family case study

1

A C K N O W L E D G E M E N T The study has provided our group opportunities to know the different problems and needs of the family in order for them to develop more in terms of their environment and especially with their health status. But all of these could not be done without the help of those significant people that help us throughout the study. The group would like to thank the following: First of all, The Lord, we thank you for giving us a chance to live and experience this opportunity. Thank you for making all things possible, for giving us all we needed, and for making us earn insights in this way knowing the worth of our life. For His guidance and safety which He gives every day, for all the blessings that He has showered upon us, and for giving us the strength to pursue everything. Next To our loving parents, thank you so much for helping us with your prayers, for allowing us to be exposed in the community, and for helping us with our needs especially

financial

matters. To our clinical instructors Mrs. Evangeline Ocop, Mrs. Brenda Morales, Ms. Honeylette Villanueva, and especially Mrs. Anabel Bauzon who were always there to help and support us especially in our activities and programs, and in making our case presentation successful. We are grateful for the encouragement you gave us every time we feel discouraged especially for the outcome of our activities, for the patience, for understanding our differences, for the concern, and for the guidance you gave us. We appreciate it and it inspires us more to continue and pursue and we are happy and blessed to have you as our clinical instructors. We would also like to thank the Rural health unit of Calinan that organized and find a proper and appropriate place for us to have our community exposure. To The barangay health workers at Subasta health center, for

their warm welcome and for extending their help and assistance if we

needed to. We would also like to extend our gratitude to the Panadero family for accommodating, welcoming, and for trusting us to share their basic and personal information that made our case study successful. Next, to the members of the community for attending and participating in our different activities and programs and for

2

understanding our purpose in the community. The community was participative and interactive during the activities that motivated us to do our best. Lastly we would like to thank our classmates and for our group. For the support and friendship, for the team building in our programs and activities and working altogether to make this case study a successful one.

I N T R O D U C T I O N

3

“It is health that is real wealth and not pieces of gold and silver.” A saying that strongly correlates to Community health nursing in such a way that it focuses on the welfare of everybody. Community Health Nursing is a specialized field of nursing, public health and some phase of social assistance and function as well as part of the total public health program for the promotion of health, improvement of the conditions in the social and physical environment, rehabilitation of illness and disability according to WHO. The philosophy of Community Health Nursing is based on the worth and dignity of man (Margaret Shetland). Its goal is to raise the level of health citizenry. The traditional function of the community health nursing is to help other help themselves. To achieve any degree of self reliance, people need to cultivate their own resources, both human and material at all stages and phases of development. The community health nurse, as a practitioner, teacher, interpreter, stimulator, listener and organizer is a significant factor in determining the success or failure of the health effort. The nature of these efforts will be constantly challenged and changed by goals, resources and constraints of the socioeconomic, ideological and political situation. The practice of the community health nursing will need to remain fluid and flexible if it is to be consistent with community needs, available resources, scientific knowledge and capabilities of people being served. According to WHO, (World Health Organization), a community is a social group determined by geographic boundaries and/or common values and interests. Its members know and interact with one another. It functions within a particular social structure and exhibits and create norms, values and social institutions. It may be a neighborhood or cluster of families, an ethnic group, an industry or a school. With these definitions, it is evident that community is a very important target of health care. Every community has problems to be identified. Communities with poor financial and environmental conditions in particularly, are some concerns of the nation with regards to health. Davao City is the biggest in Southern Mindanao in terms of population area. The city contributed 22.11 % of the total 5.2 million populations in the region, said National Statistics Office XI We chose Panaderol Family because we had identified problems

4

that would affect their health and give solutions for them to cope up. We prioritized the problems seen in the family and take methods on knowing the problems. By rendering health teachings and interventions, the family will be able to understand and learn about the existing and potential health problems and the family will be able to take appropriate actions to solve their problems on their own.

O B J E C T I V E S

5 GENERAL: At the end of our 5 week exposure on Barangay Subasta, Calinan, Davao City; we, student nurses of Ateneo de Davao University, BSN 3-D group 2, will be able to apply our learnings in our community health nursing concept and will be able to provide adequate and proper nursing care.

SPECIFIC: In order to achieve above the general objectives, our group will be able to:

Psychomotor:

 Conduct an ocular survey to find a family suitable for the case study;  Gather demographic data and other pertinent information about the client as well as the family to support the case study;  Illustrate the family eco map;  Extrapolate to the family the health teachings applicable to their problems;  Trace the client’s genogram, family diseases and health conditions in a diagram format with a corresponding legend;  Formulate 5 Family Nursing Care Plans for the family;

Cognitive:

 Identify observable and underlying problems within the family;  Lay down information about the background of our family case study, its purpose , why the client was chosen and how can they be an attractive and proponent of the study;  Present the initial data base of the client;  Rate the family’s coping potential/capacity based on the Family Coping Index;

6  List down problems noted in the family;;  Prioritize problems based on the Scale for Ranking Health Conditions and Problems According to Priorities;  Evaluate the results of our interventions if the family improved their condition;  Lay down the contributions of our Case Study to Nursing Education, Research and Practice; and  List down all references used for this particular Case Study.

Affective:

 Establish rapport with the family to develop a good working relationship;

I N I T I A L

D A T A

B A S E

7

A.

NAME

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

SEX

HOMER PANADERO MARJ PANADERO BARK PANADERO MAGGIE PANADERO STEWIE PANADERO

AGE

MALE

EDUCATIONAL

STATUS

ATTAINMENT

MARRIED

1st yr College

Motor driver Vendor

FEMALE

26

MARRIED

1st yr College

MALE

8

SINGLE

Grade2

FEMALE

6

SINGLE

Kinder2

MALE

RELATION

CIVIL

SINGLE

OCCUPATION

RELIGION

TO FAMILY

Roman catholic Roman catholic Roman catholic Roman catholic Roman catholic

FATHER WIFE

SON

DAUGHTER SON

PLACE OF RESIDENCE OF EACH MEMBER -The Panadero family is living together in one house, located at purok 1 Subasta, Calinan Davao city.

TYPES OF FAMILY STRUCTURE

According to membership -

The Panadero family is a nuclear type of family because they are living in one household and consisting of a mother, father and their children.

According to Residence

THE

8 -

The Panadero family is matrilocal since they live in one compound with Marj’s parents and siblings.

According to Authority -

Egalitarian is the authority in Panadero family in which decision lies with both couple.

DOMINANT FAMILY MEMBER IN TERMS OF DECISION-MAKING, ESPECIALLY IN MATTERS OF HEALTH CARE -

Both Marj and Homer are responsible in making decisions with regards to health care. The two of them work hand in hand to provide the family’s health needs. Financial matters are discussed by both Marj and Homer. They help and support each other in making decisions for their family.

