Sample Family Care Study (N107)

N107- Family Case Study 2012
I.
INTRODUCTION
A. OVERVIEW Community refers to a group of people who interact with each other; it is a social group
determined by geographic boundaries, common values and interest. It functions within a social structure, exhibits and creates norms, values, and social institution. (Microsoft Encarta, 2009) In Community health nursing, one of the two major fields of nursing in the Philippines, nursing practice in the community means different things to different nurses. Its primary goal is the promotion and preservation of health of its client that could be in the individual, family, population, group and community. In community health nursing practice includes nursing directed to individuals, families, groups; the dominant responsibility is the population as a whole. With these, the health of the people is a reflection of the communities of which they live, play, work and learn. Communities shape the lifestyle that people adopt and their livelihood of living safe, fulfilling and productive lives. Family, basic social group united through bonds of kinship or marriage, present in all communities. Ideally, the family provides its members with protection, companionship, security, and socialization. The structure of the family, and the needs that the family fulfills vary from society to society. The nuclear familytwo adults and their childrenis the main unit in some societies. In others, it is a subordinate part of an extended family, which also consists of grandparents and other relatives. In a community, the family is considered to be its basic unit. (Microsoft Encarta, 2009) Our community experience has been founded on the above principle. This exposure did not only provide an avenue to apply what we have acquired in the classroom but also provided an opportunity to serve our fellowmen. Because being in the community is more than meeting the requirements in the Related Learning Experience (RLE), it is being experience the real world, making real memories and rendering service with competence, conscience, commitment and care. This paper presents a case of a nuclear family of five (5) members at The Tent City, Calaanan, Cagayan de Oro City. As a community health student nurse assigned in the area, I was given a chance to care for a certain family. After initial survey of the place, I came across to the XX family. The objective of the study is to smooth the progress of putting into practice the concept of family-oriented nursing care and make certain an organized approach in the delivery of the nursing services to the families in the community, purposely in the application of the nursing process. It aims to identify the health problem of a family within the community. As student nurse, I could give and apply some nursing interventions that are applicable and attainable within the community health services.
Sample by: Torregosa, Cyrus Dan A.
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At the end of two (4) weeks of Community Health Exposure, I will be able to provide to the XX family nursing interventions to the identified health problems affecting the family. The health programs of the Department of Health (DOH) for the promotion of health and prevention of illnesses and the improvement of the conditions in the social and physical environment will also be imparted to the family, and also to participate with the family in the over-all health plan affecting the family, in its implementation and evaluation.
B. SCOPE AND LIMITATION OF THE STUDY This Family Health Care Study provides information and additional knowledge about health to the family concerned. The student is focusing only on the XX family, on their health promotion, prevention of illness and possible ways of alleviating health problems. The student also rendered health teachings according to our knowledge of health care concepts as well as through the culminating and microteaching last March 01, 2012. The student also emphasized DOH programs offered by the Department of Health and the services they offered at Barangay Health Centers. Family care study covers only four (4) weeks of Community Health Nursing. This is also limited to the family's capabilities and willingness to participate and cooperate with the nursing interventions.
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II.
SPOT MAP
A. NARRATIVE DESCRIPTION Tent City, Calaanan Relocation Site, Canitoan Cagayan de Oro City, Misamis Oriental is
located Southwest and 7.5 kilometers away from Cagayan de Oro City proper. Our reference point is from Liceo de Cagayan University-main campus to Tent City, Calaanan Relocation Site, Canitoan Cagayan de Oro City. From here the students have to charter a jeepney to transport the group to and from with the fare of 43 pesos. From the school, the jeepney should turn right on the intersection going to Patag, passing through the SSS building, GSIS building, Highschool Department, National Grid of the Philippines. The jeepney will then turn left with the House of Bulalo as the landmark then going to the Villarin street passing through the establishments of Department of Telecommunication and National Irrigational Administration, straight passing the St. Marys Academy and Mt. Carmel Church. Then turn left from the intersection between Macanhan and Upper Carmen passing Immanuel Mission School and Landfill Zayas, Upper Carmen going downward passing the Silver Creek Subdivision and St. Therese Chapel. Upon arriving on the Canitoan Road, the jeepney must turn left to P.N Roa area, going straight passing to the P.N Roa Elementary school then finally to the Tent City. The Tent were numbered and arranged by five, the tent of our family is # 273.
B. ALTERNATIVE ROUTE One may ride a jeepney going to Cogon Market where you will stop near Petron Gasoline Station facing south you will go then to the street leading to National Bookstore. At the back of the National Bookstore is where you will the find the jeepney going to the P.N Roa including Calaanan. Upon riding on that jeepney, you can pass by the Rotonda circle and Upper Carmen passing Immanuel Mission School and Landfill Zayas, Upper Carmen going downward passing the Silver Creek Subdivision and St. Therese Chapel. Upon arriving on the Canitoan Road, turn left to P.N Roa area, going straight passing to the P.N Roa Elementary school then finally the Tent City.The Tent were numbered and arranged by five, the tent of our family is # 273.
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C. ILLUSTRATION/DIAGRAM OF THE MAP Spot Map of The Tent City, Calaanan Relocation Site, Canitoan, Cagayan de Oro City, Misamis Oriental
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III.
FAMILY PROFILE
Clients Name: Position in the Family: Gender: Age: Civil Status: Birth date: Birth place: Citizenship: Religion: Occupation: Monthly income:
Mr. XX Head Male 27 years old Married April 08, 1984 Punong, Gingoog City Filipino Roman Catholic Motor- rela driver P 1,500.00 NO PICTURE TAKEN
Clients Name: Position in the Family: Gender: Age: Civil Status: Birth date: Birth place: Citizenship: Religion: Occupation: Monthly income:
Mrs. XX Wife Female 22 years old Married May 14, 1989 Punong, Gingoog City Filipino Roman Catholic Housewife None
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Clients Name: Position in the Family: Gender: Age: Civil Status: Birth date: Birth place:
XX1 1st Child Female 4 years old Child January 23, 2008 Northern Mindanao Medical Center, CDOC
Citizenship: Religion:
Filipino Roman Catholic
XX2 2nd Child Female 2 years old Child May 07, 2009 Northern Mindanao Medical Center, CDOC
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XX3 3rd Child Male 1 year old Child October 26, 2010 Northern Mindanao Medical Center, CDOC
IV.
FAMILY HEALTH HISTORY

