Family Case Analysis 2
Family Case Analysis 2
Family Case Analysis 2
Angeles City
Presented by:
GROUP 1- BSN III-1
ANO, CARL ELEXER
CALMA, ARIANE CAMILLE
DIZON, REQUELITO
SOTTO, MICHELLE LOUIE
BALILO, NOEL LEONCIO
CABRERA, KRISTINA EDNA
CUYUGAN, MARY ANN
DE JESUS, LUIGI MIGUEL
ESTRADA, FLORENCE ANCEL
LIBRES, MARY ANGELICA TEOFFY
PALCIS, DANIEL
VALENCIA, PRECIOSA
Presented to:
JOANNE MARIE GALANG, R.N.
I. INTRODUCTION
Ogden Nash was basically a humorist, but such quote made a lot of sense. To interpret
it, it must mean that the family is a model which, physical manifestations would include the
presence of a man one calls father, a woman one calls mother, and of course those sons and
daughters running about to get their tasks done as they, undeliberately, grow older. A sleeping
dog or a cat basking on the sunlight at the patio would constitute to the occasional animal he
was talking about. And as for the common cold, generally, this would mean a highly contagious,
self-limiting disease brought about by different strains of viruses with symptoms of sore throat,
runny nose, nasal congestion, sneezing and coughing.
So how did common cold get to associate itself with the family? One would say, its
communicability is the primary factor, yes. Looking beyond the natural scope of things, the
predetermined communicability of the common cold lies on the word, common, not as of the
ordinary, but as of the shared. Usually, in a family, if one child is coming down with a cold,
surely, a sibling will follow, especially if such come from a depressed family devoid of the
advantages of nutrients to keep their immune system on the pink of health. Perhaps Nash was
only trying to imbibe to us the power of family, that even diseases are shared. A loving family is
worth all the riches in the world, for they will always be there for you, no matter what happens.
Ergo, no poor family is too poor if they have a family deeply rooted in love and compassion for
each other.
On a more serious note, In Article 15: The Family, of the 1987 CONSTITUTION OF THE
REPUBLIC OF THE PHILIPPINES: “The State recognizes the Filipino family as the foundation
of the nation. Accordingly, it shall strengthen its solidarity and actively promote its total
development. This reinforces the value of the family in community health nursing, as it plays
mediator between the first and third type of clientele, the individual and the society.
The family, being the crucial entity of the society is also deemed as the critical unit of
care since it is an efficient and accessible avenue for much of the community health nursing
effort. How ironic to say that a family shares a disease to be family! As aspiring nurses, it is the
duty of the researches to at least, be there for the family to reinforce health goals and promote
self-reliance, that it’s a deliberate nature of the family to share, yes, but not illness. Family
Health Nursing is a level of community health nursing practice focused or directed on family as
the unit of care/ client, with health as a goal and nursing as a medium or provider of care.
Family-centered care is the key concept in community health nursing practice.
Family Case Analysis is an instrument utilized by PHN nurses and student nurses alike
in delineating all prevailing problems of the community by centering on the families constituting
it. Home visits are the number one means in order to accomplish this. In here, the family’s
health needs will be assessed and the nurses, or the student nurses, rather, will provide health
teachings and render nursing care to accommodate and address their inadequacies and
liabilities in terms of family life and do something about them.
Before the exposure, the student nurses have a main criteria in choosing a family as a
subject; 1.) Depressed, 2.) Lack knowledge about healthy lifestyle, 3.) At least four members of
the family, 4.) At least have children who are 7 years old and below and the Griffin family suits
are criteria the most. They cannot do health tasks effectively making them at risk with different
health hazards.
A. Objectives
Family assessment begins with a complete health history. It is one of the most effective
ways of identifying existing or potential health problems. History is followed by physical
assessment of family members (Kozier, 2004).
1. BRIAN GRIFFIN
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36 °C
P- 73 bpm
R- 21 cpm
BP- 100/60 mmHg
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen. He can hear and respond when he is asked.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
His nail plates are colorless and have concave curves. They are slightly long and
untrimmed. His nail beds returned to previous state in less than three seconds after pressure
was applied.
