DE LA SALLE HEALTH SCIENCES INSTITUTE

COLLEGE OF NURSING AND SCHOOL OF MIDWIFERY

COMMUNITY HEALTH NURSING

FAMILY NURSING CARE PLAN

MALAGASANG II-D

PRESENTED TO: Ms. Rose Salazar, R.N., M.A.N.

CLINICAL INSTRUCTOR

PRESENTED BY: Antonio Raphael M. Bicos

BSN 34 RLE GROUP 2
August 11, 2010
 DE LA SALLE HEALTH SCIENCES INSTITUTE
COLLEGE OF NURSING AND SCHOOL OF MIDWIFERY

FAMILY NURSING CARE PLAN

HEAD OF THE FAMILY: Agustin Sinchongco

FAMILY MEMBER: 6
ADDRESS: Malagasang II-D
FAMILY STRUCTURE: Nuclear Family
PLACE OF ORIGIN: Munting Mapino, Naig
RELIGION: Born Again Christian
ETHNIC GROUP: Filipino

On the day of assessment, the person interviewed was Ms. Monalisa Sinchongco. According to her, the entire family renders Mr. Agustin
Sinchongco, her husband, as the head of the family. She said that this is due to the fact that he is the greatest contributor to the family's basic
needs. Furthermore, he imposes family rules and makes decisions most of the time, especially on matters which the mother cannot decide herself.
The family is composed of 6 members, namely Mr. Agustin, Ms. Monalisa, Mark John, James Michael, John Cyrus, Laurice Anne Sinchongco. They
reside in Malagasang II-D, Imus, Cavite for about 2 years now, at the time when they transferred from Naig to start a new life according to them. .
The whole family's religious orientation is that of the Born Again Christian, and all of them are naturally born Filipinos.
 1. Assessment of Family Structure and Dynamics / Socio-Economic and Cultural Characteristics:
A. Family Structure / Socio-Economic
Family Member Relation Sex Birthdate Civil Highest Educ. Occupation Monthly Remarks
to Head Status Completed Earning
No. Name Month Year Age Type of Plac
Work e
1 Monalisa Wife F April 1977 33 Married 2nd year college No N/A N/A Client indicated that she
Sinchongco undergraduate permanent did not have a permanent
job job, she would sometimes
do laundry work for other
people and would
sometimes sell food in
front of their church. She
mentioned that she could
not estimate her daily /
monthly earnings because
it varied too much.
2 Agustin Head of M Augus 1970 39 Married Vocational N/A N/A N/A Client was recently fired
Sinchongco the family t course from his plumbing job in
Cavite City hence his
unemployment

3 Mark John Eldest M May 2001 9 Single Presently N/A N/A N/A Client does not live with
 Sinchongco Son studying as a the family and lives in
Grade 3 Manila together with her
student aunt
4 James Son M May 2002 8 Single Presently N/A N/A N/A
Michael studying as a
Sinhcongco Grade 1
student
5 John Cyrus Son M July 2006 4 Single N/A N/A N/A N/A
Sinchongco
6 Laurice Daughter F June 2010 1 Single N/A N/A N/A N/A
Anne month
Sinchongco

Among the Sinchongco family, two out of six belong to the working group (15 to 60 or 65 years of age), but none of them is currently
employed. Ms. Monalisa is their only source of income as of now, with her working from time to time doing laundry and cooking for other
people she would earn enough to get them by the day, Ms. Monalisa’s mother also helps in some finances concerning their children acquiring
money from abroad as a caregiver (mother not mentioned above because she does not live together with the family). Mr. Agustin was only
able to take up a vocational course in plumbing and repair, whereas Ms. Monalisa was only able to reach 2 nd year college til she started living
with her present husband. The eldest son, Mark John, is only 9 years old is currently taking up grade 3 while James Michael is currently taking
up Grade 1.The two other children, John Cyrus and Laurice Anne are still unschooled. In terms of income, none of the members are
unemployed meaning that their source of income is unstable which is very bad with regards to the size of their family.
a.1. Dominant Family Members in terms of decision making especially on the aspect of health care: Monalisa Sinchongco(Mother)
a.2. Presence of any obvious/readily observable conflict between members of the family: ( ) yes (/) no
a.3. Adequacy to meet basic necessities (foods, clothing, shelter, etc.): (/) yes ( ) no
 a.4. Who makes decisions about money: Monalisa Sinchongco(Mother) & Agustin Sinchongco(Father)
a.5. Membership in an Organization: ( ) yes (/) no
Name of the Organization : N/A
Nature of Organization: N/A
Position in the Organization: N/A

