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I.

Introduction

“Where does the family start? It starts with a young man falling in
love with a girl - no superior alternative has yet been found”.
--Winston Churchill

Indeed, it is a lovely start to find a man falling in-love with a young lady. It
is where the growth of a fruitful family is rooted. Nourishing that love between the
family members, it is heart-melting to reminisce that once, in the life of both this
parents, they were plainly in-love. Eventually, as the love grows, lives were
added. More love binds the relationship as a whole. More love stands as the
walls that protect. More love holds them up. More love binds them together.
Taking a simple look, you will see that the mother of the adopted family is
seriously committed to this love. No greater fulfillment is going to even the feeling
of being a part of this family even just for a while. As nurses, being under the
same roof with the clients, gave the student nurses in this study a glimpse of their
life as a family—their whole being.
Family as the client has been the main concern of this Family Case
Analysis (FCA). It is one basic principle of Community Health Nursing (CHN)
where it is stated that the family is the unit of care, for an individual would always
belong to a family. Thus, Family Health Nursing is the basic and core component
of CHN practice (Bailon-Reyes, 2006, p.8)
Family is the basic unit of the society. Moreover, the society is the public.
By that, it is clear that Public health is the main concern of CHN. Winslow defined
public health as the science and art of preventing disease, prolonging life, and
promoting physical and mental and efficiency through organized community
efforts towards a sanitary environment, the control of community infections, the
education of the individual in principles of personal hygiene, the organization of
medical and nursing service for the early diagnosis and treatment of disease and
the development of social machinery which will ensure to every individual in the
community a standard of living adequate for the maintenance of health” (p.30
Winslow, 1989).
The people that builds up the country and the world at large, and the same
persons who are potential of being ill or healthy makes up this “public”—the
community. Therefore, promoting a healthy community is the main goal of CHN.

Employed CHN is a synthesis of nursing practice and public health


practice applied to promoting and preserving the health of the populations. The
practice is general and comprehensive. It is not limited to a particular age group
or diagnosis, and is continuing, not episodic. The dominant responsibility is to the
population as a whole; nursing directed to individuals, families, or groups
contributes to the health of the total population. Health promotion, health
maintenance, health education, and management, coordination, and continuity of
care are utilized in a holistic approach to the management of health care of
individual, family, and group in a community. (ANA, 1980, p.2)

Throughout the course of this FCA, the adopted family had been assisted in
identifying their existing problems as they were taught to cope with it and
eradicate unnecessary conditions and factors to improve their health and quality
of life as a whole. As to maintain the privacy of the adopted family, they were
assigned with pseudonames that would be used for the whole activity. Namely:
Mr. Lorenzo for the father, Mother Mae for the mother, Anthony for the youngest
(son), and Ann for the eldest (daughter).

The student nurses involved in this study aim to help the said family as far
as they can to add another piece of experience to their student lives. Also, to give
back the love lavished upon them though they were not lawfully part of this
family. Most especially, it helped them nourish the love and compassion found in
being Christ’s servant as nurses while their future careers is fast approach.
A. Objectives

a. Short Term

(Student-centered)
After one to two days of home visits, the student nurses will be
able to:

♥ Introduce the purpose of their family case analysis.


♥ Establish rapport with all or at least some of the family members
as evidenced by (AEB) light conversations.
♥ Gain their trust and the necessary cooperativeness AEB
answering interview-questions honestly.
♥ Assess the history and health status of all or at least some of
the members.
♥ Perform physical assessment of the present members of the
family cephalo-caudally
♥ Identify potential problems that might exist or actually existing
related to hygiene, sanitation, or health condition.
♥ Initiate planning of the possible interventions.

(Family-centered)
After one to two days of home visits, the family will be able to:

♥ Accept and understand the underlying purpose of the family


analysis AEB accepting the offer of making them the subjects
and showing cooperativeness.
♥ Establish rapport with all the student nurses AEB light
conversations.
♥ Trust to the student nurses AEB allowing them to join in their
side-line job.
♥ Show enthusiasm in physical assessment done to them.
♥ Cooperatively respond to the questions asked such as
regarding history and health status of the members.
♥ Honestly mention the reason behind some recognized
problems related to hygiene, sanitation, and health condition.

b. Long Term

(Student-centered)
After four to five days of home visits, the student nurses will be
able to:

♥ Gather the necessary information to formulate the appropriate


nursing intervention.
♥ Identify all the existing problems and properly provide
immediate interventions and plan for long term interventions
such as maintenance of good sanitation.
♥ Establish stability with regards to the family’s health status AEB
normal vital signs and decreased risk factors.
♥ Supply or advice the family to supply lacking materials in the
house that cause problems to arise.
♥ Achieve the goals they have set like gaining the family’s trust.

(Family centered)
After four to five days of home visits, the family will be able to:

♥ Manifest enthusiasm in resolving the existing problems AEB


inquiry and initiative in management of the problem
♥ Participate in care provided to them by student nurses like
physical examination and interventions in sanitation.
♥ Initiate lifestyle changes necessary to obtain improvement in
health status.
♥ Comply with the habit modifications carefully provided to them
by the student nurses.
♥ Switch to the proper treatment or utilize community health
center before consultation to herbolarios
♥ Seek health care from authorized providers of care and utilize
community resources.

A. Early Climate and Acceptance, First few words, Number of visits

“Immersion” is the best way to describe the bustle of home visit. The group
felt very excited before they are immersed in the community and meet the
chosen family. On the 21st day of February, 2009 was the start of the group to be
in the community. They are assigned in zone 2 of Macapagal Village, Clark Field,
Pampanga. The student nurses have criteria in choosing a family in which the
family should be classified as poor where in the allowance of the each of the
family members are less than P2, 768.00, family member of five and above, a
living children less than 7 years old, and the most Important of all is that they are
willing to cooperate. The family is very supportive and very warm, very
cooperative and they are very friendly, they are also very accommodating to the
point that whenever they do something, they stop it or do it while entertaining us,
multi-tasking it is. They also always see to it that nobody stands and gives
everyone a very comfortable chair to seat to. They even thought us the barbecue
stick making, the mother’s sideline. They have a very cheerful aura.

1st Home Visit – January 21, 2009


It was a very hot day when the student nurses met the chosen family at
around 10:30 in the morning. On the same day the student nurses stated their
purpose of visiting the family. The group was overwhelmed with the hospitality
shown by the family. “Good morning pu ate! Pwede da kayu pu ainterview?” said
by the student nurses. “Uwa sige, gawan yu kaming family yu!” said by the
mother. The group explained the purpose saying “taga AUF kami pu, ikayu pu ing
apili mi para keng Family Case Analysis mi. Bali mga two to three weeks kami pu
kanyan mumunta keni.” “uwa ok mu pu itamupin pu mamako kung 11 am ne?”
we were struck because of the response of the mother saying “uwa gawan yu
kaming family yu!” and gave as the thought of them being a subject of a previous
FCA subject, and true, they were used as the subject with a preceding FCA.
Never the less, that did not gave the group a negative notion and continued the
purpose. At that moment the student nurses established rapport and had light
conversations with the family and able to take their 1st vital signs and did
physical assessment to the few members present.

2nd Home Visit – January 22, 2009


It was a hot Monday morning when the student nurses conducted their
second home visit. They went to the chosen family at around 10:00 p.m. in the
morning. The groups were very much welcomed by the family with hospitality
while the mother is doing her “sideline”, making barbeque sticks. On the second
day of interview, the student nurses interviewed the family regarding their
demographic data. They were able to take the history of past and present illness
of the family as well. Mentioning the death of Mother Mae to be caused by
cancer, they wee able to explain that the heredity factor can predispose her to
the said disease. They also assessed the problem is experienced by the family
experiencing and classified them. They were also thought of the barbeque stick
making and had a wonderful experience, not mentioning the sticks we have
broken.

3rd Home Visit –January 23, 2009


A sunny morning around 10am when the member of the group went to the
chosen family and the mother is not at home; her sister who’s living in the left
side of their family subject’s house entertained them. She told them that mother
is on the PTA meeting with her children at school. On that day, the student nurses
made an ocular inspection of the house, of course with the consent and
supervision of the sister of mother Mae. On that said day, they have also
identified problems that the family is experiencing like the inside of the house
having improper disposal of garbage and some exposed wires. While some of
the group outside noticed the poor drainage system. Also the practice of the
burning garbage where ashes where ashes are found scattered outside.

4th Home Visit – January 27, 2008


For a change, it was a very cloudy morning when the student nurses went
to the family and welcomed them again with hospitality and it was the very first
time for the group to see the youngest and the big sister who were preparing for
school. With a limited time, they took their physical assessment for not to soil the
oppurtunity. It was around 10:30 a.m. when the group arrived in the family with a
rushing behavior because they are avoiding the mother to be disturbed, as to her
kindness, she asked them to stay for a while and wait for her as she took her
children to school. Patiently waiting, mother Mae arrived and she urgently
entertained the group with her apologies of waiting for her. As usual, they made
an interview and conducted a physical assessment to mother, and this time, they
made is as comprehensive as they can. They also pointed out the problems they
identified during the previous home visit. Mother Mae interestingly showed
enthusiasm in resolving the problems. They cleaned the house and threw the
garbage. They also advised her to refrain from burning the garbage outside.

5th Home Visit –January 28, 2009


It is a Wednesday morning as they arrived in their family and mother gave
them a big “HELLOOOOOOOO” and a smile on her face showing her
enthusiasm as they arrive. Immediately they conducted the interview completing
the requirements and asking the left questions unasked. As they come deeper
with their rapport to the mother, they have come to the point of asking their
favorite foods, past time etc, there then the mother asked the group if they are
eating the famous “native adobo” and that craved the appetite of the group. They
also begun giving health teachings to Mother Mae such as visiting the health
center. They also evaluated the coping of the family with regards to the changes
being applied like the garbage disposal and such. As time pass by, the
conversation went. When the group were about to go, mother Mae said, ”Sandali
lang may papabaon ako sainyo, ulamin nyo masarap ito.” The group reluctantly
took the plastic bag not knowing what is inside. As they arrived at the heath
center, they checked the plastic bag seeing a hot freshly cooked native adobo.
How thoughtful their family was.

6th Home Visit –January 29, 2009


It is the last day of home visits and the group and stayed for a while, they
helped the mother make barbecue sticks and had a meaningful conversation
while doing the chores. This was also the time for them to evaluate the changes
in behavior that took place on the part of the subjected family. They also
performed final physical assessment to compare the progress with the initial
data. This served as an over-all evaluation of the family’s health status. As the
clock waved goodbye, the group gave tokens to the family as a sign of their
gratitude for the kindness the family gave to them. The families were so happy
for the things that the group gave them that the mother said a million of thanks. It
was a happy satisfying overwhelming experience that the group will possibly
remember forever.

II. Family Constellation

NAME AGE SEX POSITION EDUCATIONAL GENERAL APPEARANCE


IN THE ATTAINMENT
FAMILY

Mr. 37y/o male father Elementary (Referring from pictures) He is


Lorenzo graduate approximately the same or
slightly taller than Mother Mae
and not too fat and not too
skinny. He has thinning hair on
the front part of his head. He
has light brown-colored skin.
According to Mrs. Mae, Mr.
Lorenzo works in a company
(junkshop). He goes to his
work by means of a bicycle.
Mrs. Mae told the group that his
husband is a smoker he
consumes 1 pack of cigarette
every day. He seldom
experience cough and colds.
Mrs. Mae 30y/o Female Mother High school On the group’s initial visit Mrs.
Mae was wearing a yellow t-
graduate
shirt and blue pajamas and her
hair was pony tailed. Mrs. Mae
is 30 years old who weight 49kg
and has a height of 152 cm. her
vital signs were taken and
recorded as follow;
T = 36.1°C/axilla
PR = 55cpm
RR =20bpm
BP = 110/70mHg
Height: 152cm
Weight: 49kg
BMI: 21.21
Nutritional status: normal

Ann 9y/o female Eldest Still in


child Upon initial visit Ann wearing
Elementary
a clean school uniform, and
black shoes. She is alert and
awake. Ann 9year old. Her
vital sign are as follow:

T = 36.5°C/axilla
PR = 83bpm
RR =17 cpm
Height: 125cm
Weight:31 kg
BMI: 19.84
Nutritional status: normal
Anthony 5 y/o Male Youngest Still in During the initial visit Anthony
Kindergarten was seen clean white sando
and blue short. He has black
complexion with short nails.
Anthony is a 5 year old who
weight 15 kg and has height 111
cm. temperature: 36 *C: Pulse
Rate: 120 bpm: Respiratory
Rate: 23 cpm..

T = 36°C/axilla
PR =120bpm
RR =23cpm
Height: 111 cm
Weight: 15 kg
FNRI= normal weight should
be 14.4 to 23.5

III. Health Assessment (IPPA-CEPHALOCAUDAL)

Mother: Mae Macapagal


Physical Examination
First Home Visit (January 23, 2009)
A. General appearance and Behavior
On the group’s visit Mother Mae Macapagal was wearing a yellow t-shirt and blue
pajamas and her hair was tied up. Mother Mae Macapagal is 30 years old who
weighs 49kg and has a height of 152 cm. Her vital signs were taken and
recorded as follow; temperature: 36.1°C: Pulse Rate:55 pm: Respiratory
Rate:20cpm: blood pressure 110/70 mmHg

Physical Assessment

Mental Status
• Client is alert and awake with eyes open and looking at the student nurse.
• She established eye contact when asked questions.
• She also smiles and frowns appropriately without difficulty.
• The client is cooperative, when asked, can answer properly.
• The client was able to express free-flowing thoughts and expresses realistic
perceptions.
• She is aware of self, other, time, home address and current location.
• She listens and can follow directions without difficulty.
• She was able to recall recent event without difficulty.
• She recalls her birthday and answer information correctly.

Motor Function -Walking gait – has slouched posture with opposing arm
swing upon walking; maintaining balance

Integumentary System:
• Skin is brown in complexion, no odor, and uniform in color. Her skin turgor is
normal because when her skin was pinched, it go back to previous state
immediately. The skin is not edematous and is in normal temperature. With
sensation to touch, pain & temperature.
Skull & Face (Head)
• She has a round skull, no contusions, bruises noted nodules and masses,
and no tenderness palpated. She has symmetrical facial movements as
evidenced by client’s ability to smile, frown, raise his forehead & eyebrows
& shows his teeth. Facial features and facial movements are symmetrical.
Hair
• Hair is long, dry, straight, thick, black and evenly distributed hair. There is
no dandruff, no area of loss of hair and no infection/infestation.

Nails
• Her nails are untrimmed and dirty as well. She has light brown, smooth,
epidermis is intact, has convex curve nails, no discoloration of the nail beds,
no clubbing of nails, normal capillary refill (<2-3 sec), and no edema.