NUTRITIONAL STATUS
Age: 32 years old
Height: 168 cm
Weight: 63 kg
Formula:
Body Mass Index (BMI) = Weight in kilograms (kg)
Height in meter squared (m2)
Body Mass Index (BMI) = 63 kg
2.8 m2
= 22.5
Interpretation:
Healthy Weight
Legend:
BMI Table
( Based on Asia-Pacific Obesity Guidelines )
Vital signs:
T- 36.7 °C
P- 67 bpm
R- 18 cpm
BP- 110/70 mmHg
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . He can hear and respond when he is asked.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
His nail plates are colorless and have concave curves. They are still slightly long and
untrimmed. His nail beds returned to previous state in less than three seconds after pressure
was applied.
2. Lois Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.5 °C
P- 75 bpm
R- 17 cpm
BP- 110/80 mmHg
General Appearance and Mental Status:
During the assessment, Lois Griffin was wearing a white shirt and pink pants. Her hair is
tied up, She is cooperative, coherent and oriented to person, place and time. She has a steady
gait and shows no difficulty in speaking. She also exhibits thought association and has a sense
of reality. She has no difficulty recalling past and present events. She stands 155 cm and
weighs 52 kg.
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. She has moist mucous membranes and her palpebral
conjunctiva is pink in color. Her pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen. Her hearing in her right ear is slightly impaired but she was able
to respond when asked.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
Lips and Teeth
Outer lips are symmetrical. She exhibits ability to move her lips. Inner lips and buccal
mucosa are uniform in color. She has an incomplete set of teeth and her tongue is in central
position and she can move it freely.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are long and untrimmed.
Her nail beds returned to previous state in less than three seconds after pressure was applied.
NUTRITIONAL STATUS
Age: 45 years old
Height: 155 cm
Weight: 52 kg
Formula:
Body Mass Index (BMI) = Weight in kilograms (kg)
Height in meter squared (m2)
= 21.6
Interpretation:
Healthy Weight
Legend:
BMI Table
( Based on Asia-Pacific Obesity Guidelines )
Vital signs:
T- 36.8 °C
P- 78 bpm
R- 20 cpm
BP- 110/70 mmHg
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. She has moist mucous membranes and her palpebral
conjunctiva is pink in color. Her pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . Her hearing in her right ear is slightly impaired but she was
able to respond when asked.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are long and untrimmed.
Her nail beds returned to previous state in less than three seconds after pressure was applied.
3.Meg Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.3 °C
P- 89 bpm
R- 22 cpm
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, with discharges in minimal amount and no discolorations are
present at the surface of eyelids. Lids close symmetrically. She has moist mucous membranes
and her palpebral conjunctiva is pink in color. Her pupils constrict when looking at near objects
while they dilate when looking at far objects.
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . She can hear and respond only through movements.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. Discharges in minimal amount were
noted and there is the absence of nasal flaring. Also, no nodules and masses were noted upon
palpation.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. A small wound was found on her right knee.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are slightly dirty and
untrimmed. Her nail beds returned to previous state in less than three seconds after pressure
was applied.
NUTRITIONAL STATUS
Age: 4 years old
Height: 88 cm
Weight: 9 kg
Vital signs:
T- 36.5 °C
P- 85 bpm
R- 24 cpm
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . She can hear and respond only through movements.
Nose
Her nose is straight and her septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and
there is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and she can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
THORAX AND LUNGS
Lungs
There is full and symmetrical chest expansion. There is effortless and rhythmic
respirations and no adventitious breath sounds were heard upon auscultation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. She has normoactive
bowel sounds.
Skin
She has brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. A small wound was found on her right knee.
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities.
Fingernails
Her nail plates are colorless and have concave curves. They are trimmed and short. Her
nail beds returned to previous state in less than three seconds after pressure was applied.
4. Stewie Griffin
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36.2 °C
P- 90 bpm
R- 20 cpm
General Appearance and Mental Status:
During the assessment, Stewie was wearing a white shirt and red shorts, and a pair of
blue slippers. He is unable to express himself through speech. He has a steady gait. He stands
88 cm and weighs 10 kg.
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . A small wound was found at the lower pinna of his left ear. He
can hear and respond through head movements.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
Lips and Teeth
Outer lips are symmetrical. He exhibits ability to move her lips. Inner lips and buccal
mucosa are uniform in color. He has an incomplete set of teeth and his tongue is in central
position and he can move it freely.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities. Wounds are present on both lower extremities and right hand.
Fingernails
His nail plates are colorless and have concave curves. They are dirty and untrimmed.
His nail beds returned to previous state in less than three seconds after pressure was applied.
