Family Nursing Care Report of Mr.

A Family
With Asthma Diagnosis in Banjarmasin

A. Assessment
1. General Data
The Head of Family

: Mr.S

The Head of Family address

: Jl.Pekapuran Raya Gg jembatan 8

The Head of family Occupation

: Teacher

The Head of Family Education

: S1

a. Members of family
No

Name

Sex

Family
relationship

Age

Education

Mr. S

Male

Husband

52 years old

S1

Mrs. D

Female

Wife

48 years old

D1

Mr. F

Male

1st Child

25 years old

SMA

Miss.C

Female

2nd Child

19 years old

SMA

Genogram:
1

Note:
: male

developed disease :

: female

: passed away
1

: client
: married
: divorced
: lineage

--------

: living together

: astma

b. Type of family
Type of this family is nuclear family, because consist of parents and two
children, daughter and son who living together in the same house.
c. Ethnic background
All members of the family is Banjarese and they are Indonesian.
d. Religion
All family members are Moslem and they obey and run the rules.
e. Socio-economic
Head of the family works as a teacher and so does his wife.
1) Head family Income

: Rp 3,000,000.00 / month

2) Wifes Income

: RP 2,200,000.00 / month

If combined, the average income of family is about Rp 5,200,000.00 /

month. And the average of outcome is about Rp 2.500.000,00-Rp
3,000,000.00 / month.
From the income and property owned by the family, the family have high
socioeconomic status.
f. Activities and recreation of family
Every day the client and family run their activities based on their role in
family. Family can fulfill recreation and relaxation need, they are
watching tv and gathering together in living room with their youngest
child because the oldest one has been separate to work in another city and
live in his own house.
2. History of development family
a. Stage of family development
Mr S has two children, the oldest son aged 24 years old and the the
youngest aged 19 years old. So the family is in stage of family launching
adult chidren.
b. Problem of family development
Mr. S has fulfilled the task of development is becoming a nuclear family

with two children, Mr. S also always keep the intimacy of the couple and
two children their was college
c. History of nuclear family
1) Mr. S
Since birth the client has suffered from asthma. Client ever
hospitalized in Ulin General Hospital Banjarmasin due to astma attack
for 3 days. Now, the astma attack can be controlled by avoiding
exposure to dust. If he got astma attack, client feel shortness of breath,
coughing up and feel weak.
2) Mrs. D
Clients wife suffer from uncontrolled hypertension, which sometimes
require client to keep regular control to the doctor.
3) Mr. F
There is no history of illness that requires treatment or hospitalization
in the hospital.
4) Miss. C
Like her father, since birth Miss C has been suffered from asthma and
will relaps if exposed to dust which cause shortness of breath.
d. History of previous family
From the family of Mr. S, his father died due to formerly the client's
mother also suffered from asthma and from Mrs Ds family, her father has
hypertention and her mother died due to , the client's mother and sister
had hypertension.
3. Environment assessment
a. Housing
Land area

: 20m x 16m

House area

: 15m x 12m

Adequacy of living space, sleeping arragement, presence of breeding or

resting sites of vectors of disease (e.g. mosquitoes, roaches, etc.), presence

of accident hazards, food storage and cooking facililies. Water supplysource, ownership, sanitary condition, garbage/refuse disposal type,
drainage system type.
b. Kind of neighborhood and activities
Neighbors around the existing client-friendly home friendly. Clients living
in a rural area, so the distance from the house of the other houses so far.
Residents have a habit of doing recitals in every Friday night and Saturday
night social gathering. Lectures and gathering took place at the home of
each resident in turn.
Local residents also have an agreement if there are new residents and
guests staying there is expected to report on the RT / RW. Every 1 month
sometimes held between residents in the area of community service each
residence.
c. Transportation facilities
Client raid motorcycle if go to work and also their children but his wife
cant ride motorcycle
d. Social activities/communication
Every day, in the morning, afternoon, or evening clients and families are
always able to interact well with the surrounding community.
e. Social and health facilities
All members of the family in a healthy condition. Between family
members love each other, family health facilities included: toilet facilities,
comfortable beds, clean water source, the motor as transportation.

