FAMILY ASSESSMENT Name of Family: A Family Place of Residence: Sambag I, Cebu City A.

STRUCTURE AND CHARACTERISTICS MEMBERS OF THE FAMILY O.A RELATION TO THE HEAD DATE OF BIRTH AG E CIVIL STATUS OCCUPATI ON OTHER SOURCES OF INCOME None EDUCATIO NAL BACKGROU ND Grade 6 PLACE OF BIRTH

SEX

RELIGION

INCOME Php 290.00/d ay

Head

12.16.1978

34

Married

Catholic

Carpenter

Cebu

M.J.A

Wife

09.10.1980

22

Married

Christian

Housewife

None

Washwom an

Grade 4

Negros occidenta l Cebu Cebu Cebu Cebu Cebu

J.A J.A N.J.A J.A J.K.A

Son Daughter Daughter Son son

11.27.1998 10.2.2000 09.15.2002 10.17.2004 02.2.2008

14 12 10 8 5

M F F M M

Single Single Single Single Single

Christian Christian Christian Christian Christian

Student Student Student -

None None None None none

None None None None none

Grade 2 Grade 3 Grade 1 None none

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 4th grade. Three of their children are currently studying in 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 3rd grade and was an honor student when she was in grade 2. NJ is in his 1st 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. Their 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. In 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 family 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 Cough and colds HEALTH THREAT Poor environmental sanitation FORESEEABLE CRISIS Pregnancy

Deep wounds

Family size beyond family resources can adequately provide

G. HEALTH PROBLEMS ACCORDING TO PRIORITIES

COUGH AND COLDS

CRITERIA 1. Nature of the problem 2. Modifiability of the problem 3. Preventive potential

COMPUTATION 3/3x1 1/2x2 3/3x1 1/2x1

ACTUAL SCORE 1 1 1 0.5 3.5

JUSTIFICATION -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

4. Salience of the problem

DEEP WOUND CRITERIA 1. Nature of the problem 2. Modifiability of the problem COMPUTATION 3/3x1 2/2x2 ACTUAL SCORE 1 2 JUSTIFICATION -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

3/3x1 3. Preventive potential 2/2x1 4. Salience of the problem

1 1 5

-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 1. Nature of the problem 2. Modifiability of the problem 3. Preventive potential 1/2x1 4. Salience of the problem 3.7 FAMILY SIZE BYOND FAMILY RESOURCES CAN ADEQUATELY PROVIDE CRITERIA 1. Nature of the problem 2. Modifiability of the problem 3. Preventive potential 2/2x1 4. Salience of the problem 1 COMPUTATION 2/3x1 2/2x2 3/3x1 ACTUAL SCORE 0.6 2 1 JUSTIFICATION -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. 0.5 -the problem was recognized by the family but they didnt take any immediate action to their condition COMPUTATION 2/3x1 2/2x2 2/3x1 ACTUAL SCORE 0.6 2 0.6 JUSTIFICATION -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

4.6

-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 1. Nature of the problem 2. Modifiability of the problem 3. Preventive potential 1/2x1 4. Salience of the problem 2.8 0.5 COMPUTATION 1/3x1 1/2x2 3/3x1 ACTUAL SCORE 0.3 1 1 -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 JUSTIFICATION -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

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
Cough and colds as a health deficit Subjective cues: nah, gpang.ubo ni silang tulo ay. Usahay naai tambal, usahay wala. Depende kung naai kwarta as verbalized by the mother

FAMILY NURSING PROBLEM S

GOAL OF CARE
After the nursing interventi on, the family will be able to eliminate the cough and colds and will prevent the

OBJECTIVES OF CARE
After nursing intervention, the family will be able to: a. Acquire adequate informatio n about the disease including signs and

NURSING INTERVENTIONS
1. Discuss with the family the causes, signs and symptoms and complications of cough and colds. 1.1 cold-acute inflammation of the mucous membrane of the upper passages 1.2 causes: intake of cold food seasonal changes improper digestion of food

METHODS OF NURSE-FAMILY CONTACT 1. Home visit 2. Lecture 3. discussion

RESOURCE S REQUIRED Manpowe r: Student nurse Family/clie nt Manhour: Time and effort of family and student

EVALUATIO N

Objective cues Productive cough Average amount in sputum Clearyellowish in color Mucosal secretions noted

the family due to: - Lack of /inadequat e knowledge about the disease/he alth conditions (nature, severity, complicatio ns, prognosis and manageme nt) >failure to utilize community resources for health care due to: -failure to perceive the benefits of health care/servic es

recurrenc e of the disease in the future.

symptoms of the disease, immediate health care assistance and preventive measures

1.3 s/s: running nose/blocked nose sneezing sore throat congestion headache low fever loss of appetite lethargy insomnia 1.4 complications ear infections sinus infections bronchitis pneumonia 2. provide adequate knowledge on the various ways of maintaining cleanliness in their surroundings 2.1 ways: hand washing taking a bath everyday dispose garbage properly 3. explain the importance of proper food preparation, good nutrition, rest and sleep in strengthening ones resistance against illness so as to prevent the occurrence of cough and colds 3.1 importance prevent someone from getting sick prevent cross

nurse Materials : Visual aids

b. Be aware on how to reduce the chances of spreading communic able diseases to other family members

 c. Identify low cost home remedies for cough and colds

contamination prevent from spreading the disease health promotion and disease prevention