NUTRITIONAL STATUS
Age: 3 years old
Height: 88 cm
Weight: 10 kg
Vital signs:
T- 36 °C
P- 81 bpm
R- 20 cpm
Eyes
His eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
evenly distributed. Skin is intact, no discharges and no discolorations are present at the surface
of eyelids. Lids close symmetrically. He has moist mucous membranes and her palpebral
conjunctiva is pink in color. His pupils constrict when looking at near objects while they dilate
when looking at far objects.
Ears
His auricles are same as facial color and it is aligned with the outer canthus of the eye.
They are mobile, firm and not tender upon palpation. Pinna recoils after it is folded. There is no
presence of impacted cerumen . He can hear and respond through head movements.
Nose
His nose is straight and his septum is located in the midline. No deviations have been
observed in the shape, size and color of the external nose. No discharges were noted and there
is the absence of nasal flaring. Also, no nodules and masses were noted upon palpation.
NECK
Neck Muscle
Neck muscles are equal in size. No masses and nodules were noted upon palpation.
Head movements are coordinated and he can move his head freely.
Lymph Nodes
Lymph nodes are not palpable and there is no enlargement noted upon observation and
palpation.
Heart
Regular rhythm of apical pulse was noted upon auscultation.
Abdomen
No distention and presence of lesions and masses were observed. He has normoactive
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pigmentation such as the palms, lips and nail beds. No abrasions and edema have been noted.
He has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
Peripheral pulses are in full pulsations. Limbs are not tender and no edema is present at
extremities. Wounds are present on both lower extremities and right hand.
Fingernails
His nail plates are colorless and have concave curves. They are dirty and untrimmed.
His nail beds returned to previous state in less than three seconds after pressure was applied.
IV. SOCIO-ECONOMIC, CULTURAL AND ENVIRONMENTAL ASSESSMENT
In terms of decision making, whether heath care-related or not, it is Brian Griffin who
usually do it, although he still considers the suggestions and preferences of Lois, his wife.
EXPENSES AMOUNT
Food Php6000
Clothing and other expenses 2000
Electricity 200
Water 250
Total: Php8450
J. Housing Condition
The Griffin family lives in a one-bedroom semi-concrete shack. Sheets of boards from
Brian’s previous employer were topped against each other to form the walls of the humble
bungalow. In the front yard, one can see a table where dining takes place. Plants and flowers
stand on the right corner. For protection, they lined their lot with a simple dark blue picket fence.
The receiving area for guests is the front porch. The bedroom has the largest area in the house
with wooden bed and a television for entertainment purposes. Immediately on the left is the
kitchen devoid of cooking facilities as Lois cooks occasionally using charcoal outside the house.
In there, one can find plates and utensils for cooking and eating. The toilet facility is at the back
of the house.
According to the National Building Code of the Philippines (2000) the minimum size of
room required for human habituation individually is 3.5 square meters (adult) and 1.5 square
meters (child). For information regarding the adequacy of living space, the student nurses
measured each room’s total fixtures area and subtracted it from total floor area. Afterwards, the
available living space (resulting value) is less 3 square meters (1.5 sqm each) because of Meg
and Stewie, the children in the family. Then, the remaining space will be divided among the 2
adults in the family.
The total available space is 16.92 sq m, which is minus 3 square meters as required by
Meg and Stewie. The resulting value is 13.92 which is further divided by the 2 adults in family
who are Brian and Lois, comprising of 6.96 sqm per adult family member. Ergo, the family has
adequate living space.
As for adequacy of ventilation, the total window area should be at least 10% of the total
floor area. The house has only one window, measuring only 0.27 sqm. The total floor area is
16.92. This measurement didn’t make it to the 10%. This goes to show that the house is under
poor ventilation.
For the lighting conditions, the family use incandescent bulbs as their source of light
during evenings. However, inadequacy in daytime lighting is very evident, as there is only one
window and the walls of their house are not painted, adding to the dark feel of the atmosphere.
Sleeping arrangements constitute of the one bedroom they all sleep in. Brian and Stewie
sleep on a mat on the floor, whilst Lois and Meg occupy the bed they have. Both of which are
quite hard on the back as there is no mattress available.
The family is aware of the presence of vermin like cockroaches. Buzzing mosquitoes at
night are also of a common occurrence.
Last month, their front porch was burned because of the cooking facility left unattended.
Such would then be a big fire hazard as an evidence of a history of fire has occurred.