1. Client Mr. XX Mr. XX is 27 years of age, and is presently residing with his whole family now at the
Tent City, Calaanan Relocation Site, CDO; Tent No. 273. He had common colds and cough last month and doesnt have any chronic illness as claimed. He was fully immunized during his childhood days since his mother was a BHW in their place. Last 2005, he suffered from Urinary Tract Infection thus consulted and admitted at NMMC which lasted for 5 days. He had heredofamilial diseases of asthma, diabetes mellitus II and hypertension. No known food and drug allergy.
2. Client Mrs. XX Mrs. XX is 22 years of age, a housewife. She had her first menstruation at the age of 12 years old and had a regular monthly period. She was immunized completely during childhood. She claimed that she was positive for Hepatitis B when she was carrying her 2nd child on her womb (4 years ago) after a blood test was performed. She was in denial at that time, she did request another test but the result was still the same. She had no idea where she got the dreadful disease. She knows how the disease was transmitted. Now shes in a stage of acceptance as she claimed.
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She has no known food and drug allergy and dont have any history of diseases in their family line. She delivered her children through normal spontaneous vaginal delivery at Northern Mindanao Medical Center. She had her prenatal check-up at same institution. So far she had no complications experienced for her past pregnancy.
Gynecology History Menarche at 12 y.o. regular subsequent menses, 5 days (-) dysmenorrhea Obstetric History G1- (January 23, 2008) G2- (May 07, 2009) G3- (October 26, 2010) XX1- NSVD, NMMC XX2- NSVD, NMMC XX3- NSVD, NMMC
Hospital Confinement UTI admitted at NMMC for 4 days (2008)
3. Client XX1 Client XX1, a 4 year old female child, was delivered through normal spontaneous vaginal delivery at Northern Mindanao Medical Center. She was fully immunized. The child was hospitalized when she was about 6 months old at NMMC for a week due to Acute Gastroenteritis with Moderate Dehydration.
4. Client XX2 Client XX2, a 2 year old female child, was delivered through normal spontaneous vaginal delivery at Northern Mindanao Medical Center. She was fully immunized. Like her older sister, she was hospitalized when she was about 6 months old at NMMC for 4 days due to Acute Gastroenteritis with Moderate Dehydration.
5. Client XX3 Client XX3, a 1 year old male child, was delivered through normal spontaneous vaginal delivery at Northern Mindanao Medical Center. He was fully immunized now. Like his older sisters, again he was hospitalized when he was about 6 months old at NMMC for just 4 hours for hydration purposes due to severe dehydration. Their mother did say that her children experienced the same disease when they were about 6 months old. Coincidence?
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V. A. 1. Client Mr. XX Mr. XX claimed that he doesnt have any illnesses at the moment. His cough and colds subsided a month ago. He works as a motor-rela driver. No history of drinking alcoholic beverages and non-smoker. Vital signs was taken last February 02, 2012 with a Pulse: 88 bpm RR: 21cpm BP: 130/80 mmHg Temp: 36.2 oC.
PRESENT HEALTH STATUS
2.
Client Mrs. XX Mrs. XX claimed that he doesnt have any illnesses but do have troubled sleeping at
night when they transferred at their tent. Shes a housewife and always taking care of their young ones, making sure that theyre safe and sound. No history of drinking alcoholic beverages and non-smoker as claimed. Vital signs was taken last January 20, 2012 with a Pulse: 78 bpm RR: 23cpm BP: 110/80 mmHg Temp: 36.5
3.
Client XX1 During assessment, cough and colds with whitish sputum was noted with client XX1. Her
mother said that her cough and colds was intermittent for the past 4 weeks. The child does take Vitamin C and Multivitamins given by the clinic for free after consultation. Vital signs: Pulse: 97 bpm RR: 25cpm BP: no pedia cuff avail, Temp: 36.30C
4.
Client XX2 No illness was noted with client XX2. Shes playful, energetic and cheerful during the
course of assessment. The child also takes Vitamin C and Multivitamins. Vital signs: Pulse: 89 bpm RR: 23cpm BP: no pedia cuff avail. Temp: 36.3oC
5.
Client XX3 Cough and colds with whitish sputum was noted with client XX3 with no respiratory
distress, just like her eldest sister. The mother said that his cough and colds was intermittent for the past 2 weeks and was given Vitamin C and Multivitamins after consulting the clinic. Vital signs: Pulse: 94 bpm RR: 24cpm BP: no pedia cuff avail. Temp: 36.2 oC
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B. NURSING ASSESSMENT (SYSTEM REWIEW CHART) Name: XX, Mr. XX Vital Signs: Pulse: 88 bpm BP: 130/80 mmHg
EENT: Impaired vision blind pain reddened drainage gums hard of hearing deaf burning edema lesion teeth Asses eyes, ears, nose Throat for abnormality no problem RESP. asymmetric tachypnea apnea rales cough barrel chest bradypnea shallow rhonchi sputum diminished dyspnea orthopnea labored wheezing pain cyanotic Asses resp. rate, rhythm, depth, pattern breath sounds, comfort no problem CARDIO VASCULAR arrhythmia tachycardia numbness diminished pulses edema fatigue irregular bradycardia murmur tingling absent pulses pain Assess heart sounds, rate, rhythm, pulse, blood pressure, etc., fluid retention, comfort no problem GASTRO INTESTINAL TRACT obese distention mass dysphagia rigidity pain Asses abdomen, bowel habits, swallowing, bowel sounds, comfort no problem GENITO-URINARY and GYNE pain urine color vaginal bleeding hematuria discharge nocturia Assess urine freq., control, color, odor, comfort/ Gyn-bleeding, discharge no problem NEURO paralysis stuporous unsteady seizures lethargic comatose vertigo tremors confused vision grip Assess motor function, sensation, LOC, strength, grip, galt, coordination, orientation, speech no problem MUSCULOSKELETAL and SKIN appliance stiffness itching petechiae hot drainage prosthesis swelling lesion poor turgor cool deformity wound rash skin color flushed atrophy pain ecchymosis diaphoretic moist Asses mobility, motion, galt, alignment, joint function /skin color, texture, turgor, integrity no problem
Date: February 02, 2012 Temp: 36.2 oC Height: 55 Weight: 77 kg
-slightly elevated blood pressure of 130/80 mmHg -dirty fingernails
-dirty toenails
LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK
Place an () in the area of abnormality. Comment at the space provided. Indicate the location of the problem in the figure if appropriate, using ()
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Name: XX, Mrs. XX Vital Signs: Pulse: 78 bpm BP: 110/80 mmHg
EENT: Impaired vision blind pain reddened drainage gums hard of hearing deaf burning edema lesion teeth Asses eyes, ears, nose Throat for abnormality no problem RESP. asymmetric tachypnea apnea rales cough barrel chest bradypnea shallow rhonchi sputum diminished dyspnea orthopnea labored wheezing pain cyanotic Asses resp. rate, rhythm, depth, pattern breath sounds, comfort no problem CARDIO VASCULAR arrhythmia tachycardia numbness diminished pulses edema fatigue irregular bradycardia murmur
Date: January 20, 2012 Temp: 36.5 oC Height: 52 Weight: 58 kg
-pale in appearance
