLAN

EVALUATION CRITERIA/ INDICATORS, STANDARDS

METHODS

TOOLS

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