Family Case Analysis 2

ANGELES UNIVERSITY FOUNDATION
Angeles City
In Partial Fulfillment of the Requirements in Related Learning Experience
COMMUNITY HEALTH NURSING:

FAMILY CASE ANALYSIS
“An Assessment of Griffin Family in Barangay Sapalibutad”
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
A family is a unit composed not only of children but of

men, women, an occasional animal, and the common cold.
~Ogden Nash
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.
FCA is a tedious and painstaking requirement but it is rewarding enough as it is. It

served as a wakeup call for all student nurses, making them witnesses of the poverty and
decreasing self-reliance when it comes to healthcare which are becoming ubiquitous in the
community at present.. The plain fact that the student nurses were given an opportunity to help
these people and make them happy made all working days worth their while.
A. Objectives
a. Short Term: Student Centered

After 2 days of home visit to Barangay Sapalibutad, the student nurses will:
 Familiarize themselves with the physical surroundings of the community.
 Choose a family that would serve as the center of study for the family case analysis.
 Introduce oneself to the family and stating their purpose and methods.
 Obtain consent from the family allowing the student nurses to conduct a study.
 Establish rapport to the chosen family.
 Gather and obtain pertinent data including demographic, socio-economic, cultural, and
environmental data.
 Educate the family in the promotion of health and prevention of illness.
 Obtain individual health data by:
 Perform health assessment to each family member (IPPA-Cephalocaudal).
 Gather the following information: Mother’s obstetrical history.
 Assess the growth and development of the children and their immunization status.
 Gather and obtain each family’s nutrition status by age, weight and height.
 Gather information about family’s history and present illnesses.
 Acquire data regarding the family’s activities of daily living.
 Identify the existing and potential problems that may affect and aggravate the
family’s health status based on the data gathered.
b. Short Term: Client Centered

After 2 days of home visit, the family will:
 Demonstrate understanding regarding the purpose of home visits to be conducted by the
student nurse.
 Provide complete and necessary information in relation to all the family members’ history
of past and present illnesses, their activities of daily living and their nutritional status,
socio-economic, cultural and environmental conditions, sincerely.
 Identify the health problems present in their family.
 Acknowledge the services rendered by the student nurses.
 Establish rapport with the student nurses.
c. Long term: Student centered

After 2 weeks of home visit, the student nurses will:
 Apply the therapeutic communication skills during the interview and gain the cooperation
of the family.
 Understand the health planning situation and health practices of the family and use
these as basis in analyzing and planning future nursling interventions.
 Identify and prioritize the health problems jointly with the family.
 Formulate a family coping index.
 Plan with the family to solve the identified health and nursing problems.
 Implement nursing interventions and provide health teachings.
 Encourage every member of the family to participate in the health programs (activities
initiated by the student nurses).
 Help the family realize the importance of availing health services provided by the
community (Brgy. Health Center).
 Evaluate family’s response to the interventions and health teachings given.
 Reinforce interventions and health teaching if there is a need.
d. Long Term: Client Centered

After 2 weeks of home visit, the family will:
 Identify the health problems present in their family.
 Realize the importance of having and maintaining good health practices.
 Prioritize the identified health problems.
 Identify the ways or the appropriate actions to meet their health needs and health
problems.
 Comply with the health teachings rendered by the student nurses.
 Maintain an environment that is conducive to health and development.
 Demonstrate continuous compliance with the health teachings given even after student
nurses’ community exposure
 B. Entry, Climate of acceptance, first few words
 Group 1’s 4th rotation is in the community of sapalibutad. It is the group’s Second
time duty in a community setup but 1st time being in the community of sapalibutad,
Although not so quite familiar, the group was able to adopt the environment and cope up
with the people of the community.
 Feb 25, 2009 – Wednesday, it was the first day of encounter with the family to
adopt for family case analysis. The group scouted the community with eager of knowing
the family for their F.C.A. The group went to walk the streets with the sun raised very
high to find their family. Although it took a while, the group was able to arrive with a
family that passed the criteria for family case analysis accidentally. It was actually the
family’s neighborhood that the group is expecting to adopt, but luckily was not there and
instead of acquiring the neighbor, the Griffin family’s mother lois (mother) said that their
neighborhood left. So instead the group asked the Griffin family if they ould be the
group’s adopt family for family case analysis.
 “Gandng umaga po, Kame po ay taga AUF na naghahanap ng family na
puwedeng ma-adapt para sa FCA namen. Puwede po ba ang family niyo?” the group
said. “ah sige puwede halika pasok muna kayo” replied by the mother.”Salamat
po”comment by the group for accepting them by the family. “ Nay, ano po pangalan
niyo?” it was the first question asked by the group to start their assessment. The tension
and awkwardness ws immediately abolished and rapports was finally established, The
mother was very cooperative to the group, all possible questions were asked without
difficulties and able to answer all possible question asked. She even assured the group
that they could visit their family case analysis.

 Number of home visits:
 First home visit:
 Feb 25, 2009 – Wednesday, it was the first time that the group students will meet
their family. They initially started their establishment of rapport by greeting their family
warmly, introducing each of the members of their group and explaining to the family their
purpose for the visit. The group also identified each members of the family and tried their
best to get the trust of the family members. They started questions regarding the needed
information data including demographic data, socio-economic and cultural data of he
family. The group also gathered the mother, and her son and daughter baseline data
assessment without the father because of working time. The group initially identified
initial few family problems and conducted a schedule when to come back and to make
appropriate appointment for the assessment of the father.
 Second home visit:
 Feb 26, 2009 – Thursday. The 2nd day of the home visit. The group went to their
family and greeted the family warmly as they entered the house. The group was able to
meet the father of the family because if the set time for meeting. The group was able to
assess the father and clarify more things to obtain more specific and reliable data. The
group assessed each family members cephalocaudaly for P.A. Each member is very
cooperative during the assessment. The group assessed and identify further family
problems.
 Third home visit:
 Feb 27, 2009 – Friday, The 3rd day of home visit. The group finalized family
problems and obtain data of the living place including windows size measurement, floor
plan, house measurements and other data that is relevant for family case analysis, and
also the group was able to implement interventions for the family. And able to plan more
interventions for future home visit and identify more problems, if any. The group also
planned to which is the things needed by the family for their daily livings.
 Fourth home visit:
 March 4, 2009 – Wednesday. The 4th day of home visit. The group continued
intervention implementation for the family improvement and also conducted health
teaching for the family regarding health and wellness. The group was able to contribute
things for daily living that would aid the family towards wellness. The group was able to
improve their family hygiene by providing health hygiene kits.
 Fifth home visit:
 March 5, 2009 – Thursday. The 5th day of home visit. The group continued for
the interventions needed by the family. The group was again aided the family for hygiene
practices by assisting each family members and conducting health teachings. The group
prepared for the future home visit to evaluate the implemented intervention and also to
identify the improvements of the family and Evaluation followed.
II. Family Constellation
Name Age Position Sex Educational Status Present health status

Brian 32 yrs. Father Male High School Upon assessment Brian
Griffin old (4th yr Griffin was wearing a yellow
Undergraduate) long sleeved shirt black
pants and a pair of black
leather shoes, He is
cooperative, coherent and
oriented to time, place and
person, he has steady gait
and shows no difficulty
recalling events. He looks
exhausted. He stands 168
cm and weighs 63 kg, He
has a BMI of 22.34 which is
healthy weigh.
VS are as follows:
Temp: 36 c
PR: 73 bpm
RR: 21 bpm
BP: 100/60 mmHg
Sometimes experience
dizziness when standing
after Prolonged rest.
Lois 45 yrs. Mother Female Elementary Lois Griffin was wearing a
Griffin old (Grade 3) white shirt and pink pants,
her hair is tied up. She is
cooperative, coherent and
oriented to person, time and
place. She has a sense of
reality, shows no difficulty
recalling past event, she
stands 155 cm and weighs
46 kg, her BMI is 19.17
which is healthy weigh.
VS are follows:
Temp: 36.5 c
PR: 75 bpm
RR: 17 bpm
BP: 110/80 mmHg
She has difficulty hearing
especially with the use of her
right ear.
Meg 4 yrs 1st born Female Never been to Meg Griffin was wearing a
Griffin old daughter school white shirt and green pants
and a pair of dirty slippers.
She is unable to express
herself through speech. She
has a steady gait and unkept
appearance. She stands 88
cm and weighs 9 kg.
VS are as follows:
Temp: 36.3 c
PR: 89 bpm
RR: 22 bpm
Often Cough and colds with
nasal discharge
Stewie 3 yrs 2nd born Male Never been to Stewie was wearing a white
Griffin old Son school shirt and red shorts and a
pair of slippers. He is unable
to express himself through
speech. He has steady gait.
He stands 88 cm and weighs
10 kg.
VS are as follows:
Temp: 36.2 c
PR: 90 bpm
RR: 20 bpm
Episodes of cough and colds
III. HEALTH ASSESSMENT
To be a health educator, a community health nurse must be able to determine initially