GENERAL FAMILY RELATIONSHIP -

The panadero family is peaceful and loving family though sometimes the family experience quarrels but they easily resolve it by talking through it.

ACTIVITIES OF DAILY LIVING Sleeping pattern -

The couple, Homer and Marj, together with their sons and daughter, sleeps together in one room. There have been regular hours for getting up and retiring every night for the family. They usually sleep at around

9

8 or 9 pm and wakes up 6am In the morning because marj needs to cook and prepare her children in going to school.

Eating Pattern

SCHEDULE BREAKFAST LUNCH MERIENDA DINNER

FOODS

WHO

Rice, Fish/vegetables Rice, meat/vegetables Bananacue Rice,

PREPARES ELLEN ELLEN ELLEN ELLEN

fish/meat/vegetables/soup

-

The family shares four meals in a day breakfast, lunch, snacks and dinner.

They cook using charcoals/woods because they have no

stove. Ellen usually cooks the food since she also cook viands in which she sells during lunch.

Leisure time activities

-

During free time, the family would just watch television on their neighbor’s house since their television set is broken. And also, they

10

sleep and clean the house during free time. If they have extra money or they need to buy something, they go to town.

B.

SOCIO-ECONOMIC AND CULTURAL FACTORS

INCOME AND EXPENSES

MEMBERS

OCCUPATION

PLACE

HOMER

MOTOR DRIVER

WORK SUBASTA

P300-P500/day

PANADERO MARJ

VENDOR

SUBASTA

P300/day

PANADERO

OF INCOME

11

The family’s income is above minimum wage (referring to Davao’s minimum wage level which is P248), having an income of 400-600 per day. It has an adequacy in meeting family’s basic need such as food and shelter. They can afford to send their children to school and able to eat at least 3-4 times a day.

EDUCATIONAL ATTEINMENT OF EACH MEMBER OF THE FAMILY Name

Educational Attainment

Homer Panadero

Undergraduate First yr college

Marj Panadero

Undergraduate First yr college

Bart Panadero

Currently on Elementary Grade 2

Maggie Panadero

Currently on Kinder 2

Stewie Panadero

Doesn’t go to school yet

12

ETHNIC BACKGROUND AND RELIGIOUS AFFLIATIONS Basically, our clients are Christians. Both Homer and Marj lived in Subasta. SIGNIFICANT OTHERS Each of the family members has its own significant roles in the family. In times of financial crises, they have their neighbors who can help them in some matters matters because most of their neighbours are their relatives,

RELATIONSHIP OF THE FAMILY TO THE LARGER COMMUNITY . They are active members in their baranggay. Whenever there are activities in the Barangay, they participate.

C.

ENVIRONMENTAL FACTORS

HOUSING

Adequacy of living space

13

-

There is inadequate living space for the entire family. The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm.

Sleeping arrangement -

The family altogether sleeps inside the main room. The children sleep on the floor mat while Mr. and Mrs. Panadero sleep on the bed.

Adequacy of furniture -

They have furniture. There is a television set and DVD player but it is broken. They have few kitchen utensils. A dining table and wooden chairs, they have a wooden cabinet wherein they place or keep their clothes and other things.

Presence of insects and rodents -There were cobwebs noted at their ceilings. There were mosquitoes in the kitchen and their bedroom. There are also small rats and ants noted. It is highly possible for insects to get in because their windows are not screened.

Presence of accident hazards -There are large and sharp stones outside their door. Marj verbalized “nadagma dra akong anak, naigo sa bato unya nasamad ang ulo”.

14

Food storage and cooking facilities -There is no proper food storage. They have no refrigerator; they store their fresh meats on their mother’s refrigerator. We also noticed the cooking utensils such as plates & cooking pan left unwashed in the washing area. They are using wood and charcoals for cooking. Water supply -They get their water supply in water district. This is where they use for taking a bath, washing clothes and use for cooking. In terms of paying they pay their own water bill. Toilet facility -

The toilet is privately owned and is located inside their house. It is approximately 80x210x300 cm. The toilet is not that clean. The walls of the toilet room are covered with sacks. The type of toilet is an open pit.

Garbage disposal -

There

is

exposed

garbage in plastic

cellophane

mixed with

biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane. There is garbage collector that makes rounds every week. The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present.

Drainage System -

The type of drainage system they have is an open pit.

KIND OF NEIGHBORHOOD The houses in the community are not congested. They are spaced adequately. The Panadero family lives in a peaceful community. Whenever they need something like they need to put their fresh meats in a refrigerator their neighbors would let them

15

store their food in their refrigerator. Since some of their neighbors are their relatives, they sometimes watch TV in their relative’s house.

SOCIAL AND HEALTH FACILITIES Health Center is present where immunizations and check-ups are rendered. Subasta also houses the Subasta Elementary School wherein almost all of the children study. The community has a basketball area and a chapel that is used by the people for recreation and official activities. There are also several sari-sari stores in the area wherein they could buy the things they need.

COMMUNICATION AND TRANSPORTATION FACILITIES AVAILABLE They own a motorcycle which serves as their transportation and also to earn a living. They have their television but it is broken.

D. HEALTH ASSESSENT OF EACH MEMBER

FAMILY MEMBER Homer Panadero Marj Panadero Bart Panadero Maggie Panadero Stewie Panadero

FAMILY MEMBER Homer Panadero Marj Panadero Bart Panadero

WEIGHT

HEIGHT

59kg 20kg 20kg 11kg

156cm 115cm 85cm

Blood pressure 140/100

16

Maggie Panadero Stewie Panadero Mrs. Panadero has an undiagnosed hypertension. After taking her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.”

17

LOLA AMPARO DECEASED HYPERTENS ION

MAMA ELIZABETH HYPERTENSIO N

G E N O G R A M MATERNAL

ALVIN DECEASED HYPERTENSION

LOLO MINOY DECEASED

ANNABELLE

JEANETTE

PAPA ROGELIO HYPERTENSION

ARLIE

JONREY ROJELISA

LOUIE

Marge HYPERTENS ION

LEAH

Bart Maggie

18 PATERNAL LOLO DECEASED DIABETES

LOLA DECEASED OLD AGE

NIN

JUN DECEASED HYPERTENSI ON

ABRAHAM DECEASED HYPERTENSI ON

NINING

MAMA NOEMI HYPERTENSIO N

PAPA JAIME SR.

Homer.