Their drainage system is located on the other side of the road. Its type is of open and
flowing nature. The garbage disposal container is sack and it is covered. Garbage collectors get
their household garbage twice a week.
O. Social and Health Facilities Available
The community where the family resides has various social and health facilities. They
have the chapel wherein masses are celebrated; the elementary school and day care center
wherein most of the children in the barangay study; they have basketball court wherein certain
activities such as sports fest are being carried out; and the Barangay Sapalibutad Health Center
which offers an array of services such as immunization, family planning programs, perinatal
care and the like.
Carinderias, bakeries, and sari-sari stores are also found in the vicinity of the
community.
Current
> Mrs. Lois Griffin is fully aware of the
knowledge problem as she has mentioned the following
Family
Resources
statement during the interview:
“si meg nung kamakailan lang nagsuka ng
SN Resources
bulate”(meg vomited a worm just recently)
Community
Resources > The family has manpower resources
that enable them to easily bring their
children to the barangay health center for
proper management.
Problem# 5 Family size beyond what family resources can adequately provide:
Inadequate Family Resources
Actual
Criteria Computation Justification
score
The problem is a health threat, inadequacy
of the family resources to suffice their daily
1. Nature of the needs may result to serious health problems
2/3 x 1 .67
problem if not corrected e.g. malnutrition which is
now actually evident in the family since the
children are all underweight.
1/2 x 2 1 The problem is partially modifiable as
2.Modifiability of the reflected by the criteria being considered:
problem
> The family has a current knowledge of the
Current problem, as Mrs. Lois was able to verbalize
knowledge this problem during the interview when the
Family Resources Student Nurses asked her of what are their
problems in their house
SN Resources "...haaay syempre mahirap ang buhay
Community ngaun kaya pera ang pinakaproblema
Resources namin” (of course with the increasing
financial problem, money is our main
problem) as verbalized by Mrs. Lois.
METHOD
FAMILY RESOURC
OBJECTIVE INTERVENTI OF
CUES NURSING RATIONALE ES EVALUATION
S ONS FAMILY
PROBLEM REQUIRED
CONTACT
S> “Ayaw -Inability SHORT - Assess for -to know Home Time & After 1-2 hours
nila mag to ,ake TERM: history of past visits effort of of home visit,
tsinelas pag decisions After 1-2 parasitism medical the family the members of
naglalaro” with respect hours of history and the the family shall
to taking home visit, -Determine student have
O> appropriate the family factors nurse. enumerated
-The health will associated to -to identify ways to
Children are action due enumerate parasitism contributing prevent
not wearing to ways to factors parasitism
their misconcepti prevent -Discuss the
slippers ons or parasitism importance -to provide
when erroneous of having health
playing information good teachings At the end of
outside. LONG personal that will let the 5th home
TERM: hygiene. them visit, the family
-The father At the end maintain a members shall
and his of the 5th good have practiced
children home visit, personal measures to
have the family -Give health hygiene. prevent
untrimmed will practice teachings parasitism and
and dirty measures to regarding -to provide identify support
fingertips prevent different general groups in the
and toenails. parasitism practices on comfort and community
and identify good clean body.
-improper support personal
hand groups in hygiene.
washing the
when community -Discuss the -to minimize
eating. following: the
occurrence
of cross
infection
-Instruct and
them to parasitism.
frequently
wash hands -to minimize
and trimmed the
fingernails & occurrence
toenails. of cross
infection
- Perform the and
interventions parasitism.
to the client
like teaching
them to wear
their slippers -to minimize
always, the
trimmed the occurrence
nails of the of cross
children, and infection
washing the and
hands of the parasitism.
children
when eating.
-Perform
usage of the
fork and
spoon when
eating.
S> Ø -Inability to SHORT -Assess for -to know Home visit Family SHORT TERM:
O> take TERM: signs of poor health resources: The family
-The appropriate After 2 personal threats -open to shall have
members health hours of hygiene new verbalized
are seen actions due home visits, information understanding
wearing to: the family -Determine -to know and about the
dirty clothes -lack of will factors factors involvemen importance of
adequate verbalize associated contributing t of nursing good personal
-The knowledge understandi with poor to health interventio hygiene to their
members of regarding ng about personal threat ns health
the family proper the hygiene
have long hygiene importance Student
and dirty -inadequate of good -Discuss the -to provide nurses
fingernails financial personal importance health resources: LONG TERM:
and toenails resources to hygiene to of having teachings -Time & The family shall
avail proper their health good that will let effort to have
-The hygiene personal them explain demonstrated
members of practices hygiene. maintain a proper maintainance
the family and LONG TERM: good hygiene of good
has dirty resources At the end personal practices personal
skin as a of the 5th hygiene. and hygiene and
sign of not home visit, -Give health adequate applied health
taking a the family teachings -to provide knowledge teachings given
bath will regarding general about the as evidenced
demonstrat different comfort and diseases in by taking a
e practices on clean body. a poor bath everyday,
maintenanc good personal and proper
e of good personal hygiene cleanliness in
personal hygiene. their bodies.