Since the mother takes care of the children and is at home most of the time, she is the one who decides what to do whenever the children is
ill. She is also the one who performs activities to maintain good health, like for example, teaching and guiding them in keeping a good hygiene, and
the like. Whenever a child is sick, she brings them to the nearest health center or hospital, and takes care of them at home. During the interview, no
conflict between the family members were observed. The members talk to each other in a respectful manner, and was seen smiling most of the time.
Whenever a child needs help, she accommodates him or her well. When asked if the family's finances are sufficient to provide the family's basic
needs, she said “Kaya pero halos patayan na”. Ms. Monalisa and Mr. Agustin also does the budgeting of money. She is also not involved in any
organization in the community, nor any of the other family members.

B. Home and Environment

Date Assessed: July 23, 2010
1. Home
 a. Ownership: ( ) Owned ( ) Rented (/) Rent-free
b. Construction Materials used: ( ) Light (/) Mixed ( ) Strong
c. Number of rooms used for sleeping: 1
d. Lighting facilities: (/) Electricity ( ) Kerosene ( ) others. Specify:
e. Ventilation: (/) good ( ) poor
f. General Sanitary Condition (Overall surroundings of house and environment): Based on what was observed, the general
sanitary condition of the house and their surroundings are poor. At home, the floor was dramatically soiled, the window
sills are dusty, mosquitoes were present at the time of interview, not all storage containers were properly sealed, among
others.

In terms of ownership, the land and house were sort of rented to them for free by Ms. Monalisa’s aunt. The materials used were mixed, since
the floor was made up of soil covered with a some concrete areas, some areas of the house, the corners for example, were made up of cement, the
walls and the ceiling structures were built from wood, and the roof was made up of galvanized iron sheets in different proportions. The windows did
not have screens and is made up of wood as well. The house was divided in two areas, one portion was used primarily as a bedroom and as a
storage area for clothing, food, etc., and the other was the living room. Both rooms were used for sleeping, since not all of them can fit in the
bedroom. They do not have a bed for sleeping, but only used a huge mat ( banig) instead to line the floor. It must be noted that the floor was a bit
soiled, and even if it has a lining, such substances can be inhaled by the persons when asleep. Some may also ingest them accidentally. They also
use electricity as a source of energy to provide lighting and to make other appliances such as the television to function. During the day, they use
natural lighting entering from the door and the window to minimize their electric consumption. In addition to a natural source of air, they also have
one electric fan, hence, it can be said that it house has a good ventilation. It was also mentioned that at times, a foul odor can be smelled from within
the house, since the drainage system was located near their residence. And since the floor is made up of soil, it is unavoidable that it becomes dirty
even if a linoleum lines it up. Moreover, the lining starts to deteriorate too.
 2. Drinking Water Supply
Source: ( ) Private (/) Public Potability: Potable
Distance from house: Client was unable to estimate and only said that it was one tricycle ride away
Storage: ( ) None (Direct from faucet or pipe)
( ) Large covered container with faucet
(/) Large uncovered container without faucet
( ) Others, Specify:

The family's source of drinking water is the artesian well. It is located at around 7 meters from their house. Other activities like bathing,
washing the clothes and dishes, and the like are done near the source of water. The entire neighborhood shares on a single artesian well. They fill
their huge water drums with water early in the morning for the family to consume, and while not in use, covers it with a piece of wood. However, the
mother mentioned that she buys a mineral water for her youngest daughter, Rhian, to consume.