any abnormalities or deviations from clients’ health. Assessing the health status of a client is a
major component of nursing care and has two aspects: (1) the nursing health history and (2)
physical examination. One way by which health status of the family can be assessed is through
physical examination using cephalocaudal approach. It is done using inspection, palpation,
percussion and auscultation to identify areas for health promotion and disease prevention.
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).
Assessment enhances identification of physical and psychological needs. The amount,

depth, and level of assessment skills vary with the knowledge and expertise of a nurse. Data
about the present condition or status of the family are compared against norms or standards of
problems.
1. BRIAN GRIFFIN
PHYSICAL ASSESSMENT
( February 25, 2009, Wednesday )
Vital signs:
T- 36 °C
P- 73 bpm
R- 21 cpm
BP- 100/60 mmHg
General Appearance and Mental Status:

During the assessment, Brian Griffin was wearing a yellow long-sleeved shirt, black
pants and a pair of black leather shoes. He is cooperative, coherent and oriented to person,
place and time. He has a steady gait and shows no difficulty in speaking. He also exhibits
thought association and has a sense of reality. He has no difficulty recalling past and present
events. He looked exhausted. He stands 168 cm and weighs 63 kg.
HEAD AND FACE

Head
His hair is black in color. It is evenly distributed and no presence of dandruff was noted.
No presence of infestations were noted.
Skull and Face

He has normocephalic skull and with smooth skull contour. No nodules and masses
were noted upon palpation. His face is symmetrical in shape and there is no abnormal elevation
or depression on the face.
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.
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 a complete 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.
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. 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 )
Underweight < 18.5

Healthy Weight 18.6-22.9
Overweight > 23.0
At risk 23.0-24.9
Obese I 25.0-29.9
Obese II > 30.0
HISTORY OF PAST ILLNESS

According to Brian Griffin, he had measles during his childhood. He stayed for almost
three weeks in the hospital. This was managed through medications and rest. He also had
episodes of convulsions accompanied by fever last 2003. First he was brought to a secondary
level hospital in Angeles City for a check-up, then he was confined in a district hospital in
Magalang, Pampanga. During his stay in the said hospital, he also had an elevated blood
pressure and he was given an antihypertensive medication which, according to him, was given
sublingually. He also uses herbal medicines like Lagundi and Oregano for cough and colds and
Paracetamol for fever.
HISTORY OF PRESENT ILLNESS

Brian Griffin mentioned that he sometimes experiences dizziness when he assumes a
standing position after a prolonged period of rest. He also visits the health center for
consultation and checking of blood pressure.
ACTIVITIES OF DAILY LIVING

Brian Griffin usually wakes up at 6:00 in the morning to prepare for work. Before leaving
for work, his morning routine usually includes eating breakfast and bathing. His work starts from
8:00 in the morning and he eats lunch at home at around 11:30 a.m. After lunch, he goes back
to work by 1:00 p.m. At around 5:00 p.m, he leaves his work to eat dinner at home, then goes
back to work again by 7:00 p.m. His work ends at 12 midnight. He usually sleeps immediately
after work. He works from Monday to Saturday. During his free day ( Sunday ), he plays with his
children and helps his wife with other household chores. A television set also serves as a form
of leisure for Brian and his family.
PHYSICAL ASSESSMENT (Final )

( March 4, 2009, Wednesday )
Vital signs:
T- 36.7 °C
P- 67 bpm
R- 18 cpm
BP- 110/70 mmHg

During the assessment, Brian Griffin was wearing a white long-sleeved shirt, black pants
and a pair of black leather shoes. He is cooperative, coherent and oriented to person, place and
time. He has a steady gait and shows no difficulty in speaking. He also exhibits thought
association and has a sense of reality. He has no difficulty recalling past and present events. He
looked exhausted. He stands 168 cm and weighs 63 kg.
HEAD AND FACE

Head
His hair is black in color. It is evenly distributed and no presence of dandruff was noted.
No presence of infestations were noted.
Skull and Face

Eyes
Ears
presence of impacted cerumen . He can hear and respond when he is asked.
Nose
Lips and Teeth

mucosa are uniform in color. He has a complete set of teeth and his tongue is in central position
and he can move it freely.
NECK
Neck Muscle
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
Abdomen
bowel sounds.
Skin
He has brown-colored skin which is generally uniform except in areas of lighter
pinched.
Extremities
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
Vital signs:
T- 36.5 °C
P- 75 bpm
R- 17 cpm
BP- 110/80 mmHg
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.
HEAD AND FACE

Head
Her hair is black in color. It is evenly distributed and presence of dandruff was noted. No
presence of infestations was noted.
Skull and Face

She has normocephalic skull and with smooth skull contour. No nodules and masses
were noted upon palpation. Her face is symmetrical in shape and there is no abnormal elevation
Eyes
Her eyebrows are symmetrically aligned with hair evenly distributed. Eyelashes are also
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
Ears
Her auricles are same as facial color and it is aligned with the outer canthus of the eye.
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
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
Head movements are coordinated and she can move his head freely.
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
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
She has good skin turgor, which turned back to previous state in less than 3 seconds when
pinched.
Extremities
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)
Body Mass Index (BMI) = 52 kg

2.4 m2
= 21.6
Interpretation:
Healthy Weight
Legend:
BMI Table
( Based on Asia-Pacific Obesity Guidelines )
Underweight < 18.5

Healthy Weight 18.6-22.9
Overweight > 23.0
At risk 23.0-24.9
Obese I 25.0-29.9
Obese II > 30.0
OBSTETRICAL HISTORY
Lois Griffin has two children . She delivered them both via Normal Spontaneous
Delivery. She delivered her first child at a secondary level hospital in Angeles City while her
second child was delivered by a midwife ( home delivery ). Her first child didn’t reach full term
and she had eclampsia during the delivery of her first child. She was also given antihypertensive
drugs which were taken sublingually for elevated blood pressure. Her second child reached full
term. She has been pregnant and has given birth two times- G2P2 ( T1P1A0L2 ).

According to Lois Griffin, she had Chickenpox and sore eyes during childhood. No
interventions were made to manage these. For episodes of fever, she took Paracetamol. She
also had eclampsia during the delivery of her first child and she was given antihypertensive
drugs for elevated blood pressure which were taken sublingually.

According to Lois Griffin, she has difficulty hearing, especially with the use of her right
ear. No intervention has been done to manage this. She also uses Lagundi and Oregano for
cough and colds and a topical for muscle pains.