hygiene as -to provide
evidenced -Discuss the a
by taking a following: presentable
bath daily look.
and wearing -Instruct
comfortable them to take
clothing, a bath at
trimmed least once a
fingernails day.
and -to minimize
toenails. -Instruct the
them to occurrence
frequently of cross
wash hands infection
and trimmed and
fingernails & parasitism.
toenails.
-Instruct
tooth -to prevent
brushing at formation of
least twice a cavities/
day. plaques and
to maintain
a good oral
hygiene and
prevent bad
breath.
- Perform the
interventions
to the client
like bathe
the children,
trimmed the
nails of the
children, and
brushed the
teeth of the
children.
Problem #5: Family size beyond what family resources can adequately provide: Inadequate Family Resources
S> ∅ Inability to Short term: • Establish • To gain Home Visit Family Short term:
sustain their After 1-2 hrs rapport trust and resources: The
O> The basic needs of home with the cooperatio Understandi members of
group found due to lack visit, the family n of the ng and the family
out that the of family family will members. family. cooperation shall have
total resources be able to of the identified
monthly and failure identify • Compute family. ways to
budget of to have a ways on for the • Provides properly
the family is high paying how to family comparison Student budget their
P8,250.00 job. properly expenses of data and nurses monthly
which gives budget their and salary. determines resources: income.
every monthly deficiency Skills,
member a income. in financial knowledge, Long term:
monthly status. time, effort The
allowance of Long term: • Assess and members of
P2,062.50. It At the end the family’s • Provides motivation the family
is not of the 5th sources of baseline of the shall have
enough for home visit, income. data and students. maintained
the family’s the family determine practice
everyday will be able other measures to
needs. to find ways possible prevent fire
on how to • Provide sources. hazards.
earn extra the family
income information • Provides
sufficient to on different creativity
the needs of methods of in the
the family. earning an family and
extra raising
income. extra
income.
• Encourag
e the
family to
engage in • To allow
activities money for
that would daily needs
promote and to save
livelihood extra
such as money.
planting
vegetables.
• Explore
ways on • To
proper maximize
budgeting the money
and earned by
possible the parent.
extra
sources of
income.
S> Inability to Short term: • Assess for the • To Home Visit Time and Short term:
“Nasunuga make After 1-2 history of the obtain effort of the The
n kami decisions hrs of home event. baseline student members
nung Jan. with visit, the data. nurses and of the
31.” As respect to members of • Determine the family. family shall
reported by taking the family factors which can • To have
Lois appropriate will contribute to the determine enumerate
health enumerate occurrence of contributin d measures
O> actions due measures such. g factors. to prevent
presence of to to prevent fire
damaged inaccessibili fire hazards.
improvised ty of hazards. • To
roof appropriate • Enumerate ways prevent Long term:
resources Long term: to prevent fire occurrenc The
for care At the end hazards: e of fire members
specifically of the 5th hazards. of the
cost home visit, Establishmen family shall
constraints the t of safe have
or members of cooking maintained
economic/ the family facilities. practice
financial will measures
inaccessibili maintain to Objects to prevent
ty and practice which can fire
failure to measures contribute to hazards.
comprehen to prevent its
d the fire occurrence
nature/ hazards. should be
magnitude properly
of the stored.
problem.
Careful
utilization of
objects/
equipment
that can
cause fire
hazards.