Eyes and Vision


• Eyebrows are symmetrically aligned, evenly distributed and has equal
movements.
• Her eyelashes are evenly distributed, upper eyelashes are slightly curled
upward and lower eyelashes are slightly curled downward.
• Eyelids are intact and closed symmetrically, bilateral blinking. In her bulbar
conjunctiva capillaries are slightly visible and sclera appears white.
• Her palpebral conjunctiva is shiny and pink in color.
• Lacrimal gland, lacrimal sac and nasolacrimal duct has no edema or
tenderness.
• Cornea upon inspection for clarity it is shiny and transparent. When checked
for corneal sensitivity test it has positive blinking reflex because her eyes blink
when it is touched by the cotton.
• Her pupils are equally round and reactive to light and accommodation. The
student nurse holds an object from the nose of the client and asked the client
to look object then to a distant object. Upon looking, the client’s pupils
constricts when looking at near objects, and dilates at far objects
• The client can see objects at the periphery by letting her cover her right eye
and look directly to the student nurse’s nose.
• Holding the penlight in the periphery, the client was able to spot the moving
object.
• Holding a penlight, the student nurse asked the client to follow the movement
of the penlight with the eyes only to test for extraocular muscle test. The
nurse then moved the penlight using the 6 cardinal movements. The client’s
eyes have coordinated movements.

Ears and Hearing


• Her ears (auricles) are symmetrical in size and auricles aligned with the outer
canthus of the eye. No lesions or masses noted.
• Pinnas are elastic recoils after folded, firm and without tenderness upon
palpation.
• Internal ear has no lesions and with a presence of dy cerumen,

Nose and Facial Sinuses


• Her nose is symmetrical and uniform in color; there is no discharge or flaring,
no lesions or tenderness.
• Air moves freely as the client breathes through nares by asking client to exert
pressure on the nares, and breathe through the opposite.
• Her facial sinuses are not tender.

Mouth and Throat


• Her teeth are incomplete; she has 33 set and all have dental carries. Her
teeth are yellowish in color.
• Her tongue is pinkish in color, moves without restraint, no tenderness and no
lesions.
• Soft palate is light pink in color and it is smooth. Her hard palate is lighter pink
in color compared to the soft palate.
• Uvula is positioned in the middle of the soft palate.
• Oropharynx and tonsils are pink and smooth, no discharge and are not
inflamed.

Chest and Back


• Skin at the back is intact with uniform in temperature.
• Chest is symmetric in volume, no tenderness and masses, full and symmetric
lung expansion, and resonant sound upon percussion over the lungs and no
adventitious breath sounds.
• Breathing pattern is normal with symmetrical chest movement noted on
anterior thorax. She has a regular heart beat pattern.
• Spinal cord is vertically aligned. She has a slouched posture, with right and
left shoulders at the same height.
Abdomen
• Uniform in color, not distended, rounded symmetric contour and movements
upon by respiration and with audible bowel sounds every 5 to 20 seconds, No
lesions noted, no tenderness, relaxed abdomen with smooth and consistent
tension.

Thorax and Lungs


• Posterior thorax is chest symmetric. Regarding her spinal alignment, her
spine is vertically aligned; slouched postures, left and right shoulders and
hips is at the same height.
• Jugular veins are not visible.

Upper Extremities
• There are firm with coordinated movements;
• Her bones and joints have no deformities, tenderness nor swelling noted.
• She can sense touch, pain and temperature.
• The client is able to repeatedly and rhythmically touch the nose during the
“finger to nose test”.

Lower Extremities
• The muscles in the lower extremities are symmetrical.
• The client can resist against the pressure given by the student nurse and
elicited fine coordinated movements.
• The bones and joints in the lower extremities have no deformities and
pain, temperature and touch is felt.
• The client’s gait and balance is stable. She can walk in straight line and
can maintain balance.

B. CRANIAL NERVES

CN 1: OLFACTORY
Type: Sensory
Function: Smell
Tests perform: The student nurse asked the client to close her yes and identify
different aromas such as perfume and coffee.
Expected result: She is expected to identify the different aromas such as perfume
and coffee presented with hers closed.
Actual Result: Mother Mae was able to identify the aromas of perfumes and
coffee.

CN ||: OPTICS
Types; sensory
Function: vision and visual fields
Tests perform: the student nurse asked her to read on the newspapers
Expected result: the client will be able to read the newspapers
Actual result: Mother. Mae was able to read at a distance of 14”

CN |||: OCULOMOTOR
Types: motor
Function: Extra ocular movements of the eyes, movement of the sphincter of the
pupils.
Tests performed: the student nurse made use of a penlight at a distance of 1 foot
in front of the client’s eyes and asked the client to hold the head in a fixed
position facing the student and followed the movement of the penlight with eyes
only. The student nurses assess the 6 ocular movement and pupil reaction.
Expected result: client is expected to move her eyes though the cranial fields of
gaze that is from the center to the upper right, upper left lower right, lower left
and medially. Actual result: Mother Mae was
able to move her eyes though the cranial fields of gaze that is from the center to
the upper right, upper left lower right, lower left and medially.

CN|V: TOCHLEAR
Types: motor
Function: extra ocular eye movements specifically nerve eyeball downward and
laterally
Tests perform: the student nurse asked to asses the 6 ocular movements using
the penlight at distance or 1 foot and followed the penlight with the eyes only
Expected result: Mother Mae will be able to move her eyes downward obliquely
Actual result: Mother Mae was able to move her eyes downward obliquely
without moving hid head.

CN V: TRIGEMINAL
Type: motor
Function: jaw movement and mastication, Sensation of cornea, skin of face, and
nasal mucosa
Tests perform: The student asked the client to look upward, lightly touch lateral
sclera at eye to elicit blink reflex.
To test light sensation, the student ask the client to close eyes then wipe a wisp
of cotton over the client’s forehead
To test deep sensation, use alternating blunt and sharp ends of the cap of a pen
over the same area.
Allow the client to chew, open, and clench her jaw, while palpating the jaw
muscles.
Actual result: The client was able to blink after the sclera is touched
The client was able to identify the light and deep sensations through the objects
presented.
The client was able to open and clench her jaw without extra effort.
CN V|: ABDUCEN
Type: motor
Function: lateral movement of the eyes
Tests perform: the student nurse stand directly in front of the lint and hold
penlight at a distance of 1 foot and asked client to hold head follow the
movement of the penlight with her yes only.
Expected result: She will be able to follow the lateral movement of the penlight.
Actual result: She was able to follow the lateral movement of the penlight.

CN V||: FACIAL
Type: motor
Function: facial expression, taste (anterior or 2/3 of tongue)
Tests perform: she was asked to raise her eyebrows, smile, show teeth and puff
out cheeks.
Expected result: she is expected to raise her eyebrows, smile, show teeth and
puff out cheeks.
Actual result: she was able to raise her eyebrows, smile, show teeth and puff out
cheeks
The client was able to identify the different tastes placed on the anterior two-
thirds of the tongue.

CN V|||: VESTIBULOCOCHLEAR
Type: sensory
Function: sense of hearing and balanced
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: Mother Mae will be able to hear the words that the student nurse
whispered to the client.
Actual result: Mother Mae was able to hear the words that the student nurse
whispered to the client.

CNIX: GLOSSOPHARYGEAL
Type: motor and sensory
Function: pharyngeal movement and swallowing ability
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: When asked to say “ah”, she will be able to say it and she will
be able to elicit the gag reflex. And she will be able to move the tongue from side
to side and up and down.
Actual result: Mother Mae was able to move the tongue foam side to side and up
and down and was able to say “ah” when asked. She also elicited gag reflex.

CN X: VAGUS
Type: motor and sensory
Function: swallowing and speaking
Tests perform: assess with cranial nerve IX, assess client speech for hoarseness
and ask the client to swallow and speech
Expected result: she will be able to state her name without hoarseness voice and
was able to swallowing.
Actual result: she was able to state her name without hoarseness voice and was
able to perform swallowing.

CN XI: ACCESORY
Type: motor
Function: head movement and movement of shoulders muscle
Tests perform: the student nurse asked the client to shrug her shoulder against
resistance of the student nurse’s hand and turn head side against resistance.
Repeat both sides.
Expected result: she must be able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.
Actual result: She was able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.

CN XII: HYPOGLOSSAL
Type: motor
Function: movement of the tongue and stretch of the tongue
Tests perform: She was asked to protrude her tongue at midline, and then move
it side to side.
Expected Result: She should be able to protrude her tongue at midline, and then
move it side to side
Actual result: She was able to protrude her tongue at midline, and then move it
side to side.

B. Obstetrical History:

Mrs.Mae obstetric record is G5P2T2P0A3L2M0.She had her first


menstrual period when she was 12 years old. She has a regular menstrual cycle.
Mrs. Mae and Mr.Lorenzo were married for ten years now.. She consulted the
midwife after her delivery to her youngest child. Mrs. Mae usually takes note of
her last menstrual period for her to be aware of it.

All of the deliveries of Mrs. Mae were done in the hospital via Normal
Spontaneous Delivery with the aid of the midwife. After being confirmed that
Mrs. Mae is positive for pregnancy test she has her frequent prenatal checkups
that started for her two months of pregnancy.. She had her frequent check-ups;
her check up for the 2nd to 6th month is every month, for 7th and 8th month, twice a
month, and for the 9th month every week. Mrs. Mae had her Tetanus Toxoid
vaccine in her early pregnancy and after giving birth.
During her pregnancies she experienced morning sickness that usually last
for a weeks According to her, she craved for mangoes,oranges, and Tamarind.
According to her, she believes in some superstitions regarding pregnancy like not
eating twin bananas because it may bring about twin babies and not wearing
necklace because it might choke the baby. She also avoid taking a bath after
delivering a baby, she only takes a bath after three days.
C.Nutritional Status

Nutritional Status
BMI= Weight in Kilograms
(Height in meters)2
= 49 kg = 49kg
(1.52 m2) 2.31
= 21.21 (normal)
Age: 30 y/o
Height: 152cm
Weight: 49 Kg

BMI Range Classification


Below 15 Emaciated
15-18.9 Underweight
19-24.9 Normal
25-29.9 Overweight
30-39.9 Obese
40-more Morbidly Obese

E. History of past and present illness

Mother Mae mentioned that she did not experience any major illnesses or
hospitalizations before. She only had occasional fever, cough and colds. . But
when further asked, she made mention of her mother who died of brain cancer.

At present, she is complaining of frequent headaches. The group provided


health teachings such as increasing fluid intake and eating nutritious foods as a
form of protection for her to increase her resistance to pathogenic
microorganisms and to consult the midwife regarding her condition.

F. Activities of daily living


Mother Mae wakes up between 5 to 6 am and prepares breakfast for her
family especially the meal for her children who are about to go to school. She
cooks for about 30 minutes between 6 to 6:30 am. She joins them in eating from
6:30 up to 7 am. Then she sends them to school. While waiting, she performs her
daily activities like watching television or cleaning the house. Then she cooks
their lunch at around 11am to 12noon. Then she prepares it as her children arrive
at around 12noon. Then they eat lunch for about an hour or so from 12noon to
1pm. After lunch, she does her sideline, sharpening BBQ sticks. All her family
chores including her side-line she spends from 1pm to 6pm. She prepares food
at 6pm and they eat at 7pm. Then she sleeps at 8pm.

Health Assessment (IPPA-CEPHALOCAUDAL)


Ann (daughter)
Physical Examination
First Home Visit (January 23,2009)

A. General Appearance and Behavior


Upon initial visit Ann is wearing school uniform and black shoes. She is alert and
awake. Ann is 9 year old. Her vital sign are as follow: temperature: 36.5˚C: Pulse
Rate: 83 BPM: Respiratory Rate: 17 CPM. Her weight is 46 lbs. and her height is
125cm.

Physical Assessment

Mental Status
• Client is alert and awake with eyes open and looking at the student nurse.
• She is aware of self, other, time, home address and current location.
• She established eye contact when asked questions.
• The client is cooperative, when asked, can answer properly.
• The client was able to express free-flowing thoughts and expresses realistic
perceptions.
• She also smiles and frowns appropriately without difficulty.
• She listens and can follow directions without difficulty.
• She recalls her birthday and answer information correctly.
• She was able to recall recent event without difficulty

Motor Function
• Walking gait –coordinated movement, sitting

Integumentary System:
• Skin is brown in complexion, no odor, and uniform in color. Her skin turgor is
normal because when her skin was pinched, it goes back to previous state
immediately. The skin is not edematous and is in normal temperature. With
sensation to touch, pain & temperature.

Skull & Face (Head)


• She has a round skull, no contusions, bruises noted nodules and masses,
and no tenderness palpated. She has symmetrical facial movements as
evidenced by client’s ability to smile, frown, raise his forehead & eyebrows &
shows his teeth. Facial features and facial movements are symmetrical.

Hair
• Hair is long, dry, straight, thick, black and evenly distributed hair. No area of
loss of hair and no infection/infestation.

Nails
• Her nails are untrimmed and dirty as well. She has light brown, smooth,
epidermis is intact, has convex curve nails, no discoloration of the nail beds,
no clubbing of nails, normal capillary refill (<2-3 sec), and no edema.

Eyes and Vision


• Eyebrows are symmetrically aligned, evenly distributed and has equal
movements.
• Her eyelashes are evenly distributed, upper eyelashes are slightly curled
upward and lower eyelashes are slightly curled downward.
• Eyelids are intact and closed symmetrically, bilateral blinking. In her bulbar
conjunctiva capillaries are slightly visible and sclera appears white.
• Her palpebral conjunctiva is shiny and pink in color.
• Lacrimal gland, lacrimal sac and nasolacrimal duct has no edema or
tenderness.
• Cornea upon inspection for clarity it is shiny and transparent. When checked
for corneal sensitivity test it has positive blinking reflex because her eyes blink
when it is touched by the cotton.
• Her pupils are equally round and reactive to light and accommodation. The
student nurse holds an object from the nose of the client and asked the client
to look object then to a distant object. Upon looking, the client’s pupils
constricts when looking at near objects, and dilates at far objects
• The client can see objects at the periphery by letting her cover her right eye
and look directly to the student nurse’s nose.
• Holding the penlight in the periphery, the client was able to spot the moving
object.
• Holding a penlight, the student nurse asked the client to follow the movement
of the penlight with the eyes only to test for extraocular muscle test. The
nurse then moved the penlight using the 6 cardinal movements. The client’s
eyes have coordinated movements.

Ears and Hearing


• Her ears (auricles) are symmetrical in size and auricles aligned with the outer
canthus of the eye. No lesions or masses noted.
• Pinnas are elastic recoils after folded, firm and without tenderness upon
palpation.
• Internal ear has no lesions and with a presence of cerumen.
• In hearing acuity test by determining the function of 8th (acoustics) cranial
nerve, normal tone voice is audible. The client was able to hear on both ears
when the student nurse whispered.

Nose and Facial Sinuses


• Her nose is symmetrical and uniform in color; there is no discharge or flaring,
no lesions or tenderness.
• Air moves freely as the client breathes through nares by asking client to exert
pressure on the nares, and breathe through the opposite.
• Her facial sinuses are not tender.

Mouth and Throat


• Her teeth are incomplete; she has 30set and all have dental carries. Her teeth
are yellowish in color..
• Her tongue is pinkish in color, moves without restraint, no tenderness and no
lesions.
• Soft palate is light pink in color and it is smooth. Her hard palate is lighter pink
in color compared to the soft palate.
• Uvula is positioned in the middle of the soft palate.
• Oropharynx and tonsils are pink and smooth, no discharge and are not
inflamed.
• Gag reflex is present by using a spoon and pressed in the posterior tongue

Chest and Back


• Skin at the back is intact with uniform in temperature.
• Chest is symmetric in volume, no tenderness and masses, full and symmetric
lung expansion, and resonant sound upon percussion over the lungs and no
adventitious breath sounds.
• Breathing pattern is normal with symmetrical chest movement noted on
anterior thorax. She has a regular heart beat pattern.
• Spinal cord is vertically aligned, with right and left shoulders at the same
height.