WILSON

29 Y.0

26 Y.O

MAILAH 12 Y.O

Stewie

T Y P O L O G Y

19 DATE

CUES

FIRST LEVEL ASSESSMENT

SECOND LEVEL ASSESSMENT

(Health Problem)

(Family Nursing Problem)

HEALTH THREAT November 13, 2010

November 13, 2010

• The Panadero family is Inadequate living space for a family of living in a house where five members. there is an inadequate space for household members. • The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm. • The family altogether sleeps inside the main room. The children sleep on floor mat while Mr. and Mrs. Panadero sleep on the bed. • Presence of vectors Poor environmental sanitation due to: such as flies and

• Inability to provide a home environment conducive to health maintenance and personal development due to inadequate family resources specifically financial constraints.

•Inability to make decisions with respect to taking appropriate health

20 mosquitoes as well as a. Presence of breeding and their breeding places like resting sites for flies and used cans, bottles and mosquitoes. drums. b. Unsanitary food storage c. Unsanitary cooking facilities • Exposed garbage in plastic cellophane mixed with biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane. • Noticeable dirty sink and cooking area. • Pots and pans are not washed properly and are kept at their cooking area which is an open area. • Flies are evidently noticed over the cooking facilities and foods. • Uncovered container particularly filled with water seen near the toilet facility • Presence of flower pots that collects rain water • Mrs. Panadero verbalized “daghan lamok diri sa amoa, tungod siguro ni sa mga cacao” • Absence of a Lack of food storage facilities manifested by uncovered food on the refrigerator. • Food supplies need to table be bought daily. • Mrs. Panadero

action due to: a) Failure to comprehend the magnitude of the condition. b) Low salience of the condition. c) lack of knowledge on the consequences of the problem.

•Inadequate family resources, specifically due to financial resource and physical facilities, i.e living space and water supply.

21

•

•

November 13,

•

2010

•

•

verbalized “sa lamesa lang ginatakluban ang sobra na pagkaon. Wala man gud mi ref.” No food storage facilities such as plastic container or tupperwares, refrigerator and etc. Mrs. Panadero verbalized “maulaw mi muadto sa Barangay Health Center para makakuha ug libre na tambal ug check-up” “kung nay magkasakit naga palit ra mi ug tambal sa botika.”

community

•Failure to utilize community resources for health care due to: a) Failure to perceive benefits of health care

Self-medication as unhealthy lifestyle and personal habits or practices as health threat.

•Inabilty to recognize the presence of the problem due to: a) Ignorance of facts

Failure to utilized resources for health care

“ gapalit pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura ug ubang sakit2x”

The house is made of Presence of fire hazards wood • Cooking facilities are improperly kept outside the house. • The cooking area is

•

Inabilty to make decisions with respect to taking appropriate health actions due to:

a) Failure to comprehend the nature or magnitude of the problem b) Low salience to the problem •Inabilty to make decisions with respect to taking appropriate health actions due to: a) Failure to comprehend the nature

22

November 13,

•

2010

•

just inches away from the house The family has no Improper garbage disposal. proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present. Biodegradable and non-biodegradable garbage are not properly segregated.

• Mr. Panadero Unhealthful lifestyle and personal due to smokes and drinks habits/practices cigarette/tobacco smoking occasionally

or magnitude of the problem b) Low salience to the problem •Inability to make decisions with respect to taking appropriate health action due to: a)Failure to comprehend the magnitude of the condition.

b)Low salience of the condition.

•Inability to recognize the presence of the problem due to ignorance of facts and attitudes. •Inability to make decisions with respect to taking appropriate health action due to: a) Failure to comprehend the magnitude of the condition. b) Low salience of the condition.

November 13, 2010

• Water overflows Improper drainage system easily when it rains. • The sink of the kitchen area in the house is directly connected to the drainage system. All

•Inability to recognize the presence of the problem due to ignorance of facts and attitudes. •Inability to make decisions with respect to taking appropriate health action due to:

23 of the wastes are directly thrown in the drainage system.

d) Failure to comprehend the magnitude of the condition. e) Low salience of the condition.

HEALTH DEFICIT November 13, 2010

• Mrs. Panadero has an Presence of health deficits: undiagnosed a) Undiagnosed hypertension. After taking Hypertension her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.”

DATE

CUES

•Inability to make decisions with respect to taking appropriate health action due to: b) Failure to comprehend magnitude of the problem. c) Low salience of health maintenance. d) inaccessibility of appropriate resources of care, specifically: a. Physical inaccessibility. b. Cost constraints.

FIRST LEVEL ASSESSMENT

SECOND LEVEL ASSESSMENT

(Health Problem)

(Family Nursing Problem)

HEALTH THREAT November

• The Panadero family Inadequate living space for a

• Inability to provide a home

13, 2010

is living in a house family of five members.

environment conducive to health

where

there

is

an

maintenance

and

personal

inadequate space

for

development due to inadequate

24

household members.

family

• The house consists

financial constraints.

of

a

multifunctional

room because the room serves

as

their

bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking separated

facility

is

from

the

house located few feet away which has a floor area of 83cm x 110cm x 300cm. • The family altogether sleeps inside the main

resources

specifically

25

room.

The

children

sleep on the bed while Mr. and Mrs. Panadero November

sleep on the floor mat. • Presence of vectors Poor environmental sanitation due

13, 2010

such

as

and to:

flies

mosquitoes as well as their

breeding

places

like used cans, bottles and drums. • Exposed garbage in plastic

cellophane

mixed

with

biodegradable and nonbiodegradable.

Flies

and rodents are seen around

the

garbage

plastic cellophane. • Noticeable dirty sink and cooking area. • Pots and pans are not

washed

properly

•Inability to make decisions with respect to taking appropriate health

d. Presence of breeding and resting sites for flies and mosquitoes. e. Unsanitary food storage f. Unsanitary cooking facilities

action due to: f) Failure to comprehend the magnitude of the condition. g) Low salience of the condition. h) lack of knowledge on the consequences problem.

of

the

26

and are kept at their cooking area which is an open area. • Flies

are

evidently

noticed

over

the

cooking

facilities

and

foods. • Their water supply which is put in a water container is junked in the kitchen area and some are not covered well. • Absence

of

a Lack of food storage facilities

•Inadequate

family

refrigerator.

specifically

•

Food supplies need

resource and physical facilities, i.e

•

to be bought daily. Mrs. Panadero Failure

living space and water supply. •Failure to utilize community

verbalized mi Center

utilized

community

“maulaw resources for health care

muadto

Barangay

to

sa Health para

makakuha ug libre na

due

resources, to

financial

resources for health care due to: b) Failure to perceive benefits of health care

27

November

tambal ug check-up” “kung nay Self-medication

•

13, 2010

magkasakit

as

unhealthy

naga lifestyle and personal habits or

•Inabilty to recognize the presence of the problem due to:

palit ra mi ug tambal practices as health threat.