Lois Griffin usually wakes up at 5:00 in the morning to prepare breakfast. After that, she
boils water for their daily drinking water. At around 8:00 a.m, she starts to do the laundry. After
doing the laundry, she performs/ does their household chores. When she’s done with the
household chores, she takes care of her children. She usually cooks lunch at around 11:00 a.m
but sometimes she doesn’t cook lunch anymore, since Brian brings home lunch. She looks after
her children for the rest of the day and sometimes she looks after her neighbors’ children. She
eats dinner at around 6:00 p.m or by the time Brian arrives from work. She usually sleeps by
10:00 p.m. A television set serves as a form of leisure and she also plays with her children.
PHYSICAL ASSESSMENT ( Final )
Vital signs:
T- 36.8 °C
P- 78 bpm
R- 20 cpm
BP- 110/70 mmHg

During the assessment, Lois Griffin was wearing a yellow blouse and brown 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.
HEAD AND FACE

Head
Her hair is black in color. It is evenly distributed and presence of dandruff was noted. No
presence of infestations were noted.
Skull and Face

Eyes
Ears
presence of impacted cerumen . Her hearing in her right ear is slightly impaired but she was
able to respond when asked.
Nose
Lips and Teeth

NECK
Neck Muscle
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
Abdomen
bowel sounds.
Skin
She has light brown-colored skin which is generally uniform except in areas of lighter
pinched.
Extremities
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
Vital signs:
T- 36.3 °C
P- 89 bpm
R- 22 cpm

During the assessment, Lois Griffin was wearing a white shirt and green pants. She is
unable to express herself through speech. She has a steady gait and unkempt appearance. She
stands 88 cm and weighs 9 kg.
HEAD AND FACE
Head
Her hair is slightly dark brown to black in color. It is evenly distributed and no presence
of dandruff was noted. No presence of infestations were noted.
Skull and Face

Eyes
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
presence of impacted cerumen . She can hear and respond only through movements.
Nose
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.
Lips and Teeth

NECK
Neck Muscle
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
Abdomen
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.
pinched.
Extremities
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
Interpretation: ( Based on FNRI )

Malnourished
GROWTH AND DEVELOPMENT
Erik Erikson’s Psychosocial Stage
Meg Griffin is considered to be under the Autonomy vs. Shame and Doubt, although her
age should be under the Initiative vs. Guilt stage. Meg can’t express herself through speech.
Also, according to Lois, her mother, she is having temper tantrums and exhibits separation
anxiety. She also cries loudly and demandingly and sometimes rejects any attempts to be
comforted.
Sigmund Freud’s Psychosexual Stage

Meg Griffin is considered to be under the Anal phase. She says the word “ihi” to tell her
mother that she needs to void. She is learning to control urination and defecation.

According to Meg’s mother, Lois, Meg had erratic parasitism a few weeks before the
assessment. No intervention was done to manage this. Meg has no history of hospitalization or
any other serious childhood illness.

Most often, Meg acquires cough and colds and the family manages this through a herbal
medicine, Lagundi. Nasal discharges were noted on the assessment.
Meg usually wakes up at 7:00 a.m. She eats breakfast first, then she plays or watches
television with her brother. She takes a nap usually around 9:30 or 10:00 a.m and wakes up by
11:00 or 11:30 a.m to eat lunch. She does most of her leisure activities in the afternoon like
playing with their neighbors and sometimes she also takes afternoon naps. She eats dinner at
around 6:30 p.m or by the time her father arrives sform work. She usually sleeps at around 9:00
or 10:00 p.m.

Vital signs:
T- 36.5 °C
P- 85 bpm
R- 24 cpm

During the assessment, Lois Griffin was wearing a long white dress. She is unable to
express herself through speech. She has a steady gait and unkempt appearance. She stands
88 cm and weighs 9 kg.
HEAD AND FACE

Head
Her hair is slightly dark brown to black in color. It is evenly distributed and no presence
of dandruff was noted. No presence of infestations were noted.
Skull and Face

Eyes
evenly distributed. Skin is intact, with no discharges and no discolorations present at the surface
Ears
presence of impacted cerumen . She can hear and respond only through movements.
Nose
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

NECK
Neck Muscle
Lymph Nodes
palpation.
THORAX AND LUNGS
Lungs
Heart
Abdomen
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.
pinched.
Extremities
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
Vital signs:
T- 36.2 °C
P- 90 bpm
R- 20 cpm
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
HEAD AND FACE

Head
His hair is dark brown in color. It is evenly distributed and no presence of dandruff was
noted. No presence of infestations were noted.
Skull and Face

Eyes
Ears
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
Lips and Teeth
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
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
Abdomen
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pinched.
Extremities
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
Interpretation: ( Based on FNRI )

Malnourished
GROWTH AND DEVELOPMENT

Erik Erikson’s Psychosocial Stage
Stewie is considered to be under the Autonomy vs. Shame and Doubt stage. He likes to
be carried by his mother and also has temper tantrums. According to Lois, his mother, he is just
silent and has less facial expressions.
Sigmund Freud’s Psychosexual Stage

Stewie is considered to be under the Anal phase. He is able to go to the bathroom when
he needs to void and defecate but still needs assistance from his mother or father.

According to Lois, Stewie did not have any history of childhood illness except for fever.
This was managed through tepid sponge bath.
Stewie Griffin has no history of present illness. Only intermittent episodes of cough and
colds are experienced by the patient. This were managed through the use of Lagundi and water
therapy.

Stewie usually wakes up by the time his mother wakes up, and that is at around 5:00
a.m. He eats his breakfast at around 7:00 a.m and takes his nap at around 9:30 or 10:00 a.m up
to 11:00 or 11:30 a.m. At around 11:30 a.m or 12:00 noon, he takes his lunch. He usually
spends his afternoon doing leisure activities such as watching tv and playing with their
neighbors, and sometimes, he also takes afternoon naps. He eats dinner at around 6:30 p.m or
by the time his father arrives from work. He usually sleeps at around 9:00 or 10:00 p.m.

Vital signs:
T- 36 °C
P- 81 bpm
R- 20 cpm

During the assessment, Stewie was wearing a white shirt and green shorts, and a pair of
blue slippers. He is unable to express himself through speech. He has a steady gait. He stands
HEAD AND FACE

Head
His hair is dark brown in color. It is evenly distributed and no presence of dandruff was
noted. No presence of infestations were noted.
Skull and Face
Eyes
Ears
presence of impacted cerumen . He can hear and respond through head movements.
Nose
Lips and Teeth

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
Lymph Nodes
palpation.
THORAX AND LUNGS

Lungs
Heart
Abdomen
bowel sounds.
Skin
He has light brown-colored skin which is generally uniform except in areas of lighter
pinched.
Extremities
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
A. Type of Family Structure

The Griffin Family is a nuclear type of family, composed of parents: Brian and Lois, and
children: 4-year old Meg, and 3-year old Stewie. Brian and Lois are married for 5 years now.
Although the family is not lucky enough to have a wealthy and comfortable living, they still
manage to surpass every challenging situation that they encounter by having a positive outlook
in life.
B. Dominant family members in terms of decision making especially to health care
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.
C. Source of Income, Expenditures

The family’s source of income is Brian Griffin’s wage from being a construction worker,
earning Php275/day or Php8250/month. That would denote each member of the household
spends Php2062.50 monthly. According to NEDA, a family with an average income of less than
P 2768.60 per individual per month is considered poor. Ergo, one can classify the Griffin family
as poor. The family admits that the total earnings do not always suffice for their basic needs
such as food, clothing, extra expenses, electricity and water bill. Summary of their estimated
monthly expenses is as follows:
EXPENSES AMOUNT
Food Php6000
Clothing and other expenses 2000
Electricity 200
Water 250
Total: Php8450
According to Griffin family, in case of emergency in medical-related needs, they do not

have anyone to ask for help. They just hope that perhaps, a kind neighbor or two will be willing
to lend them some money.
D. Working Hours
Brian Griffin is the breadwinner of the household. He works from 6 am to 10 pm, 16
hours a day, Mondays to Saturdays. He is given a lunch and a dinner break, where he goes
home to eat around 12-1pm and 6-7pm, respectively.
E. Ethnic background and Religious Affiliation

Brian is a Kapampamangan native, whilst Lois is an Illongga woman. The family’s
religion is Roman Catholic, so very few restrictions are being implemented, almost negligible.
According to Lois, they attend the Holy Mass during Sundays.
F. Significant other’s roles in the family Life

Basically, the significant others’ roles in the family life is almost negligible. Lois’s
relatives are also struggling for food in the province of Negros, whilst Brian’s family of
orientation has already died. Ergo, there is really no one to help them in times of crises. Their
only hope is basically, each other.
G. Health habits/ Health Beliefs

The assessment of the health beliefs of the family would help student nurses to
recognize the family’s method on how they handle health problems. The family resorts to herbal
medicines due to shortage of money. Some of these would include oregano and lagundi for
colds, pounded guava leaves for diarrhea and they also take into consideration the practice of
the herbolarios specifically the manghihilots and mananawas. They also pay a visit or two at the
barangay health center for consultation in case of fever or other minor health complaints. Self-
medication with paracetamol and NSAIDS is also a practice. These health beliefs and customs
are considered factors that may greatly affect the children’s upbringing and health status.
H. Family’s involvement in Community activities