tingling absent pulses pain Assess heart sounds, rate, rhythm, pulse, blood pressure, etc., fluid retention, comfort no problem GASTRO INTESTINAL TRACT obese distention mass dysphagia rigidity pain Asses abdomen, bowel habits, swallowing, bowel sounds, comfort no problem GENITO-URINARY and GYNE pain urine color vaginal bleeding hematuria discharge nocturia Assess urine freq., control, color, odor, comfort/ Gyn-bleeding, discharge no problem NEURO paralysis stuporous unsteady seizures lethargic comatose vertigo tremors confused vision grip Assess motor function, sensation, LOC, strength, grip, galt, coordination, orientation, speech no problem MUSCULOSKELETAL and SKIN appliance stiffness itching petechiae hot drainage prosthesis swelling lesion poor turgor cool deformity wound rash skin color flushed atrophy pain ecchymosis diaphoretic moist Asses mobility, motion, galt, alignment, joint function /skin color, texture, turgor, integrity no problem
-difficulty sleeping -(+) Hep. B
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Name: XX, XX1 Vital Signs: Pulse: 97 bpm
Date: January 26, 2012 BP: no pedia cuff avail, Temp: 36.3 oC Height: 103 cm Weight: 13.2 kg
- tooth decay all throughout the assessment -cough and colds with whitish sputum in minimal amount
- Moderate personal hygiene - Dirty nails
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Date: January 26, 2012 BP: no pedia cuff avail. Temp: 36.3oC Height: 97cm Weight: 14 kg
-tooth decay all throughout the assessment
-moderate personal hygiene -dirty fingernails
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Date: January 26, 2012 BP: no pedia cuff avail. Temp: 36.2 oC Height: 79cm Weight: 49 kg
-cough and colds with whitish sputum in minimal amount
-moderate personal hygiene -dirty fingernails
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VI.
INTERGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)
MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS Date: January 26, 2012 Childs name: XX3 Age: 1 year old (WEEK 2-WEEK4) Initial visit and Follow-up Visit ASSESS CHECK FOR GENERAL DANGER SIGNS NOT ABLE TO DRINK OR BREASTFEED VOMITS EVERYTHING CONVULSIONS ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? Yes__ No___ For how long? Count the breaths for one minute. _26_breaths per minute. Fast breathing? Look for chest indrawing? Look and listen for stridor. DOES THE CHILD HAVE DIARRHEA? Yes___ No__ For how long? ___days Is there blood in the stools? Look at the childs general condition. Abnormally sleepy or difficult to awaken? Restless or irritable? Look for sunken eyes. Offer the child fluid. Is the child: Not able to drink or drink poorly? Drinking eagerly, thirsty? Pinch the skin of the abdomen. Does it go back: Very slowly (longer than 2 seconds)? Slowly? DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) Yes__ No___ Decide Malaria Risk Does the child live in malaria area? No Has the child visited a malaria area in the past 4 weeks? No YES___ NO__ CLASSIFY Sex: Male Weight: 9.5 kg Temp: 36.2C ASK: What are the childs problem? Cough and colds all throughout the assessment
No Pneumonia : Cough and Cold
No Dehydratio n
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If malaria risk, obtain a blood smear. Look or feel for stiff neck. Look for runny nose. + Pf Pv -
Not done
For how long has the child had fever? __days If more than 7 days, has fever been present every day? Has the child had measles within the last 3 months? Look for signs of MEASLES Generalized rash and One of these: cough, runny nose. Or red eyes. . If the child has measles now or within the last 3 months: Look for mouth ulcers If yes, are they deep and extensive?
Look for pus draining from the eye Look for clouding of the cornea. . Decide Dengue Risk: Yes__ N o___ If dengue risk, then ask: Has the child had any bleeding form the nose or gums or in the vomitus or stools? No Has the child had black vomitus or black stool? No Has the child had abdominal pain? No Has the child been vomiting? No Look for bleeding from nose or gums. None Look for skin petechiae. None Feels for cold and clammy extremitites. None Check capillary refill ___seconds. Perform tourniquet test if child is 6 months or older and has no other signs and has fever for more than 3 days.
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DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No___ Is there ear pain? No Is there ear discharge? No If yes, for how long? ___days Look for pus draining from the ear. None Feel for tender swelling behind the ear. None No Ear Infection
THEN CHECK FOR MALNUTRITION AND ANEMIA Look for visible severe wasting. Yes. Look for edema of both feet. No. Look for palmar pallor. Severe palmar pallor? Some palmar pallor? None Determine weight for age Very Low? Low. No Anemia and low weight
CHECK THE CHILDS IMMUNIZATION STATUS Circle immunization needed today ___ BCG ___ DPT1 ____ DPT2 ____ DPT3 ___ ____
Return for next immunizat ion on:
OPV1 HEPB1 ___ OPV2 ___ _______ (date)
HEPB2 MEASLES
____ _____ OPV3 HEPB3
CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or older Is the child six months of age or older? Yes__ NO___ Has the child received Vitamin A in the past six months? Yes____ No___
Vitamin A needed today Yes___ No___
ASSESS CHILDS FEEDING if child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years old. Do you breastfeed your child? Yes__ No____ If Yes, how many times in 24 hours? _n/a__ times. Do you breastfeed during the night? Yes___ No_n/a__ Does the child take any other food or fluids? Yes___ No___ If Yes, what food or fluids? _Bear brand milk, fruits, noodles, canned goods, rice
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How many times per day?_3__ times. What do you use to feed the child? _spoon and fork_ If very low weight for age: How large are servings?___child is within normal weight___ Does the child receive his/her own serving? yes__ Who feeds the child and how?_mother, spoonfeeding; child feeds on his own most of the time During the illness, has the childs feeding changed? Yes ___ No___ If yes, how? Fair appetite
ASSESS OTHER PROBLEMS: Moderate personal hygiene
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MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS Date: January 26, 2012 Childs name: XX2 Age: 2yrs WEEK 4) Initial visit and Follow-up visit ASSESS CHECK FOR GENERAL DANGER SIGNS NOT ABLE TO DRINK OR BREASTFEED VOMITS EVERYTHING CONVULSIONS ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? No___ For how long? Count the breaths for one minute. _24_breaths per minute. Fast breathing? Look for chest indrawing? Look and listen for stridor. DOES THE CHILD HAVE DIARRHEA? Yes___ No__ For how long? ___days Is there blood in the stools? Look at the childs general condition. Abnormally sleepy or difficult to awaken? Restless or irritable? Look for sunken eyes. Offer the child fluid. Is the child: Not able to drink or drink poorly? Drinking eagerly, thirsty? Pinch the skin of the abdomen. Does it go back: Very slowly (longer than 2 seconds)? Slowly? DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) Yes__ No___ Decide Malaria Risk Does the child live in malaria area? No Has the child visited a malaria area in the past 4 weeks? No No Dehydratio n Yes__ No Pneumonia YES___ NO__ CLASSIFY Sex: Female Weight: 14 kg Temp: 36.3C ASK: What are the childs problem? None all though out the assessment (WEEK 2-