3. Kitchen
Cooking facility: ( ) electric stove ( ) gas stove (/) firewood/charcoal
Sanitary condition: Very Poor
Drainage facility: ( ) open drainage ( ) blind drainage (/) none

The mother prepares the meal for the entire family. She uses charcoal to cook the food, since the they do not own an electric or gas stove.
The food preparation and cooking is performed outside the house, near their door. The sanitary condition was said to be poor because the cooking
area is near the drainage facility, which is an open one since it is not covered, and is very visible to anyone who passes by their neighborhood. The
odor coming from the drainage can also be smelled in the area where meal preparation and cooking is done. Moreover, the table where the
ingredients and tools are placed is a bit soiled, in addition to the ash blown by the wind during cooking.

4. Waste Disposal
a. Refuse and garbage
Container: ( ) covered (/) open ( ) none
Method of disposal:
( ) hog feeding ( ) composting
( ) open dumping ( ) open burning
( ) burial in pit (/) others, specify: garbage collector

b. Toilet Type
( ) None ( ) Pail system
( ) overhang latrine ( ) water sealed latrine
( ) closed pit privy ( ) flushed type
( ) bore hole latrine
(/ ) others, specify: They use the comfort room of the church near their area which is a water sealed latrine type
Distance from house: 30 meters away
Sanitary condition: N/A

The wastes are placed in an open container, a used rice sack to be exact, before it is collected by a dump truck usually twice a week. They do
not practice composting nor open burning and any other methods of disposal. The toilet facility is located outside the house. It is shared by the
entire neighborhood. It comprises of a toilet bowl with no flushing system. A pail of water can be used to flush down its contents. Since it is near the
artesian well, the entire family takes a bath there too. The sanitation can be classified as poor. The flooring is made up of soil and the room is dark.
There are also mosquitoes and houseflies in the area and the human wastes can be smelled from afar. When taking a bath, the water goes directly
into the open drainage system.

5. Domestic Animals
Kind Number Where kept
Dog 2 Outside the house
Cat 1 Outside the house

The family does not have a pet or own any type of animals.

C. Health Status of Each Family Member

1. Nursing history
All family members experienced common illnesses in the past like fever, cough and colds but none of them experienced
serious illness or life-threatening conditions. The eldest son, Emerson, had sore throat in the past and was given an antibiotic which
is Amoxicillin. The eldest child, Riza, had bronchopneumonia when she was still 2 years old but she is in a good state of health at
present according to her mother.
Their usual food intake includes 1-2 cups of rice per meal with vegetables or fish. Sometimes, they include beef in their
diet. They also eat pork but only occasionally because it is much more expensive compared to vegetables. In case there are
leftovers or excess food after their meal, these foods were either fried or cooked with broth and made into soup. They consume 6-10
glasses of water per day and they also drink fruit juices. For snacks, they usually eat bread and junk foods which, according to the
mother, is her children’s favorite snack.
 2. Developmental Assessment for infants, toddlers and preschooler (MMDST)s: (see attached pages)

3. PHYSICAL ASSESSMENT/RESULT OF LABORATORY/DIAGNOSTIC EXAM OF ALL FAMILY MEMBERS

SYSTEM ROS P.E.
General/Overall Health Status
SHEENT
CHEST/LUNG
CARDIO
ABDOMEN
GUT
EXTREMITIES

None of the family members has a disease or health problem at present. They are all in good state of health and the mother reported that all of
them were able to perform their activities of daily living.

D. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

1. Immunization status of Family members
HEPA B
Name Age BCG OPV DPT Vit. A M Vac Remarks
VAC
1 2 3 1 2 1 2 3
Monalisa Sinchongco 33 √ √ √ √ √ √ √ √ √ √ Complete
Agustin Sinchongco 39 √ √ √ √ √ √ √ √ √ √ Complete
Mark John Sinchongco 9 √ √ √ √ √ √ √ √ √ √ Complete
James Michael Sinhcongco 8 √ √ √ √ √ √ √ √ √ √ Complete
John Cyrus Sinchongco 4 √ √ √ √ √ √ √ √ √ √ Complete
Laurice Anne Sinchongco 1 month √ √ √
 All of them are fully immunized except from the youngest child, Rhian. Her mother was not sure if she already received her three doses of anti-
Hepatitis B vaccine. It is a good that their other children received complete immunization because they already have protection from some of the
diseases. However, they should visit the health center in order to make sure that Rhian would be vaccinated.
2. Healthy Lifestyle Practices: (/) yes ( ) no
Specify: eating nutritious foods, sleeping early
The family has some healthy lifestyle practices that they do in order to prevent acquiring certain diseases. One of these is eating
nutritious foods like vegetables. According to the mother, she prefers cooking vegetables rather than pork because pork is too expensive and
it is not so healthy for the body. On the other side, there are many nutrients that a person can get from eating vegetables. Another healthy
lifestyle practice that they do is to sleep early so that they can also wake up early. Doing this will also help in their development and would
make them stronger and more active for the next day’s activity.