According to Lois, she often participates in seminars being held in the barangay health
center. They also make use of its services in times of minor health complaints.
I. Family’s utilization of Community Resources

Community resources in the barangay include the health center, and the chapel.. The
family makes use of the health center for the vaccination of their children and goes there in
cases of fever, coughs and cold, which can’t be managed by self-medication. Nobody in the
family goes to school as of the moment. The church is also utilized by the family as they
conscientiously attend the Holy Mass every Sunday.
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.
K. Food Sources, Storage and Cooking Facilities

For breakfast, lunch and dinner, the family always buy home-cooked meals from the
canteen where Brian Griffin works. They also buy from sari-sari stores and the market near their
place. Lois only prepares the rice, and the viands will be taken cared of Brian. Food storage
comprises of food in covered casseroles or plates. Since they do not have refrigerator to keep
their leftovers, they just eat it up on the next meal. Usually, they just use homemade charcoal
stove or grill with wood to cook their rice in the front yard.
L. Water Supply (source, ownership, potability, storage)

The family has a level 3 water system. They own such water supply facility. Adults in the
family drink the water from the household tap, whilst the water to be drank by the children
should be boiled first. Their type of drinking water storage is pitchers or jars with cover.
M. Toilet Facility (type, ownership, sanitary condition)

Their toilet facility is at the rear of the house. Its nature is of a septic tank without water
carriage so naturally, it has to be mechanically flushed by pouring water in it. It is observed to be
in good condition because of the surrounding area of the toilet bowl is clean and no
discoloration or foul odor is evident.
N. Drainage System (type, sanitary, condition) and Garbage Disposal
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.
P. Communication and Transportation Facilities

In the community, the families who can afford have telephone lines installed and own
their own transportation vehicle. However, the Griffin family can’t, so they just have to deal with
commuting, riding a bicycle, a tricycle or public utility jeepney to go places. They can also walk if
the destination is just considerably near. Their primary means of communication is the actual
familial interaction. Their family seemed closed-knit anyway they communicate with their family
in Negros through their neighbor’s cellphone.
V. PROBLEM IDENTIFICATION
A. List of Problem Identified
No. Problems Identified Score Rank
1 Presence of Health Deficit: Cough and Colds 4.67 1

Poor Environmental Sanitation: Presence of Vermin, Rodents
2 4.34 2
and Flies
3 Presence of Health Deficit: Parasitism 4.17 3
4 Poor Personal Hygiene 3.84 4

Family size beyond what family resources can adequately
5 3.34 5
provide: Inadequate Family Resources
6 Presence of Accident Hazard: Fire Hazard 3 6
7 Poor Environmental Sanitation: Lack of Food Storage Facilities 2.84 7.5
8 Poor Daytime Lighting Condition 2.84 7.5
9 Presence of Developmental Delay 2.33 9
10 Poor Ventilation due to Economic/ Cost Implication 1 10

B. Priority Setting
Problem# 1: Presence of Health Deficit: Cough and Colds

Actual
Criteria Computation Justification
score
The problem is a health deficit, cough and
colds are deemed to be a normal reaction of
1. Nature of the the body against microorganism which has
3/3 x 1 1
problem invaded the body, and this is by expelling
these microorganisms through coughing
reflex.
2/2 x 2 2 Upon the observation of the criteria
2.Modifiability of the regarding the modifiability aspect of the
problem problem, the student nurses was able to
deem that that the problem has a highly
Current modifiable aspect AEB the justifications
 stated below:
knowledge
Family
 > The family has a current knowledge of the
Resources
SN problem as during the interview the Mrs. Lois
 was able to verbalize the presence of the
Resources
Community problem
 "inuubo tsaka sinisipon sila"(they have
Resources
cough and colds)
> The family's manpower and physical

resources are available AEB the family's
willingness to cooperate and comply with the
Student Nurses health teachings and as
verbalized by Mrs. Lois she has a
management for the problem AEB her
statement:
“kapag inuubo sila, gumagamit ako nung
lagundi, minsan yung oregano pag walng
lagundi” (when they have cough and colds, I
tend to give them lagundi extracts and if not I
use oregano as alternative)
> The Student Nurses are well informed and

knowledgeable about the mechanism of
cough reflex and the management to be
done to prevent the occurrence of
complications thus making them enable to
impart this knowledge to the family, another
thing is the Student Nurses willingness to
help the family to minimize if not to eradicate
this problem.
> The Barangay Health Center offers

Mother's Class and conducts information
dissemination on how to properly manage
such problem and when to seek medical
attention.
3. Preventive Prevention of aggravating these conditions
Potential have a moderate potentiality as reflected by
the criteria the Student Nurses have
Severity ▼ observed:
Duration ▲ > The problem is already severe as both of

Current the children are affected.
▲
Management
High -risk >The problem has existed for not so long
▲ time ago, since this problem just existed 2-3
Group
days ago therefore this can still be managed
through home care.
2/3 x 1 .67 >The family has a current management on

the problem,
“kapag inuubo sila, gumagamit ako nung
lagundi, minsan yung oregano pag walng
lagundi” (when they have cough and colds, I
tend to give them lagundi extracts and if not I
use oregano as alternative) as verbalized by
Mrs. Lois upon interview.
> The children are the high risk group of the

problem, since their not well develop
immune system and their lifestyle as a child
makes them susceptible in acquiring such
conditions.
Prior to the interventions and health
4. Salience of the teachings, the family has already viewed this
2/2 x 1 1
problem as a problem, which needs an immediate
action.
Total Score 4.67
Problem# 2 Poor Environmental Sanitation: Presence of Vermin, Rodents and Flies

Actual
score
Presence vermin, rodents, flies and
mosquitoes are good vector of diseases;
1. Nature of the
2/3 x 1 .67 presence of these vectors increases the
problem
susceptibility of acquiring diseases, thus
imposing a health threat to the Griffin Family.
The problem is highly modifiable AEB the
2.Modifiability of the following criteria observed:
problem
> The family has a current knowledge of the
Current
 problem as during the interview the Mrs. Lois
knowledge was able to verbalize the presence of the
Family 
Resources
problem
"ay oo may mga daga dito tsaka ipis
SN Resources 
ganyan"(oh yes there are rats and
Community  cockroach here)
Resources
> The family's manpower and physical
resources are available AEB the family's
willingness to cooperate and comply with the
Student Nurses health teachings and as
verbalized by Mrs. Lois they minimize
presence of such mosquitoes by physical
means.
2/2 x 2 2
> The Student Nurses are well informed and
knowledgeable about vector borne diseases
and the management to be done to prevent
the occurrence of these diseases and on
how to eradicate those rodents and insects,
thus making them enable to impart these
knowledge to the family, another thing is the
Student Nurses willingness to help the family
to minimize if not to eradicate this problem.
> The Barangay Health Center offers

Mother's Class and conducts information
dissemination on how to prevent the
multiplication of these vectors and
insecticides are also available in the
community.
3. Preventive 2/3 x 1 .67 Prevention of these vectors has a moderate

Potential potentiality as reflected by the criteria the
Student Nurses have observed:
Severity ▲
> The problem is not yet severe since no one
Duration ▼ on the family was affected by the problem,
Current ▲ the rodents bit no one, no one has acquired
Management any of the vector borne diseases.
High -risk Group ▲
>The problem has existed for a long time
ago, this has already existed approximately
for almost 5 years as verbalized by Mrs. Lois
that there were already rodents and insects
the moment they transferred to their house
>The family has a current management on
the problem this is through physical means,
"pinapatay namin yung lamok sa kamay" (we
kill them by clapping our hands against
them) as verbalized by Mrs. Lois upon
interview.
> The children and even Mr. Mrs. Griffin are

all at risk to be affected of the problem, since
they all live on the house.
Prior to the interventions and health
4. Salience of the teachings, the family has already viewed this
2/2 x 1 1
problem as a problem, which needs an immediate
action.
Total Score 4.34
Problem# 3 Presence of Health Deficit: Parasitism