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Not done
DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No___ Is there ear pain? No Is there ear discharge? No No Ear
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If yes, for how long? ___days Look for pus draining from the ear. None Feel for tender swelling behind the ear. None Infection
OPV1 HEPB1 ___ OPV2 ___ _______ (date)
HEPB2 MEASLES
____ _____ OPV3 HEPB3
ASSESS CHILDS FEEDING if child has ANEMIA OR VERY LOW WEIGHT or less than 2 years old. Do you breastfeed your child? Yes_ _ No____ If Yes, how many times in 24 hours? _n/a__ times. Do you breastfeed during the night? Yes___ No_n/a Does the child take any other food or fluids? Yes___ No___ If Yes, what food or fluids? _noodles, milk, fruits, rice and canned goods How many times per day?_3__ times. What do you use to feed the child? _spoon and fork_ If very low weight for age: How large are servings?_n/a_____ Does the child receive his/her own serving? yes__ Who feeds the child and
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how?_child herself, spoonfeeding During the illness, has the childs feeding changed? Yes ___ No___ If yes, how? Fair appetite
ASSESS OTHER PROBLEMS: Tooth decay and moderate personal hygiene
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MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS Date: January 26, 2012 Childs name: XX1 (WEEK 2-WEEK4) Initial visit and Follow-up visit ASSESS CHECK FOR GENERAL DANGER SIGNS NOT ABLE TO DRINK OR BREASTFEED VOMITS EVERYTHING CONVULSIONS ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? No___ For how long? Count the breaths for one minute. _25_breaths per minute. Fast breathing? Look for chest indrawing? Look and listen for stridor. DOES THE CHILD HAVE DIARRHEA? Yes___ No__ For how long? ___days Is there blood in the stools? Look at the childs general condition. Abnormally sleepy or difficult to awaken? Restless or irritable? Look for sunken eyes. Offer the child fluid. Is the child: Not able to drink or drink poorly? Drinking eagerly, thirsty? Pinch the skin of the abdomen. Does it go back: Very slowly (longer than 2 seconds)? Slowly? DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) Yes__ No___ Decide Malaria Risk Does the child live in malaria area? No Has the child visited a malaria area in the past 4 weeks? No Yes__ No Pneumonia : Cough and Cold YES___ NO__ CLASSIFY Age: 4yrs Sex: Female Weight: 13.2 kg Temp: 36.7C ASK: What are the childs problem? Cough and colds all throughout the assessment
No Dehydratio n
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Not done
DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No___ Is there ear pain? No Is there ear discharge? No No Ear
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If yes, for how long? ___days Look for pus draining from the ear. None Feel for tender swelling behind the ear. None Infection
OPV1 HEPB1 ___ OPV2 ___ _______ (date)
HEPB2 MEASLES
____ _____ OPV3 HEPB3
ASSESS CHILDS FEEDING if child has ANEMIA OR VERY LOW WEIGHT or less than 2 years old. Do you breastfeed your child? Yes_ _ No____ If Yes, how many times in 24 hours? _n/a__ times. Do you breastfeed during the night? Yes___ No_n/a Does the child take any other food or fluids? Yes___ No___ If Yes, what food or fluids? _noodles, fruits, rice and canned goods_ How many times per day?_3__ times. What do you use to feed the child? _spoon and fork_ If very low weight for age: How large are servings?_n/a Does the child receive his/her own serving? yes__ Who feeds the child and
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how?_the child herself, spoonfeeding During the illness, has the childs feeding changed? Yes ___ No___ If yes, how? Fair appetite
ASSESS OTHER PROBLEMS: Tooth decay and moderate personal hygiene
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VII.
HOME AND ENVIRONMENT
1. Housing
All families who were victims of the typhoon Sendong, including family XX were sent at Calaan Relocation Site, Canitoan, Cagayan de Oro City (known as the Tent City) and were also given a tent (known as the Shelter box) by the government where they will temporarily reside. The family was on Tent No. 273. The whole covering and (doors, flooring,
small windows) of the Tent is made up of polyester cloth which is a specialized kind of cloth that can stand heat and rain, and cant be easily tear or damage. They were given a special mat additional for their flooring inside the tent. Two doors, the back and front have a pair of zippers used to lock their houses when theyre not around. Windows are widely open at night time. The family said that when its day to noontime (around 9am-3pm) its totally hot inside the tent, and very cold at nighttime to dawn (around 10pm-5am). Inside the tent, at the center of it is where their little sala is seen, and the left and right compartments serve as the rooms where they usually sleep, change clothes and for the privacy of the couple. Clothes hanging inside are noticeable also (resting sites of vectors of diseases such as mosquitoes). Uses no electricity for their lighting facilities and other electrical devices ( cell phone charger, electric flashlight, electric fan, radio) Has proper ventilation when the doors and windows are widely open
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2. Water supply
Water comes from the common source where they usually have to walk and fetch from the water station (25 meters away from their tent- washing clothes and dishes, taking baths)
They
use
pail
and
plastic
containers as storage of water for washing the dishes.
Uses plastic gallons as storage for purified drinking water where its usually free and delivered by DUAL NARRA. If their supply is already consume, they then usually buy purified drinking water at the nearest drinking water system.
3. Toilet facility
The LGUs, NGOs and other private sectors donated these portalette, a portable toilet where the people urinates and expel their wastes. Every day it is cleaned by a poso negro personnels.
The walls are made up of special concrete plastic thing. Antipolo type After three weeks of visit, the toilet facility was changed from a portalet into a water sealed type for a better and more sanitized toilet for all.
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4. Kitchen
Doesnt have sink, they usually wash dishes at the water station 25 meters away from their tent Uses firewood/charcoal for cooking Washes their dishes using pail as storage of water Foods are placed on the table outside the tent; leftovers are covered with plates only and a special covering device was noted
5. Garbage/waste disposal
The family does not segregate their Uses plastic cellophane container then wastes. throws it when its already full at the big barrel for garbage collection
6. Domestic Animals
They dont have any domesticated animals and pets in their tent.
7. Neighborhood
Their neighbors are composed mostly of low-income families and all of them were victims of the typhoon Sendong. Most of these families are friendly and show concern for one another especially when there is a problem among them.
The health center is near and no need to spend money for fare
No fresh air and trees that give shade to the surrounding
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VIII.
FAMILY COPING INDEX