3. Adequacy of rest and sleep: (/) yes ( ) no how many hours: 8 hours
The family’s usual sleeping time is around 8 PM and they usually wake up at 4 AM. They get 8 hours of sleep every night which
makes them in a good state or mood upon waking up. Even their youngest daughter has this kind of sleeping pattern because she was trained
this way by her mother. None of them uses any sleeping aids in order to fall asleep.

4. Relaxation/Stress Management: (/) yes ( ) no

Specify: lying on bed, praying
One way of managing stress for the family is to have a quiet time so that their mind and body can have some rest. They usually do
this by lying on bed in order to be relaxed and feel comfortable. Sometimes, they would go out for a walk around the neighborhood or go to the
nearby malls. When they prefer to stay at home, they usually watch television most especially those programs that are very entertaining. This
makes them feel relaxed and their stress would be relieved by this simple act.
 5. Use of protective measures: (/) Mosquito net (/) footwear ( ) protective clothing
(/) others, specify: candles
The most common protective measure that they utilize is wearing slippers when they go out of the house. Through this, they
would be able to avoid sharp objects that they might step on the ground and prevent their feet from becoming dirty. They also use umbrella
and hat when going somewhere because the weather is too hot. During rainy days, the children also use umbrellas and wear raincoats in
addition to it so that they would not catch a cold or become sick when they got home.

2. PROBLEM SHEET

Health Conditions and Problems Cues / Data Family Nursing Problems

Unhealthful lifestyle and personal
habits/practices: lack of exercise /
physical activity
Faulty eating habits
Poor home condition/sanitation as
manifested by:
1) Inadequacy of living space
 Activities of daily living includes cleaning
the house, sweeping the floor and
washing the clothes
 Mother believes that their daily activities
are enough as a form of exercise
 Eats junk foods during snack time
 Forgets to wash hands before and after
eating
 The house is divided into two rooms – the
living room and the bedroom/storage area
– both of which are used for sleeping and
other activities like playing, watching
television shows, studying, resting, etc.
Inability to recognize the presence of the condition or
problem due to attitude/philosophy in life which
hinders recognition/acceptance of a problem
Inability to make decisions with respect to taking
appropriate health action due to failure to comprehend
the nature / magnitude of the problem
Inability to provide a home environment conducive to
health maintenance and personal development due to:
1. Inadequate family resources, specifically:
a) financial constraints / limited financial
resources
b) limited physical resources – lack of available
rooms for the different activities of the
family.
2. Failure to see the long term benefits of