Problem #7.5 Poor Environmental Sanitation: Lack of Food Storage Facilities
Method
of
Problem Resourc
Nursing Family Expected
Cues Analysis Objectives Rationale es
Interventions Contac Outcome
Required
t
S: Ø Inability to Short >Establish >to gain trust Home Family Short term:
recognize term: raport visits Resource The family
O: the After 2 >to obtain baseline s: shall have
>The presence of hours of >Assess Food data >plates verbalized
Family the nursing Storage and understandi
has no problem intervention Facilities plastic ng on the
refrigerat due to: the family >to develop food importance
or will >Discuss to the awareness to the covers of proper
>They >Inadequat verbalize family the family about the storage of
don’t e understandi possibilities of prevention and Student food
have knowledge ng on the contaminating intervene about it nurse’s
cabinet about the importance the food if not resources Long term:
for food consequen of proper properly stored. : The family
storage ce of the storage of >time shall have
> problem food >Explain the >to increase their and effort complied
Leftover possible awareness that this with the with the
foods >Inadequat Long term: consequences could bring about cooperati health
were left e financial After 1 of and complication to their on and teaching
on the resources home visit, complication health. participati given on
table in a to avail the family they may on of the proper food
plate food will comply acquire from family storage..
with storage with the contaminated and
cover facilities health food due to student
teaching improper nurse.
given on storage >to prevent easy
proper food spoilage and
storage. >Encourage contamination of the
covering of foods
food properly
with plates or
any appropriate
Method
of
Problem Resourc
Nursing Family Expected
Cues Analysis Objectives Rationale es
Interventions Contac Outcome
Required
t
S: Ø Inability to Short >Assess >to obtain baseline Home >Knowled Short term:
provide a term: lighting data visits ge and The family
O: home After 1 hour condition communi shall have
>Upon environme of nursing cation verbalized
entering nt which is intervention >Allow the >to assess family’s skills of understandi
the conducive the family family to compliance on the the ng on the
house it to health will verbalize some health teachings student health
was quite maintenanc verbalize ways to given nurse teaching
dark and e due to understandi improve their given
there inadequate ng on the source of >Particip regarding
was family health lighting >to include the ation and the
insufficie resources teaching family in planning acceptanc importance
nt specifically: given >Identify with and increasing e of of adequate
number regarding the plans to awareness family lighting
of light >Financial the alleviate poor members
bulbs constraints/ importance lighting >to provide enough Long term:
limited of adequate light >time The family
>Use of financial lighting >Instruct the and effort shall have
2 resources mother to keep with the demonstrate
incandes Long term: the door open cooperati d
cent >Limited After 3 of during daytime >to provide enough on and implementat
lights physical home visits, light participati ion of the
resources the family >Encourage on of the means the
>Hard to (e.g. bulbs) will mother to open family identified
read demonstrat the widows and and such as
when e remove student opening
inside implementa obstruction nurse. windows
the tion of the such as
house means the curtains
during identified
daytime such as
opening
windows
Initial Final
Category Justification
1 3 5 1 3 5
1. PHYSICAL
INDEPENDENCE Initial:
The Family has moderate physical
This category is concerned
independence ask evidenced by the
with the ability to move about,
to get out of bed, to take care mother Is able to provide the family
of daily grooming, walking, need on basic needs such a s food
etc. Note that it is the family
preparation nurturing of the children,
competence that is
measured- even though an grooming and the like, but still the
individual is independent, if mother still lack some more information
the family is able to
to proper render this care, because at
compensate for this. The
family is important-hence, if times the children are still important.
the focus of care is poor, for Final:
instance, if the mother is After the health teachings and
giving care to a handicapped
child that she shared with interventions given by the student nurse
other members of the family, the mother’s physical independence
the independence might be increase to an efficient level AEB she
considered incomplete. The
was able to maintain her children
causes of independence may
vary however. Lack of hygiene.
independence in the family
may be due to actual physical
incapacity, the inability of
“know-how”, the willingness or
fear of doing necessary tasks.
2. THERAPEUTIC Initial:
COMPETENCE
Initially the family has very low
therapeutic competence, as the mother
This category includes all the does not necessary manage the illness
procedures or treatment
of the members in the family, she lacks
prescribed for the care of
illness, such as giving information on “How to” do such
medications and using procedure, the family relies on OTC
appliances, dressings,
drugs.
exercises, and relaxation and
special diets.
Final:
On the final visit, After giving all the
necessary intervention to correct them
previous believe and practices the
family was able tom increase their
therapeutic competence. This was
supported by the mother as she readily
responds to the question given by the
student nurse regarding certain
situation.