The objective of this indicator is to present a benchmark for approximating the nursing
needs of the particular family, thus Family Coping Index. It is the coping capacity and not the underlying problem that is being rated, and it is designed to record family rather than individual coping capacity. The family cannot be seen only as a factor that affects health; rather, the family is the patient.
Legend:
1 No competence 3 Moderate competence 5 Complete competence CATEGORY
1. Physical Independence
SCALE 5
JUSTIFICATION All family members are physically fit and physically capable of performing independently. The family provides needs to its members. The father works as a motor-rela driver to provide the needs of his family. The mother takes care of the children and is responsible for bathing, grooming and making their children clean and safe.
2. Therapeutic Competence
The familys initial treatment was the use of herbal medication to treat existing diseases. They consult to the physician only if referred from the barangay health center and if immediate medical attention is required due to financial problems.
3. Knowledge of Health Condition
Has some general knowledge of the disease or condition, but has not grasped the underlying principles, or is only partially informed and does not know how to lessen & prevent the disease.
4. Application of Principles of General Hygiene
In terms of hygiene, the family was consciously practicing and applying hygiene principle as part of their lifestyle. Based on the objective observation, as well as assessment gathered. They usually attends seminars about health and hygiene as stated by the mother when there is time.
5. Health Attitudes
Accepts
health
care
in
some
degree
but
with
reservations. Most of the time, the family does not seek the help of medical professionals only if symptoms persists and intensifies.
6. Emotional Competence
The family was able to maintain a fair degree of emotional calm, face up to illness realistically and
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hopefully; their problem was only lack of financial support that was not able to sustain what are those family needs.
7. Family Living
Familys does things together and act for the good of the family as a whole and they have good interpersonal relationship. The children do respect their parents as what Ive observed.
8. Physical Environment
The house is generally in good condition and safe. But they dont have a proper drainage. The environment possibly has vectors that can cause diseases such as dengue or filariasis.
9. Use of Community Facilities
Family is aware of and uses of the health services offered in their place. Their children had received already full immunization.
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IX.
SCHEMATIC PRESENTATION OF THE FAMILY HEALTH PROBLEM
SOCIO-CULTURAL FACTORS
Economic
Political
Cultural
NONE
NONE
FATHER
MOTHER
High school undergraduate
High School undergraduate
Motor- rela driver
Housewife
Financially unstable with a monthly income of Php 1, 500
No other additional expense for the Family
HEALTH THREAT: Family size beyond what family resources can adequately provide (financially unstable)
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BIOLOGICAL FACTORS
Physical
Psychosocial
Genetic
- Typhoon Sendong took away so many things from them, but they were able to adjust in the new environment they have. Theyre in the stage of acceptance -Express anxiety over budget compensation for additional budgets
Father
Mother
Children Hypertension. DM II and asthma on paternal side
- Long dirty fingernails and toenails - Slightly elevated BP of 130/80mmhg
- Difficulty sleeping - Lack of sleep - (+) Hep. B
- Moderate personal hygiene - Dirty nails - Tooth decay - Cough and colds
HEALTH THREAT Moderate personal hygiene Heredito-familial diseases: hypertension, asthma and DM II
HEALTH DEFICIT Lack of sleep Hepatitis B disease Elevated blood pressure cough and colds
FORESEEABLE CRISIS infection hospitalization death
Dirty nails Tooth decay
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ENVIRONMENTAL
Home and Sanitation Condition
Water Supply
Toilet
Garbage Disposal Waste segregation not practiced. The family hangs a plastic bag adjacent to the tent for their garbage and throws it when full at a big barrel of garbage
Kitchen
TENTS: -No proper division. - No privacy. -Fire Hazard (made up polyester cloth)
Water Source is 25 meters away from the tent. Community faucets used for bathing and washing dishes and clothes.
Communal toilet
Dirty kitchen adjacent to their tent
Inadequate living space, no proper sleeping grounds, room for contamination is of high risk
The family is given a galloon of purified drinking water
Antipolo Portalet and Water sealed type of toilet
Prone to fire accdients
Uncovered water containers and storage
- presence of vectors for diseases such as mosquitoes and flies
HEALTH THREAT FORESEEABLE CRISIS - presence of breeding or resting sites of vectors of diseases - infection - improper garbage disposal - hospitalization - making fire at childrens reach may cause burns and - death injuries - inadequate living space Sample by: Torregosa, Cyrus Dan A. Page 37
X.
FAMILY HEALTH PLAN
CUES
HEALTH PROBLEM
FAMILY NURSING PROBLEM
GOAL OF CARE
OBJECTIVES OF CARE
INTERVENTION PLAN Nursing Method Resources Interventions of NurseRequired Family Contact
EVALUATION
Subjective: Kani lagi sila akong mga anak kay gipang ubo ug sip on, as verbalized by the wife Objective: -productive cough with whitish sputum in minimal amount - colds
Cough and colds as health deficit
1. Inability to make decisions about taking appropriate action due to: a. failure to comprehend the nature and magnitude of the problem. b. Fear of consequences of action, specifically economic consequences. 2. Inability to provide
At the end of nursing intervention, The children in the family with cough and colds will be relieved.
At the end of nursing interventions, the family will: a. gain knowledge on the management of cough and colds; b. bring the child to the health center for consultation; c. be able to carry out appropriate interventions to relieve the childs cough and colds;
1. Taught the
mother the ways to soothe the throat and relieve cough with a safe remedy such as tamarind, calamansi and ginger. 2. Instructed the mother not to use cough syrups and other decongestants if not prescribed by the doctor. 3. Instructed the mother to increase the
Home Visit Material resources: -tamarind, calamansi or ginger
Goal partially met At the end of nursing interventions, the family: a. gained knowledge on the management of cough and colds; ;
Time and effort of the nurse and the family
Expenses for transportation of the student nurses
b. was able to carry out appropriate interventions to relieve the childs cough and colds.
Page 38
- not in respiratory distress adequate nursing care to a member suffering from cough and colds due to: a. inadequate knowledge regarding the health condition; b. lack of knowledge on the nature and extent of nursing care needed; childs fluid intake. 4. Instructed the mother to keep the childs back dry.
Page 39
CUES HEALTH PROBLEM Presence of health threat due to poor condition as evidenced by lack of food storage facilities FAMILY NURSING CARE -Inability to provide a home environment conducive to health maintenance and personal development due to: a. inadequate family resources specially financial constraints or limited financial resources GOAL OF CARE At the end 30 minutes of nursing interventions, the family will be able to: a. Verbalize understanding about the importance of having better food storage. b. Place their food in a safe place away from pests. OBJECTIVES OF CARE After the nursing intervention carried out, the family will at least have better containers or cover to secure their foods and from contamination. MODE OF NURSEFAMILY CONTACT 1.Assess knowledge Home visit of the family towards the pending problem. 2.Discuss possible threats to the familys health due to these containers. 3.Discuss the advantages which will bring about the partial solution to their problem. 4.Plan appropriate action to the problem. INTERVENTION MEASURES RESOURCES NEEDED Food storage EVALUATIONS
Subjective: Gaibutang ra namo among mga pagkaon sa lamesa dayon takluban ug palto as verbalized by the wife Objective: -no other storage facilities to secure their uncooked and left over foods
After 30 minutes of nursing Time and effort interventions, the of the nurse and family was able actual to: participation a.Verbalized and understanding empowerment about the of the family importance of having better Financial food storage. Resources b. Placed their food in a safe place away from pests.
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CUES
HEALTH PROBLEM
FAMILY NURSING PROBLEMS Inability to decide about taking appropriate actions due to failure to comprehend the identified problem as a health threat
GOAL OF CARE
OBJECTIVES OF CARE
INTERVENTION MEASURES
METHODS OF FAMILYNURSE CONTACT
RESOURCES REQUIRED
EVALUATION
Subjective:
Unsanitary food Wala lage me handling as saktong a health butanganan sa threat mga plato ug uban pang materyles sa pagpreparar sa pagkaon as verbalized by the wife Objective: Unwashed utensils Unorganized placements of utensils Exposed stencils to pest and rodents Improper food storage and
After 4 weeks of rendering nursing interventions, the family will be able to practice the proper ways on handling food and recognize the importance of proper food handling