b) Ignorance of facts

sa botika.” •

“ gapalit pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura ug

•

Inabilty to make decisions with respect to taking appropriate health actions due to:

ubang sakit2x” c) Failure to comprehend the nature or magnitude of the problem d) Low • •

The house is made Presence of fire hazards

problem •Inabilty to make decisions with

of wood

respect to taking appropriate health

Cooking facilities are

actions due to:

improperly

kept

outside the house. •

salience to the

The cooking area is just inches

away

from the house

c) Failure

to

comprehend

the

nature or magnitude of the problem

28

•

November 13, 2010

The family has no Improper garbage disposal.

d) Low salience to the problem •Inability to make decisions with

proper container for

respect to taking appropriate health

their

action due to:

garbage

wastes. They just put

in

plastic

cellophane

where

flies

it

and

a)Failure to comprehend the magnitude of the condition.

rodents

are present. •

Biodegradable and

b)Low salience of the condition.

non-biodegradable garbage

are

not

properly •

segregated. Mr. Panadero Unhealthful lifestyle and personal

smokes

and

occasionally

drinks habits/practices

due

cigarette/tobacco smoking

to

•Inability to recognize the presence of the problem due to ignorance of facts and attitudes. •Inability to make decisions with respect to taking appropriate health action due to: a) Failure

to

comprehend

magnitude of the condition.

the

29

b) Low salience of the condition. November

•

13, 2010

overflows easily when it

of the problem due to ignorance of

rains.

facts and attitudes.

Improper drainage system

Water

•Inability to recognize the presence

•

The sink of the

•Inability to make decisions with

kitchen

area

respect to taking appropriate health

house

is

connected

in

the

directly to

action due to:

the

i) Failure to comprehend the

drainage system. All of

magnitude of the condition.

the wastes are directly

j) Low salience of the condition.

thrown in the drainage system. HEALTH DEFICIT November

• Mrs. Panadero

13, 2010

an

has Presence of health deficits:

undiagnosed

hypertension. taking

After

her

pressure

blood

during

e) Undiagnosed Hypertension

•Inability to make decisions with respect to taking appropriate health action due to: f) Failure

to

comprehend

our

magnitude of the problem.

home visit, her blood

g) Low salience of health

pressure was 140/100. She

also

verbalized

“naa sa among lahi ang

maintenance. h) inaccessibility

of

appropriate resources of

30

high

blood.

Pirminte

care, specifically:

naga taas akong dugo

c. Physical inaccessibility.

labi na kung kapuyon

d. Cost constraints.

ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init

ug

kakapoy

sa

trabaho.”

F A M I L Y

C O P I N G

I N D E X

31

DATE

COPING AREA

RATING

JUSTIFICATION

HEALTH EDUCATION DATE

FINAL

JUSTIFICATION

SCORE N O V E M B E R

1

PHYSICAL INDEPENDENCE

3

All the family members

• Educate the family

N

the importance of

perform activities of daily

good personal

living and are able to

hygiene as

move about

evidenced by

independently. However,

having trimmed

during visits, some

nails since

members of the family

untrimmed nails

are with dirty clothes on,

may harbor

and unclean, long nails.

microorganisms

These signify that there

and these may be

is only a partial provision

induced through the

care as evidenced

of basic care to the

mouth.

by trimmed finger

members of the family.

• Advise members of

O V E M B E R

2

clean clothes to

5

microorganisms that could cause them illness.

capacity to move and perform physical activities within their physical limits such as walking, and personal grooming. They now receive the necessary health

and toe nails, and wearing of clean

avoid harboring 2

The family has the

have the ability to

the family to wear 3

5

2

clothes.

32

0 1

0 THERAPEUTIC INDEPENDENCE

0

3

The family visits the

• Encourage the

1

5

There was a

health care

family to seek for

professionals and avails

professional help

the health care services,

for illnesses which

the family’s

such as for Bart’s colds.

you are not sure of

therapeutic

They also carry out

the cause and cure.

independence.

some needed

• When taking

significant 0

improvement on

They verbalized

medications. Aside from

medications on

that Bart was

that, the family is

their own, it is

already scheduled

practicing self-

important that they

to visit the health

medication as evidenced

have general

center and they

by the usage of

knowledge on when

emphasized that

unrecalled medicines

and how to take

they will do this as

they received from the

them. Educate the

soon as possible.

Health Center. They use

family on the right

The family was

herbal medicines like

time to take their

able to include

“tawa-tawa” when a

medicines and

that they now

member of the family

symptoms that they

became

experiences fever but

need to be aware of

conscious when it

they don’t know the

so as to avoid

comes to giving

specific use and

further

self-medications.

33

preparations.

complications.

They watch out

• Explain to the family

for some

that “tawa-tawa” is

unusuallities that

not approved by the

may occur after

Department of

they give the

Health as one of

medicines. They

the 10 Herbal

are also aware of

Medicines and it

the fact that most

needs further study.

medications should be taken with plenty of water and with a full stomach.

KNOWLEDGE

3

The family has some

• Educate the family

5

They now know

OF HEALTH

general knowledge

with regards to

what to do if one

CONDITION

about certain illness and

common diseases

of them suffer

conditions. Marge had

such as cough and

from colds or

her children immunized

colds.

cough. They were

at the health center.

• Frequently visit to

also taught with

34

However, they are not

health centers and

the ten approved

aware of the underlying

other medical

herbal medicines

principles and the care

institutions.

and showed

of illness. For example,

• Encourage them to

hypertension which they

have Marge and

for they were

know that is very

Bart’s health be

asked questions

common in their family

checked at the

regarding the

and they had not taken

health center to

herbal medicines

preventive actions yet.

know if they have

and were able to

hypertension.

answer them. In

• Teach them how to

comprehension

addition, they also

use the ten

said that they are

approved herbal

going to take

medicines by the

necessary action

DOH.

at right time if they have already observed significant symptoms of a disease. They are starting to avoid foods that can

35

trigger hypertension.