4. Structure of family
a. Interaction pattern among family member/communication
The language used to communicate with families in the family and in
society are Banjar and Indonesian language. Communication between
family more often begins afternoon because sometimes family members

busy in the morning, especially the first child of Mr. S as student.

b. Domain family member in term of decision making
Clients advise their children how to behave good, manners, how to
maintain good relations with others, and give freedom to thier children.
The strength of the family still remain in Mr. S.
c. Role of family (formal and informal)
1) Mr. S
a) Formal role :as a teacher in elementary school.
b) Informal role : head of the family, husband, father of two children,
decision maker.
2) Mrs. D
a) Formal role : as an elementary school teacher and active in
community events and gathering with another housewife in her
residence to held yasinan once a week.
b) Informal role : as a housewife and the mother of two children,
manager of family financial.
3) Mr. F
a) Formal role : as a worker.
b) Informal role :the oldest child and brother.
4) Miss C
a) Formal role :as a student
b) Informal role :the youngest child
d. Value and norm of family
the family believes that health is very important, so they used to wash
hands before eat, hygiene and attention to nutritional adequacy of family.
5. Function of family
a. Function of affective
Family give each client the attention and affection. Clients always support
what is done by members of his family during the reasonable limits and

does not violate the ethics and manners.

b. Function of social
interactions are good family members, each member of the family still
consider this and apply ethics or manners of conduct.
c. Function of health care
1) Knowing about disease/health condition
Family know enough about the disease, especially Mr S and Miss C
who develop astma. They know the causal factor that trigger astma
attack such when exposed to dust. They know the symptoms when got
astma attack such as shortness of breath and coughing up. Mr S is a
teacher in elementary school who use chalk to write down on the
blackboard, but he do not use masker when writing on the blackboard
whic trigger astma attack at that time. The knowledge about disease
management and control of the disease still less. Evidently when asked
about the current complaint, client feel weak, everyday just sit at
home, and do not use a mask when exposed to dust.
2) The ability of family to make decisions in order to take appropriate
action.
a) The family is quite understanding about the health of family
members.
b) Family Members of the family is quite sensitive to the ill.
However, sometimes these health problems are considered trivial
or not considered further.
c) The family is very worried about the possibility of attacking other
family members.
3) Providing adequate nursing care to sick family member
a) Knowledge of the disease is limited family, family understand
about things that can cause a recurrence needs to be done to
prevent recurrence.

b) If there is a sick family members and health workers eventually

need treatment, the family entrusted the care and healing for health
workers, but if the pain is still relatively mild, family advocate
fairly new rest went to the health center or doctor
c) In an effort to keep watch, It provides an only family of drugs that
are often consumed and fit of each member of the family. If the
illness is considered severe, the family immediately brought to the
health facility.
d) Each member of the family understand the functions and
responsibilities of each financial resources. Supporting facilities in
existing homes already meet the standard criteria and the
relationship between family members with well established
community.
4) Providing a home environment conducive to health mantenance and
personal development.
a) Family members have potential in each member of the family and
understand the sources owned.
b) The family realized that by creating a clean environment can
prevent the spread of many diseases.
c) The family understand and be aware of the importance of
sanitation for healthy home.
d) Family jointly maintain their health condition by eating healty
food, balanced nutrition, keep the body fit, regular and enough
sleep, gathering with family, recreation if needed with relatives,
neighbor and formed friendships.
5) Utilizing community resources for health care
a) Family clear about all the health facilities that exist around
b) The family believe and trust with health in facility and they hane
good relationship. It is proved by Mr. S who went to a health

facility when he got astma attack.

d. Function of reproduction
1) The number of children is owned by Mr. S there are 2 people
2) Family planning a number of family members just 2 people.
3) Mrs. D used IUD program since 2004 until now
e. Function of economic
1) The family is able to meet the needs of food, clothing, board of earned
income per month and the family was able to set aside earnings for
unexpected purposes.
2) The family is able to utilize existing health facilities in health centers,
clinics, general practitioners, as well as hospital clinic.
6. Stress and coping of family
a. Short and long term stressors
1) Short term stressors
a) Will implement omra
2) Long term stressors
a) Recurrence of disease Asthma Mr. S
b) tuition fees to two childrens
b. Family response to the situation or stressors
1) Short term stressors
family claimed to worry about the health of Mr. S when about to
perform the omra so that families strive to maintain the health of Mr. S
with the control routine health facility.
2) Long term stressors
for cost of His son, other family members who have worked helped
finance.
c. Coping strategy
If there are problems in the family, often resolved by consensus but to the
problems of each family member individually resolved.