After 4 weeks of rendering nursing interventions, the family members will be able to:
1. Assess the family Home visit concerning their practices on handling and preparing the food 2. Discuss with the family the health problems that will occur if improper food handling will persist and lead to undesirable illnesses such as diarrhea
1. Recogni ze the risk factors that will contribute to the identified 3. Teach the family to problems; do proper hand 2. identify washing and the different encourage them to measures to perform it before and prevent the after handling foods arousal of the risk arise factors of the 4. Discuss to the family problem on how to handle the 3. determi food properly: ne the importance of 5. Encourage the
Participation and At the end of 4 empowerment of weeks, the the family family was able to practice proper ways about handling Time and effort food and of the nurse and recognized the family member importance of proper food preparation and food handling
Page 41
handling, foods exposed to flies preparing and family to keep the handling the house clean specially food properly; the kitchen area 4. practice and apply the techniques of food handling and preparation; 5. keep their kitchen clean and free from insects an rodents
Page 42
CUES
HEALTH PROBLEM
FAMILY NURSING PROBLEMS
GOAL OF CARE
OBJECTIVES OF CARE
RESOURCES REQUIRED
EVALUATION
Subjective:
Poor home environment Hugaw jud al condition ang amu as a health palibot, cge threat man ko panlimpyo pero mahugaw ra jpon as verbalized by the wife Objective: -unclean environment -clothes hanging inside the tent -Presence of flies and mosquitoes flying the house
Inability to provide a home environment conducive to health maintenance and personal development due to failure to comprehend the identified problem as a health threat
After 4 weeks of rendering nursing interventions, the family will be able to recognize the problem as a threat and will be able to recognize the importance keeping the home clean
After 4 weeks of rendering nursing interventions, the family members will be able to take action in cleaning their tent area and maintaining its cleanliness.
1. Encourage the every Home visit family member to participate in cleaning 2. Discuss the importance of keeping the home/tent clean 3. Discuss the possible health condition that may arise 4. Encourage the family members to maintain the cleanliness in their home/tent
Participation and At the end of 4 empowerment of weeks, the the family family was able to: a. Recognize Time and effort the importance of the nurse and of home family member environmental sanitation B. Family members participated in maintain the cleanliness of their place
Page 43
CUES
HEALTH PROBLEM
GOAL OF CARE
OBJECTIVES OF CARE
RESOURCES REQUIRED
EVALUATION
Subjective cue: Sa cellopane nalang namu ginatambak tanan, then amu gnalabay sa barrel nga basurahan, kwaon raman daun sa mangulekta ug basura as verbalized by the wife. Objective cues: Presence of flies and
Improper garbage disposal as a health threat
Inability to provide home environment conducive to health maintenance and personal development due lack of knowledge of proper garbage disposal
At the end of nursing interventions, the family will be able to realize the harmful effects of improper garbage disposal and benefits of clean and healthy environment
Short term objectives:
Health teachings with emphasis on the importance of waste At the end of 15 management. minutes, the family will Human waste and receive health diseases. It is very teachings about important to keep importance of human waste out of proper waste water supplies. disposal Human waste (faeces, poo, kuma, urine, Long term wee) contains objectives: diseases that make At the end of 4 people sick. Human waste can get into the weeks , the local water supplies family will be from leaking septic able to adopt tanks, releasing proper waste contaminated water
Home visitations of the student for six visits within 6 weeks Family Interaction
Time and effort of the student and the family members Fare for the students
At the end of 4 weeks ,the goal partially met. The family was not able to apply the proper waste disposal. But the family intermittently followed the waste management.
Page 44
mosquitoes Unsegregated way of garbage disposal and dumping in a cellophane bag mangement from sewerage treatment plants, dirty nappies, leaking sewerage pipes and people using local creeks as a toilet. Injury and disease. People can get diseases like tetanus and leptospirosis if they cut or scratch themselves on pieces of metal, nails or glass. Children can be seriously hurt by playing with old car batteries or household cleaners that they find lying around. Litter can be a problem. Broken bottles and tins, for example, can cause injury. Mosquitoes and other vectors can breed in water trapped in old tyres and bottles.
Page 45
CUES
HEALTH PROBLEM
GOAL OF CARE
OBJECTIVES OF CARE
RESOURCES REQUIRED
EVALUATION
Subjective cue: Dili jud maigo ang sweldo sa akong bana, gamay kaayo. as verbalized by the wife. Wala pod ko trabaho as verbalized by the wife
Low family income as a health threat
Inability to provide home environment conducive to health maintenance and personal development due to inadequate family resources specifically financial constraints/fina ncial resources
At the end of nursing interventions, the family will be able to recognize or realize ways that will help in maximizing their money.
Short term objectives: At the end of 20 minutes, the family will be able to recognize ways in saving money through giving adequate information. Long term objectives: At the end of 4 weeks , the family will be able to apply measures in saving money.
Establish a family budget. Spend Less.Try to never waste money and make every purchase a considered purchase. Use less. If could all use and consume less there would be less waste, less power consumption, and the benefits for you are SAVING MONEY. Save Money.Each week or each month get into the habit of putting an amount,
Home visitations of the student for six visits within six weeks Family Interaction
Time and effort of the student and the family members Fare for the student
At the end of 4 weeks , the goal was partially met. The family recognized ways in saving their money but needs to be applied in longer duration for sufficient results.
Page 46
however small into your savings. Start by saving a very small fixed amount each time and then move to putting in larger amounts once you begin to save money from your other money saving strategies. Shop Wisely. Consider markets, superstores, farmer's markets, local shops, marts and stores. Buy used. There are huge money savings to be made in buying used
Objective cues: Father P1,500/mon th income Poor family living
Page 47
XI.
ACTUAL IMPLEMENTATION
WEEK 1: January 19-21, 2012 (Orientation Phase) The first encounter with my family was last January 20, 2012 when we started our family profiling and somehow after gathering data, this family fitted the criteria for the family case study. As always, I greeted Mrs. XX and introduced myself. I stated the purpose of the visit and eventually asked permission using a consent letter if it is okay for them to be a part for the family case study. Then, I explained to her the whole course of the study, its purposes, benefits and all: family profile, assessment for 4 weeks, implementation of care and health teachings and documentations. I also assessed the family about their coping as for what had happen during the typhoon Sendong. We talked a lot. She did express her feelings and verbalized her thoughts.
WEEK 2: January 26-28, 2012 (Working Phase) During this week I continued my assessment and put my attention to their 3 children. I assessed them individually using my nursing skills and with the used of the IMCI booklet. Problems were identified and made me plan for the succeeding days to come. Same with Mrs. XX, problems were raised and explanations of such diseases were discussed. done and The health whole teachings week, were implementations
imparted to the family. The importance of hygiene to achieve a healthy well being was emphasized; bathing, grooming and cutting long and dirty fingernails were performed with the family members.
Page 48
WEEK 3: February 02-04, 2012 (Working Phase) The third week of the exposure here at the Tent City, I finally assessed the head of the family Mr. XX. Hes not always at their tent since hes the only one working as a motor- rela driver for the needs and provision of his family. After the assessment and interview, health teachings were again imparted to him since he has an elevated blood pressure. He also claimed that they do have a family history of hypertension, asthma and DM II which makes him more at risk. Cleanliness not only to their bodies but also to their environment was stressed out. The disease conditions that one can get from improper handling of food, improper garbage disposal, and uncleanliness made the family more conscious about their health and hygiene. The family did raise many questions and I did answer them based on the books I read. WEEK 4: February 17-18, 2012 (Termination Phase) The fourth week and termination phase has already come. Together with the family, we evaluated the course of home visits and asked the family what theyve learned for the past weeks. Same with them, I thanked the family for the hospitality and time they had given to me. Finally, I invited them to come and join the income generating activity and microteaching this coming March 01, 2012.
Page 49
XII.
EVALUATION AND RECOMMENDATION