APPLICATION

3

The family secured initial • Advise the family to

5

The family is able

OF PRINCIPLES

immunization to the

observe proper

to follow the

OF PERSONAL

children. Though all the

hygiene to maintain

health teachings

AND GENERAL

members have adequate

health such as

that were taught

HYGIENE

sleep, there is an

bathing everyday

to them. The

inadequate and

and proper hand

members are now

improper safe

washing before and

observant in their

homemaking habits in

after eating, in

personal hygiene.

relation to storing and

preparing and

They now always

preparing foods. They

handling meals and

take a bath at

only store them in plastic

after going to the

least once a day

containers since there is

toilet.

and wash their

no refrigerator is

• Emphasize the

hands when they

available. They have no

importance of

handle things that

proper ventilation

cleaning their

may contaminate

because when they

surroundings to

them such as

36

cook, the smoke enters

avoid pests and

when they use the

their house. Also, the

rodents in their

toilet, before and

house and its

environment.

after eating and

surroundings are not

• Instruct them to

when handling

properly maintained and

properly store the

meals. They are

cleaned.

food in sealed

now conscious

plastic containers.

with their

• Encourage to

environment and

always wear

they show this by

slippers to protect

always cleaning

their feet from the

the inside and

microorganisms on

outside of their

the ground.

house. They now also have a proper food cover to protect their left-over and some containers that are more secured than before if not, they use the

37

refrigerator of their neighbor to store food. They are also observed in wearing their slippers. HEALTH ATTITUDES

3

The family accepts

• Encourage the

5

Significant

health care in some

family to give

changes occurred

degree. However, they

importance to

after the family

have some reservations.

follow-up check-up.

received the

They accept the need for • Explain the

health teachings.

medical care and the

importance of

They are now

services offered, yet

follow-up check-up

aware of the

they do not have follow-

for the proper

possible

up check-up afterwards.

treatment of the

consequences

illness.

that they may face

• Inform that signs

if they do not

and symptoms

submit

should be observed

themselves for

and reported so

follow-up check-

that complications

up. They also

could be avoided.

verbalized that

38

• Advise the family to

their confidence

visit the health

towards

center to lessen

healthcare

their anxiety and to

professionals has

gain information

now increased.

when illness occurs. • In order to assist with the financial conditions of the family, inform them of the benefits that they can get from their health center.

EMOTIONAL COMPETENCE

5

All the members of the

• Advise the family

5

The family as a

family are able to

that emotional

whole has grown

maintain a degree of

stability will aid

to become more

calmness. They consider

them to decide on

emotionally

the needs of other

matters with

competent. They

members of the family

confidence.

verbalized that

as well as the

arguments within

39

FAMILY LIVING PATTERNS

3

community. However,

them have now

the couple seems to

become less

argue over their financial

serious and less

problems.

frequent.

The family does things

• Guide the family to

5

The family was

together and shared

budget their income

able to share their

their tasks at home.

for future purposes

tasks at home.

However, there are also

such as illnesses

There was also a

conflicts due to financial

that may come in

decreasing

problems as verbalized

unexpected times,

frequency and

by the mother. Also,

education and food

seriousness of the

most of the family

supply.

arguments that

members are unable to

• Be aware of the

occur within them.

finish high school and

activities in every

They now talk

they have low academic

member of the

things out in order

competence.

family.

to come out with

• If it would be

sound decisions

possible, do self-

for the whole

education by

family.

reading books with their children.

40

PHYSICAL ENVIRONMENT

1

The house is in poor

• Cleanliness should

3

The neighborhood

condition. The floors are

be observed to

is congested and

not cemented and

shun insects and

the air in their

unsafe for the children,

rodents.

environment is not

windows are

• Compost pit is also

polluted. The

unscreened, cooking

advisable for waste

cleanliness of the

facilities and toilet is not

disposal. Instruct

house has

in good condition. They

them to do waste

improved

have no proper

segregation.

significantly yet

ventilation for cooking.

• The house should

there were still

Rodents and other

be repaired well for

some accident

insects are also present

the safety of the

hazards present.

which serves as hazards

family. If is

to the members of the

impossible to

family. Aside from that

cement the entire

the living space is too

house, advise them

small for the family of 5

to screen some

members. Furthermore,

areas for the

there are a lot of

protection of the

accident hazards inside

family members.

and outside the family

• Maintain the

41

such as the stairs that

cleanliness of their

may cause untoward

surroundings.

accidents, and unsafe

Regularly check

for children. They also

and clean the toilet

have a poor backyard as

and cooking

evidenced by the

facilities.

garbage scattered there;

USE OF

3

• Have a proper

a few meters away,

ventilation for

scattered dry leaves,

cooking so as not

muddy area, pieces of

to suffocate the

rotten wood and

members of the

untrimmed grasses.

family.

They are aware of the

• It would be

3

They are still not

COMMUNITY

services offered in their

beneficial to

active in the

FACILITIES

community and use

participate in

community

some of these such as

community activities,

gatherings. When

immunizations for the

such as GKK

there was a health

children. However, at

gatherings, fiesta,

class about

certain times, they are

and other programs

nutrition

unable to avail the

offered by the

conducted at the

services offered since

Baranggay officials.

school gym, the

they are busy because

• Provide referrals for

mother was

42

of work. They don’t

the family about the

present in order to

attend seminars

services offered by

learn from the

conducted by the

the health care

seminar but after

Baranggay.

center.

the next health

• Encourage the family to continue utilizing the available facilities and resources in the community.

class she was not present.

43

P R I O R I T I Z A T I O N O F

P R O B L E M S

INADEQUATE LIVING SPACE CRITERIA NATURE OF THE

COMPUTATION

ACTUAL

JUSTIFICATION

2/3 X 1

SCORE 0.66

There is a possibility of

PROBLEM

acquiring communicable diseases when a family member is sick. As the children grow older, the more the congested they

MODIFIABILITY

1/2 X 2

1

OF THE PROBLEM

are. It is partially modifiable because the family doesn’t have enough income to expand their home. However, the furniture can be arrange to allow more

PREVENTIVE

3/3 X 1

1

POTENTIAL

space. Increasing the living space provides privacy and reduces possibility of accidents and transfer of

SALIENCE OF THE

1/2 X 1

0.5

PROBLEM

communicable diseases. The family sees it as a problem. However, it does not see the problem as needing immediate action.

TOTAL SCORE:

3.16

44

LACK OF FOOD STORAGE FACILITIES CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION The problem is a health threat that requires action in order to avoid possible health problems from lack

MODIFIABILITY

1/2 X 2

1

OF THE PROBLEM

of food storage. The problem is partially modifiable since the family could make use of various improvised ways of temporary food storage. The best possible solution to this problem would be to increase their finances in order to purchase more efficient storage

PREVENTIVE POTENTIAL

3/3 X 1

1

devices. Acquiring proper food storage facilities will help prevent the family from acquiring communicable

45

diseases, prevent food poisoning and spoilage as well as save family SALIENCE OF THE

2/2 X 1

1

PROBLEM

resources. The family seems to recognize the some disadvantages of not being able to preserve their food.