d. Disfunctional adaptation
The family never use violence, abuse of children, blaming the child,
giving threats to resolve the problem.
7. Physical examination
a. Mr.D
"Mrs. D said he had known since the first husband was suffering from
asthma. Mrs. D asked what asthma is dangerous. "
"Mrs. D husbands often asthma if exposed to dust.
BP : 130/90 mmHg
HR : 78 x/m
RR : 22 x/m
T : 36,4 C
GDS: 120 mg/dl
1) Head
a) Hair and scalp
Inspection: straight hair, short, slightly graying, clean skin.
b) Eyes
Inspection: both eyes symmetrical, conjunctiva is not anemic,
sclera is not jaundice.
Palpation: no tenderness.
c) Nose
Inspection: symmetrical nose, secretions (+), no enlargement of the
polyp.
Palpation: no tenderness.
d) The mouth and pharynx
Inspection: no stomatitis, no dental caries, no dentures, no
firingitis, the tongue is not dirty.
Palpation: tongue palpable soft, no tenderness.
2) Ear

Inspection: symmetrical ears.

Palpation: no tenderness.
Neck
Inspection: no sikatrik, no nodules.
Palpation: no enlargement of the jugular vein and the thyroid gland.
3) Chest
Inspection: normochest shape, no nodules, no sikatrik.
Palpation: no tenderness, no fracture in the ribs.
Percussion: resonant sound in both lung fields, and dim the heart in
ICS 3-5
Auscultation: vesicular breath sounds, heart sounds s1, s2 single.
4) Abdomen
Inspection: no nodules and ascites.
Palpation: no tenderness, no enlargement of the liver and spleen.
Percussion: sound tympani in the intestine, liver and kidney dim.
Auscultation: bowel peristalsis (+)
5) Pelvic
not evaluated
6) Genetalia
not evaluated
7) Anus
not evaluated
8) Extremities
Inspection: limb complete, no injuries, , no abnormality on fingers and
toes.
Palpation: no pain and no fracture.
b. Mrs.D
"Mrs. K said about 3 years ago had a great experience dizziness, when
sent to the doctor Ny. K is said to have hypertension, Ny. K asked whether

hypertension is a dangerous disease. "

BP: 150/100 mmHg
HR: 80 x / m
RR: 20 x / m
T: 36.2
1) Head
a) hair and scalp
Inspection: straight hair, long, black, leather cleaner.
b) Eyes
Inspection: symmetrical eyes, conjunctival not anemic, sclera no
jaundice.
Palpation: no tenderness.
c) Nose
Inspection: symmetrical nose, no discharge, no enlargement of the
polyp.
Palpation: no tenderness.
d) The mouth and pharynx
Inspection: no stomatitis, no dental caries, no dentures, no
pharyngitis, the tongue is not dirty.
Palpation: tongue palpable soft, no tenderness.
e) Ear
Inspection: symmetrical ears.
Palpation: no tenderness.
2) Neck
Inspection: no enlargement or thyroid gland or lymph node.
Palpation: no enlargement of the jugular vein and the thyroid gland.
3) Chest
Inspection: normochest shape, not ana nodules and sikatrik.
Palpation: no tenderness, no fractures of the ribs.

Percussion: resonant sound in both lung, faint at heart in ICS 3-5.