Community Health Nursing has been a part of every student nurses life. It is a nurses
duty to bring to the people the health programs of the government. To provide immediate health care to the community peoples health problems before going to the higher health care facilities. Prevention is our primary task so it is our duty to do every means in order to educate the people. After four weeks of visitation, I had identified several family health problems and environmental problems as well. As included in the whole process of assessing, imparting health teachings and rendering care to the family members, I recommend that the family should give first priority to their health and avail the services offered by the local government at the Tent City for proper referrals and further intervention of their disease conditions in which they are not familiar with. I am hoping and looking forward that the XX family will apply the things that the student nurse imparted to promote health and well being. Overall, the intervention that was implemented to family made a difference on their perception towards promoting health, and preventing illness. As a practicing health care giver, the experience that I have gain during the rotation had improved my understanding about community health nursing, not only that I have implemented interventions but the feeling of being accepted as a health care provider and helped in the improvement of others lives is very heartwarming and gave me a sense of accomplishment. For me, the concept of Community Health Nursing is not all about fulfilling the requirements to pass or just intervening the problems identified, its how the health care giver touches others lives and be one of them in attaining the solution of the problem, its about empathy and motivation towards one self and the community to perform such task pertaining to promoting health and preventing disease. This exposure inculcates to us lots of learning and values which would eventually help us to become competent health care providers as future nurses.
Page 50
XIII.
BIBLIOGRAPHY
Maglaya, A., & Earnshaw, R., Nursing Practice in the Community. Community Health Nursing by DOH Kozier, et al. Fundamentals of Nursing. Singapore: Pearson Education Asia Ltd., 2004 Smeltzer, S. Medical-Surgical Nursing. Manila, 1996. Reyala, A. et al. Community Health Services in the Philippines. Manila: National League of the Philippine Government Nurses, Inc., 2000 Maglaya, A. Nursing Practice in the Community. Philippines: Argonauta Microsoft Encarta 2009. 1993-2008 Microsoft Corporation. Corp.
Page 51
XIV.
APPENDICES
A. LETTER OF CONSENT FOR CARE STUDY AND TAKING OF PICTURES
Page 52
B. PRIORITIZING HEALTH CONDITION AND PROBLEMS (ACTUAL COMPUTATION)
RANK 1 Problem: Cold and Cough as health deficit Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 3/ 3 x 1 = 1 2/ 2 x 2 = 2 3/ 3 x 1 = 1 2/ 2 x 1 = 1 Actual Score 1 2 1 1 5 Justification Health deficit problem Easily modifiable Highly preventable Needing immediate attention Highest weight
RANK 2 Problem: Presence of health threats due to poor food sanitation as evidenced by lack of food storage facilities Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 2/ 3 x 1 = 0.66 2/ 2 x 2 = 2 3/ 3 x 1 = 1 2/ 2 x 1 = 1 Actual Score 0.66 2 1 1 4.66 Justification Health threat problem Easily modifiable Highly preventable Needing immediate attention Highest weight
RANK 3 Problem: Unsanitary food handling as health threat Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 2/ 3 x 1 = .66 2/ 2 x 2 = 2 3/ 3 x 1 = 1 2/ 2 x 1 = 1 Actual Score 0.66 2 1 1 4.66 Justification Health threat problem Easily modifiable Highly preventable Needing immediate attention Highest weight
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RANK 4 Problem: Poor home and environmental condition as health threat Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 2/ 3 x 1 = 0.66 2/ 2 x 2 = 2 3/ 3 x 1 = 1 1/ 2 x 1 = 0.5 Actual Score 0.66 2 1 0.5 4.16 Justification Health threat problem Easily modifiable Highly preventable Problem not really perceived needing change
RANK 5 Problem: Improper garbage disposal as a health threat Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 2/ 3 x 1 = 0.66 2/ 2 x 2 = 2 3/ 3 x 1 = 1 1/ 2 x 1 = 0.5 Actual Score 0.66 2 1 .5 4.16 Justification Health threat problem Easily modifiable Highly preventable Not needing immediate attention Highest weight
RANK 6 Problem: Low family income as a health threat Criteria Nature of the condition or problem presented Modifiability of the condition or problem Preventive potential Salience Total Score and Rank Computation 2/ 3 x 1 = 0.66 1/ 2 x 2 = 2 1/ 3 x 1 = 0.33 2/ 2 x 1 = 1 Actual Score 0.66 1 0.33 1 2.99 Justification Health threat problem Partially modifiable Low preventable Needing immediate attention Highest weight
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Sample Family Care Study (N107)