4. give the family some home remedies for cough and colds 4.1 remedies SLK Lagundi leaves Black pepper and ginger Garlic (boiled with sugar) Chicken soup(colds) 5. Help the client identify appropriate remedy to be used 6. Assist client in preparing the chosen remedy 7. Cite ways in eliminating the disease and limiting the occurrence of transmission through medications and alternative medicines and preventive measures such as covering the mouth when sneezing or coughing and proper disposal of oral and nasal discharges 8. Evaluate the familys understanding regarding proper sanitation and

d. Choose and perform correctly the remedy chosen e. Utilize communit y resources available in resolving the condition experienc ed f. Verbalize

understan ding of proper sanitation and the remedies and preventive measures of the condition

preventive measures of cough and colds

HEALTH PROBLEM
Presence of breeding sites of vectors of diseases Subjective cues:magpundo man mi ug tubig kai wa man mi amo.ang tubig, ang uban wai takub.. nah cana

FAMILY NURSING PROBLEM S

GOAL OF CARE
After the nursing interventi on, the family will be able to eradicate the presence of these unwanted

OBJECTIVES OF CARE
After nursing intervention, the family will be able to: a. Acquire knowledge on the importanc e of proper sanitation

NURSING INTERVENTIONS 1. Assess the clients home for breeding sites and proper sanitation/hygiene 2. Discuss to the family the importance of proper sanitation 2.1reduce the numbers of microorganisms such as bacteria and viruses 2.2reduce transmission of

METHODS OF NURSE-FAMILY CONTACT Home visit Lecture discussion

RESOURCE S REQUIRED Manpowe r: Student nurse Family/clie nt Manhour: Time and effort of family and

EVALUATIO N

pud among canal aiy pwerte cadaghan ug lamok as verbalized by the mother Objective cues uncovered pail with water observed stagnant canal noted unfinished laundry noted unwashed dishes noted

nt due to: -ignorance of the importance of hygiene and sanitation -lack of knowledge regarding preventive measures of illnesses and diseases

sites of vectors causing diseases and therefore will maintain a home environm ent conducive to health.

especially at home

b. Identify vectors and possible breeding sites

c. Enumerat e methods/ technique s to eradicate the breeding sites of vectors of

communicable and infectious disease 2.3maintenance of health 2.4promote health 2.5prevent diseases and illnesses 3. explain to the client/family what vector is and its different types and breeding sites 3.1vectors- described as any agent that transmits a disease organism 3.2examples include: bedbugs cockroaches flies lice mosquitoes rat fleas 3.3breeding sites include old tires clogged canals plastic wrappers plants with large leaves 4. familiarize to the client some techniques and methods to eradicate breeding sites 4.1use of mosquito/fly trap 4.2use of mosquito repellent

student nurse Materials : Visual aids

diseases d. point out possible breeding sites of vectors of diseases e. choose from the methods/t echniques given to use at home to eradicate breeding sites f. perform the methods correctly g. verbalize their understan ding of the importanc e of proper sanitation and its effects to humans health

4.3use of mouse traps 4.4proper 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

HEALTH PROBLEM
Health seeking behaviors for health maintenance and promotion related to the need to increase intake of

FAMILY NURSING PROBLEM S

GOAL OF CARE
After the nursing interventi on, the client will be able to demonstr

OBJECTIVES OF CARE
After nursing intervention, the client will be able to: a. Verbalize understan ding on

NURSING INTERVENTIONS

METHODS OF NURSE-FAMILY CONTACT Home visit Lecture discussion

RESOURCE S REQUIRED Manpowe r: Student nurse Family/clie nt

EVALUATIO N

1. assess cleints attitude towards eating and her diet during pregnancy 2. educate the client regarding the proper diet and its importance during

nutrients and calories during pregnancy Subjective cues: gamay raman keu cog caon nya sad coi vitamins usahay cai wai kwarta pero adto ko sa health center para prenatal as verbalized by the mother Objective cues: 9 months pregnant Average type of body

due to: - lack of inadequate knowledge regarding the proper nutrition during pregnancy >inability to make decisions with respect to taking appropriate health action due to: inaccessibil ity of appropriate resources specifically cost of constraints or economic/fi nancial inaccessibil ity >failure to utilize community resources due to: lack/inadeq uate

ate changes in her diet as manifeste d by proper food selection and achieved proper balanced diet by acquiring the needed nutrients during pregnanc y

the importanc e of proper diet especially during pregnancy b. Enumerat e foods to be included in her diet as well as important nutrients

preganancy

c. Plan the desired meals with proper balanced diet suitable for pregnant women

3. educate the client about the vitamins and minerals that are essential during her pregnancy 3.1protein 3.2calcium 3.3iodine 3.4iron 3.5carbohydrates 3.6vitamin A 3.7vitamin C 3.8vitamin D 3.9Folic 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 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

Manhour: Time and effort of family and student nurse Materials : Visual aids

knowledge of community resources for health care

d. Appreciate the importanc e of prenatal checkups/visits e. Be aware of the complicati on associated with pregnancy f. Recognize the presence of health care facilities in their barangay that could help her attain proper health during pregnancy

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