Actual
score
Parasitism are health deficits brought about
by poor personal hygiene wherein
helminthes invade a child’s body more
1. Nature of the
3/3 x 1 1 particular of the gastrointestinal tract, thus,
problem
leading to infection and poor nutritional
status.
2/2 x 2 2 As reflected by the criteria below, it shows

2.Modifiability of the that the problem on presence of parasitism
problem has a high modifiability status.
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.
> With the student nurses knowledge and

childhood illness background the student
nurses can provide the family health
teachings about the importance of
preventing this condition to promote good
nutritional status
> The barangay health center provides free
dewormer that would manage the family
problem regarding parasitism.
3. Preventive The problem of the Griffin family
Potential regarding parasitism has a moderate
preventive potential after the student
Severity ▲ nurses has considered the following
▼ criteria presented below.
Duration
Current ▼
Management
> The problem is not that severe as meg
High -risk Group ▲ is the only one affected by the said
condition.
> The problem approximately exists long ago

as Meg was already able to manifest erratic
parasitism.
2/3 x 1 .67
> The family does not manage the problem
as Lois is afraid of giving dewormer to Meg
due to misinterpretation of the said
intervention AEB by her statement:
“yung kapitbahay kasi naming nung
pinurga nya yung anak nya namatay kasi
lumabas sa bibig yung bulate, kaya
natatakot ako purgahin si Meg”(I am afraid to
deworm Meg as when my neighbor
dewormed her child, her child died because
the worms came out on his mouth)
> Meg is the primary high risk group of

the said problem.
Prior to the student nurses verbalizing the
4. Salience of the problem to the family, the family is already
1/2 x 1 .5
problem aware of this but for them it does not need
an immediate action.
Total Score 4.17
Problem# 4 Poor Personal Hygiene

Actual
score
1. Nature of the 2/3 x 1 .67 Poor Personal hygiene is a health threat to
problem the family as this problem predisposes to
health deficits such as parasitism, cough and
colds and other hygiene – related health
deficit.
Upon the observation of the criteria
2.Modifiability of the regarding the modifiability aspect of the
problem problem, the student nurses was able to
deem that that the problem has a highly
Current  modifiable aspect AEB the justifications
knowledge stated below:
Family 
Resources >Lois is fully aware of the said problem
SN  especially to her children.
Resources
Community  > The family has physical resources
Resources 2/2 x 2 2 specifically cleaning articles such as soap,
shampoo and the like.
> The student nurses knowledge will enable

them to provide the family with health
teachings regarding personal hygiene such
as cutting their finger and toenails, washing
their hands and the like.
>The community offers Mother’s Class

where the family could learn about good
personal hygiene.
3. Preventive After the Student nurses have analyzed the
Potential criteria on determining the Preventive
Potential of the problem, it suggests that the
Severity ▼ problem has a moderate preventive
potential.
Duration ▼
Current ▲ > The problem is already severe as the
Management almost of the family members are observed
High -risk to have a poor personal hygiene and one of
▲ the family member already manifesting a
Group
hygiene – related illness. (Meg- parasitism)
> The problem on poor personal hygiene

2/3 x 1 .67
approximately exists for 5 months already as
Mrs. Lois tries to limit all of their consumption
due to limited financial resources, thus
affecting the family hygiene.
> as a management the family still make

sure that they take a bath for at least once a
day.
>All of the family member are the high risk

group of the said problem as all of them has
a poor personal hygiene thus all of them are
susceptible to acquire health deficit.
4. Salience of the 1/2 x 1 .5 Prior to the student nurses do their
interventions; the family does not see their
problem
poor personal hygiene as a problem at all.
Total Score 3.84
Problem# 5 Family size beyond what family resources can adequately provide:
Inadequate Family Resources
Actual
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.
> Family's physical and manpower

resources are not enough to correct the
problem. Mr. Brian's income is not enough
to suffice their needs.
>The Student Nurses can pinpoint some tips

on how they are going to minimize their
water and electric consumption and
enumerate some foods that are nutritious
yet cheap which may help in lowering their
expenses. Examples of this are:
 Use fluorescent lamp instead of light
bulbs.
 Close the faucet when not in use
 Remove barriers on the windows to let
the sunlight enter the house so that
they may minimize the use of electricity
for lighting.
 Foods such as vegetables, tofu and the
like.
> Community Resources are not available,
since if the community would manage the
family problem, they also have to help the
other families which have the said problem
and the community’s budget is not enough
to respond on this problem.
3. Preventive The problem has a moderate preventive
Potential potential as reflected by the following
criteria:
Severity ▼
> The family's monthly income is really small
Duration ▲ and would not suffice their needs and if to
compare with the NEDA prescribed share
Current ▲
Management amount of money that each of the family
members must have it is really far behind.
High -risk Group ▲
NEDA- P2, 768.60
Griffin family- P8250 (P8250/4 = P2062.50/
individual)
And to analyze their expenses it would show
that they spend more of what they can
adequately provide:
2/3 x 1 .67 Food – P6000

Miscellaneous – P2000
Electricity - P200
Water - P250
TOTAL - P8450
>The problem existed for almost 5 months
ago after Brian lost his job.
> The family has a current management on

the problem since Mr. Brian was able to find
a job on a construction firm at the city
vicinity.
> All of the family members with emphasis

on the children are the risk group of the
problem as they have all their basic need
that must be sufficed.
The family sees this as a problem, which is
for them, needs an immediate action AEB
4. Salience of the
2/2 x 1 1 when the Student Nurses did their interview
problem
Mrs. Lois was able to verbalize their
problem financially.
Total Score 3.34
Problem# 6 Presence of Accident Hazard: Fire Hazard

Actual
score
Accident hazards are health threat to the
family; on the griffin family’s case their faulty
1. Nature of the
2/3 x 1 .67 wirings are fire hazards wherein if fire
problem
happens on their house brought about by
this faulty wirings, fatality is mostly to occur.
After the student nurses have considered the
2.Modifiability of the following criteria below, it reflected that the
problem problem is moderately modifiable.
Current > the family has a current knowledge of the

knowledge  problem AEB Lois statement during the
Family Resources  interview:
“madaling magkasunog dito, nasunugan
SN Resources  na kami nung January 30”(this house can
Community easily be damage by fire, we have
Resources  experienced it last January 30)
> The family’s financial resources will not be

able to suffice the expenses needed to fix
1/2 x 2 1
the problem, since they are already
experiencing financial shortage for their daily
needs.
> The student nurses could inform the family

about the existence of the problem and site
some possible consequences that may arise
brought about by faulty wirings such as fire.
> There are no available community

resources since if the community will do
something about the problem they also have
to do the same actions they have done to the
Griffin family.
3. Preventive 1/3 x 1 .33 After the student nurses have considered the
Potential following criteria below, it reflected that the
problem has a low preventive potential.
> The problem is severe as observed by the

student nurses as majority of the electrical
wiring are exposed, and as aforementioned
by Lois, they have already experience fire
accident last January 30, and their neighbor
Severity ▼
experienced it too.
Duration ▼
> The problem approximately exists for
Current ▼ about 5 years since the problem have
Management
existed when Mrs. Lois and her family
High -risk Group ▲ transferred to that house.
“nung lumipat kami dito ganito na yung itsura
ng bahay” (when we transferred here the
house physical structure was already like
this.)
> The family does not have any current

management to the problem due to lack
of financial resources.
> All of the family members are exposed to

the problem, since all of them resides on that
house.
Prior to the student nurses conduct their
4. Salience of the interventions; the family sees it as a problem
2/2 x 1 1
problem which according to Lois needs an immediate
attention.
Total Score 3
Problem# 7.5: Poor Environmental Sanitation: Lack of Food Storage Facilities