Abdomen
• Uniform in color, not distended, rounded symmetric contour and movements
upon by respiration and with audible bowel sounds every 5 to 20 seconds, No
lesions noted, no tenderness, and relaxed abdomen with smooth and
consistent tension.

Thorax and Lungs


• Posterior thorax is chest symmetric. Regarding her spinal alignment, her
spine is vertically aligned; left and right shoulders and hips is at the same
height.
• When chest was palpated for vocal fremitus there is bilateral symmetry of
vocal fremitus by placing nurse’s hands on the back of the client and letting
her say the word “ninety-nine”.
• Jugular veins are not visible.

Motor Function

Walking gait
• Opposing arm swing upon walking; maintaining balance

Upper Extremities
• There are firm with coordinated movements;
• Her bones and joints have no deformities, tenderness nor swelling noted.
• She can sense touch, pain and temperature.
• The client is able to repeatedly and rhythmically touch the nose during the
“finger to nose test”.

Lower Extremities
• The muscles in the lower extremities are symmetrical.
• The client can resist against the pressure given by the student nurse and
elicited fine coordinated movements.
• The bones and joints in the lower extremities have no deformities and pain,
temperature and touch is felt.
• The client’s gait and balance is stable. She can walk in straight line and can
maintain balance.

CRANIAL NERVES

CN 1: OLFACTORY
Type: Sensory
Function: Smell
Tests perform: The student nurse asked the client to close her yes and identify
different aromas such as perfume and coffee.
Expected result: She is expected to identify the different aromas such as perfume
and coffee presented with hers closed.
Actual Result: Mother Mae was able to identify the aromas of perfumes and
coffee.

CN ||: OPTICS
Types; sensory
Function: vision and visual fields
Tests perform: the student nurse asked her to read on the newspapers
Expected result: the client will be able to read the newspapers
Actual result: Mother. Mae was able to read at a distance of 14”
CN |||: OCULOMOTOR
Types: motor
Function: Extra ocular movements of the eyes, movement of the sphincter of the
pupils.
Tests performed: the student nurse made use of a penlight at a distance of 1 foot
in front of the client’s eyes and asked the client to hold the head in a fixed
position facing the student and followed the movement of the penlight with eyes
only. The student nurses assess the 6 ocular movement and pupil reaction.
Expected result: client is expected to move her eyes though the cranial fields of
gaze that is from the center to the upper right, upper left lower right, lower left
and medially.
Actual result: Mother Mae was able to move her eyes though the cranial fields of
gaze that is from the center to the upper right, upper left lower right, lower left
and medially.

CN|V: TOCHLEAR
Types: motor
Function: extra ocular eye movements specifically nerve eyeball downward and
laterally
Tests perform: the student nurse asked to asses the 6 ocular movements using
the penlight at distance or 1 foot and followed the penlight with the eyes only
Expected result: Mother Mae will be able to move her eyes downward obliquely
Actual result: Mother Mae was able to move her eyes downward obliquely
without moving hid head.

CN V: TRIGEMINAL
Type: motor
Function: jaw movement and mastication, Sensation of cornea, skin of face, and
nasal mucosa
Tests perform: The student asked the client to look upward, lightly touch lateral
sclera at eye to elicit blink reflex.
To test light sensation, the student ask the client to close eyes then wipe a wisp
of cotton over the client’s forehead
To test deep sensation, use alternating blunt and sharp ends of the cap of a pen
over the same area.
Allow the client to chew, open, and clench her jaw, while palpating the jaw
muscles.
Actual result: The client was able to blink after the sclera is touched
The client was able to identify the light and deep sensations through the objects
presented.
The client was able to open and clench her jaw without extra effort.

CN V|: ABDUCEN
Type: motor
Function: lateral movement of the eyes
Tests perform: the student nurse stand directly in front of the lint and hold
penlight at a distance of 1 foot and asked client to hold head follow the
movement of the penlight with her yes only.
Expected result: She will be able to follow the lateral movement of the penlight.
Actual result: She was able to follow the lateral movement of the penlight.

CN V||: FACIAL
Type: motor
Function: facial expression, taste (anterior or 2/3 of tongue)
Tests perform: she was asked to raise her eyebrows, smile, show teeth and puff
out cheeks.
Expected result: she is expected to raise her eyebrows, smile, show teeth and
puff out cheeks.
Actual result: she was able to raise her eyebrows, smile, show teeth and puff out
cheeks
The client was able to identify the different tastes placed on the anterior two-
thirds of the tongue.

CN V|||: VESTIBULOCOCHLEAR
Type: sensory
Function: sense of hearing and balanced
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: Mother Mae will be able to hear the words that the student nurse
whispered to the client.
Actual result: Mother Mae was able to hear the words that the student nurse
whispered to the client.

CNIX: GLOSSOPHARYGEAL
Type: motor and sensory
Function: pharyngeal movement and swallowing ability
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: When asked to say “ah”, she will be able to say it and she will
be able to elicit the gag reflex. And she will be able to move the tongue from side
to side and up and down.
Actual result: Mother Mae was able to move the tongue foam side to side and up
and down and was able to say “ah” when asked. She also elicited gag reflex.

CN X: VAGUS
Type: motor and sensory
Function: swallowing and speaking
Tests perform: assess with cranial nerve IX, assess client speech for hoarseness
and ask the client to swallow and speech
Expected result: she will be able to state her name without hoarseness voice and
was able to swallowing.
Actual result: she was able to state her name without hoarseness voice and was
able to perform swallowing.

CN XI: ACCESORY
Type: motor
Function: head movement and movement of shoulders muscle
Tests perform: the student nurse asked the client to shrug her shoulder against
resistance of the student nurse’s hand and turn head side against resistance.
Repeat both sides.
Expected result: she must be able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.
Actual result: She was able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.

CN XII: HYPOGLOSSAL
Type: motor
Function: movement of the tongue and stretch of the tongue
Tests perform: She was asked to protrude her tongue at midline, and then move
it side to side.
Expected Result: She should be able to protrude her tongue at midline, and then
move it side to side
Actual result: She was able to protrude her tongue at midline, and then move it
side to side.

Nutritional Status

BMI= Weight in Kilograms


(Height in meters)2
31kg = 31kg
(1.25 m2) 1.5625
= 19.84 (normal)

BMI Range Classification


Below 15 Emaciated
15-18.9 Underweight
19-24.9 Normal
25-29.9 Overweight
30-39.9 Obese
40-more Morbidly Obese

F. History of past and present illness


Ann, as mentioned by her mother, was hospitalized last 2005 due to
convulsion at a private hospital.
Her present health status shows that she has coughs.

G. Activities of daily living


Anne wakes up at 7am and prepares for school. She’s at school from 7-
11am. She walks home at 11 and arrives at 12. She eats at 12noon and goes
back to school at 12:45. Her afternoon class starts at 1pm and ends at 4. She
walks home at 4pm and arrives at 4:15. She plays for about an hour up to 5:15.
She does her homework until 6pm and eats at 6:30. She sleeps at 8pm.

Health Assessment (IPPA-CEPHALOCAUDAL)


Anthony (Son)
Physical Examination
First Home Visit (January 23,2009
A. General Appearance and Behavior
During the initial visit Anthony was seen clean white sando and blue short. He
has black complexion with short nails. Anthony is a 5 year old who weight 15 kg
and has height 111 cm. temperature: 36˚C: Pulse Rate: 120 BPM. Respiratory
Rate: 23 CPM.

Physical Assessment

Mental Status
• Client is alert and awake with eyes open and looking at the student nurse.
• She is aware of self, other, time, home address and current location.
• She established eye contact when asked questions.
• The client is cooperative, when asked, can answer properly.
• The client was able to express free-flowing thoughts and expresses realistic
perceptions.
• She also smiles and frowns appropriately without difficulty.
• She listens and can follow directions without difficulty.
• She recalls her birthday and answer information correctly.
• She was able to recall recent event without difficulty

Motor Function
• Walking gait –coordinated movement, sitting

Integumentary System:
• Skin is brown in complexion, no odor, and uniform in color. Her skin turgor is
normal because when her skin was pinched, it go back to previous state
immediately. The skin is not edematous and is in normal temperature. With
sensation to touch, pain & temperature.
Skull & Face (Head)
• She has a round skull, no contusions, bruises noted nodules and masses,
and no tenderness palpated. She has symmetrical facial movements as
evidenced by client’s ability to smile, frown, raise his forehead & eyebrows &
shows his teeth. Facial features and facial movements are symmetrical.

Hair
• Hair is long, dry, straight, thick, black and evenly distributed hair. No area of
loss of hair and no infection/infestation.

Nails
• Her nails are untrimmed and dirty as well. She has light brown, smooth,
epidermis is intact, has convex curve nails, no discoloration of the nail beds,
no clubbing of nails, normal capillary refill (<2-3 sec), and no edema.

Eyes and Vision


• Eyebrows are symmetrically aligned, evenly distributed and has equal
movements.
• Her eyelashes are evenly distributed, upper eyelashes are slightly curled
upward and lower eyelashes are slightly curled downward.
• Eyelids are intact and closed symmetrically, bilateral blinking. In her bulbar
conjunctiva capillaries are slightly visible and sclera appears white.
• Her palpebral conjunctiva is shiny and pink in color.
• Lacrimal gland, lacrimal sac and nasolacrimal duct has no edema or
tenderness.
• Cornea upon inspection for clarity it is shiny and transparent. When checked
for corneal sensitivity test it has positive blinking reflex because her eyes blink
when it is touched by the cotton.
• Her pupils are equally round and reactive to light and accommodation. The
student nurse holds an object from the nose of the client and asked the client
to look object then to a distant object. Upon looking, the client’s pupils
constricts when looking at near objects, and dilates at far objects
• The client can see objects at the periphery by letting her cover her right eye
and look directly to the student nurse’s nose.
• Holding the penlight in the periphery, the client was able to spot the moving
object.
• Holding a penlight, the student nurse asked the client to follow the movement
of the penlight with the eyes only to test for extraocular muscle test. The
nurse then moved the penlight using the 6 cardinal movements. The client’s
eyes have coordinated movements.

Ears and Hearing


• Her ears (auricles) are symmetrical in size and auricles aligned with the outer
canthus of the eye. No lesions or masses noted.
• Pinnas are elastic recoils after folded, firm and without tenderness upon
palpation.
• Internal ear has no lesions and with a presence of cerumen.
• In hearing acuity test by determining the function of 8th (acoustics) cranial
nerve, normal tone voice is audible. The client was able to hear on both ears
when the student nurse whispered.

Nose and Facial Sinuses


• Her nose is symmetrical and uniform in color; there is no discharge or flaring,
no lesions or tenderness.
• Air moves freely as the client breathes through nares by asking client to exert
pressure on the nares, and breathe through the opposite.
• Her facial sinuses are not tender.

Mouth and Throat


• Her teeth are incomplete; she has 30set and all have dental carries. Her teeth
are yellowish in color..
• Her tongue is pinkish in color, moves without restraint, no tenderness and no
lesions.
• Soft palate is light pink in color and it is smooth. Her hard palate is lighter pink
in color compared to the soft palate.
• Uvula is positioned in the middle of the soft palate.
• Oropharynx and tonsils are pink and smooth, no discharge and are not
inflamed.
• Gag reflex is present by using a spoon and pressed in the posterior tongue

Chest and Back


• Skin is intact with uniform in temperature.
• Chest is symmetric in volume, no tenderness and masses, full and symmetric
lung expansion, and resonant sound upon percussion over the lungs and no
adventitious breath sounds.
• Breathing pattern is normal with symmetrical chest movement noted on
anterior thorax. She has a regular heart beat pattern.
• Spinal cord is vertically aligned, with right and left shoulders at the same
height.

Abdomen
• Uniform in color, not distended, rounded symmetric contour and movements
upon by respiration and with audible bowel sounds every 5 to 20 seconds, No
lesions noted, no tenderness, relaxed abdomen with smooth and consistent
tension.

Thorax and Lungs


• Posterior thorax is chest symmetric. Regarding her spinal alignment, her
spine is vertically aligned; left and right shoulders and hips is at the same
height.
• When chest was palpated for vocal fremitus there is bilateral symmetry of
vocal fremitus by placing nurse’s hands on the back of the client and letting
her say the word “ninety-nine”.
• Jugular veins are not visible.

Motor Function

Walking gait
• Opposing arm swing upon walking; maintaining balance

Upper Extremities
• There are firm with coordinated movements;
• Her bones and joints have no deformities, tenderness nor swelling noted.
• She can sense touch, pain and temperature.
• The client is able to repeatedly and rhythmically touch the nose during the
“finger to nose test”.

Lower Extremities
• The muscles in the lower extremities are symmetrical.
• The client can resist against the pressure given by the student nurse and
elicited fine coordinated movements.
• The bones and joints in the lower extremities have no deformities and
pain, temperature and touch is felt.
• The client’s gait and balance is stable. She can walk in straight line and
can maintain balance.

CRANIAL NERVES

CN 1: OLFACTORY
Type: Sensory
Function: Smell
Tests perform: The student nurse asked the client to close her yes and identify
different aromas such as perfume and coffee.
Expected result: She is expected to identify the different aromas such as perfume
and coffee presented with hers closed.
Actual Result: Mother Mae was able to identify the aromas of perfumes and
coffee.

CN ||: OPTICS
Types; sensory
Function: vision and visual fields
Tests perform: the student nurse asked her to read on the newspapers
Expected result: the client will be able to read the newspapers
Actual result: Mother. Mae was able to read at a distance of 14”

CN |||: OCULOMOTOR
Types: motor
Function: Extra ocular movements of the eyes, movement of the sphincter of the
pupils.
Tests performed: the student nurse made use of a penlight at a distance of 1 foot
in front of the client’s eyes and asked the client to hold the head in a fixed
position facing the student and followed the movement of the penlight with eyes
only. The student nurses assess the 6 ocular movement and pupil reaction.
Expected result: client is expected to move her eyes though the cranial fields of
gaze that is from the center to the upper right, upper left lower right, lower left
and medially. Actual result: Mother Mae was
able to move her eyes though the cranial fields of gaze that is from the center to
the upper right, upper left lower right, lower left and medially.

CN|V: TOCHLEAR
Types: motor
Function: extra ocular eye movements specifically nerve eyeball downward and
laterally
Tests perform: the student nurse asked to asses the 6 ocular movements using
the penlight at distance or 1 foot and followed the penlight with the eyes only
Expected result: Mother Mae will be able to move her eyes downward obliquely
Actual result: Mother Mae was able to move her eyes downward obliquely
without moving hid head.

CN V: TRIGEMINAL
Type: motor
Function: jaw movement and mastication, Sensation of cornea, skin of face, and
nasal mucosa
Tests perform: The student asked the client to look upward, lightly touch lateral
sclera at eye to elicit blink reflex.
To test light sensation, the student ask the client to close eyes then wipe a wisp
of cotton over the client’s forehead
To test deep sensation, use alternating blunt and sharp ends of the cap of a pen
over the same area.
Allow the client to chew, open, and clench her jaw, while palpating the jaw
muscles.
Actual result: The client was able to blink after the sclera is touched
The client was able to identify the light and deep sensations through the objects
presented.
The client was able to open and clench her jaw without extra effort.