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N107- Family Case Study 2012

Sample by: Torregosa, Cyrus Dan A.

N107- Family Case Study 2012

Sample by: Torregosa, Cyrus Dan A.

N107- Family Case Study 2012

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Filipino Roman Catholic

Filipino Roman Catholic

Sample by: Torregosa, Cyrus Dan A.

Filipino Roman Catholic

FAMILY HEALTH HISTORY

Sample by: Torregosa, Cyrus Dan A.

Hospital Confinement UTI admitted at NMMC for 4 days (2008)

Sample by: Torregosa, Cyrus Dan A.

PRESENT HEALTH STATUS

Sample by: Torregosa, Cyrus Dan A.

Date: February 02, 2012 Temp: 36.2 oC Height: 55 Weight: 77 kg

-slightly elevated blood pressure of 130/80 mmHg -dirty fingernails

LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK

Sample by: Torregosa, Cyrus Dan A.

Date: January 20, 2012 Temp: 36.5 oC Height: 52 Weight: 58 kg

-difficulty sleeping -(+) Hep. B

LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK

Sample by: Torregosa, Cyrus Dan A.

Name: XX, XX1 Vital Signs: Pulse: 97 bpm

- Moderate personal hygiene - Dirty nails

LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK

Sample by: Torregosa, Cyrus Dan A.

Name: XX, XX2 Vital Signs: Pulse: 89 bpm

-tooth decay all throughout the assessment

-moderate personal hygiene -dirty fingernails

LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK

Sample by: Torregosa, Cyrus Dan A.

Name: XX, XX3 Vital Signs: Pulse: 94 bpm

-cough and colds with whitish sputum in minimal amount

-moderate personal hygiene -dirty fingernails

LEGEND: 1ST WEEK 2ND WEEK 3RD WEEK 4TH WEEK

Sample by: Torregosa, Cyrus Dan A.

INTERGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)

No Pneumonia : Cough and Cold

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Return for next immunizat ion on:

OPV1 HEPB1 ___ OPV2 ___ _______ (date)

____ _____ OPV3 HEPB3

Vitamin A needed today Yes___ No___

Sample by: Torregosa, Cyrus Dan A.

ASSESS OTHER PROBLEMS: Moderate personal hygiene

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Return for next immunizat ion on:

OPV1 HEPB1 ___ OPV2 ___ _______ (date)

____ _____ OPV3 HEPB3

Vitamin A needed today Yes___ No___

Sample by: Torregosa, Cyrus Dan A.

ASSESS OTHER PROBLEMS: Tooth decay and moderate personal hygiene

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Sample by: Torregosa, Cyrus Dan A.

Return for next immunizat ion on:

OPV1 HEPB1 _ OPV2 _ _______ (date)

_ OPV3 HEPB3

Vitamin A needed today Yes_ No_

OPV1 HEPB1 _ OPV2 _ _______ (date)

_ OPV3 HEPB3

Vitamin A needed today Yes_ No_

OPV1 HEPB1 _ OPV2 _ _______ (date)

_ OPV3 HEPB3

Vitamin A needed today Yes_ No_