Family Nursing Care Plan & Community Dx

A Family Case Study of the A. Family

IN PARTIAL FULFILLMENT OF THE COURSE REQUIRMENT IN NCM 102 – RLE IN COMMUNITY HEALTH NURSING BACHELOR OF SCIENCE IN NURSING

Presented to the Faculty Of Manila Doctors College, College of Nursing

Buzon, Myra Katrina R. Caberte, Iris D. Jinno, Chieri D.

Group 31

March 2010 Acknowledgement The students would like to extend their profound gratitude to the following people who have generously shared their help in the completion of this study: First and foremost, God Almighty for giving us unending intelligence and strength to finish every task to facilitate and is dedicated for us to finish. Our parents for providing us their never ending support in this study. And last but not the least, to our clinical instructor, Mr. Nyl Rafols Patangan, RN, who is never weary of providing us encouragement and guidance all throughout the making of this study. He has always been accessible and approachable every time when we are in need of help.

Dedication This family nursing care plan is intended for the improvement and betterment in terms of health of our host family, the Atienza’s. We dedicate this presentation to their family who gave us their cooperation and whole-heartedly accepted our favour of giving us an ample amount of time for us to conduct our interviews and for responding to us with complete honesty. We give our full efforts to make this care plan the best and most appropriate one to improve their health. Lastly we ask God, the Father Almighty to always guide the Atienza’s in their future endeavours more practically in the terms of their health.

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Abstract A family nursing care plan is the blue print of the care that the nurse designs to systematically minimize or eliminate the identified health and family nursing problems through explicitly formulated outcomes of care (goals and objectives) nd deliberately

chosen

set of

interventions,

resources

and

evaluation

criteria

standards, methods and tools. Features of Family Nursing Care Plan: 1.

The nursing care plan focuses on actions which are designed to solve or minimize existing problem. The plan is a blueprint for action. The core of the plan are the approaches, strategies, activities, methods and materials which the nurse hopes will improve the problem situation.

2.

The nursing care plan is a product of a deliberate systematic process. the planning process is characterized by logical analyses of data that are put together to arrive at rational decisions. The interventions the nurse decides to implement are chosen from among alternatives after careful analysis and weighing of available options.

3.

The nursing care plan, as with all plans, relates to the future. It utilizes events in the past and what is happening in the present to determine patterns. It also projects the future scenario if the current situation is not corrected.

4.

The nursing care plan is based upon identified health and nursing problems. The problems are the starting points for the plan, and the foci of the objectives of care and intervention measures.

5.

The nursing care plan is a means to an end, not an end in itself. The goal in planning is to deliver the most appropriate care to the client by eliminating barriers to family health development.

6. Nursing care planning is a continuous process, not a one-shot-deal. The results of the evaluation of the plan’s effectiveness trigger another cycle of the planning process until the health and nursing problems are eliminated.

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Table of Contents Acknowledgement

1

Dedication

1

Abstract

2

Table of Contents

3

I. II.

Introduction

4

Background of Study 4-6 A. B.

Study Locale Spot Map

III.

Family Background 7

IV.

Socio-Economic Data 7

V.

Home and Environment 8

VI.

Family Functional Assessment by Gordons 9 - 15 A. B. C. D. E. F. G. H. I. J. K.

Health Perception-Health Management Pattern Nutritional Metabolic Pattern Elimination Pattern Activity and Exercise Cognitive Perception Sleep and Rest Self-Perception/Self Concept Role-Relationship Pattern Sexuality-Reproductive Coping Stress Tolerance Pattern Values Beliefs Pattern

VII.

Physical Examination 15 - 25

VIII.

Typology of Nursing Problems

26

A. 1st Level Assessment B. 2nd Level Assessment IX.

Problem Scoring

27 -28

4

X.

Priority Setting

29

XI.

Family Nursing Care Plan 32

30 -

XII.

Action Plans 35

33 -

XIII.

Evaluation

36

XIV.

Recommendation

37

Appendices 53 Appendix A Appendix B Appendix C I. Introduction

38 -

A family nursing care plan is the blue print of the care that the nurse designs to systematically minimize or eliminate the identified the identified health and family nursing problems through explicitly formulated outcomes of care (goals and objectives) nd deliberately chosen set of interventions, resources and evaluation criteria standards, methods and tools. The use of the family nursing process will result in a care plan describing the needs and care for each client. An organized sequence of problem solving steps used to identify and to manage the health problems of clients. II.

Background of the Study A. Study Locale About Barangay Talon Dos Barangay Talon Dos in the City of Las Piñas was created on April 3, 1978 by virtue of Presidentiable Decree No. 1335 signed by then President Ferdinand Marcos. Predominantly Residential Components The decree ordered that the subdivisions of BF resort, Sta. Cecilia, Sarino, Mother Earth and Camella be detached from the mother Barangay Talon to form Barangay Talon Dos. Today this Barangay is composed of 26 residential villages and sectors. Demography

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Talon Dos is one of the twenty barangays of Las Piñas City with a population of 47, 479 (2007 PopGen) and land area of 391.61 hectares. It is situated on the southern side of the midsection of Las Piñas. It is bounded on the north by ZapoteAlabang Road and Barangay Pamplona Dos; on the west by the Zapote River, Bacoor, and Cavite; on the east by Barangay Talon Cuatro and on the south by Barangay Talon Cinco. Health and Sanitation Barangay Talon Dos provides health and nutrition and social welfare services such as the Barangay Health Centers and Days Care Centers.