TOTAL SCORE:

3.66

FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION It is a health threat because this condition is a hindrance to the realization of one’s health potential. It also obstructs the members of the family from achieving their optimal health

MODIFIABILITY OF THE PROBLEM

2/2 X 2

2

potential. It is modifiable because the family can avail freely to the resources that barangay health

46

center gave to PREVENTIVE

3/3 X 1

1

POTENTIAL

them. Utilizing community resources for health care can help lessen the cost of the medicines or treatments. This will also make the family be more aware of

SALIENCE OF THE

0/2 X 1

0

their health status. The family doesn’t

PROBLEM

see this as a problem. TOTAL SCORE:

3.66

SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION It is a health threat because when the family doesn’t know principles of right medication (dosage, route, frequency), instead of recovering from the disease/illness this could worsen this

MODIFIABILITY OF THE PROBLEM

2/2 X 2

2

condition. It is modifiable because the check-

47

ups in the clinic/health center are free for them and they can avail it PREVENTIVE

2/3 X 1

0.66

POTENTIAL

anytime they want. The family needs to be informed about the right medications or treatments on certain health problems, by this way they would know the proper medication must be

SALIENCE OF THE

0/2 X 1

0

PROBLEM

given. The family doesn’t view it as a problem.

TOTAL SCORE:

3.32

PRESENCE OF FIRE HAZARDS CRITERIA NATURE OF THE PROBLEM

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

JUSTIFICATION It is a health threat because this has the potential to cause future accidents, particularly firerelated incidents, if

48

not immediately MODIFIABILITY

1/2 X 2

2

OF THE PROBLEM

resolved. The problem is partially modifiable because even though there are immediate interventions that can be done the family do not have the income to modify this problem and they have a hard time thinking of an alternative

PREVENTIVE

3/3 X 1

1

POTENTIAL

interventions. The preventative potential is high if safety measures and precautions are promoted in the family. Elimination of fire hazards will also reduce the risk of injury and subsequent family stressors due to fire-

SALIENCE OF THE

0/2 X 1

0

PROBLEM

related accidents. The family doesn’t view this condition as a problem.

TOTAL SCORE:

2.66

49

IMPROPER GARBAGE DISPOSAL CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION It is a health threat because the manner in which they dispose of their waste can be detrimental to their health which is conducive to

MODIFIABILITY

1/2 X 2

0.50

OF THE PROBLEM

disease. It is partially modifiable because they do not know the proper disposal

PREVENTIVE

3/3 X 1

1

POTENTIAL

of garbage. The preventative potential of the problem is high, since the implementation of proper waste disposal will prevent the formation of possible reservoirs

SALIENCE OF THE PROBLEM

0/2 X 1

0

of disease. The family does not perceive the waste disposal as a problem and are content with their method since it

50

saves time and energy. TOTAL SCORE:

2.16

UNHEALTHFUL LIFESTYLE AND PERSONAL HABITS/PRACTICES CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION It is a health threat since unhealthy lifestyle can greatly affect the health of

MODIFIABILITY

1/2 X 2

1

OF THE PROBLEM

the family. It is partially modifiable because the family has to change their lifestyle to prevent acquiring

PREVENTIVE

2/3 X 1

0.66

POTENTIAL

illnesses/diseases. The preventive potential is moderate because the family needs to understand the bad effects of unhealthy lifestyle. They have to start changing their lifestyle within

SALIENCE OF THE PROBLEM

1/2 X 1

0.5

themselves. The family sees it as a problem but doesn’t need immediate

51

action. TOTAL SCORE:

2.82

IMPROPER DRAINAGE SYSTEM CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

PROBLEM

JUSTIFICATION It is a health threat since it can cause diseases to the members of the household and It can also be potential breeding place for insects

MODIFIABILITY

1/2 X 2

1

OF THE PROBLEM

and rodents The lack of funds and facilities as well as man power makes this only partially

PREVENTIVE

2/3 X 1

0.66

POTENTIAL

modifiable. The preventative potential of the problem is moderate, since the establishment of a proper drainage system will prevent the formation of possible reservoirs

SALIENCE OF THE

0/2 X 1

0

of disease. The family does not

52

PROBLEM

perceive drainage as a problem. TOTAL SCORE:

2.66

UNDIAGNOSED HYPERTENSION CRITERIA NATURE OF THE

COMPUTATION 3/3 X 1

ACTUAL SCORE 1

PROBLEM

JUSTIFICATION It is a health deficit because if the illness will not be treated, it could get

MODIFIABILITY

1/2 X 2

1

OF THE PROBLEM

worse. Problem is partially modifiable because it is dependent on Mrs. Marj compliance to the health teachings given to him to alleviate discomforts felt such as headaches and giving priority and importance to such

PREVENTIVE

3/3 X 1

1

POTENTIAL

health problem. The possibility of complications of hypertension can be prevented if health

SALIENCE OF THE

1/2 X 1

0.5

actions are done. The family sees it as

53

PROBLEM

a health problem but is not considered as the priority among the family’s problems. TOTAL SCORE:

3.5

Presence of resting sites of vectors of diseases such as insects and rodents CRITERIA NATURE OF THE

COMPUTATION 2/3 X 1

ACTUAL SCORE 0.66

JUSTIFICATION The problem is classified as a health

PROBLEM

threat because this condition is conducive

MODIFIABILITY

2/2 X 2

2

to disease. It is easily modified since it

OF THE PROBLEM

only needs effort, knowledge, and cooperation of the PREVENTIVE

3/3 X 1

1

family. If proper sanitation of environment is

POTENTIAL

practiced, diseases and infection can be prevented. SALIENCE OF THE PROBLEM

1/2 X 1

0.5

The family is aware of the existing potential of a health threat

54 but they are taking this as problems that need not much attention and immediate action.

TOTAL SCORE:

4.16

THE PRIORITIZED NEEDS

PRESENCE OF RESTING SITES OF VECTORS OF DISEASES SUCH AS INSECTS AND RODENTS

4.16

LACK OF FOOD STORAGE FACILITIES

3.66

FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH

3.66

SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES

3.32

INADEQUATE LIVING SPACE

3.16

UNDIAGNOSED HYPERTENSION

3.5

UNHEALTHFUL LIFESTYLE AND PERSONAL HABITS/PRACTICES

2.82

PRESENCE OF FIRE HAZARDS

2.66

IMPROPER DRAINAGE SYSTEM

2.66

IMPROPER GARBAGE DISPOSAL

2.16

55

56

F A M I L Y

N U R S I N G

C A R E

P L A N S PRESENCE OF RESTING SITES OF VECTORS OF DISEASES SUCH AS INSECTS AND RODENTS Cues

Health Proble m

Subjecti Presenc ve e of resting “”dagh sites of angyud vectors dinhisa of amoa, diseases siguros such as a cacao insects ningaka and hoy” rodents Objecti ve

Family Nursing Problems

Goal of Care

Objective s of Care

Nursing Intervention

 Inability to perform appropria te health actions due to: A. Lack of knowledge in identifying possible unwanted outcomes. B. They do not have control

After nursing intervent ions, the family will be able to recogniz e and perform appropri ate measure s in order to

After nursing interventio n, the family will: A. Understan d the effects of the presence of breeding sites in the area.