CN V|: ABDUCEN
Type: motor
Function: lateral movement of the eyes
Tests perform: the student nurse stand directly in front of the lint and hold
penlight at a distance of 1 foot and asked client to hold head follow the
movement of the penlight with her yes only.
Expected result: She will be able to follow the lateral movement of the penlight.
Actual result: She was able to follow the lateral movement of the penlight.

CN V||: FACIAL
Type: motor
Function: facial expression, taste (anterior or 2/3 of tongue)
Tests perform: she was asked to raise her eyebrows, smile, show teeth and puff
out cheeks.
Expected result: she is expected to raise her eyebrows, smile, show teeth and
puff out cheeks.
Actual result: she was able to raise her eyebrows, smile, show teeth and puff out
cheeks
The client was able to identify the different tastes placed on the anterior two-
thirds of the tongue.
CN V|||: VESTIBULOCOCHLEAR
Type: sensory
Function: sense of hearing and balanced
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: Mother Mae will be able to hear the words that the student nurse
whispered to the client.
Actual result: Mother Mae was able to hear the words that the student nurse
whispered to the client.

CNIX: GLOSSOPHARYGEAL
Type: motor and sensory
Function: pharyngeal movement and swallowing ability
Tests perform: whispered few words at the client back and allow repeating client
back.
Expected result: When asked to say “ah”, she will be able to say it and she will
be able to elicit the gag reflex. And she will be able to move the tongue from side
to side and up and down.
Actual result: Mother Mae was able to move the tongue foam side to side and up
and down and was able to say “ah” when asked. She also elicited gag reflex.

CN X: VAGUS
Type: motor and sensory
Function: swallowing and speaking
Tests perform: assess with cranial nerve IX, assess client speech for hoarseness
and ask the client to swallow and speech
Expected result: she will be able to state her name without hoarseness voice and
was able to swallowing.
Actual result: she was able to state her name without hoarseness voice and was
able to perform swallowing.

CN XI: ACCESORY
Type: motor
Function: head movement and movement of shoulders muscle
Tests perform: the student nurse asked the client to shrug her shoulder against
resistance of the student nurse’s hand and turn head side against resistance.
Repeat both sides.
Expected result: she must be able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.
Actual result: She was able to shrug her shoulder against resistance of the
student nurse’s hand and turn head side against resistance.

CN XII: HYPOGLOSSAL
Type: motor
Function: movement of the tongue and stretch of the tongue
Tests perform: She was asked to protrude her tongue at midline, and then move
it side to side.
Expected Result: She should be able to protrude her tongue at midline, and then
move it side to side
Actual result: She was able to protrude her tongue at midline, and then move it
side to side.

B. Immunization Status
1st dose 2nd dose 3rd dose
Error! Bookmark
BCG _______ _______
not defined.

DPT

OPV

HEPA B

MEASLES _______ _______

Anthony is fully immunized before he turns 1 y/o in their health center.

C. Growth and Development


Erik Erickson’s Psychological Stages
Initiative vs. Guilt
During this stage, a child should learn to do socially acceptable behavior
and this is the time when a child learns to set his own goals. As for Anthony he
actively socializes with other people especially those who are within his age
group but he’s very shy with older people like the student nurses. He doesn’t
cooperate well in the first two days of student nurses and family interaction
Initiative in doing even basic things such as wearing of shoes. Her mother is
consistent in disciplining him. He does what satisfies him because in this stage a
child becomes more eager in adventures. There are no distinct limitations that
are set for him by her mother.
Sigmund Freud’s Psychosexual Stages
Phallic Stage
In this period the child focuses feelings chiefly on the parent of the opposite sex.
And during the group’s home visit, they had observed that he is close to his
mother. The group did not observe any sexual diversion on his part.

D. Nutritional Status
Ht: 111cm
Wt: 15 kg (normal) Age: 60months
FNRI= Normal weight 14.4-23.5 Therefore, Anthony is Normal

E. History of past and present illness


Anthony, as mentioned by her mother was hospitalized due to BPN
(bronchopneumonia) last 2005 at a public hospital.
His present health status reveals that he has no presence of illness.

G. Activities of daily living


Anthony wakes up at 7am and prepares for school. He’s at school from 7-
10am. He walks home at 10 and arrives at 10:15. He eats at 110:30am up to
11am. He plays at 12noon up to 5pm. He does his homework until 6pm and eats
at 6:30. He sleeps at 8pm.

TYPE OF FAMILY STRUCTURE


The chosen family, the Macapagal family is of a nuclear type. The nuclear
family consists of a father, mother and child living together. This type of family
structure is found in almost societies, although the length of time in which the
family remains in this form varies even within the same society. The family
consists of Mr. Lorenzo, Mrs. Mae & their 2 children namely: Ann and Anthony.
Mr. Lorenzo is a junkshop worker in a company in Clark field, Pampanga while
Mother Mae, is a full time house wife and she is responsible in taking care of the
families needs and health. The type of residence is bilocal since they live
separately from their parents. Two of their children are going to school. In spite of
the problems that they are facing, their relationship with each other is good
because they have a positive outlook in life and really loves each other.

ETHNIC BACKGROUND AND RELIGIOUS AFFILIATIONS


Originally, Mr. Lorenzo is from Surigao while Mrs. Mae is originally from
Macapagal village. The religion of the family is Catholic Mrs. Mae honestly told
us that they seldom go to church because they have no time to go and also the
church is far from their village.

DOMINANT FAMILY MEMBERS IN DECISION MAKING


The family can be classified under the Matriarchal type of family when it
comes to the authority exercised w/in the household since Mr. Lorenzo is always
out for work the mother is considered the head of the family and has power in
decision-making. She told us that also because Mr. Lorenzo is poor in decision
making and just follows Mrs. Mae’s orders. She is the one who decide for the
family especially when its money matters. As well as, in terms of discipline and
with the health of the children Mrs. Mae is the one who dominates.

SOURCES OF INCOME, EXPENSES AND OCCUPATION


The family’s main source of income is Mr. Lorenzo’s work at the junkshop.
According to Mrs. Mae, Mr. Lorenzo earns 7,500 a month. While Mr. Lorenzo is
at work Mrs. Mae is sharpening BBQ sticks as a form of sideline for their monthly
expenses. She earns 8 pesos for every 1,000 pcs of BBQ sticks. According to
them, their funds are enough to meet their basic needs such as food, clothing
and shelter although there are times when they are not able to pay their monthly
expenses like the electric & water bills in due to the time given & so they are left
with no choice but to borrow from their relatives or even from their neighbors. As
soon as they save enough money, they would pay the people they have
borrowed money from. They do not have excess money for medical-related
needs, activities and leisure.

The family has no financial assets available in case of emergency. If there


is an emergency, however, they are able to borrow money from their neighbors
and relatives.
Source of income
1Junkshop worker
Usual profit P7,500 a month

The following is the family expenditures:


(Monthly)
Rice P1120.00
Fish, meats, Vegetables P1, 050.00
Electric bill P550.00
Water bill P400.00
Kid’s allowance” (P20/day) P1,240.00
Extra Expenses (soap, toothpaste, shampoo,etc) P300.00
Total: P4,660/month
NATURE OF WORK, WORKING HOURS
Mr. Lorenzo is a regular junkshop worker he regularly goes to work at
7:00am and comes back at 5-6pm. His schedule of work is from Monday to
Saturday. The reason the student nurses were not able to meet him.

SIGNIFICANT OTHERS/RELATIVES ROLE IN FAMILY’S LIFE


They live in the vicinity close to other relatives on the side of his wife’s
family. Although there are some relatives in that area, their relatives do not
interfere with the affairs and businesses of the Macapagal family.
FAMILY HEALTH HABITS, BELIEFS, PRACTICES AND SUPERSTITIONS
The Macapagal family believes in albularyos(herbolarios). They also make
use of herbal medicines (like oregano, lagundi, kalamansi, bayabas, & ampalaya)
when they have minor illnesses like cough, colds & fever. However, Mrs. Mae
cleared that they have nothing against the credibility of the medical doctors. In
fact, they seek for medical advice when their diseases can no longer be cured by
the albularyos & the herbal medicines they use.
On the other hand, cleanliness is quite practiced in their home but,
sometimes the children, after going to school usually play with their friends and
go home dirty. The family believes that some diseases like cough and colds are
brought about by the sudden change of temperature and climate. They make use
of kalamansi as a remedy such diseases.

COMMUNITY, SOCIAL AND HEALTH RESOURCES AND FAMILY’S


UTILIZATION OF THESE RESOURCES
The community has a Barangay Health Center located near their house
wherein they barely utilize any of the services given by the Barangay Health
Center; where in the BHC is only giving free medical missions and feeding
programs only when student nurses are around to facilitate the said activity. The
BHC (barangay health center) is also giving such services (Vaccines, medical
mission, Family Planning Programs, Pregnant Care, feeding programs etc.) but
this services are only given when the midwife is around (every Tuesday).

LIVING CONDITION
The house structure is made of hollow blocks, concrete cement and
cut wood. There is a gap between the walls and roofing, allowing entrance of
cold and hot air and insects. During the day, they are lighted by artificial
lighting because sunlight cannot light the house due to some environmental
factors such, as their house is covered by big trees; Also the location of their
windows do not provide entry for the light to come in. The house is not stable
and has many threats. The wires are exposed since they do not have a
ceiling and during rainy season water flows to their house making them at risk
for some diseases like Leptospirosis. It has a bedroom, kitchen, toilet, and a
living room. There are 6 windows throughout the house which measures
93.98cmX60.96cm (living room), 75.2cmX86.36cm (bedroom),
60.96cmX71.12cm (kitchen). Their windows do not have screens w/c allows
the entry of mosquitoes and flies. Also they have an incandescent light bulb
which is located in the bathroom (60watts) 1 fluorescent(40watts) in the living
room, 1 fluorescent in the bedroom(18watts), 1 fluorescent outside near the
door(18watts). The household was also positive from mice & cockroaches
due to the garbage exposed in front of their house. According to the mother
their house has approximately 11m2

TFA [total floor area]: 11m2


Total surface requirement per individual is as follows:
-Adult: 13 y/o above = 3m²
-Child: 1 y/o (0-12 y/o) = 1.5 m²

Member Age TSR


Father 37 y/o 3m²
Mother 30 y/o 3m²
Child 1 5 y/o 1.5m²
Child 2 9 y/o 1.5m²
= 9m2
Therefore the living space is adequate.
The computation of ventilation is as follows:
Living room: 93.98 X 60.96cm total window size=living bed
=0.94m X 0.61m room + room + kitchen
=0.5734m X 2 windows =1.15m2 +1.31+0.87m2
= 1.15m2 =3.33m2
Bedroom: 76.2 X 86.36 cm
=0.76m X 0.86m
=0.6536 X 2 windows
=1.31m2
Kitchen: =60.96 X 71.12
=0.61 X 0.71
=0.4331 X 2 windows
=0.87m2
Adequate= required window size is 10% of TFA
TFA =11m2 X 10%
=1.1m2
3.33m2 (total window size) > 1.1m2
Therefore, there is adequate ventilation
The computation for lighting is as follows:
Adequacy of lighting= 50watts incandescent bulb or 20-40watts fluorescent bulb
=60watts incandescent bulb + 40watts fluorescent light + 18watts
+18watts
=136watts
Therefore, there is adequate lighting both daytime and nighttime.

FOOD STORAGE, SOURCE & COOKING


The kitchen consists of a small table sink and cooking (charcoal) facility
where the 4 family members eat altogether.
The size of the house appears adequate for the size of the family. Their
appliances consist of radio, electric fan, television, VCD player and stove (but not
used).
Their food resources are bought on daily basis. Mrs. Mae buys and brings
home the food to be prepared for the day. They cook the food with charcoal. The
family also, do not have a refrigerator where they could store their food & so
when there are left over food, they have no choice but to place it on the dining
table & cover it w/ another plate to be eaten for the next meal or hang it in a
casserole just above the cooking facility.

TOILET FACILITY
They have a small bathroom near the kitchen. They use plastic container
as a dipper in flushing the toilet. The toilet is fairly clean because there is some
urine smell but there is no fecal stains observed in the toilet bowl. The roof also
has small holes on it.

WATER SUPPLY

They obtain their water supply from jetmatic, which is owned by their neighbor.
According to them, they pay 2 pesos per pale. They drink the water from the
jetmatic and store it in a pitcher. The family regularly boils the water before
drinking it. This provides them to have a potable drinking water.

DRAINAGE SYSTEM
They have an open type of drainage system. It is man-made type of
drainage system in which they dug pits where water can flow and will not be
directed towards their house in case of heavy rains or typhoons; since their
house is located at a slope of the village. This is a man-made drainage facility
where they dug pits to make flood-water and the like to be in free flowing when it
is raining while the water usually dries up and absorbed by the soil when the rain
stops.

GARBAGE DISPOSAL
They do no have proper ways of throwing their garbage. Their garbage is
placed outside of the house and is burned. All the waste materials including
bamboo waste, plastic, leftover foods etc. are burned all together. Sometimes
they just place it in an area and leave it there where it is exposed to chickens,
ducks, and, flies, cockroaches and other insects w/c is a threat to the health of
the family. The collection of garbage in their community is irregular.

COMMUNICATION AND TRANSPORTATION


The family has 2 cellular phones, which belong to Mr. Lorenzo and Mrs.
Mae. According to them, these were bought for them to be able to contact their
relatives in case of emergency.
On the other hand, the family doesn’t own any vehicle Mr. Lorenzo uses
his bike to go to work. While the children walks to school every morning since the
school is just near their house. The family commutes if they go to other place
such as malls or visiting their relatives and other sorts of things.
A. PROBLEM IDENTIFICATION

Problem # Problem Score

Problem #1: Presence of Coughs (Ann) as a Health Deficit 4.67

Problem #2: Unhealthful Lifestyle and Personal Habits


or Practices: CIGARETTE SMOKING as a
Health Threat 4.34

Problem #3: Inappropriate role Assumption (Mrs. Mae


has the power to decide) as a Health Threat 3.84

Problem #4: Presence of Rodents and


Cockroach as a Health Threat 3.84

Problem #5: Inadequate/Insufficient Family Resources


as Health Threat 3.34

Problem #6.5: Lack of food storage facilities as a Health


Threat 2.84

Problem #6.5: Poor Environment Sanitation: Improper


Drainage System as a health threat 2.84

Problem #8: Improper Garbage Disposal as a Health threat 2.50

Problem #9: Risk for Cross-infection as a health threat 2.5

Problem #11: Presence of Accident Hazards (Exposed


Electrical wires) as a Health Threat 2

Problem #11: Poor environmental Sanitation: Air Pollution as


a Health Threat 2

Problem #11: Risk for injury as a Health threat 2


B. Priority Setting

Problem #1: Presence of Coughs (Ann) as a Health Deficit


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 3 / 3 x 1 1 The problem is a health deficit


problem because one of the members
needs immediate care to prevent
the pass of infection from one
member to another. It alters the
normal health status of one of
the members that may alter the
proper functioning of the family
as a whole.