Auscultation: the sound of vesicular breath, heart sounds s1, s2 single.
4) Abdomen
Inspection: no nodules, no ascites.
Palpation: no tenderness, no enlargement of the liver and spleen.
Percussion: tympani sound of the intestines, liver and kidney dim.
Auscultation: bowel peristalsis (+).
5) Pelvic
not evaluated
6) Genitalia
not evaluated
7) Anus
not evaluated
8) Extremities
Inspection: limb complete, no cuts, stitches, no abnormalities of the
hands and feet.
Palpation: no tenderness, no fracture.
c. Miss. C
BP: 120/80 mmHg
HR: 74 x / m
RR: 20 x / m
T: 36.2
1) Head
a) hair and scalp
Inspection: straight hair, long, black, scalp clean.
b) Eyes
Inspection: symmetrical eyes, conjunctival not anemic, sclera no
jaundice.
Palpation: no tenderness.

c) Nose
Inspection: symmetrical nose, no discharge, no enlargement of the
polyp.
Palpation: no tenderness.
d) The mouth and pharynx
Inspection: no stomatitis, no dental caries, no dentures, no
pharyngitis, the tongue is not dirty.
Palpation: tongue palpable soft, no tenderness.
e) Ear
Inspection: symmetrical ears.
Palpation: no tenderness.
2) Neck
Inspection: no sikatrik, no nodules.
Palpation: no enlargement of the jugular vein and the thyroid gland.
3) Chest
Inspection: normochest shape, no nodules, no sikatrik.
Palpation: no tenderness, no fracture in the ribs.
Percussion: resonant sound in both lung fields, the sound of faint at
heart.
Auscultation: vesicular breath sounds.
4) Abdomen
Inspection: no ascites, no sikatrik.
Palpation: no tenderness, no enlargement of the liver and spleen.
Percussion: timpani sound in the intestine, liver and kidney dim.
Auscultation: bowel peristalsis (+).
5) Pelvic
Not evaluated.
6) Genitalia
Not evaluated.

7) Anus
Not evaluated.
8) Extremities
Inspection: no ascites, no cuts, stitches, no deformity of the fingers and
toes.
Palpation: no tenderness, no fracture.
8. Hope family of health workers
The family hopes that health workers can function properly, is able to give a
good and proper ministry to anyone who need not only to patients who are
sick residents who need health care assistance, without distinction of status
and class.

DATA ANALYSIS

NO
1

DATA

PROBLEM

DO :

Innefective family

a. Mr S said that he is a teacher in

therapeutic regimen

elementary school which use

chalk when writting on the
blackboard.
b. Mr S said that he will got astma
attack when exposed to the dust.
c. Mr S did not use masker when
exposing to the dust.
d. Mr S said that he did not visit his
doctor or go to public health
centre immediately when got
astma attack because he took his
medicineby himself.

management

ETIOLOGY

DO :
a. Chest auscultation : wheezing
b. Client looked coughig up.

Risk factors :

Risk for caregiver

a. Mr Ss wife said that she was

role strain

worry about her husband chronic

disease.
b. Mr S wife asked about her
husband

disease

whether

the

disease can be threaten or not in

rest of his life.

INTERVENTION
NO

DIAGNOSIS

GOAL

INTERVENTION

Ineffective

After the

family

intervention is

listen to client

of value and may

therapeutic

done, family will:

concerns.

identify additional

regimen

a. Understanding

b. Assist client to

factors that affect

a. Make time to

RATIONALE
a. Promotes feelings

management

about

develop realistic

related to

management

health goals and

of regimen.

incorporate

responsibilities and

wellness

demands on the

personal

activities and

clients time,

responsibility

practices

especially with

for own

(exercise,

women, make it

actions and

smoking

appear difficult to

participate in

cessation,

include any

problem-

nutrition,

additional activities

b. Accept

outcome of therapy.
b. Multiple

solving

vitamin

activities.

supplements)

c. Focus on
family
members
health.

of self-care.
c. Identifies areas of

into daily

confusion or

routine.

conflict or lack of

c. Determine

accurate

clients

information that

perception or

may impede

understanding of

cooperation with

regimen.

regimen.

d. Instruct client

d. Thorough

carefully in all

understanding may

aspects of

enhance cooperation

medication

with regimen and

regimen, times,

help in identifying

interaction with

potential for

food, and side

compromise.

effects.
e. Suggest placing

e. When clients
routine is stable,

doses of

and he or she

medications in

engages in activities

various

away from home, it

locations.

is helpful to keep a
supply of
medications in more
than one location
such as work or
home of family and
friends.

Risk for
caregiver
role strain.