3. KNOWLEDGE ON
HEALTH CONDITION Initial:
Upon assessing the family
This category is concerned
with the particular health knowledge about certain disease,
condition that is the occasion condition especially those of common
for care, knowledge of the
diseases. The mother was able to
disease or disability,
understanding of responds on some of the question but
communicability of diseases still lack of knowledge on how to
and modes of transmission,
properly manage such diseases.
understanding of general
patterns of development of a Final:
newborn baby and the basic Upon final visits with the health
needs of infants for physical teachings given and reinforcement of
care and tender loving care.
the knowledge, the family was able to
verbalize on how to manage these
disease in case it happen to occur in
their family.
4. APPLICATION OF
PRINCIPLES OF GENERAL Initial:
HYGIENE
In terms of application of principles
This is concerned with family of general hygiene the family has an
action in relation to idea on how to properly do the
maintaining family nutrition,
procedure they also have the
securing adequate rest and
relaxation for family members knowledge on the importance of
and carrying out accepted completing the EPI program
preventive measures such as
immunizations, medical
appraisal and safe Final:
homemaking habits in relation After health teaching were given
to storing and preparing food. appropriate intervention, during the final
visit the family is now knowledgeable on
properly do the procedures, application
of procedure in general of its
importance.
5. HEALTH ATTITUDES
Initial:
This category is concerned
The family has a bright idea about
with the way the family feels
about health care in general, health are, only they do not know how
including preventive services,
to improve and practice this activity
care of illness and public
health measures.
Final:
The final visits the family has able to
verbalize the health teaching render,
eg. It is important to address antibiotics
about health care must be definitely to
the health centre for clarification
6. EMOTIONAL
COMPETENCE
7. FAMILY LIVING
9. USE OF COMMUNITY
FACILITIES
I personally learned the importance of the family in the society, as the basic unit of the
society, it is important to maintain the health of the family. Comparing the family with the human
body, as when one part of the body is infected, later on the whole body will be affected
systemically, just like with the family and society, when a family is considered ill, later on the
society will be systemically affected.
I also learned the importance of good communicating skill. With the absence of a good
communicating skill the student nurse will not be able to establish rapport with his/ her client,
thus affecting the assessment process, making the problem identification and prioritization be
difficult, thus, altering the maximum care you may give to the family.
Assessment is the very crucial part of doing the family case analysis, with all the data
that you will gather throughout the assessment process, there you will derived the problems you
will intervene to correct this problems.
The most important thing that a student nurse must have is the initiative, time, effort, and
patience, without those things you will not be able to gather all the information you need, the
client’s cooperation and compliance is also a vital ingredients for the success of making a family
case analysis.
Finding a family was hard, and the intolerable heat was unnerving, and didn’t help at all. It was
quite of a feeling of hopelessness and lose that we weren’t able to find a family on the first day,
or let me rephrase that, “a SUITABLE family…” The first foster family we had was so depressed
that we ourselves weren’t sure if we could help them. The mother wasn’t also much of a reliable
source of information for she must have mental problems based on her words and actions. Our
second foster family- the Griffin family, was really nice and accommodating. They were an
inspiration to us, especially Mother Lois. She always has this hopeful note in her words that
everything will be all right when the time comes, and despite the fact they are poor, that wouldn’t
hinder her to always wear a smile and face the world with happiness and courage.
In making the FCA for the second time, it was a real reinforcement of establishing rapport with
the family as we have to visit them for two weeks. Perhaps, it was hard for them to treat us like
we weren’t a bother at all; as of course, people always have better things to do. Still, I’ve
learned the value of kindness and optimism through them, beyond physical examinations,
problem identification and priority setting. However trite this may sound, I can say that
somehow, God has made the family an instrument so I will bear in mind the fact that some
families have real problems, and I was chosen to try to do something about them.
Requelito A. Dizon Jr
Family Case Analysis is not just about accomplishing the paper but it involves more of
indulging or integrating yourself into the life of the family you adopted so that you personally
discover problems which will allow you to do your nursing role.
The student nurses have learned that a Family Case Analysis entails hard work.
Thorough assessment is truly important to identify the problems of the family with appropriate
nursing interventions.
Through the student nurses’ exposure to various families, they also learned that
community health nurses, are the key persons in the provision of comprehensive and
continuous family health care. Thus, a genuine concern and proper coordination is needed for
the efficacious delivery of care.
After being immerse in this kind of activity, there are many thing that I have learned
about life. Upon on what we have witness on the family that we had encountered. Life is not that
easy. You must make some effort in order to survive. It’s not the material things, the fame,
fortune and power that makes us completely happy, but the thought of having helped someone
who is in great need of us. We honestly haven’t been happier that we are right now, because of
the pleasure we have knowing that we have helped people in our own little way.