Actual
score
The Griffin Family’s problem on lack of food
storage facilities is considered to be a health
threat as it predisposes the family to
Gastrointestinal problems such as diarrhea,
1. Nature of the
2/3 x 1 .67 Acute Gastroenteritis and other food borne
problem
diseases, since improper storage of food
predisposes contamination of the food thus
leading to the said Gastrointestinal
problems.
2.Modifiability of the Upon the observation of the criteria
problem regarding the modifiability aspect of the
problem, the student nurses was able to
deem that that the problem has a partially
modifiable aspect AEB the justifications
stated below:
> the family has a current knowledge of the

said problem AEB Lois statement:
“tinatakpan ko na lang ng pinggan yung
tira namin na pagkain kung meron,
nilalangaw kasi, wala naman ako
paglalagyan”(I just cover it with plates if ever
we have left over foods, to prevent those
flies going on to the food, we don’t have any
food storage to utilize)
1/2 x 2 1
> The family does not have any physical
resources such as articles like Tupperware
that they can use to store their foods, and
also the family does not have enough
financial resources to suffice the expenses
they need for them to b able to buy those
storage facilities mentioned.
> With the equipped knowledge that the

student nurses have, the student nurses are
capable enough to provide health teachings
to the family such as the consequences that
may arise due to lack of food storage
facilities such as contamination of the food
they eat ant the ingredients they use in
cooking.
> the community is not directly related to

address the problem, the problem is more of
a family oriented problem therefore, a family
oriented action would be helpful in managing
the problem.
Upon the assessment of the following criteria
3. Preventive mentioned below, the problem on lack of
Potential storage facilities yields a moderate
preventive potential.
> The problem of the family on lack of food

storage facilities is considered to be severe
as evidenced by the observations of the
student nurses upon the assessment of the
housing and environmental sanitation of the
house the student nurses was able to
observe that the storage facility that the
family uses is very dirty as evidenced by soil
particles and flies present on the storage
Severity ▼ facility.
Duration ▼ > The problem is already long duration since
Current
▲ they do not really have enough utensils and
Management
storage facilities even before (5 years
High -risk Group ▲ approximation)
> As a management to the problem Lois

uses plates to cover their left over foods if
2/3 x 1 .67 any.
> High- risk group are all the family members

of the Griffin family since all of them benefit
on the said food.
The family see this as a problem but it does
4. Salience of the
1/2 x 1 .5 not need an immediate action as they have
problem
more prioritized problem compared to this.
Total Score 2.84
Problem# 7.5: Poor Daytime Lighting Condition

Actual
score
The family’s problem on poor lighting is
considered to be a health threat to the
family, since with poor lighting condition, it
may bring strain on the eyes which may lead
to eye problem such as blurring of the vision,
another thing is this may lead to accidents
1. Nature of the
2/3 x 1 .67 since without the use of enhancement for
problem
lighting condition such as lamps the family
member cannot see their home environment
clearly thus may lead to accidents such as
sliding and the like.
1/2 x 2 1 After considering the criteria below, the

2.Modifiability of the Student Nurses have arrived to a result that
problem shows that the problem of the Griffin family is
moderately modifiable.
Current
knowledge  > The family has a current knowledge on the
Family Resources  problem as shown with the behavior of Mrs.
Lois wherein the student nurses have
SN Resources  observed Mrs. Lois invites the student nurse
Community to just stay on the outside.
Resources  “pasensya na kayo dito na lang tayo sa
labas madilim kasi”(let’s stay here outside it
is too dark inside).
> The family has limited financial resources

in which the family cannot suffice the
expenses in improving their lighting
condition.
> The student nurses are well equipped of

the knowledge about having a good lighting
condition thus, the student nurses can
provide the family some health teachings to
the family regarding the importance of
having a good lighting condition such as it
prevent straining the eye and making their
environment more visible, they can also
pinpoint some articles that contribute to the
problem such as the curtain that blocks the
light coming in on their small window.
> The community itself has limited resources

to address this problem, as observed, most
of the household on the community suffers
from this problem, thus the community must
respond to the problem of the other
members of the community if the community
will respond to the problem of the Griffin
Family.
3. Preventive The Griffin family’s problem on poor lighting
Potential condition has a moderate preventive
potential as reflected by the criteria shown
below:
> The problem is severe as evidenced by

upon entering the house the student nurse
have observed that it is impossible to see
without the aid of electricity, the house is so
dark.
>The problem has exist for approximately

about almost 5 years, as stated by Mrs. Lois:
Severity ▼ “dati ang madilim dito, kahit nung paglipat pa
▼ lang namin dito” (this situation was the same
Duration
even the first day we were here when we
Current ▲ transferred, it is really dim inside the house)
Management
High -risk Group ▲ >The family uses light bulbs and open their
window to manage the problem.
2/3 x 1 .67
> All of the family members of the Griffin
family are exposed to this problem as they
were all living on that house.
Poor lighting condition is viewed by the
family as a problem upon interview with Lois
4. Salience of the
1/2 x 1 .5 and does not need immediate action prior to
problem
the student nurses conduct their health
teachings.
Total Score 2.84
Problem# 9: Presence of Developmental Delay

Actual
score
Developmental Delay is a health deficit as a
1. Nature of the delay in the developmental years would
3/3 x 1 1
problem only indicate an abnormal physiological
function of the body.
The problem is partially modifiable upon the
2.Modifiability of the consideration of the following criteria:
problem
>The family does not have any current
Current knowledge on the problem AEB Mrs. Lois
knowledge  just regard the problem as if it is just only
Family Resources  normal for Meg as she is a preterm child.
SN Resources  > Family manpower resources are

Community available; the family can go to the Barangay
Resources  Health Center for proper referral.
1/2 x 2 1
> Student Nurses are well equipped with
knowledge and skills enabling them to
impart information about the presence of
the problem so that the family could
address this problem properly and avoid
aggravation of the said condition.
> Community has NGO’s and government

hospitals for proper medical management of
the problem.
3. Preventive The problem has a low preventive potential
Potential as reflected on the following criteria the
Student Nurses considered:
Severity ▼
> The problem is considered to be severe
Duration ▼ due to the following reasons:
Current  The awareness of the family to this
Management ▼ problem is not evident.
High -risk Group ▲  With Meg’s age, her actions are
inappropriate AEB she still doesn’t
know how to speak which is not
expected for children like her with the
same age.
1/3 x 1 .33
>The problem exists for so long already
approximately 3 years as she meg is
already 4 years old now and the things she
does is only normal for a child with 1 year of
age.
>They family do not have any management

on this problem since their awareness to
this problem is not evident.
>The main risk group of the problem is

Meg; Lois is also affected especially on
doing her ADL’s since she has to attend
with Meg’s needs.
The family does not view Meg’s
developmental delay as a problem since
4. Salience of the
0/2 x 1 0 they are not aware of the existence of this
problem
problem prior to the Student Nurses
informing them about this problem.
Total Score 2.33
Problem# 10 Poor Ventilation due to Economic/ Cost Implication

Actual
score
The problem is basically a health threat to
the Griffin Family as poor ventilation
condition predisposes cross contamination
since there is an inadequate air circulating
1. Nature of the
2/3 x 1 .67 on their home environment, another thing is
problem
that with poor ventilation condition, the family
members may suffer to respiratory problems
since there is minimal amount of air
circulating on their house.
After the student nurses have considered the
2.Modifiability of the following criteria below, it reflected that the
problem problem is highly modifiable.
Current > The family has no current knowledge of the

knowledge 
said problem AEB upon interview, Mrs. Lois
Family 
Resources told the student Nurses that:
 “hindi naman problema yan ganyan nay
SN Resources
an dati pa, tsaka ok lang yan presko naman
Community  napasok naman ang hangin eh”(it’s not a
Resources
problem anymore, it is just the same when
we transferred here, anyway it is cool here)
> The family has limited resources especially

0/2 x 2 0
financial resources since they are currently
financially challenged.
> With the skills, initiative and knowledge of

the student nurses, the student nurses can
provide the family with health teachings
regarding the importance of having a good
ventilation condition such as it will promote
relaxation and prevent cross contamination
of diseases.
> The community has no adequate
resources on resolving the problem, since it
would be of too much cost on the community
funds.
3. Preventive After the student nurses have considered the
Potential following criteria below, it reflected that the
problem has a low preventive potential.
Severity ▼
> The measurement of the windows of the
Duration ▼ house of the Griffin Family have not passed
Current ▼ the standard of the National Building code of
Management the Philippines R.A 6541 as evidenced by
High -risk Group ▲ the total measurement of the windows of the
house yield 0.27m2 which is less than 1/10th
of the total floor area of the house (16.92m2),
making their ventilation condition poor.
> The problem on poor ventilation condition