1. Inform the family members the possible consequences of neglecting the problem of rodents and insects inside their home R: In order to inform the family about the problem and broaden

Meth od of Nurs e Famil y Cont act H O M E V I S I T

Resourc Evaluation es Required

Material Goal Resource achievement s on process  Th ey need the followi ng materi al s in order to get rid or

The family was able to learn the importance of preventing the formation of breeding sites of vectors however; they are still

57

 P resen ce of mosq uitoe s insid e and outsi de the hous ehold .  U ncov ered conta iners partia lly filled with water seen near the toilet facilit y.  P resen ce of

over the situation.  Inability to provide a healthy environm ent due to financial crisis.

minimiz e or prevent the formatio n of breeding sites of vectors.

B. will be able to spot the places in their house where insects and pests reside. C. Implement agreed upon measures to reduce the breeding sites of vectors in their environme nt.

their knowledge about it. 2. Discuss to the family ways on how to promote proper extermination of pests. R: For the family to avoid from getting diseases. 3. Explain to them the importance of having a clean and pest free living environment. R: To provide them a healthy environment and to maintain their area clean. 4. Teach the family how to get rid of the insects and rodents in

lessen pests inside their house: Mouse traps, mosquito nets, “katol” or bug spray.  Hu man Resou rces Time and effort of the nurse and cooperati on of the family. Financial Resource s  M oney

on the process of fully implementing such preventive measures in their environment.

58

flowe r pots that colle ct rain water .

their house. R: Rodents and insects are carriers of certain diseases. 5. Assess the house for any openings where rodents or insects may enter. R: To be able to know where the portal of entry of rodents and insects for repair. 6. Explore for home remedies for pest control. R: To be able to help the family find cheaper materials if they have financial constraints. 7. Search the house for

for the transp ortatio n of the nurse and the mone y for the family to buy materi als to exter minat e pests.

59

likely breeding sites like dark corners or stagnant water etc. R: To be able to find the source of the pests to eliminate them completely. 8. Encourage them to maintain proper environmental sanitation. R: proper sanitation measures serve as a safeguard to various illnesses.

60

LACK OF FOOD STORAGE FACILITIES

Cues

SUBJECTI VE:

Health Family nursing problem problem

Lack of food storage Mother facilities verbalized, manifest “SA ed by lamesalan uncover gginabuta ed food ngangsubr left on anapagka the on, wala table. man gud me ref.” OBJECTIE : NO food storage facilities such as plastic

Inability to recognize the presence of a problem due to economical constrains.

Goal of care

Objectives Nursing of Care Intervention

Metho Resourc Evaluation d of es Nurse Required Family Conta ct

After 12 days of communit y exposure, the family will be able to provide storage facilities for their food.

After 12 days of community exposure, the family will be able to:

Home visit

1, discuss with the family the importance of maintaining a conducive environment for health Find maintenance alternative such as food having storage storage facilities by facilities. improvising R: Proper and food storage recycling facilities used cans, contribute in plastic ensuring the containers; safety of the asking food from consumed by someone the family,

Human resources : -time and effort of both the nurse and family -people who could give unused tin cans, container s, etc. cooperati on of the members of the

GOAL ACHIEVEM ENT IN PROCESS. Although the family was able to recognize potential health conditions that might occur if food will be contaminat ed due to improper storage, however they haven’t

61

containers , refrigerato r, ect. Noted

who might give; or buy a new but cheap one.

thus contributing directly to their health. 2, Cite the possible Recognize diseases that potential members of health the family will condition acquire such that might as diarrhea, occur if parasitism, food will be ect. And the contaminat possible food ed due to poisoning If improper foods will be storage. contaminated or spoiled due to improper storage. ®harmful pathogens that could cause a variety of infections such as diarrhea, etc. are likely to be found in contaminated foods. This

barangay health team, particularl y the barangay health workers. Material sources: -food, storage facilities, bought or recycled. Financial resources : -money for the nurse transport ation -money if food storage facilities are going to be bought.

found alternative food storage facilities yet.

62

could also cause poisoning. 3. Identify the family’s reason for the lack of food storage facilities. ®identifying the motives behind the identified problem aids in coming up with appropriate solutions. 4. recognize how the family perceives the problem. ®knowing if the family’s concern with the identified problem could enhance the family’s participation in solving the

63

problem. 5. identify measures that have been implemented to alleviate the problem or see if there is any. ®for the student nurse to have an idea with what measure still needs to be implemented and what measure implemented by the family needs to be continued. 6. explore with the family the courses of action available for them to solve the problem specifically:

64

a. using recycled tin cans, plastic containers, used plastic jars as food storage facilities. ®to provide materials that are free without the need of spending money. b.looking for people whom they could possibly ask the above mentioned items. ®identifying possible people who could help in obtaining the necessary materials will be of help to save time.

65

FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH

cues

subjective :

Health proble m

Family Nursing Problem

Failure A. Failure to to perceive utilized benefits of ‘maulaw commun health care mi adto sa ity due health resource center kay s for B. Inadequa bag’o ra health te man gud care knowledge mi nag about the renta ug available balay diri.” community resources of health care.

Goal of care

Objective of care

After 8 hours of Nursing Interventio ns, the family will be able to verbalized understan ding about the benefits they can get in the communit y health center.

After 8 hours of nursing interventio ns, the family will be able: A. To verbaliz ed underst anding about the availabl e commu nity resourc es for health.

Nursing Intervention s

Metho d of Nursin gFamily Conta ct a.Educate the H family about the O beneficiaries of the M available community E health resources. V Rationale: To give I further information S about the benefits of I available community T health resources. B. Introduce

Resourc es required

evaluation

Human resource s:

Goal met.

Time and effort of both the nurse and the family Knowled ge of the Nurse he/she could impart Financial resource s: expenses

The family is now aware that they can avail the government programs offered in their community.