B. Modifiability of the 2 / 2 x 2 2 The problem is easily modifiable


problem because:

Current   Current Knowledge


Knowledge The family recognizes
Resources  the presence of coughs of
of the Ann and the need for her to
Family be properly taken care of
Resources  AEB the verbalization of the
of the problem by mother Mae
Nurses
Resources   Resources of the Family
of the The family has adequate
Community resources to make a
particular intervention to the
problem since they have and
are knowledgeable of the
use of some herbal
medicines useful for treating
the cough like Lagundi.

 Resources of the Nurses


Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. Also, they
have proper know-how to
perform independent nursing
intervention to help treat or
soothe the cough.

 Resources of the
Community
The community resources
are also available to assist the
family in terms of consulting
about the disease condition.
The problem is moderately
C. Preventive 2/ 3 x 1 0.67 preventable.
Potential (PP)
 Severity or gravity of the
Severity =PP problem.
or The problem has high
Gravity gravity because it can affect
 the health status of the other
Duration =PP members. Also it can alter
 the functioning of Ann in the
Current =PP family making the role
Manage assumptions within the
ment  family altered too.
Exposur =PP  Duration of the Problem
e to any The problem has
high risk existed approximately two
group  days before the student
nurses arrived.
 Current Management
Since the supposed
provider of care Mother Mae
knows some herbal
medicines that can be a
remedy to the cough, it is
currently managed.
 Exposure to any high risk
group
Since the brother of
Ann is younger and spends
most of the time with Ann, he
is at risk to be infected in
case the cough is caused by
infection.

D. Salience 2/2x1 1 The family recognizes the need


to intervene with the problem the
moment they knew it is existing
AEB Mother Mae being worried
of the condition of her daughter.
TOTAL SCORE 4.67

Problem #2: Unhealthful Lifestyle and Personal Habits or Practices:


CIGARETTE SMOKING as a Health Threat
CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because the presence of a
smoker within the family can
affect both the smoker and the
other family members not
smoking. They can be active and
passive smokers who will have
both affectations in their health
status and state of equilibrium.

B. Modifiability of the 2 / 2 x 2 2 The problem is easily modifiable


problem because:

Current   Current Knowledge


Knowledge The family recognizes
Resources  the problem existing AEB
of the mother Mae verbalizing that
Family her husband smokes even
Resources  when he is still single till now
of the that he’s married even with
Nurses the advices of mother Mae to
Resources  stop it.
of the
Community  Resources of the Family
The family has basic
know-how as to what are the
possible effects of smoking
specifically the ill effects
such as possible
development of respiratory
diseases.

 Resources of the Nurses


Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
expand their knowledge of
the ill effects of smoking.

 Resources of the
Community
The community resources
are also available where they
could provide teachings and
early diagnosis of possibly
occurring disease.

C. Preventive 2 / 3 x 1 0.67 The problem has low


Potential (PP) preventability because:

Severity =PP  Severity or gravity of the


or problem.
Gravity The problem has high
 gravity because it can affect
Duration =PP the whole family once as
 active and passive smokers.
Current =PP  Duration of the Problem
Manage The problem has
ment  existed even before the
Exposur =PP student nurses arrived long
e to any before the couple was
high risk married.
group 
 Current Management
Mother Mae
constantly advices Mr.
Lorenzo to stop smoking yet
it is not effective since Mr.
Lorenzo still engages into it.
 Exposure to any high risk
group
Since the whole
family is residing in the
house, they are all belonging
to the high risk group
because all of them can
inhale the smoke either
passively or actively.

D. Salience 2/2x1 1 The mother recognizes the


existence of the problem that
requires prompt intervention
because it might cause her
husband or her and her children
respiratory diseases.
TOTAL SCORE 4.34

Problem #3: Inappropriate role Assumption (Mrs. Mae has the power to
decide) as a Health Threat
CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because if the mother takes all
the responsibility in decision-
making, she can make unlikely
decisions that may affect the
family as a whole. But if the
parents share in the
responsibilities of making
decisions, they are more able to
make wise choices.

B. Modifiability of the 2 / 2 x 2 2 The problem is easily modifiable


problem because:

Current   Current Knowledge


Knowledge The mother
Resources  recognizes the problem
of the existing AEB mother Mae
Family verbalizing that her husband
Resources  is a calm person, the reason
of the she assumes to be the
Nurses maker of decisions. Also,
Resources  that Mr. Lorenzo is always
of the not at home.
Community  Resources of the Family
The couple can have
talks to share the problems
with each other that each
may contribute to its
solution.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
make wise choices.
 Resources of the
Community
The community resources
are also available where they
could provide counseling.

C. Preventive 2 / 3 x 1 0.67 The problem is moderately


Potential (PP) preventable because:
 Severity or gravity of the
Severity =PP problem.
or The problem has low
Gravity gravity because it can only
 affect the whole family once
Duration =PP the primary decision-maker
 —Mrs. Mae—has taken a
Current =PP wrong choice.
Manage  Duration of the Problem
ment  The problem has
Exposur =PP existed even before the
e to any student nurses arrived.
high risk  Current Management
group  Mother Mae makes
the decision because her
husband is not present at all
times. Therefore there is no
management undertaken to
share the decision-making
responsibilities between both
parents.
 Exposure to any high risk
group
Since the family is
taken holistically, once Mrs.
Mae took a wrong decision,
it can affect the whole family.

D. Salience 1/2x1 0.50 The family recognizes the


existence of the problem but
does not require prompt
intervention since Mother Mae
still manages to do decision-
making while her husband is at
work and they have been used
to this kind of role assumptions.
TOTAL SCORE 3.84

Problem #4: Presence of Rodents and Cockroach as a Health Threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because the presence of
breeding sites of insects and
rodents are usual vectors of
microorganisms causing fatal
diseases to the family such as
leptospirosis.

B. Modifiability of the 2 / 2 x 2 2 The problem is easily modifiable


problem because:

Current   Current Knowledge


Knowledge The family recognizes
Resources  the problem existing AEB
of the mother Mae verbalizing that
Family even Anthony recognized the
Resources  occurrence of the rodents
of the and insects esp. cockroach
Nurses in their house AEB their
Resources  manual eradication of these.
of the  Resources of the Family
Community The family has no
adequate resources to make
the best intervention to the
problem. But they have
manpower to manually
eradicate the insects and
rodents.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
think of how to effective
eradicate or totally prevent
their growth and
multiplication.
 Resources of the
Community
The community resources
are also available where they
could provide teachings and
manpower. They can also have
fumigations and programs like
general community cleaning.

C. Preventive 2 / 3 x 1 0.67 The problem is moderately


Potential (PP) preventable because:
 Severity or gravity of the
Severity =PP problem.
or The problem has high
Gravity gravity because it can affect
 the whole family once these
Duration =PP rodents and insects
 contaminate their food or
Current =PP bring about infection to them.
Manage  Duration of the Problem
ment  The problem has
Exposur =PP existed even before the
e to any student nurses arrived.
high risk  Current Management
group  Since a there is
careful prioritization of
income, they are not using
the most effective way of
killing the insects or totally
destroying their breeding
site. However, they manage
the problem by manual
eradication of the insects.
But this is still inefficient
 Exposure to any high risk
group
Since the whole
family is residing in the
house, they are all belonging
to the high risk group.

D. Salience 1/2x1 0.50 The family recognizes the


existence of the problem but it
does not require prompt
intervention for them because
they already became used to its
occurrence and it does not
cause them harm at the
moment.
TOTAL SCORE 3.5

Problem #5: Inadequate/Insufficient Family Resources as Health Threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because if the family is not able
to suffice the needs of the
individual member, each can
have decreased ability to cope
with life’s processes. Food, for
example, is lacking, the children
may have decreased energy
level to cope with the pressures
in their studies.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

Current x  Current Knowledge


Knowledge The family does not
Resources x recognize the problem
of the existing because Mother
Family Mae—the provider of care—
Resources  is carefully prioritizing the
of the most immediate needs.
Nurses However, in doing this, she
Resources  neglects the other needs
of the which may also contribute to
Community the total necessities of the
individual members. They
also do not feel the
insufficiency because they
have been deprived of being
provided with the secondary
necessities in life such as
own water supply, storage
facilities and the like.
 Resources of the Family
The family has no
adequate resources to make
the best intervention to the
problem. The sideline of Mrs.
Mae is still not sufficient.
They also do not have the
knowledge to put up a
business or plant a
vegetable garden, and the
like.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
think of other profitable
livelihood or handicraft.
 Resources of the
Community
The community resources
are also available where they
could provide teachings and
encourage vegetable planting or
attend mothers’ classes that. At
times. Teach about livelihood.

The problem has moderately


C. Preventive 2 / 3 x 1 0.67 preventable because:
Potential (PP)
 Severity or gravity of the
Severity =PP problem.
or The problem has low
Gravity gravity because it cannot
 affect the whole family
Duration =PP immediately and effects will
 only occur if the there
Current =PP happened to be an
Manage immediate expenditure
ment  which is not as expected or
Exposur =PP is not included in the usual
e to any budget.
high risk  Duration of the Problem
group  The problem has
existed even before the
student nurses arrived.
 Current Management
Mr. Lorenzo is
currently working to earn a
living But since there is an
insufficient income, Mother
Mae tries to add up to their
income by sharpening BBQ
sticks. However it is still
insufficient to make their
income above poverty line.
 Exposure to any high risk
group
Since the whole
family is residing in the
house and all of them have
individual needs, they are all
belonging to the high risk
group.

D. Salience 2/2x1 1 The family recognizes the


existence of the problem and it
requires prompt intervention.
The reason Mrs. Mae is trying
her best to earn as well.
TOTAL SCORE 3.34

Problem #6.5: Lack of food storage facilities as a Health Threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because improperly stored food
can lead to food spoilage and
eventually malnutrition (less than
body requirements) because it
will be wasted rather than be
eaten to provide nourishment for
the children. It will also allow for
the growth of pathogenic
microorganisms that when
eaten, will affect the health of the
family members like the ill
effects of molds and the like.
B. Modifiability of the 1 / 2 x 2 1 The problem is partially
problem modifiable because:

Current x  Current Knowledge


Knowledge The family does not
Resources x recognize the existence of
of the the problem and its bad
Family effects since they had been
Resources  used to not having food
of the storage (e.g. refrigerator)
Nurses and they do not recognize
Resources  the need of such. They have
of the been used to using
Community casserole as food storage.
 Resources of the Family
The family has no
adequate resources to make
the best intervention to the
problem and alternatives are
not known to them like use
of air-tight containers.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
choose alternative food
storages that will aid in
proper storing of food.
 Resources of the
Community
The community resources
are also available where they
could provide health teachings
for the proper storing of food and
the possible risk of improperly
stored food.

The problem has moderately


C. Preventive 2 / 3 x 1 0.67 preventable because:
Potential (PP)
 Severity or gravity of the
Severity =PP problem.
or The problem has low
Gravity gravity because it cannot
 affect the whole family
Duration =PP immediately and effects will
 only occur if the food cooked
Current =PP will not be all consumed.
Manage  Duration of the Problem
ment  The problem has
Exposur =PP existed even before the
e to any student nurses arrived and is
high risk unknown to the members.
group   Current Management
Since a there is a lack
of proper food storage for
the family, the management
they do is to consume all the
food cooked and to dispose
the left over so that it the
possible ingestion of spoiled
food and growth of
pathogenic microorganisms
may be lessen.
 Exposure to any high risk
group
Since the whole
family is residing in the
house and eating the same
food prepared, all the
members are at risk of
ingesting contaminated food
and spoiled food.

D. Salience 1/2x1 0.50 The family does recognize the


existence of the problem but it
does not require prompt
intervention for them since they
are used to utilizing casseroles
as container for food leftovers.
TOTAL SCORE 2.84

Problem #6.5: Poor Environment Sanitation: Improper Drainage System as


a health threat
CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because if the drainage remains
inefficient, water may flow into
the house during rainy days and
it may pose some flood-borne
(like leptospirosis) disease to the
family or may serve as a
breeding site for mosquitoes.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

Current   Current Knowledge


Knowledge The family recognizes
Resources x the problem existing
of the because they are worried of
Family the possible entry of water
Resources  into their house especially
of the that rainy season is fast
Nurses approaching. Mother Mae—
Resources  the provider of care—is
of the carefully keeping the water
Community to be directed on to another
way during rains.
 Resources of the Family
The family has no
adequate resources to make
the best intervention to the
problem. It is costly in terms
of money, time, and
manpower to construct a
proper drainage in their
vicinity. Also, the father who
can think and do alternative
is not always present.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
think of another alternative
or precautions during the
rainy season.
 Resources of the
Community
The community resources
are also available where they
could provide teachings and
manpower. They can also help in
providing alternatives like sand
bagging and the like.

C. Preventive 2 / 3 x 1 0.67 The problem is moderately


Potential (PP) preventable because:

Severity =PP  Severity or gravity of the


or problem.
Gravity The problem has low
 gravity because it cannot
Duration =PP affect the whole family
 immediately and effects will
Current =PP only occur when the rainy
Manage season arrives.
ment   Duration of the Problem
Exposur =PP The problem has
e to any existed even before the
high risk student nurses arrived.
group   Current Management
Since a there is an
insufficient income, Mother
Mae does not prioritize the
construction of a drainage
system to be included in
their expenses. Therefore
instead, they dug a pit that
will direct the flow of water to
deviate away from towards
their house to another way
Constructing a man-made-
like-drainage system. .
 Exposure to any high risk
group
Since the whole
family is residing in the
house, they are all belonging
to the high risk group.

D. Salience 1/2x1 0.50 The family recognizes the


existence of the problem but it
does not require prompt
intervention for them because
the effects only occur whenever
there are heavy rains.
TOTAL SCORE 2.84

Problem #8: Improper Garbage Disposal as a Health threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because once the garbage
became a breeding site for
vectors or other insects that
bring about transmission of
infective agents; it can be a
threat to the healthy functioning
of the family per individual
member and as a whole such as
vector-borne diseases like
dengue and malaria.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

Current x  Current Knowledge


Knowledge The family does not
Resources  recognize the risk of leaving
of the the garbage near their sink.
Family Moreover, they are not
Resources  aware of the benefits of
of the keeping garbage in a more
Nurses appropriate place.
Resources   Resources of the Family
of the The family has adequate
Community resources to make a
particular intervention to the
problem since they can
throw their garbage outside
in a can where in the
garbage collectors can
collect or they can dig holes
that they can bury the bio-
degradable trash.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. Also, they
have proper know-how to
perform independent nursing
intervention like health
education.

 Resources of the
Community
The community resources
are also available to assist the
family in terms of regular
garbage collection or garbage
cans provided all through out the
community vicinity.

The problem has low


C. Preventive 1 / 3 x 1 0.33 preventability.
Potential (PP)
 Severity or gravity of the
Severity =PP problem.
or The problem has high
Gravity gravity because it can affect
 the health status of all of the
Duration =PP members. If it progresses to
 a more severe problem like
Current =PP becoming a breeding site for
Manage infectious agents, it can pose
ment  danger to the family’s health.
Exposur =PP  Duration of the Problem
e to any The problem has
high risk existed even before the
group  student nurses arrived and is
unknown to the family.
 Current Management
Current management
is absent since the family
does not see the
disadvantages of putting the
garbage in a plastic hanging
near their sink and cooking
facility and the supposed
provider of a healthy
environment is not
knowledgeable of it too.
 Exposure to any high risk
group
Since the children
are fond of playing, they can
have contact with the
garbage that may possibly
have infectious agents and
may cause them infection
altering their normal health
status.