1/3 x 1 .33
of the Griffin Family existed for
approximately almost 5 years ago, as
verbalized by Mrs. Lois on her statement:
“nung lumipat kami dito ganyan na yan”
(when we transferred here the windows are
already like that)
> The family does not have any current

management of the problem due to low
salience of the problem.
> All of the family members are all affected

of the problem since all of them is living
together on that house.
4. Salience of the Mrs. Lois does not regard this as a problem.
0/2 x 1 0
problem
Total Score 1
VI. FAMILY NURSING CARE PLAN (in order of priority)
Problem# 1: Presence of Health Deficit: Cough and Colds
CUES FAMILY OBJECTIVE INTERVENT RATIONALE METHOD RESOURC EVALUATION

NURSING S IONS OF ES
PROBLEM FAMILY
CONTACT
>Presence >Inability to Short Term: >Determine > to Home >Time and >After 1-2
of nasal make >After 1-2 factors that determine Visit effort of hours of home
discharges decisions hrs. Factors can contributing the student visit, the
(meg an with respect that can contribute to factors/ nurses and members of the
stewie) to taking contribute to its etiologies. the family family shall
appropriate its occurrence. >To obtain have verbalized
>Verbal health occurrence. >Assess for baseline different ways
reports by action due Long Term: Family’s data. to manage
Lois Griffin to inability >After the current cough colds.
to decide end of the knowledge. >At the end of
which action 5th home >Reinforce 5 home visits,
to take. visit, the non the members of
>Inability to members of pharmacolog >to promote the family shall
provide the family ic measures wellness have
adequate will have such as demonstrated
nursing care changes in water changes in
to the sick, lifestyle to therapy. lifestyle to
dependent prevent >Identify prevent coughs
members of coughs and community >To and colds.
the family colds. resources increase
due to lack and facilities immune
of for support. system
knowledge >Teach >To prevent
about health deep increasing
condition breathing mucus
and exercises consolidatio
necessary and n
intervention/ coughing
treatment/ exercises
care. >Advice
client to eat
vit. C rich
food
>Prevent
from
drinking milk
Problem# 2: Poor Environmental Sanitation: Presence of Vermin, Rodents and Flies
CUES FAMILY OBJECTIVE INTERVENT RATIONALE METHOD RESOURC EVALUATION

NURSING S IONS OF ES
PROBLEM FAMILY
CONTACT
>presence >Inability to Short Term: >Assess >To obtain Home >Cooperati Short Term
of provide a >After 1hrs. family’s baseline Visit on of both >After 1 hours
cockroaches home Nursing environment data for family of Nursing
mostly in environment intervention al planning members Intervention,
kitchen conducive to the family conditions. appropriate and family shall
>absence of health will intervention student have verbalized
accessible maintenanc verbalize >Discuss s nurses of the
sink in the e due to different and explain >having a >knowledg importance of
kitchen inadequate methods to importance clean e of environmental
>kitchen family minimize of environment student sanitation.
and storage resources presence of environment greatly nurses
are in dose specifically vermin. al sanitation reduces the >use of Long Term
proximity financial Long Term >Discuss chance of cleaning After 3 days of
constraint >After 3 use of breeding agents home visits and
and limited days of pesticides vermin such as Nursing
physical Nursing and other >Inhibits house Intervention,
resources Intervention physical and kills the bleach or family shall
family will method to pests and Lysol have
minimize reduce thus >Pesticides
and control number of lessening
the pests in the occurrence
presence of house of vermin.
cockroaches >Encourage
. immediate >Prevent
plates and unpleasant
kitchenware smell and
before and areas of
after use. infestations.
>Encourage >Prevent
proper hand ingestion of
washing microorgani
before and sm carried
after eating by pests.
Problem # 3: Presence of Health Deficit: Parasitism
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.
Problem # 4 HEALTH THREAT: UNHEALTHY LIFESTYLE HABIT: POOR PERSONAL HYGIENE

METHOD
FAMILY RESOURC
OBJECTIVE INTERVENTI OF
CUES NURSING RATIONALE ES EVALUATION
S ONS FAMILY
PROBLEM REQUIRED
CONTACT
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
ANALYSIS NURSING METHOD OF RESOURCES EXPECTED

CUES OF THE OBJECTIVES INTERVENTI RATIONALE FAMILY REQUIRED OUTCOME
PROBLEM ONS CONTACT
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.
Problem #6: Presence of Accident Hazard: Fire Hazard
ANALYSIS NURSING METHOD RESOURCE EXPECTED

CUES OF THE OBJECTIVES INTERVENTIONS RATIONALE OF FAMILY S OUTCOME
PROBLEM CONTACT REQUIRED
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
Problem #7.5 Poor Daytime Lighting Condition
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
Problem #10: Poor Ventilation due to Economic/ Cost Implication
CUES FAMILY OBJECTIVES NURSING RATIONALE METHOD RESOURCE EVALUATION

NURSING INTERVENTI OF S
FAMILY
ANALYSIS ONS CONTAC REQUIRED
T
S> Ø > poor SHORT TERM: >Discuss to >To analyze Home >knowledge SHORT TERM:
ventilation After 1 the family the and realize Visits and GOAL MET,
O>the house due to low hour, the importance of the ideas communicati After 1 hour,
has only one salience of family will be having good regarding the on skills of the family will
window the able to ventilation matter the nursing verbalized
measuring to problem verbalize students. understandin
60cm x 45cm >lack of understandin >Explain the g about the
or 0.27m2 adequate g about the possible >For the >Participatio importance of
such knowledge importance of consequences family to n and having
measurement of the having of having poor become Acceptance adequate
is less than importanc adequate ventilation aware of the of family ventilation
10% e of proper ventilation possible members and
requirement ventilation and >Provide consequences consequences
posited by . consequences health >Time and if having poor
national if having poor teachings effort of the ventilation.
building code ventilation. about the >To provide student
of the significance of knowledge nurse and
Philippines as LONG TERM: adequate and realize the family. LONG TERM:
The total Floor After the 3 ventilation the benefits GOAL MET,
area is 16.92 days of home of having After the 3
m2 visit, the >encourage adequate days of home
family will be to Remove ventilation visit, the
>it is quite able to unnecessary family
warm inside demonstrate obstruction >To allow demonstrated
the house. techniques on which are passage of air techniques on
how to contained in inside the how to
improve the windows. house. improve
proper proper
ventilation. >Plan with ventilation.
the family in
thinking on
ways to >Develop
improve participation
ventilation on part of the
family.
VII. FAMILY COPING INDEX
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
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:
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
This category has to do with

  Initially, the student nurses observed
the maturity and integrity with
which the members of the that the family has a high emotional
family are able to meet the competence AEB how the family face
usual stresses and problems
their problem with enthusiasm and
of life, and to plan for happy
and fruitful living. This positive behavior no matter how difficult
involves the degree to which the problem is in which the family was
individuals accept the
able to maintain up to the last visit.
necessary disciplines
imposed by one’s family and
culture; the development and
maintenance of individual
responsibility and decision;
and willingness to meet
reasonable obligations, to
accept adversity with
fortitude, and to consider the
needs of others as well as
one’s own.
7. FAMILY LIVING

Initially, the family was observed that
largely with the interpersonal 
or group aspects of family life-
 they have an excellent family living AEB
how well the members of the the family regards a high respect to one
family get along with one
another, they support one another and
another, the ways in which
they make decisions affecting do things as a family especially when it
the family as a whole, the comes to decision making. The family
degree to which they support
was able to maintain this up until the
one another and do things as
a family, the degree of final visit.
respect and affection the
show for one another, the
ways in which the manage the
family budget, the kind of
discipline that prevails.
8. PHYSICAL
ENVIRONMENT  Initial:
Initially, the family’s physical
with the home and community environment has a fair grade. This is
or work environment as it due to the presence of accident
affects family health. This
hazards, level of storage facilities.
includes the conditions for
housing, presence of accident Transportation is also difficult; the
hazards, screening, plumbing, family uses the public mode of
facilities of cooking and for
transportation.
privacy; level of community
(deteriorated or modern,
presence of social hazards Final:
such as bars, street gangs,