Poor home condition/sanitation as
manifested by:
1) lack of food storage facilities
Poor home condition/sanitation as
manifested by:
1) presence of breeding or resting
sites of vectors of diseases
Unhealthful personal habits/practices,
such as the non-use of self-protection
measures.
 “Hindi naman kami nagtatago ng pagkain
dito. Kadalasan sakto lang para sa isang
lutuan o sa isang araw,” the mother said.
 No refrigerators or sealed plastic wares
were seen within the home.
 Food is placed in a plate with another
plate on top as cover.
 The floor is soil-based, and the floor lining
(made up of linoleum) has slight tears.
 The main room used for sleeping and
storage of clothing and other equipments
is dark.
 The house is very near the open drainage.
 “Kapag umuulan, may kaunting tubig na
naiipon diyan sa harapan,” the mother
said.
 Upon entering the house, members of the
family and guests leave their footwear
outside.
 “Wala kaming kulambo. Hindi kami
gumagamit noon,” the mother said.
 “Minsan kapag nagugutom na
nakakalimutan nang maghugas ng kamay,
lalo na yung mga bata. Ito pa namang
maliit mahilig maglaro,” the mother said.
investment in home environment improvement.
3. Inadequate knowledge on preventive
measures.
Inability to provide a home environment conducive to
health maintenance and personal development due to:
1. Inadequate family resources, specifically:
a) financial constraints / limited financial
resources
b) limited physical resources – lack of
appropriate tools for storage.
2. Failure to see the long term benefits of
investment in home environment improvement.
Inability to provide a home environment conducive to
health maintenance and personal development due to:
1. Inadequate family resources, specifically:
a) financial constraints / limited financial
resources
2. Inadequate knowledge on preventive
measures.
Inability to provide a home environment conducive to
health maintenance and personal development due to:
1. Inadequate family resources, specifically:
a) limited physical resources – lack of bed nets
to provide protection against mosquitoes
and other disease vectors.
2. Failure to see the long term benefits of
investment in home environment improvement.
3. Inadequate knowledge on the importance of
hygiene and sanitation.
 3. Prioritization of Nursing Problem

A. SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO PRIORITIES

SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO PRIORITIES

CRITERIA WEIGHT
1. NATURE OF THE CONDITION OR PROBLEM PRESENTED
A. WELLNESS STATE 3
B. HEALTH DEFICIT 3 1
C. HEALTH THREAT 2
D. FORSEEABLE CRISIS 1
2. MODIFIABILITY OF THE CONDITION OR PROBLEM
A. EASILY MODIFIABLE 2
B. PARTIALLY MODIFIABLE 1 2
C. NOT MODIFIABLE 0
3. PREVENTIVE POTENTIAL
A. HIGH 3
B. MODERATE 2 1
C. LOW 1
4. SALIENCE
A. A CONDITION OF THE PROBLEM NEEDING IMMEDIATE ATTENTION. 2 1
B. A CONDITION OF THE PROBLEM NOT NEEDING IMMEDIATE ATTENTION. 1
C. NOT PERCEIVED AS A PROBLEM OR CONDITION NEEDING CHANGE. 0
SCORING
 I. DECIDE ON A SCORE FOR EACH OF THE CRITERIA.
II. DIVIDE THE SCORE BY THE HIGHEST POSSIBLE SCORE AND MULTIPLY BY THE WEIGHT. (SCORE/HIGHEST SCORED WEIGHT)
SUM UP THE SCORE FOR ALL THE CRITERIA. THE HIGHEST SCORE IS 5 EQUIVALENT TO THE TOTAL WEIGHT.
MAGLAYA, A.S 2003. NURSING PRACTICE IN THE COMMUNITY. ARGONAUTA CORP. PHILIPPINES
 B. CASE ILLUSTRATION ON PRIORITY SETTING
Lack of exercise / physical activity
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 It is a health threat that requires immediate action to
become physically fit and reduce the likelihood of
acquiring a disease.

MODIFIABILITY OF THE PROBLEM The problem is easily modifiable since resources are
2/2 x 2 2 available. They just need to schedule a time for
performing exercises.

PREVENTIVE POTENTIAL Susceptibility to other diseases can be prevented if the

family will have a regular exercise.
3/3 x 1 1
The family does not see the condition as needing
SALIENCE immediate attention.

1/2 x 1 1/2
TOTAL SCORE 4 1/6

Faulty eating habits

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 It is a health threat that requires immediate action to
reduce the likelihood of having a disease.

MODIFIABILITY OF THE PROBLEM The problem is easily modifiable. The resources are
2/2 x 2 2 available and they just need to have discipline to do the
proper health action.

PREVENTIVE POTENTIAL The possibility of having a disease will be prevented if

they avoid eating junk foods and make it habit of washing
3/3 x 1 1 their hands.

The family sees condition as needing immediate attention.

SALIENCE

2/2 x 1 1
TOTAL SCORE 4 2/3
 Inadequacy of living space
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 The problem can be classified as a health threat because it is a
condition that may provoke an illness if no action is taken.