D. Salience 1/2x1 0.50 The family recognizes the need


to intervene with the yet it does
not need immediate attention for
them since the disadvantages
are not immediately seen too
like the occurrence of diseases
and such.
TOTAL SCORE 2.50

Problem #9 Risk for Cross infection as a health threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because spread of the infection
may cause illness to the family
members and may impair their
role assumptions.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

 Current Knowledge
The family does not
recognize the problem
existing because they are
not aware of the possible
routes of spreading the
infection.
 Resources of the Family
The family can have
Current X herbal medicines to treat the
Knowledge sick member and they can
Resources  have precautions in
of the interacting with the sick
Family individual like frequent hand-
Resources  washing.
of the  Resources of the Nurses
Nurses Knowledge and time of
Resources  the student nurses are
of the available to establish
Community awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
expand their knowledge of
the possible modes of
transmission of the infection.
 Resources of the
Community
The community resources
are also available where they
could provide teachings.
Furthermore, it can provide
medications for the ill person to
treat underlying disease.

C. Preventive 1 / 3 x 1 0.33 The problem has low


Potential (PP) preventability because:

Severity =PP  Severity or gravity of the


or problem.
Gravity The problem has high
 gravity because it can affect
Duration =PP the whole family when they
 inhale the microorganism
Current =PP suspended in the sick
Manage person’s secretions.
ment   Duration of the Problem
Exposur =PP The problem has
e to any existed even before the
high risk student nurses arrived.
group   Current Management
The mother does not
know how to treat the sick
person. And she does not
intend to bring her to the
health center.
 Exposure to any high risk
group
Since the whole
family is residing in the
house, they are all belonging
to the high risk group
because all of them can
inhale the pathogen
suspended or contained in
the secretion of the sick
person.

D. Salience 1/2x1 0.5 The family does not recognize


the existence of the problem
because they are not aware of
the disease’s mode of
transmission and how to
manage cross infection But if so,
they would treat it as requiring
prompt intervention because it
can entail their health as a
family.
TOTAL SCORE 2.5

Problem #11: Presence of Accident Hazards (Exposed electrical wires) as a


Health Threat
CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because it poses danger for the
family once they accidentally
touch the exposed electrical
wire. Once they do, level of
functioning may decrease or the
family may suffer from loss a
member or total impaired
functioning of one of the
members.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

 Current Knowledge
The family does not
Current x recognize the presence of
Knowledge the exposed electrical wires
Resources x and the danger it may bring.
of the  Resources of the Family
Family The family has adequate
Resources  resources to make a
of the particular intervention to the
Nurses problem especially that
Resources  father Lorenzo is an all-
of the around laborer. However,
Community they do not know the
existence of the problem and
so they do not make use of
their resources.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. Also, they
have proper know-how to
perform independent nursing
intervention like help the
family fix the exposed wires
with electric tapes.
 Resources of the
Community
The community resources
are also available to assist the
family in terms of available tools
and manpower.

The problem has low preventive


C. Preventive 1/ 3 x 1 0.33 potential.
Potential (PP)
 Severity or gravity of the
problem.
The problem has high
gravity because it can affect
cause an unlikely accident to
any of the members and
may impair his/her
functioning in the family.
Duration of the Problem
The problem has
existed even before the
Severity =PP student nurses arrived.
or However, its existence was
Gravity not known by the family.
  Current Management
Duration =PP Since the supposed
 member—father Lorenzo—
Current =PP should be the rightful person
Manage to fix the problem is always
ment  not around, there is no
Exposur =PP current management being
e to any undertaken.
high risk  Exposure to any high risk
group  group
Since all of them are
prone to electrical accident,
they all belong to the high
risk group esp. the children
who are curious of many
things, explorative, and
playful.

D. Salience 0/2x1 0 The family does not recognize


the problem and therefore has
low salience because the
exposed wires have been there
ever since and no family
member yet had been affected.
TOTAL SCORE 2

Problem #11: Poor environmental Sanitation: Air Pollution as a Health


Threat
CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because the presence of smoke
upon burning of the plastic and
other materials can be harmful
and irritating to the lungs.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

 Current Knowledge
The family does not
Current X recognize the problem
Knowledge existing AEB mother Mae
Resources X verbalizing that they utilize
of the this process to eliminate
Family their wastes. Yet, she did not
Resources  made mention some
of the questions of its ill effects.
Nurses  Resources of the Family
Resources  The family either can dig
of the a hole where they can burry
Community these wastes. Or they can
collect them in a plastic bag
and wait for the collectors to
get it. Yet they do not utilize
any of these.
 Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
expand their knowledge of
the ill effects of air pollution
through burning of plastic.
 Resources of the
Community
The community resources
are also available where they
could provide teachings.
Furthermore, the garbage
collection occurs at times.

C. Preventive 1 / 3 x 1 0.33 The problem has low


Potential (PP) preventability because:

 Severity or gravity of the


problem.
The problem has high
gravity because it can affect
the whole family when they
inhale the smoke.
 Duration of the Problem
The problem has
existed even before the
Severity =PP student nurses arrived
or because it has been the
Gravity family’s practice.
  Current Management
Duration =PP The family does not
 know that there is a problem
Current =PP occurring with regards to the
Manage ill effects of burning their
ment  garbage. Therefore,
Exposur =PP interventions are absent.
e to any  Exposure to any high risk
high risk group
group  Since the whole
family is residing in the
house, they are all belonging
to the high risk group
because all of them can
inhale the smoke either
passively.

D. Salience 0/2x1 0 The family does not recognize


the existence of the problem so
it does not require prompt
intervention because no yet
became sick of their practice of
burning garbage and it is their
most convenient way of
disposing their garbage.
TOTAL SCORE 2

Problem # 11: Risk for Injury as a health threat


CRITERIA COMPUTATION SCORE JUSTIFICATION

A. Nature of the 2 / 3 x 1 0.67 The problem is a health threat


problem because injury caused by the
accident hazards can impair the
proper functioning of the family
member that will be injured.

B. Modifiability of the 1 / 2 x 2 1 The problem is partially


problem modifiable because:

 Current Knowledge
The family does not
Current X recognize the problem
Knowledge existing because they are
Resources  not aware of the accident
of the hazards.
Family  Resources of the Family
Resources  The family can fix the
of the exposed wires especially
Nurses that the father is an all-
Resources  around laborer and is
of the knowledgeable of fixing it..
Community  Resources of the Nurses
Knowledge and time of
the student nurses are
available to establish
awareness and recognition
of the problem. They are
also knowledgeable for the
teachings to help the family
expand their knowledge of
regarding the danger of the
exposed wires and the injury
it may cause.
 Resources of the
Community
The community resources
are also available where they
could provide teachings.
Furthermore, it can provide
manpower to help in fixing the
accident hazards.

C. Preventive 1 / 3 x 1 0.33 The problem has low


Potential (PP) preventability because:

 Severity or gravity of the


problem.
The problem has high
gravity because it can affect
the whole family when they
are injured of the accident
hazards such as the
exposed wires of electricity.
 Duration of the Problem
The problem has
existed even before the
student nurses arrived.
Severity =PP  Current Management
or The mother does not
Gravity know that the problem is
 existing long ago and no
Duration =PP management is done.
  Exposure to any high risk
Current =PP group
Manage Since the whole
ment  family is residing in the
Exposur =PP house, they are all belonging
e to any to the high risk group
high risk because all of them is at risk
group  of the injury the accident
hazards can bring.

D. Salience 1/2x1 0 The family does not recognize


the existence of the problem
because they are not aware of
the danger it is bringing.
Furthermore, the risk for injury of
their members is not also
known.
TOTAL SCORE 2.
VI. Family Nursing Care Plans

Problem 1
First Level of Assessment: Presence of Coughs (Ann) as a Health Deficit
Second Level of Assessment: Inability of the family to provide nursing care to its sick member due to:
a. Lack of knowledge and skill in carrying out the necessary treatment/procedure/care
b. Ignorance of facts about the disease and health condition
Method of Family
Cues Analysis of the Objectives Nursing Rationale Contact Resources Expected
Problem Interventions Required Outcome
S > “Mga 2 days ne Inability of the Short Term: >Identify reasons -to provide baseline Home visits >Family’s
manguku. Balamu family to provide After 1-2 days of behind acquiring data to which cooperation Short Term:
pin mimika ya eh!” nursing care to its home visits, the the disease treatment will be The family shall
as verbalized by sick member due family will be able > Discuss the mode directed >Student Nurse’s have been able to
mother Mae. to: to recognize the of transmission with - to prevent transfer of time, effort, skills recognize the
a. Lack of necessity of the family. disease and knowledge necessity of
O > The client knowledge and skill intervention in the > Encourage intervention in the
manifested: in carrying out the relieving the increase fluid >Community relieving the
> non productive necessary coughs intake. - to relieve itchy throat resources: Health coughs and colds
coughing treatment/procedur Long Term: or liquefy possible center’s free Long Term:
e/careb. Ignorance After 4-5 days of secretions medication The family shall
of facts about the home visits, the > provide warm - To mobilize have used safe and
disease and health family will use safe versus cold liquids secretions. effective ways in
condition and effective ways as appropriate. treating or
in treating or > Provide gentle alleviating the
alleviating the back rubbing disease condition
disease condition > Always check - to provide comfort like increasing fluid
like increasing fluid child’s back for intake or taking
intake or taking sweat. Wipe the -to limit or rule out herbal medications.
herbal medications. back for sweat. aggravating factors.
> Encourage to - To increase body’s
take in Vitamin C resistance to
regularly. microorganism
> Advise mother to - To identify proper
seek medical treatment and
advice. interventions.
Problem 2
First level Assessment: Unhealthful Lifestyle and Personal Habits or Practices: CIGARETTE SMOKING as a Health
Threat
Second level Assessment: Inability to recognize existence of the problem due to:
a. Ignorance of facts or inadequate knowledge of ill effects of smoking
b. Attitude in life which hinders recognition of the problem
Method Of
Nursing Resources Expected
Cues Analysis Of The Objectives Rationale Family
Interventions Required Outcomes
Problem Contact
-To gain the
S = “Bayung Inability to Short term: > Establish rapport cooperation of Home visits > Time and Short term:
tawu ya pa recognize After 2 home the client interest of the The family shall
sisindi ne. existence of the visits, the family > Provide health -To help the family have verbalized
Kayari na ning problem due to: will verbalize teachings about family be understanding of
metung, understanding of smoking and its aware of the > Participation the ill effects of
makasindi ne a. Ignorance of the ill effects of effects negative and smoking both on
ing katuki.” As facts or smoking both on effects of cooperation of the smoker &
verbalized by inadequate the smoker and smoking. the family those who inhale
Mother Mae knowledge of ill those who inhale > Encourage the -To lessen the the second hand
effects of smoking the second hand family member who habit of > Knowledge, smoke.
O= smoke. smokes to lessen smoking and skills and
> lips of Mr. b. Attitude in life the number of eventually attitude of the Long Term:
Lorenzo are which hinders Long Term: sticks he lights in a stopping its student nurses The family, esp.
dark in color recognition of the After 6 days of day. use. Mr. Lorenzo shall
[seen on problem home visits, Mr. > Encourage the -To avoid have done efforts
pictures] Lorenzo will smoker to smoke affectation of to reduce by about
make efforts to outside the house. children to 1-2 sticks the
>consumption reduce by about inhale the number of
of 1 pack per 1-2 sticks the second hand cigarette he
day as stated number of cigar > Keep children smoke. smokes a day.
by Mother Mae sticks he smokes away from -To avoid
in a day. smokers. inhaling the
smoke that
could cause
respiratory
problems.
Problem 3
First level Assessment: Inappropriate role Assumption (Mrs. Mae has the power to decide) as a Health Threat
Second level Assessment: Inability to recognize existence of the problem due to:
a. Ignorance of facts or inadequate knowledge
b. Attitude/philosophy in life which hinders recognition of the problem

