CUES SUBJECTIVE: Diri ako maaram kun ano ini pero maiha na ini nga akon kabutang.

Namanhod anay tapos yana diri na ako naabat ha akon mga kamot ngan tiil kahuman hinay-hinay nga naupos nak mga tudlo , as verbalized by the client. Waray ha iya mga bugto napresentar pag-upod ha iya kay may mga pamilya man na guinaariglar, sagdi nala ito hiya, nagtitikakipot naman iya samad as

HEALTH PROBLEM Illness state: Leprosy as a health deficit

FAMILY NURSING PROBLEM I. Inability to recognize the presence of the problem due to A. lack of knowledge B. denial about the existence and severity as a result of fear of consequences of diagnosis of problem, specifically: 1. social stigma 2. cost implications 3. physical consequences

GOAL OF CARE After three hours of nursing intervention the patient will be able to recognize the presence of the problem.

OBJECTIVES After three hours of nursing interventions, the patient, family and health workers will be able to:

IMPLEMENTATION PLAN INTERVENTION METH RESOURCE OD S 1. Conduct interview to Home Interview forms gather relevant visit Health informations assessmen regarding the history t kit of present illness. 2. Conduct cephalocaudal physical assessment having emphasis on peripheral sensation. 3. Conduct health education in the level of understanding of the patient, family members and health worker about the:

a. Define in their own words the definition of leprosy and enumerate at least 2 cardinal signs of leprosy.

a. Definition and cardinal signs of leprosy such as: Skin lesions Decreased or Negative peripheral sensation

Wound dressing materials Visual aids Hand-outs Human resources (family member, Brgy. Health Worker, Rural Health midwife, Public Health Nurse and Municipal Health doctor) Transporta tion fee

EVALUATION PLAN CRITE STANDARD TOOL RIA Verbal 1. Patient Intervie feed participated w back during history taking and physical examination.

Verbal feed back

2. Patient, family member and BHW: a. Enumerated cardinal signs of Leprosy.

Intervie w

b. Enumerate two mode of transmission.

b. Etiologic agent (mycobacterium leprae) and mode of transmission such as: Prolonged

Verbal feed back

b. Matatapnan ka kun an imo maiha na kausa, may leprosy ngan ha talsik gihap

Intervie w

verbalized by the mother. Waray man may guinyakan an doctor kun ano akon sakit as verbalized by the patient. Waray ko man gamit panlimpyu han ak samad, waray man ak iparalit as verbalized by the patient. Guin-dadara gad unta ak han una ha EVRMC, waray la ka dayon kay waray kami pan-gastos as verbalized by the client. OBJECTIVES Depressed nose bridge Hypopigm

exposure lepromatous patient. Transmitted through respiratory droplets. c. Enumerate at least 4 basic guidelines for contact, airborne and droplet precautions. c. Contact, airborne and droplet precautions such as: Maintain at least 3 meter distance when conversing with the client. Wear mask for prolonged conversation. Limit the patients transfer within the facility. Separate the clients personal belongings such as towel, spoons etc. d. Treatment needed for the said health problem such as: Multidrug therapy (Rifampicin, Clofazimine and Dapsone) Wound dressing e. Common sideeffects of the said medication and

hit iya laway. As verbalized by the BHW.

Verbal feed back

c. Enumerated 4 Intervie basic w guidelines for contact, airborne and droplet precautions.

d. Name at least two treatments needed to heal alleviate signs and symptoms.

Verbal feed back

d. Enumerated two treatment s needed for leprosy

Intervie w

e. Enumerate atleast 3 common

Verbal feed back

e. Magmamara ngan magiiba it color hit

Intervie w

ented patches on the face claw hand deformity with muscle atrophy and scars from fingertip amputatio ns. Lymph adenopath y at right femur Painless ulcer on right foot Hyperpig mented upper and lower extremitie s Dry skin Extensive loss of sensation in the hands and feet Barangay medical history revealed positive for

MDT side effects and its management.

its treatment such as: Drying of the skin (Mgt. Submerge dry skin with water) Skin hyperpigmentatio n (Mgt. Explain that it will reverse within few months after completion of MDT) Photosensitivity (Mgt. Avoid exposure to extreme sunlight) f. Discuss the importance of compliance to medication regimen such as: Prevents drug Resistance Helps alleviate signs and symptoms 4. Plan with the family for the health checkup of the sick member of the family. Verbal feed back

panit pero mabalik ngahaw ngan madali ak masilawan ha mata as verbalized by the patient.

f. Enumerate at least 2 importance for strict compliance to medication.

f. Enumerated 2 importance for strict compliance to medication.