The problem can only be partially modified using available

MODIFIABILITY OF THE PROBLEM
PREVENTIVE POTENTIAL
½x2 1 resources, but does not necessary entail expanding the living
space, only maximizing the area in as much as possible.
Only moderate prevention cam be implied since the family is in
full control of the financial resources that could have possibly
2/3 x 1 2/3 prevent such problem.

1/2 x 1 ½ Necessary action needs to be undertaken but is not the

SALIENCE immediate problem at the moment.
TOTAL SCORE 2 5/6

Lack of food storage facilities

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 The problem can be classified as a health threat because it is a
condition that may provoke an illness if no action is taken.

The problem can be easily modifiable since there are resources

MODIFIABILITY OF THE PROBLEM 2/2x 2 2 within the home that only needs to be utilized properly with no
need for a huge amount of money, hence, can solve the problem.

The problem can be highly prevented only if appropriate steps are

undertaken by the family members involved.
PREVENTIVE POTENTIAL 3/3 x 1 1
The problem needs immediate attention since it involves food,
which provides nutrition to the family.
1x1 1
SALIENCE
TOTAL SCORE 4 2/3

presence of breeding or resting sites of vectors of diseases

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 The problem can be classified as a health threat because it is a
 condition that may provoke an illness if no action is taken.

It is only partially modifiable since a major reconstruction is

MODIFIABILITY OF THE PROBLEM 1/2x 2 1 needed which cannot be performed but the family but preventive
measures can be done instead.

It is moderately preventable since the resources are limited and

new practices must be highly maintained over time.
PREVENTIVE POTENTIAL 2/3 x 1 1
It needs immediate attention since the family is vulnerable to
vector-causing diseases.
1x1 1
SALIENCE
TOTAL SCORE 3 2/3

Unhealthful personal habits/practices, such as the non-use of self-protection measures.

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
NATURE OF THE PROBLEM 2/3 x 1 2/3 The problem can be classified as a health threat because it is a
condition that may provoke an illness if no action is taken.

It is only partially modifiable since some measures may involve

MODIFIABILITY OF THE PROBLEM 1/2x 2 1 the use of a minimum amount of money.

It can be highly prevented since the measures can be easily

performed.

PREVENTIVE POTENTIAL 3/3 x 1 1 It needs immediate attention since the family is to prevent
accidents, injuries, and illnesses.

