Roquero, FNCP
Roquero, FNCP
Roquero, FNCP
Presented to
The faculty of
School of Nursing
Pasay City
In Partial Fulfillment
Of the Requirements
Submitted by:
TABLE OF CONTENTS
I. INRODUCTION
A. RATIONALE
B. OBJECTIVES
C. METHODOLOGY
D. LIMITATIONS OF THE STUDY
B. EVALUATION
VIII. REFERENCES
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I. Introduction
Community Health Nursing is one of the major fields of nursing. Through this, nursing
care is provided to community people, specifically for the member of each family. The
American Nurses Association wrote that: Community health nursing practice promotes and
preserves the health of populations by integrating the skills and knowledge relevant to both
nursing and public health. The practice is comprehensive and general, and is not limited to a
particular age or diagnostic group; it is continual, and it is not limited to episodic are . While
community health nursing practice includes nursing directed to individuals, families and groups,
the dominant responsibility is to the population as a whole (Clark, 1999:50).
Family is a basic unit of society. Which is according to Maglaya it perform a two major
functions, the reproduction and socialization. It is generally considered as the basic unit of care
in community health nursing for many reasons. In addition to that, Family also performs health-
promoting, health, maintaining and disease prevention activities.
RATIONALE
In the Philippines there are many social changes that are affecting the family. Due to
social problems in our society such as corruption, poverty, education system, lack of
government support, increases unemployment rate, insufficient and ineffective provision
particularly to the marginal sector.
STATEMENT OF OBJECTIVES
Determining these common problems that has a great impact to the society would lead to
developmental problem such as lack of education, lack of prevention and ignorance of
diseases, inability to provide the needs of the family and others.
METHODOLOGY
segments. The first part of the instrument pertains to the demographics of the respondents, which is Age.
The second part of the instrument focuses on the respondent’s perception on Motivation and Stereotyping.
The instrument used in this study was a survey questionnaire online through personal inquiry; it allows the
researcher to gather a significant amount of data at relatively little cost (Gilbert, 2005).
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Providing this information about the concept of family it is understood that family plays
a vital role. In addition, as far as community health nursing is concern, it is ought to provide an
adequate care, to support population health and deliver preventive health care services.
The respondent was a bit hesitant in sharing some of the information, which I completely
understand because they might deem it a little bit sensitive. Therefore, I have to be cautious on
questions that I prepared and keenly observe if it is appropriate of conversation.
It is perceptible that the family belongs in the average or middle class. Upon visitation, I
tried to observe the house structure and surroundings, the respondent offered us a seat and we
had a communication, in a therapeutic manner. The respondent discussed how their life is
going on and while listening I’m taking down notes at the same time particularly in the
important areas. After further discussion and chatting with her, I assessed her condition,
performing the 13 areas of assessment which will be elaborated on the succeeding parts of this
study.
Community health nursing provides an extra effort. For me, community exposure is
more challenging aside from having a long walk, knocking on every house door, we sometimes
also are being rejected. However, nursing taught us, that it is our duty to respect the culture and
beliefs of every person. Doing community service, a person will find themselves and be exposed
to the lifestyle of other people. It taught us that being a nurse means being flexible.
The Canaria Family is a Extended type of family. The respondent, Catherine Canaria was the
one present during the survey and she lives with her mother, brother and child while her
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husband is an OFW in hong kong. They lived in a house made up of Mixed but
predominantly strong materials. The family’s ethnic background is pure Igorot. No
significant beliefs were noted that is related to the health of the family. When we got there,
the head of the family was resting and sleeping as told by the respondent. Some complaints
were verbalize by respondent regarding the health status of her brother, the health history
of her mother(Agnes) and stroke as the cause of her father’s death last November 2016.
When we were there the respondent (mother) was taking care of the child while Agnes is
resting and sleeping in her room.
The mother stated that they were able to provide the needs of the family because the
father is an OFW working as a care giver in hong kong who sends them 15,000 php per
month while she also verbalized that there is underemployment in their place. The brother
is underemployed who works as a laborer when there is an available working offer. The
grandmother stays at the house. They share in paying the taxes and expenses in the house.
The family was able to provide the necessities of the family, such as foods and paying of the
bills. The family has a PhilHealth Insurance.
3. Environmental Factors
• The Canaria’s house is made up of cement and woods, floor house with cemented
flooring. Adequate living space to accommodate all the family member.
• Dining and cooking area is not separated.
• Toilet facility is located outside the house, water sealed owned by the family.
• They burn some of their garbages and give the others every Friday in the street for
garbage collection
• Segregation of garbages is observed
• There were presence of rodents, flies, mosquitoes, cockroaches and rats.