66

B. Lear n further informat ions about availabl e health services .

to the family the government programs offered in the community. Rationale: To let the family sort the available health services regarding to their needs. C. Inform the family that they can avail the services offered in the community. Rationale: it will help them gain confidence to seek help and avail the health facilities in their community.

on trasportat ion

67

SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES

Cues

Health Proble m

Subjective Self: medicati on as “ kung unhealth nay y magkasak lifestyle it naga and palit ra mi personal ug tambal habits or sa practice botika.” s as health “ gapalit threat. pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura

Family Nursing Goal of Problem care

Objective of care

Inabilty to recognize the presence of the problem due to:

After 1 week of nursing intervention s, the family will be able:

A. Ignoranc e of facts Inabilty to make decisions with respect to taking appropriate health actions due to: B. Failure to compreh end the nature or magnitud

After 1 week Nursing Interventio ns, the family will be aware of the possible effects and complicati ons of selfmedicating ,

A. To recognize the importanc e of consultin g with health care providers. B. The family should

Nursing intervention

A. Inform the client about 10 herbal medicine s approved by DOH.

Metho d of Nurse Famil y Conta ct H O M E

Rationale:

V

Give them alternative medication that is assured and approved by DOH.

I

B. Inform the client

S I T

Resourc es required

Evaluation

Human resources :

Goal Met.

The family recognized Time and the effort of importance both the of nurse and consulting the family health care providers Knowledg as they e of the verbalized “ Nurse mas he/she nakablo could nami karon impart na importante Financial man gyud resources mag pa : consulta o expenses mag pa

68

ug ubang sakit2x”

e of the problem C. Low salience to the problem

not easily comply to any medicatio n without prescripti on of a health care provider.

the importanc e of having a consult action with a health care provider before using any medicatio n. Rationale: this will help the family be aware of what underlying condition

on check up.” trasportati on They also verbalized understand ing about using the 10 herbal medicines approved by DOH “ dili man diay tanan herbal medicines ky pwede lng gamiton.”

69

INADEQUATE LIVING SPACE

CUES

HEALT H PROBL EM Family Inadequ Verbalized ate living : space “Pasensya for a han niyo family of na among 5 balay kay member guot s. kayo” Objective: - The Panadero family is living in a house where there is an inadequat e space for household members. - The

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIV NURSING METH E OF CARE INTERVENTI ODS ON

RESOUR EVALUATI CES ON

Inability to provide a home conducive to health maintenance due to inadequate family resources, specifically limited financial resources.

Within one meeting of community exposure family will be able to maximize the living space without renovating the house.

After nursing intervention the family will be able to: a. obtain knowledge on what areas to maximize b. understand the importance of maximizing the living space. c. know the things that are important inside the house

Human resource s: • Ti m e an d eff ort of bo th th e nu rs e an d th e fa mil y

1. Establish rapport. R: To gain trust and cooperation of the family. 2. Teach the family on the importance of having adequate space. R: Having adequate space enables the family to move freely in their house. 3. Encourage the family to arrange their things properly to

H O M E V I S I T

GOAL MET After providing the appropriate nursing intervention s the family was able to: a. obtained knowledge on what areas to maximize b. understand the importance of maximizing the living space

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house consists of a multifuncti onal room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311 cm x 250 cm x 300 cm. They have a separate room for their comfort room which has a floor area 80 cm x 100cm x 300 cm. The

maximize their living space. R: Arranging things properly will maximize their living space. 4. Encourage to maintain the family size since they have inadequate space for living. R: Since the house is too small if they will add another member in their family the chances is they will be more crowded inside their house. 5. Instruct the family to dispose

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Kn ow led ge of th e nu rs e he /sh e co uld im pa rt

Financial resource s: • Ex pe ns es on tra ns po rta tio n

c. know the things that are important inside the house

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cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm. -The family altogether sleeps inside the main room. The children sleep on the bed while Mr. and Mrs. Panadero sleep on the floor mat.

unnecessary things in their house. R: Disposing unnecessary things will help them to maximize their house. 6. Instruct the family not to buy things that are unnecessary. R: If they will add more things in their house the chance is they will be fuller. 7. Instruct the family to clean always the house. R: Cleaning the house will prevent them from getting disease.

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C O N C L U S I O N The family Panadero cannot provide adequate resources for their needs because of their low income. They couldn’t even afford to buy a refrigerator to keep their food fresh. The family member, especially the children are susceptible to the disease that the rats, mosquitoes, and cockroaches may harbor because of the scattered garbage outside their house. Fire hazards in their home shows because cooking facilities are improperly kept outside the house and their house is made up of wood.

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R E C O M M E N D A T I O N The goal of Community Health Nursing is to aid the individual, family and community in acquiring their optimum level of holistic health. Promotion and preservation of health lifestyle and disease prevention through proper health teachings, appropriate application of health actions, community activities are some of the ways to build a stepping stone for the certain aims of Community Health Nursing. To fulfill the certain objectives the cooperation and collaboration of not only the assigned family, community but also with the barangay health officials and workers of Barangay Subasta are needed. The members of the group would like to recommend:

To the Clinical Instructors Despite the responsibilities given and the different pressures around, the clinical instructors still managed to overcome certain situations in the community with confidence and respect. They were willingly able to impart their vast knowledge and experiences regarding Community Health Nursing. They offered their uttermost guidance, patience, support and understanding that paved a way for the students to learn and apply those teachings given. Thus, the members of the group recommend the clinical instructors to continue their helpful acts that made them role models to different student nurses.

To the Barangay Health Officials and Workers

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To be able to help and provide proper health care and services, the workers of the Barangay Health centers should continue to portray being role models to the residents of the community. They should also be more open and accommodating in order to be effective health teachers. Lastly they should be updated with the latest studies and researches for prevention and the betterment of the quality of health services.

To the Panadero Family In order to acquire more knowledge regarding health, the family should engage in certain different programs that can serve as a basis in handling health matters at home. In certain situations which require appropriate health actions, decision-making is very crucial and the health of all the family members are at risk, the integration of promotion and maintenance of health are essential. If the family encounters a certain illness, they should go to the Barangay Health Center for proper consulation and diagnosis. The family should also be open to the suggestions and introduction of health teachings for them to practice regularly at home to manage good health conditions. Moreover, as concern and responsible residents of the community, the family should share and impart their newly acquired knowledge to their neighbors, friends and to the rest of the people in the community.

To the Student Nurses

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Exposures in the community strengthened the meaning of being a Student Nurse. It unlocks certain opportunities for the Student Nurses to handle real situations in the community and allow them to deal and interact with different types of families, and also apply Nursing knowledge and skill. In order to properly provide health actions, the student nurse should be patient and willingly able to assist in certain situations when required.

To the Members of the Group During the community exposure, responsibilities, hardships and obstacles are encountered but with patience and hard work everything may come to pass, along with the moral lessons. Hence , we encourage the members of the group to be dedicated in their work, working together as one and be open to suggestions from others. Unity acts as key to success, we should properly utilize this trait to achieve our objectives.