1x1 1
SALIENCE
TOTAL SCORE 3 2/3

HEALTH FAMILY OBJECTIVES OF CARE PLAN OF INTERVENTION EVALUATION PLAN

PROBLEM NURSING
PROBLEMS
NURSING INTERVENTIONS METHODS OR RESOURCES OUTCOME CRITERIA /
TOOLS REQUIRED INDICATORS
1. Lack of Inability to After nursing intervention, 1. Guide the family in time Home Visit Time and 1. The family’s daily routine
exercise / recognize the the family will: management and scheduling of effort of both includes regular exercise.
physical presence of the a. manage their schedule exercise.
activity condition or to provide enough time for 2. Discuss with the family the Health the nurse and
problem due to exercise importance of exercise: Teaching family to 2. The family verbalizes the
attitude / b. know the benefits that a. to become healthy and fit achieve the reason for doing regular
philosophy in they can get while b. to reduce the risk of having a Demonstratio desired exercise.
life which performing basic exercises disease n of basic outcome
hinders c. make sure that all 3. Involve the children in planning the
recognition / members will participate in health measures to have their active exercises 3. All family members
acceptance of the activity participation. Visual aids or participate in performing
a problem d. have a regular 4. Provide information about the posters exercises based on the
exercise effectiveness of having a regular showing agreed schedule.
exercise. different
5. Discuss the different forms of
exercise that they can utilize. forms of
6. Develop their skills in performing exercise
the exercise.
2. Faulty Inability to After nursing intervention, 1. Demonstrate the proper way of Home Visit Time and 1. The family washes their
eating habits make decisions the family will: washing the hands. effort of both hands before and after
with respect to a. make it a habit of 2. Discuss the food pyramid and
taking washing their hands before provide food choices for snack Health the nurse and eating
appropriate and after eating 3. Provide information about: Teaching family to
health action b. replace junk foods with a. the risk of eating too much junk achieve the 2. The family avoids eating
due to failure to more nutritious foods for food Demonstratio desired junk foods
comprehend snack b. the importance of removing junk n of Proper outcome
the nature / c. know the benefits of food from the diet
magnitude of replacing junk foods on Hand 3. The family verbalizes the
the problem their diet washing Visual aids or health benefits that they get
posters of the after doing the plan.
food pyramid,
food samples
and
sample
menus for
snack
Presence of After nursing intervention, Discuss the health and economic Home visit with Paper, pen, and The family is able to maintain a
breeding/re the family will be able to: benefits of keeping the home neat discussion and tape (for the home and environment that is
sting sites a.realize the value of and clean. demonstration note/reminder) clean and disease-free.
of vectors keeping the home free
of diseases from vectors of diseases.
b. realize the value of
keeping the home neat
and clean.
c. come up with their own
interventions to prevent
vectors from staying in
their home.
d. use available resources
to resolve the problem
e. maintain practices to
prevent breeding of
vectors for a long period of
time.
f. prevent members from
acquiring diseases caused
by vectors.
Non use of After nursing intervention,
self the family will be able to:
protection a. realize the importance
of using self protective
measures.
b. be more innovative in
thinking of ways to provide
self protection.
c. learn ways to protect
themselves from
accidents, injuries, and
diseases
d. devise ways to for self
protection without the need
for too much amount of
money.
e. maximize available
resources to achieve
Discuss how the family can prevent
diseases using available resources.
Suggest activities to keep the home
environment clean and disease-free.
Perform planned actions together with
the family.
Instruct family not to store too many
objects on dark, moist areas.
Leave a note on the planned actions
to remind the family on what they
should do from time to time.
Instruct family to encourage their
neighbors to perform the same
measures.
Discuss with the family members the
problem diagnosed.
Discuss with the family members the
importance of using self protection
measures.
Suggest activities and resources that
can protect themselves from injury,
accidents, and disease.
Reassure the willingness of the family
members to cooperate with this
activity.
Utilize available resources to achieve
desired goals.
a.the family performs the
Human preventive measures learned on
resources, the day of intervention everyday.
including time b. the family members remain
and effort of the disease free and in good state of
nurses and the health.
family members c. the family members work
hand in hand with their neighbors
Cleaning aids and friends in maintaining the
(brooms and whole neighborhood clean and
broomsticks, disease free.
rags, and the d. no foul smelling odor can be
like) observed in the neighborhood.
Home visit Human The family is remains free from
resources, disease and injury.
including time a. the family members always
and effort of the use proper clothing and footwear
nurses and inside and outside the home.
family members b. the family uses a bed net
when sleeping.
c. no sharps and toxic
substances are seen hanging or
just lying around the house.
d. no blisters or wounds can be
seen on the family members
especially of the hands and feet.
 objectives. Work with the family in planning for
the courses of action.

Promote the use of footwear inside

and outside the home.

Encourage the use of bed nets to

protect them from mosquito and other
animal bites.

Instruct parents to keep sharp objects

and toxic agents away from their
children.