Doing a Family Case Analysis proved that theories are not enough to have the courage
to face all the trials in life. Basically, it was an experience that served as an eye opener for the
student nurses to deeply feel the true impact of poverty. This activity also served as an
opportunity for them to enhance their critical thinking and socialization to understand and
somewhat abate a family’s certain condition.
Through interacting with the family we adopted, I’ve implied different nursing
interventions taught to us, we had health teachings to promote health and prevent
illness, and also we cleaned the environment together with them to maintain proper
management of the surroundings.
In the community, we are able to meet the health needs of the people in our own
little ways; we are able to help them even in small ways. With that, I have learned that
nursing is not just a profession taught to gain income rather it is giving compassion and
service to our countrymen. I also learned a lot in the different techniques on how to
establish rapport to families and how to teach them regarding family planning, proper
hygiene and prevention of communicable diseases. I’ve learned that many of us are
lacking knowledge regarding promotive and preventive measures to maintain good
health, so it is indeed necessary for us nurses to render care and give appropriate
interventions and management for them to achieve health.
To sum it all up, in my exposure in the community, I’ve learned so much on how
to be a competent community health nurse through the experiences I had.
-Florence Ancel Estrada
I realized the importance of having a stable job in order to adequately provide the
individuals needs of family members. It is also equally important to plan on how many
children that the couple could support with their present resources. I have also
pondered on the family’s situation which made me thankful n where I am right now.
Discrimination aside, I appreciate the efforts of my parents in providing me all that they
could give for me to have a better future. It has been seen by our group how the
children are undernourished and how inadequate their housing condition is. This has
made me realize the implications on what could happen if a family would not be able to
meet their individual needs. The children are always the one who suffers greatly for their
health and education are always compromised with such poor condition. It must be
responsibility of both parents to give their best in supporting their children. I have been
and still fortunate that parents had given me the opportunity to be educated even
though they are having difficulties in working. This made me realize that as a student
nurse. I could help change the community by exerting efforts to educate the families on
how to improve their condition amidst the lack of financial resources. It is true, indeed
that the primary responsibility in shaping an individual’s value of health comes from their
own families.
Being a PHN is also like handling a patient in a hospital, the only difference is that you
handle the whole family itself that you adopted. And the main goal is not just curing the
patient but also helping the family in preventing other potential problems that may arise,
and to also help them in coping from the instances in this fast paced world.
Daniel T. Palcis
Community Health Nursing is not a simple act or Nursing service rendered by either Registered
Nurses or Student Nurses. The primary objective of community Health Nursing in a large sense
is to promote the primary level of prevention, Health promotion, and also continuation of Health
care from the Hospital.
Community Health Nursing provides awareness and knowledge regarding the current
health situation of he community. As student Nurses, and as members of the health care team,
our responsibility is to promote and provide quality care. Even if we are still student nurses, we
already have the capacity to change, manipulate or improve the health situation of the
community. We should always take part and take in to consideration all of the nursing tasks that
we perform. Student nurses should love their craft or the art of nursing per se in order to provide
efficient nursing care.
The community health should be one of the primary objectives of a nurse. A healthy
mind and body contributes to the over-all heath of a person. As student nurses we should
always take part and never ignore the current over-all status of the community because a
healthy community also reflects the health service provided by the health sectors or providers.
Preciosa C. Valencia
IX. SOCIOGRAM:
This chapter illustrates graphic representation of the several home visits made, including
the interactions of the student nurses with the families, the assessment, planning, interventions
and evaluation done.
Legends:
Home Satisfaction
Entrance
Small Garden
Door
Window
Cooking Area
Wall
Comfort
ComfortRoom
Room
Backyard/Garden
Griffin family’s humble abode Entertainment corner
Untalan, A. Concepts and Guidelines in COPAR. 1st ed. Manila: Educational Publishing House,
2005.
Maglaya, A. Nursing Practice in the Community. Marikina City: Argonauta Corp., 2004.
Cuevas, F. et. al. Public Health Nursing in the Philippines. 10th ed. Philippines:
2007
http://wisdomquotes.com
http://psychology.about.com/od/theoriesofpersonality/ss/psychosexualdev.htm
http://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htm
Handouts from:
Primary Health Care II (2007-2008)