Barangay Health Centers Two health centers are found in BF Resort Village and Barangay Hall compound provide primary health care for minor medical and dental problems, immunizations and pre-natal care. Day Care Centers A Day Care Center is a community work place facility providing a full range of health, nutrition, early education, psychosocial and other services to children below 6 years old. Day care centers in Talon Dos are found in Carnival Park A and B, Manggahan, Satima and Vatican Dulo River Side. Feeding and Multivitamin Enhancement A barangay nutrition scholar and barangay health workers provide primary delivery of nutrition information and services in the

community

together

with

the

regular

feeding

and

multivitamin supplementation programs of the committee on health and sanitation. Anti-Rabies Vaccination To protect dogs and humans from the ill-effects of rabies, the barangay, in the cooperation with the Department of Agriculture conducts annual anti-rabies vaccination of dogs. Waste Management

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The proper management of solids and wastes protects public health and the environment; thus; Barangay Talon Dos does its part by composting and bio-digesting “wet garbage.” Talon Dos Waste Management Facility “Wet wastes” collected from homes by the barangay biomen are processed into compost as soil conditioners into biogas for cooking at the Waste Management Facility in BF Resort Village. The facility is a project of Sen. Manny Villar and Con. Cynthia Villar, in cooperation with Barangay Talon Dos and BF Resort Village Homeowners Association.

B. Spot Map

BARANGAY

TALON DOS

LAS PIÑAS

CITY

7

Figure 1

Talon Dos is one of the twenty barangays of Las Piñas City with a population of 47, 479 (2007 PopGen) and land area of 391.61 hectares. It is situated on the southern side of the mid-section of Las Piñas. It is bounded on the north by ZapoteAlabang Road and Barangay Pamplona Dos; on the west by the Zapote River, Bacoor, and Cavite; on the east by Barangay Talon Cuatro and on the south by Barangay Talon Cinco.

III.

Family Background The head of the family is Herminia D. Green. She was born on June 7, 1942 at Bulacan and is 67 years old. She is a Bachelor of Science in Education and was a former Filipino teacher. She currently earns income through a tricycle business. She owns three tricycles and earns money 8

through boundaries paid to her and usually owns P3, 000.00 a month. She owns a bungalow type house at #24 Alice Crisostomo St., BR Resort Village, Talon II, Las Piñas City. They have been living there for 15 years already. The primary dialect that they use is tagalong. They also use other dialects such as, English, Ilonggo, Bicol, and Kapampangan. Dante D. Atienza Jr. (Herminia’s son) is a 38 year old father of three children. He was born on May 19, 1971 and is 38 years old. He worked as an FX driver, but is currently not working. He is helping his wife managing the food store where his wife is working. His wife, Lucila S. Atienza, 47 years old, is a high school graduate who was born on October 30, 1963. She earns about P1500.00 a day (5 days a week). They have three children who are currently studying. Hannah Grace S. Atienza is their eldest daughter. She was born on August 7, 1994 and is 15 years old. She is a third year high school student at Saint Francis of Assisi College. Jay Marvin S. Atienza is the second among the siblings. He was born on December 12, 1995 and is 14 years old. He is a freshmen student at St. Mark’s Academy. The youngest of the sibling is John Oliver S. Atienza. He was born on November 3, 1996 and is 13 years old. All of them are Roman Catholics. IV.

Socio Economic Data According to the priorities for expenditure, the family prioritizes food first. The next is health, followed by education, house bills and then clothing. Their primary source of income is the food business that Lucila is currently in. She earns about P13, 000.00 a month (minus the rental fee and other expenditures in the food store). Other sources of income include the tricycle business Herminia is in, where she earns P3, 000.00 monthly. When Dante works as a FX driver he earns P20, 000.00 monthly, making their average monthly income P36, 000.00. Now that Dante is currently jobless, the average monthly income they earn as of now is P16, 000.00. The family’s monthly expenses reaches as much as P15, 000.00 – P20,000.00 monthly; making their earnings short for paying expenses. The family recognizes the Barangay Captain as one of the first persons they know to be leader of the community. Some of the projects that the community has are Clean and Green Project, Proper Segregation Program and Lighting System. The family is aware of these projects and are utilizing it.

V.

Home and Environment 9

Herminia owns the land and house they are living at. The house is made of light materials and concrete. The house is well-ventilated and use electricity as a source of light. The family’s source of drinking water is commercially prepared. They have their drinking water delivered from a nearby water station. They store their drinking water in clean bottles and pitchers which are usually covered. Their water supply is supplied by Nawasa, and if water is not available, they have it delivered. The type of toilet the family owns is a flush type toilet. The sewerage system is a blind drainage and its condition is free flowing. The family practices waste segregation. They used a covered trashcan as a container used for garbage collection. Garbage is collected once a week, during Thursdays. Herminia owns three love birds. She keeps them in a cage and feed them every day. Roaches an flies are present in their household. They control these pests by using pesticide to kill them. The health programs that are present in the community are free consultation and weighing , EPI, Ligtas Tigdas, Well-baby clinic , pre-natal checkups, Anti-rabies vaccine. The family is aware of the health programs present in the community but does not utilize it at once. The first person that the family consults in times of illness is the neighbourhood albularyo and they only consult the doctor whenever the illness becomes severe.

Formula for Ventilation: Total window area (cm.sq) X 100 Total floor area (cm.sq) Total window area (TWA) = window length x window width Total floor area (TFA) = floor length x floor width Results: Well ventilated: >20% Fair: 18 – 19% Poor: