Professional Documents
Culture Documents
I a student nurse would like to express his heart felt appreciation to the following people. To the dean of the college of nursing Maam Carmela Camela B. Urbano, RN, RM, for giving her heartfelt support to me and also to Maam Iril I. Panes our clinical instructor for companioning us during our community survey. To Maam Sally J. Edsa for giving us her knowledge and skills about the Family Health Nursing. I would like to thank for the brgy. Officials on our area of exposure, to my family, friends, classmates and to my assigned family that who makes effort and good respond for my interview and most especially to my God our savior.
Chapter l
Introduction
The family is the smallest unit of the society and the natural fundamental core of the community and consequently, it is considered as the primordial recipient of the nursing effort, which is contributory to the development, and progress of the community through active involvement and self responsibilities of each constituent. It is composed of persons, male and female, being molded to be as one, working hand in hand to maintain a good atmosphere among the family members. A nucleus controls the functions of the entire cell and can be thought as the command center of the cell. The nucleus as well has different components which are all needed in order for it and the cell to function well, same as with the c o m ma n d e r o r t h e h e a d o f t h e f a mi l y a n d t h e m e mb e r s wh o h a s d i f f e r e n t functions within the family. The impression or status of each family will always affect the status of the community as a whole. Community health nursing is a response to the health n e e d s o f t h e p e o p l e . I t d o e s n o t f o c u s o n a p a r t i c u l a r c l a s s o r f a mi l y. It is c o mp r e h e n s i ve a n d g e n e r a l i n a p p r o a c h . C o mm u n i t y h e a l t h s e r vi c e i s n o t episodic as it requires continuous observation and monitoring of community as a wh o l e . P r o m o t i o n a n d p r e s e r va t i o n o f t h e h e a l h t o f i t s d i fferent clients
Chapter II
OBJECTIVES OF THE STUDY
General Objectives: At the end of the student nurse-family relationship, the adopted family will be able to improve their health status and become self-reliant in maintaining their health through appropriate interventions in a given time frame. Specific Objectives After home visits and student nurse-family interaction, the family should be able to: Established rapport and trust with the student nurse. Give relevant and factual information during surveys and interviews Participate actively during home visits and assessment interviews Identify actual and potential problems which can be a barrier in attaining optimum health. Categorize the identified health problems as health threat, health deficit or foreseeable crisis through the assistance of their student nurse. Prioritize the identified family health nursing problems with the assistance of their student nurse. Plan possible solutions or nursing actions to the prioritized health problems. Generate interventions considering the student nurses capabilities, community and the familys resources. Carry out the planned interventions together with the student nurse Perform the health teachings taught by the student nurse Evaluate the effectiveness of the intervention using the set objectives as a basis, and Evaluate changes in condition after giving interventions.
Chapter III
INITIAL DATABASE
A. Family Structure, Characteristics, and Dynamics Family members Age Gender Relationship Educational Occupation to the attainment family health Married Father Head Primary Farmer education level 2 Married Mother Wife Primary Housewife (respondent) education level 3 Child Eldest child Child n/a n/a Child Second child Child n/a n/a Child Third child Child n/a n/a Child Child 4rth child 5th child Child Child n/a n/a n/a n/a Civil status Position in the family
38
Male
37
Female
18 13 .10 7 5
The Scrambled family is a nuclear family. Nuclear family cosist of husband, wife and children (natural or adopted) who live in common household that loves prevail to each other.They lives been living in Brgy. Laguilayan, Purok lll-A, Isulan, Sultan Kudarat since birth. For any forms of conflicts to the family they makes decisions by planning well the conflicts to solve especially in delivering their children to school for the good of their future. The family money keeper is turned to Mrs. Scrambled.
Chudi - has no any degenerative, chronic, or infectious diseases as of the present time. He has not completed immunizations. Chuy - has no any degenerative, chronic, or infectious diseases as of the present time. He has not completed immunizations.
With no known vices like smoking and drinking. Was able to recognize the importance of having a healthy wellbeing.
2. Nutritional-metabolic pattern
Do not take any food supplements or vitamins Daily food intake is mainly rice, dried fish and vegetables
3. Elimination pattern
Eliminates everyday with an average frequency of urine: 4 times According to Mrs. Scrambled, all of the family members have no difficulty in voiding. The family members defecate everyday and some, every other day with no difficulty in defecating noted.
4. Activity-exercise pattern Naga exercise kami everyday. verbalized by the mother.
Family usually stays at the house of Mrs. Scrambled parents since they have a lot of free time and its near their house too. Children are playing with the neighbors children.
5. Sleep-rest pattern Family usually has 10- 12 hours of uninterrupted sleep according to the
mother. They usually sleep at around 7 in the evening and wake up at around 6 to 7 in the morning.
-they watch television and listen to music when there is a free time to relax.
6. Cognitive-perceptual pattern
significant others by their first names. Was slightly able to respond accordingly and correctly to questions. Memory intact. No sensory defects.
7. Self-perception/self-concept Perceived situations (health deficits) to be very stressful but remain
Both parents are still in the reproductive age. They are not using family planning method but Mrs. Scrambled now try hard to practice it.
10. Coping Stress Gets strength in the assurance and guarantee provided by family
members.
11. Values/ Beliefs Pattern
Theyre religion is Islam. They believe that if there is no God theyre not exist in this world.
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention. The children in the family has not all completed their immunization.. The family has adequate rest and sleep. The father is busy in farming. The mother also busy in gardening and sometimes talking some nonsense issue in the community with their neighbor. The children are playing with other children in the community. The mother recognizes the importance of health in the family and they do initial action if one of them is sick. She usually goes in health center if one of them is ill. But if its just common colds or cough shes just going to buy medicine.
Chapter IV
FAMILY BACKGROUND
This chapter shows the family background of the study which includes, Database of the Respondent, Family Tree, General Household Data, Activities of Daily Living which could be an indicative for the present health status of the family as it continues to influence the each of the family member.
Family History On year 1981, Mrs. Scrambled stopped her elementary education because of financial problem. She was in the level ll. She is the second eldest child of their family. Because of the incident Mrs. Scrambled decided to officially not to go to school anymore. In her teen age life, she loves to gardening, caring of her younger sisters and mingling with her friends until she met Mr. Scrambled her husband. On the year 1993 they planned to get married and build a family. They lived at Purok lll-A, Laguilayan, Isulan, Sultan Kudarat there home town. Their parents also lived actually beside their house. Mrs. Scrambled delivery of her eldest and second child was successfully delivered on their house with the help of her mother that can handle delivery at home. Mr. and Mrs. Srcambled works hard in order to provide the needs of their family. Thats why sometimes they felt so tired and weak in the end of the day. For how many days I have been with the family. I can say that there family needs help and needs to correct their habits like not eating in the proper time, food selection and proper food preparation and especially for Mr. and Mrs. Scrambled that needs proper rest and sleep and good health.
The respondent upon interview is the mother in the family. NAME: Mrs. Scrambled AGE: 37 years old GENDER: Female ADDRESS: Purok 3-A, Laguilayan, Sultan Kudarat BIRTH PLACE: Laguilayan, Sultan Kudarat RELIGION: Islam OCCUPATION: Housewife CIVIL STATUS: Married NATIONALITY: Filipino NO. OF CHILDREN:5 EDUCATIONAL ATTAINMENT: under elementary ESTIMATED MONTHLY INCOME: none NAME OF HUSBAND: Mr. Scrambled
Chapter V
TYPOLOGY OF NURSING PROBLEM
This chapter discusses about the problem that were identified during assessment and interview with the family. It includes the cues/data, the family nursing problem and the nursing diagnosis. The problems identified are categorized into presence of wellness state, health deficits, health threats, and foreseeable crisis and stress points.
Family Scrambled House is made of . , kalakat, and the ceiling is made of A. Inability to provide a home
kugon
environment conducive to health maintenance and personal development due to: Subjective data: a. Inadequate family resources; specifically limited financial sa loob ako nag luluto nang resources.
Objective data: The income of the family is about Php 10,000-15,000 per harvest. Subjective data: Mother verbalized, kulang talaga ang income naming para sa aming 5 anak lalo na mag co college na yung panganay ko .
II. Family size beyond what family resources can adequately provide as a health threat. A. Inability to make decisions with respect to taking appropriate health action due to: a. Inaccessibility of appropriate resources for care such as financial constraints.
Objective data: The familys drainage is an open type. They just throw it anywhere. Subjective data: Mother verbalized, sa bomba ako naghuhugas nang plato at dyan ko narin hinuhugasan ang anak ko kapag mag tae para madali na ah
III. Poor environmental sanitation specifically improper drainage disposal as a health threat Inability to recognize the presence of condition or problem due to : a. Lack of knowledge A. Inability to make decisions with respect to taking appropriate health action due to: a. Low salience of the problem b. Failure to comprehend the nature of the problem IV. Poor environmental sanitation specifically unsanitary waste disposal as a health threat A. Inability to make decisions with respect to taking appropriate health action due to: a. Low salience of the problem. b. Negative attitude towards health problem c. Inaccessibility if appropriate resources for care specifically financial constraints V. Faulty/ unhealthful nutritional/eating
habits or feeding techniques/practices specifically inadequate food intake both in quality and quantity as a health threat. A.Inability to recognize the presence of condition or problem due to : a.Lack of knowledge B. Inability to make decisions with respect to taking appropriate health action due to: a. Low salience of the problem. b. Negative attitude towards health problem c. Inaccessibility if appropriate
Objective data: The family has no comfort room. They just void anywhere and defecate in the lining . Subjective data: Mother verbalized sa lining ang mga anak ko naga tae ako nilalagay ko sa cellophane at tinatapon ko dun sa lining kasi la kaming sariling palikuran. Objective data: They has no appropriate eating time
Subjective data: Mother verbalized kasi makalimutan naming magkain kasi busy talaga ang buhay
Objective data: Improper storing of food. Subjective data: Mother verbalized nilalagay lang naming sa
upuan ang mga pagkain kasi wala kaming reef
Vl. Poor sanitation/environmental condition/sanitation specifically lack of food storage facilities as a health threat
A. Inability to recognize the presence of condition or problem due to : a. Lack of knowledge B. Inability to make decisions with respect to taking appropriate health action due to: a.Low salience of the problem b.Failure to comprehend the nature of the problem
Chapter VII
PRIORITIZING PROBLEMS This chapter shows the setting of priorities of family health problems that has been identified. It includes a computation on how priorities were shown with their corresponding justification. I. I. Accident hazards specifically fire hazard, as a health threat.
Actual score
0.66
Justification
This problem is a health threat The problem is partially modifiable. The only way to Solve this problem is to renovate the house, thus it needs money. The problem could be moderately prevented. This could be done if the family will be very alert in watching out especially if they are cooking since the house could catch fire anytime. The problem, compared with the other problems does not need immediate attention since it requires time and Money.
3. Preventive potential
2/3 x 1
0.66
1/2 x 1
Total score
2.32
II. Family size beyond what family resources can adequately provide as a health threat.
Justification
This problem is a health threat The problem could not be modified at all. The family size cannot be trimmed down to smaller size The problem may be prevented but the family size cannot be trimmed down.
7. Preventive potential
1/3 x 1
0.66
0.5
The family know that it needed attention but believes it doesnt need immediate action
Total score
2.32
III. Poor home condition specifically lack of food storage facilities as a health threat
Actual score
0.66
Justification
This problem is a health threat This problem is partially modifiable since the family lacks resources specifically in the financial aspect. However, appropriate health teachings may correct this
11.Preventive potential
1/3 x 1
0.33
problem The problem is low in preventive potential since there is lack of appropriate resources that could solve this. The problem is not needing immediate attention according to the family
1.99
IV. Poor environmental sanitation specifically improper drainage disposal as a health threat
Actual score
0.66
Justification
This problem is a health threat
This problem is partially modifiable since the family has no enough budgets to address this problem.
The problem has low preventive potential since the family has no sink or pipes. They have no choice but to wash outside their house. .
16.Preventive potential
1/3x1
0.66
2.32
Actual score
0.66
Justification
This problem is a health threat
This problem is partially modifiable since the family has no enough funds to build their own toilet.
This can be highly preventable if the family had prioritized in building a toilet
3. Preventive potential
3/3x1
Family recognizes this as a problem but they said it didnt need immediate attention.
Total score
2.66
Habits or feeding techniques/practices specifically inadequate food intake both in quality and quantity as a health threat.
Actual score
0.66
Justification
This problem is a health threat
This problem is partially modifiable since the only way to solve this is to have money to pay the
electric bill.
3. Preventive potential
3/3x1
This can be highly preventable if the family had paid their electric bill.
3.66
Chapter VIII
NURSING CARE PLAN
This chapter shows the identified and prioritized problems in a ranking order. This chapter also presents the family care plan formulated by the student nurse together with the family. Problem List Problem
1. Faulty/ unhealthful nutritional/eating
score
3.66
Habits or feeding techniques/practices specifically inadequate food intake both in quality and quantity as a health threat.
2. Poor environmental sanitation 2.66
Family size beyond what family resources can adequately provide as a health threat.
4. 5. Accident hazards specifically fire
2.32
2.32 1.99
Hazard, as a health threat 6. Poor sanitation/environmental condition/sanitation specifically lack of food storage facilities as a health threat
Summary and Evaluation The family Scrambled is a nuclear family. A typical type of family composed of a father, a mother and child/children. They live in Purok 3-A, Brgy. Laguilayan, Sultan Kudarat. They have started residing there since birth. Their house is made of kalakat and bamboo.Their house has no window and it cant sustain the adequate ventilation needed by the family. The Scrambled familys main source of income is coming from Mr. Scrambled tricycle driving. He earns about Php 10000-15000. Mrs. Scrambled does not work; she is in charge of the house and in taking care of the children. With Mr. Scrambled monthly income, the family strives hard to accommodate everything they need for them to live. The total monthly income of Mr. Scrambled when divided into 7 members, thus, they can be considered poor. Mrs. Scrambled also said that they do not have any financial assets at hand in case of emergency. They typically borrow money from their Relatives and neighbors. All of them are Muslim . Mrs. Scrambled said that they always attend sambayang.since their Mosque is not far from their house. The Scrambled family hardly enjoys the community resources since she did not know about it. She only knows about 4PS and did not participate in any other organizations. The father is usually out while the mother is in the house doing household chores. The familys main source of water is the pitcher pump of neighbor. They wash their clothes, plates and get their drinking water supply there. They put their water in a water jug. They usually dont sterilize their drinking water supply. They have no Toilet. They usually urinate anywhere and defecate in the lining. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. The Scrambled family practices poor environmental sanitation and has a lifestyle that affects their health. Many problems were identified such as health threats which include which affect their optimum level of functioning. A nursing care plan then is made to attend the different problems noted.
On the other hand, the family has still opportunities to improve their health. They have the skill to increase their health potential of optimum wellness. Scrambled family is very cooperative and accommodating. They listen to the health teaching of student nurse.
Together with the family, the student nurse as an instrument has helped the family through motivation and support to change their lifestyle and improve their health status. Even though the time for the student nurse to go for home visit was not enough to address to all the nursing problems, the family is now provided with fair knowledge which they could use anytime as the need takes place. Recommendations The following below are suggestions and recommendation recognized by both the student nurse and family: The Scrambled family should maintain a healthy and clean environment. They must clean their house and surrounding to avoid the occurrence of vectors of diseases. They should remove the cogon near their cooking area for it may cause fire. The family should also maintain proper hygiene such as taking a bath regularly, trimming their nails, changing of dirty to clean clothes, do not let the children wear no clothes, abstain them from walking barefooted, brush their teeth frequently, and must do proper and regular hand washing. . The Scrambled family should persevere to perform proper waste segregation and disposal of their garbage. The family should be aware that organizations in the community are open and present for their problems to be addressed properly. They should be encouraged to verbalize their concerns with regard to the community so that resolutions can be made.
FAMILY ASSESSMENT GUIDE FAMILY DATA Family Name: Havey Address: Laguilayan, Sultan Kudarat I. II. DEMOGRAPHIC DATA Household Number: 7 FAMILY DATA Length of Residency : since birth Place of Origin : Laguilayan, SK Family Size : Medium Religion : Islam
Age Gender Relationship Educational Occupation to the attainment family health Married Father Head Primary Farmer education level 2 Married Mother Wife Primary Housewife (respondent) education level 3 Child Eldest child Child n/a n/a Child Second child Child n/a n/a Child Child Child Third child 4rth child 5Th child Child Child Child n/a n/a n/a n/a n/a n/a Civil status Position in the family
Family members
38
Male
37
Female
18 13 10. 7 5
lll. FAMILY CHARACTERISTIC Type of Family Structure A. Extended: B. Matriarchal: C. Nuclear: D. Patriarchal: E. Dominant Family Member:
Family health Status Health History Father: cough, fever and headache Mother: colds, cough and fever Children: colds, cough, fever and headache
Felt Family needs (identify and Rank According to Priority) 1. Money 2. Shelter 3. Food 4. Clothes 5. Electricity 6. 7. 8. III. HOME AND ENVIRONMENT Is your lot owned? Yes_______ No Is your house owned? Yes ____ No_________ Type of House materials Wood__/__ Makeshift_____ Mixed_______ Concrete______ Other palm fronds
oil
No:
What are the appliances owned by the family? TELEVISION AND RADIO Type of garbage Disposal ___Collected Burning_/___ ___Waste Segregation Burying___ ___Feeding to Animals Throw in the river/sewer __/_Open Dumping Other, Specify _____
Type of waste disposal ___flush ___Pit privy _/__Wrap and throw ___Water Sealed Defecates I the irrigation of lining_other, specify H. Type of drainage system Open ___Closed I. Source of water supply ___Owned
___Bought The Drinking water storage ___Refrigerator covered ___Uncovered
Shared
___other, specify
J.
Containers Used ___Plastic Pitchers ___Jars, Clay pots ___Bottles water jug _Others, Specify K. Food storage/Cooking facilities ___Covered ___Uncovered ____stove ___ Refrigerator ___ cabinet ___ Pots/pans, etc. L. Common household PETS found at Home none
IV.
M. Are there breeding sited of insects, rodents, etc. present? ___Yes No HEALTH AND HEALTH PRACTICES A. Common illness encountered for the last 6 months treatments applied Headache, cough and colds, fever, flu
Whom do you consult for health related problem? _/__ Manghihilot ___ Midwife ___ Doctor ___BHW ___ Albularyo ___Nurse ___ Health Center ___ Others, Specify
B. For problems other than health, whom do you consult? Family Members Friends ___Priest/nun __/_relatives ___Barangay Officials ___Others, specify C. Immunization Status of Family Members
Have you had adequate? 1. Rest and Sleep? 2. Exercise? 3. Relaxation activities? 4. Stress management activities?
V.
ENVIRONMENT
1. Kinds of Neighborhood 2. Social and Health facilities available 3. Communication and transportation facilities
VI.
AWARENESS OF COMMUNITY ORGANIZATION A. Are you aware of existing organization in community? B. If yes, name all the organization/s you know. 4Ps C. Are you a member of any of these organization YES
Yes
___No
Attending meetings Planning Implementation Give donations Evaluations ______Other, specify F. Names five (5) formal and non-formal leaders of the community whom you think can lead the people. 1. Brgy.Captain Argueza 2. Henry 3. Datu Wawi 4. 5.