Encourage the use of clothing even

when at home.
IV. FAMILY NURSING CARE PLAN

MMDST
________ introduction to MMDST

Last June 22, 2010, an MMDST examination was

performed at Barangay Poblacion, Imus, Cavite. Christine Mae,
female, was born on the 28th of May 2009 at the said town. At the
day of examination, the child was a year and 24 days old.
On the MMDST form, the child was examined based on her
Personal- Social, Fine Motor Adaptive, Language, and Gross
Motor skills. On some areas of the examination, the child was
uncooperative even when several measures to relate to the child were performed. This was probably due to the child’s inability to identify with new people. The mother also
mentioned that she seldom exposes her children to persons beyond their home. Hence, most of the tests were asked to the mother. On the Personal-Social Level, the mother
said that the child is able to imitate some housework like holding the rag and pretending that she is wiping something. She also said that the child indicates what she wants not by
crying through pointing on the object, or trying to pronounce some words like “mamam” to pertain food. The mother said that she is also able to drink from a cup with assistance.
When tried to play with a ball, the child did not pay attention. When tried to play with him using the rattle, and with the use of facial expression, the child still did not pay attention
and held on to her mother. When she was annoyed, she began crying. Hence, the activity was marked as refused. However, the mother said that the child plays with her siblings,
parents, and grandmother.
On the Fine Motor Adaptive Level, the child was asked to scribble spontaneously on a sheet of paper using a pencil. The child held the pencil, but when asked to scribble,
the child refused again. However, the mother said that the child scribbles on her sister’s notes. He was also asked to take some cheese curls to test for his pincer grasp. The
child took one neatly.
Upon examination of the Language, the mother was asked if the child can already speak dada or mama and assign the words to the correct persons. The mother said that
she can speak dada, but not mama. Moreover, she just pronounces the word without giving distinction to his father or to any other person.
 Lastly, the Gross Motor Level was assessed. The child was first asked to stand alone momentarily, and the child was able to do so, but after a few seconds, cried. The
mother said that the child can stand on her own and even walk a few feet without assistance. However, the child was unable to show how she walks because she began crying.
The child also refused to perform the stoop and recover activity, since she began to be impatient on the activities.
As a result, the refused twice, failed one activity, and the rest of the activities were performed whereas some passed by report of the mother. Hence, the child’s
development can be classified as ___________
 B. CASE ILLUSTRATION ON PRIORITY SETTING
Problem:
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

TOTAL SCORE

Problem:
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
 TOTAL SCORE

Problem:
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
 TOTAL SCORE

Problem:
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

TOTAL SCORE
IV. FAMILY NURSING CARE PLAN
HEALTH FAMILY OBJECTIVES OF CARE PLAN OF INTERVENTION EVALUATION PLAN
PROBLE NURSING
M PROBLEMS
NURSING INTERVENTIONS METHODS RESOURCES OUTCOME CRITERIA /
OR TOOLS REQUIRED INDICATORS
V. SUMMARY OF LAST DAY OF HOME VISIT
 The first home visit done last June 22, 2010 was also the last home visit to the de Guzman family due to time constraints. On that day,
the initial home and family assessments were done, including which is the MMDST for the child assessment. To assess the condition of the
family, we performed an interview and did some observations as well. We have assessed that the space of the home, especially that of the
rooms they use for sleeping is quite inadequate to accommodate all seven members of the family. Although they use two rooms for sleeping,
the other room is quite dark and a bit crowded, because it is where they store their fresh clothes, some other equipments, the books and other
school supplies of their children, some other old things, mats used as beddings, blankets, and many others, whereas the other room they use
is the living room. During the day, they entertain their guests in the living room and this is where their children play around, relax, watch
television shows, and study. At nighttime, they use the space for sleeping. We have also observed that they have a poor sanitation,
evidenced by the soiled floors and ceilings, among others. Only two of the children and the mother were at home, but on examination and
interview, the results were fine. According to the mother, nobody in the family has an illness at present and in the past few months. It was
also observed that even the family members leave their footwear outside the house, besides from the guests, thus, they are barefooted inside
the house. The floors is lined with a linoleum, but underneath reveals a soil. The lighting is good, they use a natural source and if it becomes
dim, they switch on their electric bulb. The ventilation is good too, since they have an electric fan aside from the natural wind. The bathroom
and the artesian well are shared by the entire neighborhood. In terms of waste disposal, the family keeps them in a sack before it is collected
by the garbage collectors who come usually twice a week. The neighborhood is surrounded by an open drainage system where their wastes
go directly. In terms of finances, three of them are working, which, the mother said, is sufficient for their basic needs. Food consumption is at
three to four times a day, which usually consists of rice, vegetables, fish, or bread, and seldom includes meat and chicken. The kitchen is
located outside the house, since the mother thinks that it is safer since she uses charcoal to cook the meals. The source of drinking water is
that of the artesian well, but for the youngest child, they purchase a mineral water. Each family member takes a bath at least once a day and
brushes their teeth when at home. Each family member walks in the morning and in the afternoon when going to their workplace or at school
and then back at home. However, they do not have a regular physical exercise like jogging, etc.
VI. PHOTODOCUMENTATION