• Canaria’s place location is considered a hazardous place.
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• Water supply came from the stream, they used it for washing and buy in the refilling
water station for their drinking water.
• Canaria’s drainage is open.
• Neighbors houses are close to them.
• Barangay health center is 15 minutes via jeepney from their house.
•
4. Health Assessment of Each Family Member
1. Agnes- born with one kidney. She had a gallstone surgery.
2. Catherine- Irregular menstruation ever since she started taking the pills (family
planning). TT3 shot only.
3. Jeremiah-no significant illness,
4. Levy- He has gallstone and is a subject for surgery
5. Mhiah- She has a common cold, completed immunization
The family completed the immunization, able to seek the clinic or barangay health
center when feeling sick.
IV. Typology of Nursing problems in Family Nursing Care Practice
1. First Level of Assessment
i. Presence of Health Threats
A. Health history of specific condition or disease
- The family has a history of stroke, gallstone and Diabetes Mellitus. The Family has
insufficient knowledge on preventive ways of gallstone.
- Mhiah has a common cold.
D. Accident hazards
- There is a stairs on the way to the house which can be dangerous when wet because it
is slippery and dark. Fall hazard noted.
N. Family Disunity
- No family conflicts
ii. Presence of Health Deficits
- Mr. Levy has gallstone
- Ms. Mhiah has common cold
- Mrs. Agnes has Renal Agenesis
ii. Inability to make decisions with respect to taking appropriate health action
due to:
• Lack of/ inadequate knowledge/insight as to alternative courses of action open to
them
- The couple lack of knowledge about other family planning aside from pills and
natural method.
• Failure to comprehend the nature/ magnitude of the problem/condition
- improper drainage system, presence of breeding sites of vectors.
iii. Inability to provide adequate nursing care to the sick, disabled, dependent or
vulnerable/ at risk of the family member due to:
• Inadequate family resources for care
- The family is helping each other in times of need.
- They lack of skill in carrying out measures to improve home environment. Another
factor that contributes is due to limited financial resources.
disease.
• Lack of food storage facilities. 6. Poor home/environmental
• Type of toilet facility is open pit condition/sanitation
• With presence of flies located near the a. Lack of food storage facilities
house. b. Unsanitary environment
Not a problem
Score: 4.5
2. Common Cold
Foreseeable Crisis
Not Modifiable
Not a problem
Score: 4
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3. Renal Agenesis
Foreseeable Crisis
Not Modifiable
Low
Not a problem
Score: 3.3
Not a problem
Score: 2.3
Foreseeable Crisis
Not Modifiable
Not a problem
Score: 3.6
1. Psychosocial Status
She is under Erick Erisckson’s Intimacy vs Isolation. This stage is during young adulthood (ages
18 to 40 yrs), where an individual begin to share ourselves more intimately with other and explore
relationships leading toward longer term commitments with someone other than a family member. .
a. Mental Status
She is conversant. Able to follow directions when asked. She is oriented about day, time
and place. Responsive where she can identifies things and names.
b. Emotional Status
Client is in good mood when talking to her.
3. Environmental Status
Client lives in an adequately spaced house close to neighbors’ houses. The location has a good
ventilation and lighting.
4. Sensory Status
a. Visual Status
Eyes are symmetrically aligned and showed equal movement when asked to raise and
lower eyebrows. Pupils of the eyes are black and equal in size. Pupils are round and
reactive to light and accommodation. Able to distinguish far objects. Conjunctiva is red.
b. Auditory Status
She can hear words clearly and answers immediately and appropriately. She doesn’t
wear any hearing aids.
c. Olfactory Status
Has no difficulty in classifying fragrant and sour odor.
d. Gustatory Status
Able to discriminate sweet, salty and sour.
e. Tactile Status
Able to identify sharp or dull when elicited to the client.
b. Motor Status
a. Musculo-Skeletal Status
During assessment, there is no difficulty in abducting, flexing, extending in upper and
lower extremities is observed. No known deformities and with good posture.
b. Mobility
Nomal mobility and able to perform ADL
6. Nutritional Status
The client verbalized that he cooked meat combined with vegetables. She eats three to five
times a day.
8. Elimination Status
She usually defecates once a day and able to urinates five times a day. With hyperactive
bowel sound.
9. Circulatory Status
a. Pulse rate
67 bpm
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b. Blood pressue
100/70 mmhg
c. Capillary refill
Goes back 2-3 seconds
Skin is brown with good skin turgor as evidenced by pinching then goes back after 1-2 seconds.
There are no rashes noted.