Intervie w

II. Inability to make decisions with respect in taking appropriate health action due to: a. Conflicting opinions among family

After a day of comprehensi ve nursing interventions , the family will be able to choose appropriate actions

After one day of nursing interventions: a. One member of the family will be able to accompany the patient upon medical

Compli 3. Patients sister ance came along with with the client agreed for medical upon check-up interve assistance. ntions

Record s review

Leprosy. Income: none Leaves alone

members regarding action to take III. Inability to provide adequate nursing care to the sick member of the family due to: A. Lack of necessary facilities, equipment and supplies for care

regarding the health problem. After 3 hours of nursing interventions the family will be able to provide nursing care to the patient.

check-up.

After 3 hours of nursing interventions:

a. The family 5. Discuss with the will be able family alternatives in to provide providing nursing boiled water care to the client in lieu for such as use of boiled Normal water in the absence Saline of NSS. Solution used for wound dressing b. The patient will be able to demonstrate aseptic technique in wound dressing 6. Demonstrate the proper aseptic technique in wound dressing such as starting from the cleanest to dirtiest area.

Compli 4. Previously ance boiled water with used in the agreed wound upon dressing interve ntions

Direct observa tion.

B. Inadequate knowledge and skills in carrying out the necessary

Compli 5. Patient Direct ance demonstrated observa with aseptic wound tion. agreed dressing. upon interve ntions Compli 6. Patient placed ance the soiled with wound agreed dressing at a upon plastic bag interve securely tied. ntions Direct observa tion.

c. Family 7. Advise the member/s patient/family and the member to dispose patient will properly the soiled be able to dressings in order to follow proper prevent the spread of ways in infection. disposing Place the soiled soiled wound dressings.

dressing in a plastic bag securely tied. Wash hands after disposing the soiled dressings.

V. Failure to utilize community resources for health care due to: a. fear of consequences of action specifically financial consequences b. lack of family resources specifically financial resources

After 3 days of nursing intervention the patient will be able to subject self for consultation and treatment.

After 3 days of nursing interventions: a. BHW will be able to send the patient to RHU for medical check-up. 8. Link with Barangay Health Worker for check-up assistance. Compli 7. BHW took the ance patient to RHU with for medical agreed check-up. upon interve ntions Compli 8. After routine of ance physical with examinations, agreed patient was upon diagnosed with interve Leprosy and ntions recently subjects for Leprosy treatment. Verbal feed 9. Patient went back back to RHU together with the BHW for treatment and further Record s review

b. Public Health 9. Refer patient to the Doctor will be Rural Health Unit for able to the confirmatory of diagnose the the health problem. health problem and subject the patient for treatment. c. Patient will be 10. Subject the patient able to take for treatment with the the supervision of medication as Barangay Health prescribed Worker. with the supervision of the BHW.

Record s review

Intervie w

medication instructions d. Student nurses and health workers should be able to positively reinforce the client for participating with the treatment. e. Patient will be able to verbalize faith to God. 11. Provide emotional support by providing positive reinforcement in subjecting self for treatment. Verbal feed back c. Patient verbalized Cge Maam mapatambal ako total libre man. Salamat gihap ha iyo Intervie w

12. Provide spiritual support by strengthening the patients faith by introducing St. Francis of Assisi as the patron saint for Leprosy guilt.

Verbal feed back

d. Diri ko na Intervie guin-sasayop w it Guinoo kay aon man ngani gihap ini hinimu-an as verbalized by the patient.