An improvement was observed after the
delinquency, pest such as
rats, etc.), availability and health teachings.
conditions of schools and
transportation.
9. USE OF COMMUNITY
FACILITIES
This category has to do with

 Initial:
the degree to which family Initially, the family does not have
members know about and the enough knowledge on what are the
wisdom with which they use
available programs in the community
available community
resources for health, that they could avail, though they have
education, and welfare. The  some ideas of the barangay programs.
coping ability does not
indicate the level of the need
for services, but rather the Final:
degree to which they can During the final visit, after the
cope when they must seek dissemination of the barangay
such aid.
programs that they could avail
especially of that health related, the
family is now knowledgeable of this and
has developed interest on these
programs.
VIII. LEARNING DERIVED
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.
Carl Elexer Ano

At first, it was again, quite difficult for me to adjust from hospital environment to community
setting. After 2 consecutive rotations in the ward, all I could ever think of was doing SOAPIEs
and charting, making endless nursing care plans, administering meds- you get the idea.
However, in making Family Case Analysis, I realized that I could be of more help if I would focus
more on the family rather than the individual or the community as a whole, as this fundamental
unit making up the society is a buffer between the latter two, giving rise to a more efficient
catalyst I hope to become, even in just my small ways.
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. 
Ariane Camille M. Calma

In Sapalibutad you can learn many things if you put yourself into it”. The lesson that I have
learned in the community and to our adopted family because through them I came to realize that
simple things could be a meaningful one. At first, I was wondering how to adjust myself to
different situations that I will be going to experience. But moreover, I was able to appreciate
more things because of these experiences. I learned to value those, which are essential, and
the family had taught me that the value of simplicity of life does not hinder a person to maintain
happiness and always can smile through life passes.
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.
Michelle Louie Sotto

“There is no higher Religion than human service to work for the common good is the
greatest creed” –George Shinn
Community Health Nursing has made me recognized the importance of nurses
and health care providers especially in rendering health to the public. Indeed I felt so
very importance to the family. I also had experienced living in the resettlement areas in
which they have to live in the narrow alley. I never knew how lucky I was not until I
experienced it. I also felt the warmth with the family worked with us so that they would
be able to sustain and maintain wellness. I believe that in order for all the people to
reach the top we have to work hand in hand. It was good to see how much we change
and impact their lives. Indeed helping other people is never been a vain.
Noel Leoncio Q. Balilo
The family is a social group, is universal and it is significant element in man’s social life.
In every part of the world it consists of family. This family case analysis has given us another
new experience. It given us a chance not only to learn and to put into practice all the things that
we learn from school but it has also provided us an opportunity to help people who are really in
need. This is a activity which will make you realize many reality in our life. It made me
understand how lucky I am with the family I have, a family which is so perfect for me to say.
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.
Kristina Edna C. Cabrera

Through family case analysis, the student nurses learned how to develop communication skills
and how to deal with every individual in the proper way. Moreover, with the family’s economic
condition, the student nurse learned that being poor is not a hindrance to achieve and build
relationships and a healthy and satisfying life.
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.
Luigi Miguel H. de Jesus

As I was exposed in the community for almost 9 days, I’ve encountered a lot of
people and I had the chance to assess either pregnant women, sick children or
hypertensive individuals. I had the chance to see the deficits, threats to health of the
family we have adopted. I also learned how to properly assess a house and its family
members, on how important health is with the family.
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.
Mary Angelica Teoffy R. Libres

Through this experience, I have learned, discovered, and appreciated many
things. I have learned the importance of proper communication in dealing with the family
or other individuals and I also learned the importance of health teachings and how it can
affect the behavior and viewpoints of the family. Since the family are total strangers,
importance has to be emphasized on building trust, this may be a vital point in
coordinating with the family and in achieving the plans you have made with the family.
Since the period of the home visits consists only of a few days, it is important to give
your best in achieving self-reliance and also compliance to every health teaching given.
Compliance is an important thing I saw through this experience, seeing the family have
a change in behaviour even without reminding them is a something when achieved very
satisfying.
There are so much to learn in immersing yourself in an economically depressed
area but the most important thing is to be thankful with our condition in life because not
all people experiences the good life we have.
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:
Student Nurses Implementations
Griffin Family Health Teachings
Home Satisfaction
Assessment & Rapport

Nursing Interventions
Finding a family to fit the criteria, or are more than willing to be a part of the student
nurses’ education is quite of a dilemma. The student nurses had a hard time doing so, but
all complaints dissolved when they have found one.
The student nurses firstly, established rapport with family they chose to study. On the
succeeding days, health teachings were dispensed, thorough assessment and nursing
interventions were done and implementations to address problems were executed to help
alleviate the condition of the family, even just for a bit.
Finally, on the last day of visit they’ve evaluated each problem’s progress in terms of its
degree compared to their first day of visit and in here they’ve found out that some problems
such as personal hygiene and home environment had improved, leading to an increased
family satisfaction.
X. SPOT MAP AND DOCUMENTATION
FLOOR PLAN
Entrance
Small Garden
Door
Window
Cooking Area
Bedroom /Living Room

Kitchen Bed
Bedroom/ Livingroom Kitchen
Wall
Comfort
ComfortRoom
Room
Backyard/Garden
Griffin family’s humble abode Entertainment corner
Interview with Mother Lois The comfort room where laundry is
Cookware devoid of cooking facility Homemade cooking facility using charcoal

or wood
Wound Dressing Vital signs taking
Aftermath of an unattended cooking The house’s only window
Wound Dressing Part II Stewie taking a bath on the heat of

summer
Meg also in for a refreshing bath The student nurse with some home essentials for
the family.
Coolness! Hairdressing stint for Meg
The Griffin family with the student

nurses
Sweeping the floor.

XI. BIBLIOGRAPHY
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)

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ANGELES UNIVERSITY FOUNDATION

In Partial Fulfillment of the Requirements in Related Learning Experience

COMMUNITY HEALTH NURSING:

“An Assessment of Griffin Family in Barangay Sapalibutad”

A family is a unit composed not only of children but of

FCA is a tedious and painstaking requirement but it is rewarding enough as it is. It

a. Short Term: Student Centered

b. Short Term: Client Centered

c. Long term: Student centered

d. Long Term: Client Centered

Name Age Position Sex Educational Status Present health status

III. HEALTH ASSESSMENT

To be a health educator, a community health nurse must be able to determine initially

Assessment enhances identification of physical and psychological needs. The amount,

General Appearance and Mental Status:

HEAD AND FACE

Skull and Face

Lips and Teeth

THORAX AND LUNGS

Underweight < 18.5

HISTORY OF PAST ILLNESS

HISTORY OF PRESENT ILLNESS

ACTIVITIES OF DAILY LIVING

PHYSICAL ASSESSMENT (Final )

General Appearance and Mental Status:

HEAD AND FACE

Skull and Face

Lips and Teeth

THORAX AND LUNGS

HEAD AND FACE

Skull and Face

THORAX AND LUNGS

Body Mass Index (BMI) = 52 kg

Underweight < 18.5

HISTORY OF PAST ILLNESS

HISTORY OF PRESENT ILLNESS

ACTIVITIES OF DAILY LIVING

General Appearance and Mental Status:

HEAD AND FACE

Skull and Face

Lips and Teeth

THORAX AND LUNGS

General Appearance and Mental Status:

Skull and Face

Lips and Teeth

THORAX AND LUNGS

Interpretation: ( Based on FNRI )

Sigmund Freud’s Psychosexual Stage

HISTORY OF PAST ILLNESS

HISTORY OF PRESENT ILLNESS

PHYSICAL ASSESSMENT ( Final )

General Appearance and Mental Status:

HEAD AND FACE

Skull and Face

Lips and Teeth

HEAD AND FACE

Skull and Face

THORAX AND LUNGS

Interpretation: ( Based on FNRI )

GROWTH AND DEVELOPMENT

Sigmund Freud’s Psychosexual Stage

HISTORY OF PAST ILLNESS

ACTIVITIES OF DAILY LIVING