Method
Nursing Resources Expected
Cues Analysis Of The Objectives Rationale Of Family
Interventions Required Outcomes
Problem Contact
S =Ø Inability to recognize Short term: > Establish rapport -To gain the Home > Time and Short term:
existence of the problem After 2 home > Provide health cooperation of the visits interest of the The family shall
O= due to: visits, Mrs. teachings about the client family have verbalized
Mrs. Mae Mae will be negative effects of -To help the family understand the
stressed out that a. Ignorance of facts or able to leaving the decision be aware of the > Participation importance of
she makes the inadequate knowledge understand the on one parent alone negativity of their and cooperation consulting her
decisions at b. Attitude/philosophy in importance of >Stressed out practice. of the family husband in
home because life which hinders consulting her benefits of having -For them to weigh decision-making
her husband is recognition of the husband in combined opinions the advantages > Knowledge, Long Term:
always not problem decision- before deciding. and disadvantages skills and Mr. Lorenzo shall
around. making. > Encourage the of sharing in attitude of the then be able to give
Furthermore, she family member to decision-making student nurses his part in the
described her Long Term: always assume their tasks. decision-making
husband as non- After 6 days of roles with -To remind them process whenever
dominating and home visits, responsibility and be that equality in he is around or in
calm&quiet. Mr. Lorenzo not dominating or authority is needed making major
will be able to inferior but only fair. to gain mutual decisions for the
give his part in > Discourage the respect. family.
the decision- weak authoritarian -To develop a
making attitude of Mr. strengthened and
process Lorenzo and confident authority
whenever he is encourage him to in him esp. that he
around or in take part in making is the head of the
making major choices for their family.
decisions for family. . To make them
the family. > Include the children feel belongingness
in tackling the and let them voice
decisions and out themselves.
options.
Problem 4
First level Assessment: Presence of Rodents and Cockroach as a Health Threat
Second level Assessment: Inability to provide a home environment that is conducive to health maintenance due to:
a. inadequate knowledge of preventive measures
b. inadequate financial family resources
Inability to make decisions with respect to taking appropriate action due to:
a. failure to comprehend the nature, magnitude/scope of the problem.
b. Low salience of the problem
Analysis Of The Nursing Method Of Resources Expected
Cues Objectives Rationale
Problem Interventions Family Contact Required Outcomes
S =”Dacal > Explain the -To inform the Home visits > Time and Short term:
ipas keni bale. Inability to Short term: present family about the interest of the
Bahay-ipis ne provide a home After the environmental present condition Observations family The family shall
pin awus ing environment that initial home condition of the have verbalized
anak ku keng is conducive to visit, the surrounding of Interview > Participation understanding
bale mi eh.” health family will be the house and cooperation of the harmful
maintenance due able to > Advise the family -To have a clean of the family effects of
O = The to: verbalize to regularly clean the and healthy insects and
following were a. inadequate understanding surroundings of their environment that > Knowledge, rodents inside
observed: knowledge of of the harmful house is conducive to skills and their house.
preventive effects o health attitude of the
> Presence measures insects and > Instruct the mother -To prevent them student nurses Long-term:
cockroach b. inadequate rodents inside to cover their kitchen from being
financial family their house. utensils or store in contaminated by > Cleaning The family shall
>manual resources the cabinet the cockroaches materials like perform and
eradication of Long-term: > Instruct the mother broom and soap demonstrate
cockroaches Inability to make After 5 days of regularly to cover -To prevent it or insecticides compliance of
decisions with home visits, their water from becoming a health teachings
> temporary respect to taking the family will breeding for and effective
disposal of appropriate be able to insects and eradication of
garbage action due to: a. perform and > Instructed the rodents the rodents.
inappropriately failure to demonstrate mother to properly > Rooting out the
. comprehend the compliance of throw their garbage cause of the
nature, health and cover it problem serves
magnitude/scope teachings and as one of the
of the problem. effective best solutions in
b. Low salience eradication of problem coping
of the problem the rodents.
Problem 5
First Level: Inadequate/Insufficient Family Resources as Health Threat
Second Level: Inability to provide food storage facilities conducive to health maintenance due to:
a. inadequate family resources specifically limited physical resources
b. failure to see benefits of investments in home environment improvement
Inability to make decisions with respect to taking appropriate health action due to:
a. lack of knowledge as to alternative courses of action open to them
b. low salience of the problem
Method of
Cues Analysis of the Objectives Nursing Rationale Family Resources Expected
Problem Interventions Contact Required Outcome
S= “Manakitan Inability to Short Term: > Compute for - to provide Home visits Determination Short Term:
yamung sustain and After 1-2 days the family’s comparison and and hard work The family
7,500php ing meet their basic of home visits, expenses and identify of the family. shall have
bulan in asawa needs due to the family will be salary. deficiency when planned means
able to plan
ku. eh” as lack of family means to
it comes to Time and effort to improve their
verbalized by resources, improve their financial status for both the condition such
the mother. especially condition such as >Give the family family and the as intake of
income. intake of - to give the student. nutritious yet
information
O = The family nutritious yet family an idea cheaper food.
regarding the
income per cheaper food. on how to earn Health
different ways
month is only P on earning extra extra income Teachings Long Term:
7,500 divided Long Term: provided by the The family
into 4 of them. After 5-6 days income. student nurse is shall have been
of home visits, > Encourage the
They are the family will be family to plant
necessary. able to
considered able to recognize vegetables. - to earn extra recognize
poor since only effective ways to > Provide tips on money; to effective ways
P 1,875 is increase and proper provide for food to increase and
allotted per maximize their budgeting. - to maximize maximize their
family member. income or > Encourage the use of income or
minimize their them to buy money minimize their
expenses like cheaper but expenses like
prioritizing nutritious foods - to meet the prioritizing
promotion of such as cheaper
health to avoid
nutritional promotion of
meats or needs without health to avoid
expenses due to vegetables.
illness. compromising expenses due
health needs to illness.
Problem 6.5
First Level: Lack of food storage facilities as a Health Threat
Second Level: Inability to provide food storage facilities conducive to health maintenance due to:
a. inadequate family resources specifically limited physical resources (e.g. Lack of space to construct
facility)
b. failure to see benefits of investments in home environment improvement
Inability to make decisions with respect to taking appropriate health action due to:
a. lack of knowledge as to alternative courses of action open to them
b. low salience of the problem
Cues Analysis of the Objectives Nursing Intervention Rationale Method of Resource Expected
Problem Family s Outcome
Contact Required
S> Ø >Inability to provide Short Term: >Assess the presence -To differentiate present Home >Student Short Term:
O> left food storage facilities After 1-2 days of methods utilized by the situation to the ideal for Visit nurse’s, The family shall
overs conducive to health home visit, the family to store food determination on the time, have demonstrated
were maintenance due to: family will be able focus of intervention effort and proper storage of
stored on a. inadequate family to demonstrate >Discuss with the family >To help the family skills food and
casserole resources specifically proper storage of the existence of the recognize the current >Family’s understand the
>lack of limited physical food and problem problems as well as its time, rationale and
refrigerat resources (e.g. Lack of understand the effect to their health cooperati possible
or that space to construct rationale and >Stress importance of >To encourage on and consequences of
prevents facility) possible giving appropriate participation from the decision improper food
food b. failure to see consequences of attention to proper family in changing making storage
spoilage benefits of investments improper food storage of food and its inappropriate habits competen
in home environment storage benefits ce Long Term:
improvement >Advice the family to >To promote equal >Commu The family shall
>Inability to make Long Term: After 5 maintain open authority in decision nity’s have promoted and
decisions with respect days of home visit, communication and making each material apply proper food
to taking appropriate the family will be discuss about obtaining responsibilities for the resources storage in their
health action due to: able to promote equipments that will be rest food everyday living as
a. lack of knowledge and apply proper conducive to their health storage evidence by
as to alternative food storage in maintenance equipmen presence of
courses of action open their everyday >Advice the family to ts (e.g. covered food
to them living as evidence consider alternative food >To meet the family’s refrigerato
b. low salience of the by presence of storage to prevent food financial capabilities r, food
problem covered food spoilage and cover,
stored or avoiding contamination (e.g. Tupperwa
left overs. Tupperware) re)
Problem 6.5
First level Assessment: Poor Environment Sanitation: Improper Drainage System as a health threat
Second level Assessment: Inability to make decisions with respect to taking appropriate health action due to:
a. Failure to comprehend the nature, magnitude/scope of the problem.
Inability to provide a home environment which is conducive to health maintenance due to:
a. Limited physical resources like lack of space to construct facility
b. Lack of knowledge on preventive measures.
c. Inadequate family resources specifically financial constraints and manpower.
Cues Analysis of the Objectives Nursing Rationale Method of Resources Evaluation
problem Intervention contact required
S = “Pag Inability to make Short term: After >Discuss the - To know the -Home visits Human Short term: The
mumuran, decisions with respect 1-2 days of home importance of complication & -Interview resources: family shall have
lulub keni bale to taking appropriate visits the family good provide baseline Family’s verbalized
health action due to: -Observation
ing danum. will verbalize environmental information & cooperation and understanding of
Atin kasi a. Failure to understanding of sanitation. acknowledge the time student’s the importance of
siwang eh!” comprehend the the importance of presence of the knowledge time sanitation & its
O = drainage nature, it and its possible >Encourage problem. and effort. effects to health
magnitude/scope of
system is only effects to health cleaning of the such as the water
the problem.
a constructed such as the water area where most - To control the can enter the
pit that allows Inability to provide a
can enter the flies or mosquito spread of disease house and
flow of water home environment house and breed. or cause of soaked-wet all
be deviated which is conducive to soaked-wet all dengue. their house
from the health maintenance their house >Inspire the appliances.
house due to: appliances. family to clean - To promote .
towards a. Limited physical their good
another resources like lack of Long term: After surroundings so environmental Long term: The
direction; still space to construct 4 days of home that when water sanitation. family shall have
this is facility visits, the family floods out, the been able to
ineffective b. Lack of knowledge will be able to water that will properly
during rainy on preventive demonstrate enter their house demonstrate
days. measures. proper efforts to will be less dirty. proper efforts to
=there is a c. Inadequate family construct a construct a
hole beneath resources specifically proper drainage >Provide health - To inform the proper drainage
the door that financial constraints system. teachings family of the system.
allows and manpower. regarding the benefits of having
passage of benefits of having a good drainage
water into the a good drainage system.
house. system.
Problem 8
First Level of Assessment: Improper Garbage Disposal as a Health threat
Second Level of Assessment: Inability to provide a home environment which is conducive to health maintenance and
personal development due to:
a. Failure to see benefits of investment in home environment improvement
b. Lack of knowledge of importance of hygiene and sanitation
c. Ignorance of preventive measures
Cues Analysis of the Objectives Nursing Rationale Method of Resources Evaluation
problem Intervention contact required
S> O Inability to Short term: >Assess the -to obtain a -Home visits -student nurses’ Short term:
provide a home After 2-3 days of general housing baseline data -Interview time, effort, and The family shall
O> garbage environment home visit, the condition -to determine skill have developed
-Observation
placed on a which is family will develop >Identify the degree of -family’s time awareness on
awareness on the the importance
plastic bag conducive importance of
unsanitary nursing and cooperation, of good
was seen health good garbage disposal intervention compliance, environmental
hanging near maintenance environmental >Assess the needed participation and sanitation as
the cooking and personal sanitation as reasons of the -to provide understanding evidenced by
facility. development evidenced by failure to dispose background >community disposing the
due to: disposing the garbage properly information for waste containers garbage properly
a. Failure to garbage properly >Discuss with the nurses to and garbage and
see benefits of and implementing the family the know which collection implementing
investment in cleanliness possible health habit to correct cleanliness
Long term:
home After 5 days of
consequences of -to encourage Long term:
environment home visit, the improper initiative to The family shall
improvement family will be able garbage disposal maintain a have maintained
b. Lack of to maintain a -Help the family clean a clean
knowledge of clean environment find the environment by environment that
importance of that is conducive appropriate place a proper is conducive to
hygiene and to health where to dispose disposal of health
sanitation maintenance as or temporarily waste maintenance as
c. Ignorance of evidenced by place the house -to initiate the evidenced by
disposing the disposing the
preventive garbage in a more
wastes family’s garbage in a
nature appropriate compliance to more appropriate
container like can. teachings container like
about can.
sanitation that
were given.
Problem 9: First Level of Assessment: Risk for Infection as a Health Threat
Second Level of Assessment: Inability to recognize the presence of the problem due to:
a. Ignorance of facts/lack of knowledge
Inability to provide adequate nursing care to the at risk member of the family due to:
a. Ignorance of facts about health condition
b. Lack of knowledge in carrying out necessary precaution
Cues Analysis of the Objectives Nursing Rationale Method of Resources Evaluation
problem Intervention contact required
S> “Mga 2 days Inability to Short term: >Identify reasons -to provide baseline -Home visits -student nurses’ Short term:
ne manguku” recognize the After 2-3 days behind acquiring the data to which -Interview time, effort, and After 2-3 days
presence of the of home visit, disease treatment will be skill of home visit,
directed -Observatio
O> Ann has problem due to: the family will -family’s time and the family shall
> Discuss the mode - to prevent transfer n
coughs and a. Ignorance of develop cooperation, have developed
colds facts/lack of awareness of transmission with of disease compliance, awareness
knowledge about the family. participation and about
Inability to contributing > provide warm - To mobilize understanding contributing
versus cold liquids secretions.
provide factors that >community factors that
as appropriate.
adequate might increase waste containers might increase
> Provide gentle - to provide comfort
nursing care to risk for spread back rubbing for the and garbage risk for spread
the at risk of infection like ill individual collection of infection like
member of the contact to > Always check -to limit or rule out contact to
family due to: droplet child’s back for aggravating factors. droplet
a. Ignorance of secretions. sweat. Wipe the - To increase body’s secretions.
facts about back for sweat. resistance to
health condition Long term: > Encourage to take microorganism Long term:
b. Lack of After 5 days of in Vitamin C After 5 days of
knowledge in home visit, the regularly. - contact with it is a home visit, the
carrying out family will be >Advise other route for family shall
necessary able to hinder members to avoid transmission of have been able
precautions the spread of contact with pathogen to hinder the
infection AEB secretions of ill spread of
treating the individual. -to avoid inhalation infection AEB
primary ill >Advise ill individual of secretion by other treating the
individual. to cover mouth and members primary ill
nose when coughing - To identify proper individual.
or sneezing treatment and
> Advise mother to interventions.
seek medical advice.
Problem 11 First Level: Presence of Accident Hazards (Exposed electrical wires) as a Health Threat
Second Level: Inability to provide a home environment, which is conducive to health
maintenance and personal development due to:
a. Ignorance of preventive measures
b. Failure to see benefits of investment in home environment improvement.
c. Lack of skills in carrying out measures to improve home environment
Cues Analysis of the Objectives Nursing Rationale Method of Resources Expected
Problem Intervention Family Contact Required Outcome
S> Ø >Inability to provide a Short Term: >Assess the -To assess Home Visit >Student nurse’s Short Term:
O> exposed home environment, After 1 day of general housing degree of knowledge, time, The family shall
electrical wires which is conducive to home visit, the condition nursing effort and skills in have been able
were seen health maintenance family will be able intervention to maintaining the to recognize and
hanging close to and personal to recognize and >Help the family be given; obtain family’s identify dangers
the doorway in development due to: identify dangers in identify and baseline data environment safe in the presence
and out of the a. ignorance of the presence of recognize -To involve the and accident free of accident
accident hazards hazards and
house. preventive accident hazards family in the >Family’s time,
and know the know the
>Mr. Lorenzo is measures existing in their achievement of compliance and
importance and importance and
not always b. Failure to long term benefits
house their accident cooperation as long term
around to help fix see benefits of having an >Discuss to the free environment well as skills in benefits of having
the exposed of accident free family the -To increase the maintaining an an accident free
wires investment environment as importance of family’s accident hazard environment as
in home evidence by the having an knowledge and free environment evidence by
environment efforts made to accidents free encourage them >Community’s efforts made to
improvemen keep the family environment and to maintain an material keep the family
t. aware of the its long term accident free resources like aware of the
c. Lack of danger of the benefits. environment storages facility, danger of the
skills in exposed wires. >Discuss to the -To provide divider, etc. exposed wires.
carrying out Long Term: After family the possible background
measures to 5 days of home consequences of knowledge of Long Term:
improve visit, the family the presence of what to expect in The family shall
home will manifest accident hazards a failure of have manifested
environment application of the >Help the family maintaining an application of the
teachings given eliminate accident accident free teachings given
AEB elimination AEB elimination
hazards existing environment
of accident of accident
and provide ways >To make the
hazards like hazards like
properly kept
on how to tape family think and properly kept
cables and wires. them and prevent make ways on cables and wires.
them being improving their
exposed. housing
condition.
Problem 11
First level Assessment: Poor environmental Sanitation: Air Pollution as a Health Threat
Second level Assessment: Inability to recognize existence of the problem due to:
a. Ignorance of facts or inadequate knowledge of ill effects of gas emissions in
burning plastics and other materials
b. Attitude in life which hinders recognition of the problem
Inability to provide a home environment, which is conducive to health maintenance due to:
a. failure to see benefits of investment in home environment improvement
b. ignorance of preventive and alternative measures.
Method
Nursing Resources Expected
Cues Analysis Of The Objectives Rationale Of Family
Interventions Required Outcomes
Problem Contact
S = “Sisilaban Inability to recognize Short term: > Establish rapport -To gain the Home > Time and Short term:
mi ngan ing existence of the After 2 home visits, cooperation of the visits interest of The family shall
basura mi problem due to: the family will > Provide health client the family have verbalized
ken. Pati a. Ignorance of facts or verbalize teachings about the ill -To help the family be understanding of the
plastic.” as inadequate knowledge understanding of effects of burning the aware of the negative > ill effects of burning
verbalized by of ill effects of gas the ill effects of garbage outside like of their practice of Participation the garbage
Mother Mae emissions in burning burning the dangerous gas burning the garbage and including plastic
plastics and other garbage including emissions and possible air cooperation materials outside
O= materials plastic materials pollution. of the family
>presence of b. Attitude in life which outside. > Encourage the -To lessen the danger Long Term:
ashes and hinders recognition of family member to shift of inhaling the smoke > The family shall
burnt the problem Long Term: to another way of emitted by the burning Knowledge, have done efforts to
materials After 6 days of getting rid of their process. skills and think of another way
piled up on Inability to provide a home visits, the waste like burying attitude of of disposing or
their front home environment, family will make biodegradable -To avoid affectation of the student getting rid of their
yard. which is conducive to efforts think of materials. children to inhale the nurses garbage instead of
health maintenance another way of gas emitted by the burning.
due to: disposing or > Discourage the plastic.
a. failure to see getting rid of their practice of burning the And to provide
benefits of investment garbage instead of plastic in case they do decision or choice for
in home environment burning. not want to shift to the family.
improvement digging & burying. -To avoid accidents
b. ignorance of > Keep children away like burns especially
preventive and from the flame. for the playful children.
alternative measures. .