Client usually sleeps 6-8 hours and able to take a nap at noon.
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Health Problems Family Nursing Problem Goal of Care Objectives of Care Intervention Plan
1. Gallstone Inability to continue After nursing After nursing intervention, the Educate the client HOME VISIT Time and effort of
medication due to intervention the client client will able to: about the existing the student nurse
unable to remind will be able to disease. and the family
himself taking due acknowledge the severity Explain the importance members
medication. of his situation. of regular check-up and Encourage them to
surgery. consider lifestyle Expenses of
modification for transportation of
The family will be able to their benefits. the student nurse
support the client in heath
needs. Reiterate the
importance taking
the medication
regularly
Health Problems Family Nursing Problem Goal of Care Objectives of Care Intervention Plan
2. Common Cold Inability to continue After nursing After nursing intervention, the Educate the client HOME VISIT Time and effort of
medication due to intervention the client client will able to: about the existing the student nurse
unable to remind will be able to disease. and the family
himself taking due acknowledge the Explain the importance members
medication. presence of the disease. of complying in Encourage them to
treatment regimen. consider lifestyle Expenses of
modification for transportation of
The family will be able to help
their benefits. the student nurse
the client in health needs.
Reiterate the
importance taking
the medication
regularly
1st LEVEL ASSESSMENT: Presence of rodents, mosquitoes and other insects around the house as health threat
2nd LEVEL ASSESSMENT: Inability to provide a home environment which is conducive to health maintenance and development
Health Family Nursing Problem Goal of Care Objectives of Care Intervention Plan
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3. Presence of Inability to provide home After nursing After nursing intervention, the Establish rapport HOME VISIT Time and effort of
rodents, environment which is intervention, the family family will: Explain the diseases the student nurse
mosquitoes and conducive to health will be able to know on that might occur to and the family
other insects maintenance and Verbalize the family due to
how to prevent diseases members
around the development due to: understanding of improper waste
house as health a. Lack of due to unclean disposal.
environment and know individual risk factor Expenses of
threat knowledge of Demonstrate to the
that contribute to transportation of
importance of the importance keeping family the proper
hygiene and the environment clean. unsanitary waste ways of excreta the student nurse
sanitation. disposal including disposal.
b. Lack of diseases that may Discuss to the family
knowledge of acquire. the advantage in
preventive having a clean
measures. Implement agreed- environment.
Presence of risk factors upon health actions
of specific disease such as maintaining
the toilet clean and
free from flies.
Health Problems Family Nursing Problem Goal of Care Objectives of Care Intervention Plan
4. Renal Inability to continue After nursing After nursing intervention, the Educate the client HOME VISIT Time and effort of
Agenesis medication due to intervention the client client will able to: about the existing the student nurse
unable to remind will be able to disease. and the family
Explain the importance
himself taking due acknowledge the members
medication. presence of the disease. of complying in Encourage them to
treatment regimen. consider lifestyle Expenses of
modification for transportation of
The family will be able to help their benefits. the student nurse
the client in health needs.
Reiterate the
importance taking
the medication
regularly
Health Problems Family Nursing Problem Goal of Care Objectives of Care Intervention Plan
2. Presence of Inability of the family After nursing After nursing intervention, the Assessed the family HOME VISIT Time and effort of
Hereditary intervention, the family family will: history of the the student nurse
to manage health and
disease will take necessary hereditary disease. and the family
non health crisis Engage themselves to
measures to prevent or members
Discuss to the family
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related to not seeking properly management regular check-up. the importance of Expenses of
health care to for gallstone, stroke and healthy lifestyle and transportation of
Diabetes Mellitus. Able to understand the causative factors. the student nurse
appropriate health importance of healthy
worker about the lifestyle such as eating Encourage the family
nutritious foods, to have regular
hereditary disease.
exercise and other check-up.
preventive measures.
Provide preventive
measures from
acquiring hereditary
disease.
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Recommendations are one of the most important things for of any nurse to patient
relationship. We do this in order to improve the life of the client but also do this to put them
back in the right path of recovery.
First, I established rapport to the client to be able to get accurate data during the
interview. I suggested that she should check the next date for her Tetanus Toxoid vaccine and
emphasized the importance of completing the vaccine. I assessed her knowledge about nutrition
as a basis for health teaching on nutrition. I also advised her to exercise and observe cleanliness
around the house. I recommended her to increase her fluid intake and reiterated the
importance of hand washing. Lastly, I advised her to go to the clinic if any health problems are
present.
VIII. References
BH, J. (2016). Promoting Patient- and Family-Centered Care Through Personal Stories.