Problem 11 First Level of Assessment: Risk for Injury as a Health Threat


Second Level of Assessment: Inability to provide a home environment which is conducive to health maintenance and personal
development due to:
a. Failure to see benefits of investment in home environment improvement
b. Ignorance of Preventive measures
Cues Analysis of the Objectives Nursing Rationale Method of Resources Expected
Problem Intervention Family Contact Required Outcome
S> Ø >Inability to provide a Short Term: >Assess the -To assess Home Visit >Student nurse’s Short Term:
O> exposed home environment, After 1-2 days of general housing degree of knowledge, time, The family shall
electrical wires which is conducive to home visit, the condition nursing effort and skills in have been able
were seen health maintenance family will be able intervention to maintaining the to recognize risk
hanging close to and personal to recognize risk >Help the family be given; obtain family’s for injury brought
the doorway in development due to: for injury brought identify and baseline data environment safe about by the
and out of the a. Failure to see about by the recognize -To involve the and accident free presence of
presence of accident hazards
house. benefits of accident hazards family in the >Family’s time,
accident hazards such as the
>Mr. Lorenzo is investment in existing in their achievement of compliance and
such as the exposed wires.
not always home environment exposed wires.
house their accident cooperation as
around to help fix improvement. >Explain possible free environment well as skills in Long Term:
the exposed b. ignorance of Long Term: After injury for the - to help maintaining an The family shall
wires preventive 5 days of home members increase level of accident hazard have manifested
measures visit, the family >Discuss to the awareness free environment application of the
will manifest family the -to encourage >Community’s teachings given
application of the importance of them to maintain material AEB elimination
teachings given having an an accident free resources like of accident
AEB elimination accidents free environment storages facility, hazards like
of accident environment and -To provide divider, etc. properly kept
hazards like its long term background cables and wires.
properly kept benefits. knowledge of
cables and wires. >Discuss to the what to expect in
family the possible a failure of
consequences of maintaining an
the presence of accident free
accident hazards environment
>Help the family >To make the
eliminate accident family think and
hazards existing make ways on
and provide ways improving their
on how to tape housing
them and prevent condition.
them being
exposed.
VIII. FAMILY COPING INDEX
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Therapeutic 1 3 5 1 3 5 Initial:
Competence ♥
This category
On the initial visit, during the interview, Mother Mae stated that she uses (OTC) over-the-

includes all counter drugs without consulting a doctor or even just in the health center. She also
procedures or mentioned that she prefers to go to herbolarios rather than doctors. But though she
treatment consults doctors when her children are the ones that are ill.
prescribed for
the care of Final:

illness, such as
After giving advices to Mother Mae about the necessity of seeking professional (medical)
giving
medications and assistance when encountering sickness within the family, she demonstrated willingness to

using visit the clinic and consult to the authorized provider of care. She also mentioned that she
appliances, is willing to participate in the up-coming activities and seminars that will be held at the
dressings, health center where in her presence was recognized by the student nurses after the course
exercises and of the FCA.
relaxation, and
special diets.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Knowledge of 1 3 5 1 3 5 Initial:
Health ♥ Before the student nurses made the necessary interventions or give teachings, Mrs. Mae
Condition showed confusion in the condition of Ann’s cough. Also, when asked about her history, she
This category is refused to include the cancer of her mother where in it should be included.
concerned with
the particular
health condition
that is the
occasion for
♥ Final:
care (e.g.
knowledge of
After thoroughly explaining the disease condition and possible reasons of its occurrence,
the disease,
Mrs. Mae showed enthusiasm in knowing the disease. She also manifested a clear
understanding
acceptance of the new knowledge learned.
of
communicability
of diseases and
modes of
transmission)
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Application of 1 3 5 1 3 5 Initial:
Principles of

Personal and During the initial visit, the student nurses observed the some practices that do not
general Hygiene
contribute to proper hygiene and sanitation of the house. Anne was not well groomed. And
This is concerned
with the family they place their garbage hanging next to their cooking facility. They also burn their garbage
action in relation
to maintaining instead of burying or waiting for the collectors.
family nutrition,
securing
adequate rest and
relaxation for the
family members
and carrying out ♥ Final:
accepted
preventive
measures such as During the final visit, and the visits after the student nurses initiated activities to improve the
immunization, family’s hygiene, the house started to be observed clean and in order. Mother Mae also
medical appraisal
and safe showed change in wanting her child Ann be presentable. She also explained to Anthony
homemaking
habits in relation that he needs to wear his shoes in going to school.
to storing and
preparing food.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Health Care 1 3 5 1 3 5 Initial:


Attitudes ♥
During the initial visit, Mother Mae verbalized that she consults to doctors only for
This category
sometime. She prefers to go to herbolarios because she believes it would be more
is concerned
effective. She seldom goes to the health center because she thought services are not
with the way
available. She does the same with her children because she is the primary provider of care
the family feels
in the house.
about health
care in
Final:
general, ♥
including After the health teachings and advices given to the family, Mother Mae started to seek
preventive medical assistance from authorized provider of care before self-medicating. She also
services, care begun to understand the need fro check-ups fro the proper preventive and curative
of illness, and measures for her family. She also showed enthusiasm in visiting the health center.
public health
measures.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Emotional 1 3 5 1 3 5 Initial:
Competence
This category has ♥
to do with the During the initial home visit, the family members do fairly well but sometimes the children
maturity and
integrity with were left unattended. Mother Mae and her husband are seldom seen together. And a
which the
members of the neighbor commented that she would always shout at her husband.
family are able to
meet the usual
stresses and
problems of life,
and to plan for
happy and fruitful Final:
living. This
involves the ♥
degree to which After interventions, Mrs. Mae verbalized that though she shouts at Mr. Lorenzo, it would not
individuals accept
necessary mean or start a fight. This shows that though they are misinterpreted at times, they are
disciplines strongly bonded with love and emotional security with one another. And she does not regret
imposed by one’s
family culture; the of marrying at a young age.
development and
maintenance of
individual
responsibility and
decision; and
willingness to
meet reasonable
obligations.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Family Living 1 3 5 1 3 5 Initial:


Patterns
This category is ♥ During the initial visit, Mother Mae was the primary decision-maker. She clearly stated that
concerned largely
with the it was she that makes most of the decisions because her husband is a quiet type of person
interpersonal or
group aspects of and would not want to intervene with such tasks. .
family–how well
the family
members get
along together,
the ways in which ♥
they make Final:
decision affecting
the family as a
whole, the degree After encouraging Mother Mae involve in Mr. Lorenzo in activities for their health’s
to which they improvement, she showed concern for her husband and decided to include him in decision-
support one
another and do making.
things as a family,
the respect and
affection they
show for one
another, the ways
in which they
manage the
family budget, the
kind of discipline
that prevails.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Physical 1 3 5 1 3 5 Initial:
Environment ♥
This category is
During the initial visit, the house of the family was in poor condition. It has accident
concerned with hazards, poor cooking facilities and improperly disposed garbage. Added to this are the
the home and
community or garbage burned outside and the electrical wires exposed. There are also breeding sites for
work
insects and the improper drainage system.
environment as
it affects family
health. This ♥
Final:
includes
condition for
housing, After the Nursing Intervention, the house’s condition improved. The student nurses advised
presence of
accidence the family to throw their garbage outside instead of keeping in hanging near their cooking
hazards, facility. They were also advised to get rid of their burning practices and start eliminating
screening,
plumbing, hazards in their home.
facilities for
cooking and for
privacy, level of
community,
availability and
conditions of
schools and
transportation.
CATEGORY INTIAL FINAL JUSTIFICATION
SCORE SCORE

Use of 1 3 5 1 3 5 Initial:
Community ♥
During the initial visit, the family sends their son and daughter Ann and Anthony to the
facilities
This category
community’s elementary school. Thus, it indicates that they know some of the community
has to do with facilities and services. However, they do not make use of the medical services provided in
which family
members know the health center because of lack of confidence and their self-medicating habits. Further
about with which
more, they seek herbolarios first.
they use
available
community
resources for
health,
education, and ♥ Final:
welfare. The
coping ability
does not After the information were given that provided awareness to the family by the student
indicate the nurses, the family started to seek medical privileges provided in the community health
level of the need
for services, but center. They used the facilities they need appropriately and promptly (e.g. free
rather the
degree to which medications); knows when to call for help and whom to call. The student nurses also
they can cope noticed her participation in mothers’ classes.
when they must
seek such aid.
VIII. Learning Derived
The family case analysis made me realized a lot of things and gave me
experiences that I can cherish in my life. I enhanced my social ability in doing our
family case analysis because we need to interact with them in gathering
information.
I realized that doing this project we have helped the family enhance their
knowledge about health. The family helped me realized to be thankful with the
blessing I receive everyday, to be satisfied with the things that I have in my life.
God bless.
Clefanny Ann M. Bayani
BSN III-5
“The first duty of a human being is to assume right functional relationship to
society–more briefly, to find your real job and do it.”
–Charlotte Perkins Gilman
Working is biblical. Jesus even emphasized that whosesoever not being
fruitful must be cut off from His people. The fig tree that it did not bear fruit
causing it to die and to wither exemplified this gigantic responsibility for us to be
productive and be of help to others.
As a Christian, I want to live out this benevolent task. As a nurse I want to
extend my helping hand to my patients. Moreover, as a student I want to take
part in making our group works satisfactory.
Gladly, this activity molded me the way I wanted. I developed the “working
attitude” that made me a step further towards nursing competence and sense of
responsibility. Also, I developed persistence just to finish the part assigned to me
and to pursue perfection to honor our Lord and to benefit my group mates.
Most importantly, I found the essence of this career and the big part it
contributes to society. I learned the lessons I need to gain to be more Christ-like–
a compassionate heart. I discovered the purpose behind this God-led journey–to
channel His foremost care to the least of His people. And I realized the fullness of
life by being able to observe life in different views.
Generally, you can’t just be someone roaming around while watching
others make a difference in this world. You have to be in practice and stand up
for God and humanity. Think of this: the work will never be finished unless you’ve
started. Glory to God, that’s the same thought I had ‘till I made it to the end.
Blando, Sherida Mae R., SN
BSN III-5 Group 18
Community Health Nursing is both applications of Nursing and public
Health which gives human service to every member in the community. It had
made great contributions in the health of people providing health services and
health teachings. It extends individuals and families in their homes, place of work
and schools.
Community health Nurses are very significant in providing health services
in different places of the community and they give health teachings on how to
prevent certain diseases and cure them from their illness.
Family Case Analysis is a task of the community health nurses in
assessing the family to identify their abnormalities. It helps the family conscious
of health dilemmas to resolve their problem using the community resources.
I’ve learned many things during our duty in the community. In every place
we go, many things we discover. One of these is learning. We learned based
from our experiences. There is a big difference between knowledge and skills.
Upon exposure you really need energy to do things. You also apply the
knowledge that you have learned unlike knowledge you just understand or
memorize certain rational without any application.
The hardest part in the community requirement is this FCA but I learned a
lot. I learned how to establish rapport effectively and to be patient upon
assessing them especially tequila. I learned how to interview therapeutically and
assess their physical assessment and know their abnormalities; providing health
teachings concerning their health and environment. I learned that teamwork
really matters. In this FCA it enhanced my grammar in English. I realized upon
this FCA that I am fortunate in my life. Upon seeing or experiencing the family
that we assess regarding their status in life. I appreciate now the blessing that
God have given to me, with this FCA serve as reflector of life in me and as an
application to all the knowledge I learned during my second year as a nursing
student.
- -Rajah Lorenzo Sotelo, S.N

I, as a student nurse, have used my skills and knowledge based from my


learning from school. On continuing community nursing compilation of data and
identifying different problems within a certain community. Upon analyzing such
gathered data, I may come up with the corresponding management.

The case analysis further increased my knowledge not only as a


community health nurse but also as a human. This did not only quench my thirst
for knowledge but also my urge to render service especially to the ones needing.
We give comfort and care to the family by rendering care, providing information
and interventions. I realized, as a future nurse, I myself must not wait for a
patient or one who needs. Instead, I must be the one searching for them. To sum
up, CHN our profession, truly is a honorable one.

- Anthony Riel San Diego


IX Sociogram

Legend:

Ape= family before interventions

Modern Man= Family after interventions

Gadgets= resources including student nurses’ efforts

Men in between ape and modern man= process of FCA


X. Spot map and Documentation
Spot map
Legend: -Health Center -Adopted Family’s house - Macapagal Village Grade School
Main door
(Floor plan)

Living room

Masters bedroom

kitchen

Bathroom
Documentation

After having found the family


to be adopted, the student
nurses went back the next
day and they were welcomed
warmly as though they were
known long before.
This is the house of the
adopted family. This shows
the history taking that took
place days prior to
interventions.

This

shows the presence of exposed electrical wires


inside and outside the house. This is near the
door.

One of the problems recognized was the danger of burning the garbage
practiced by the family.
The student nurses helped in
maintaining the house clean like
sweeping the floor.

They also extended a helping hand


in hanging-dry the laundry.
This is the cooking facility of the
Macapagal Family. They say it’s
cheaper.

This is
the
toilet
facility. Though it does not have a water
carriage, it looks clean and tidy.

This is the
inside of their house. The house looks small
but it has the appliances they need.

They seem to
be ready in

accommodating a lot of visitors because they


a have enough number of chairs.

The outside of the house and the


front yard would suggest that life is quiet
and peaceful in this community.
Upon actual assessment. Vital signs
taking.

The sideline
of Mrs. Mae
and her
neighbors is sharpening BBQ sticks. It is hard
way to earn money. Just 8 pesos per 1000
pieces.

Striking a pose with the family is something that will


never be out-scheduled.
APPENDIX
BMI = Weight in kilograms
Height in (m)²
Interpretation:
<13 = emaciated
13 – 18.5 = underweight
18.5 – 24.9 = normal
25 – 29 = overweight
30 and above = obese

*REFERENCE: Rodolfo F. Florentino, M.D. et. Al. FNRI-PPS Anthropometric Tables and
Charts for Filipino Children (Based on the suggested marginal cut-off points), Manila,
Philippines, 1992.

The anthropometric method of measuring the nutrition status of an individual may reveal
the condition of his body that results from the utilization of essential nutrients made available
from his daily diet. (Serraon – Claudio, Basic Nutrition for Filipinos, 2002

Formula in Inadequate Living space:

TSR:
Adult: 13 y/o above = 3m²
Child: 1 y/o (0-12 y/o) = 1.5m²
= Summation of TSR/per member
TSR> TSA = inadequate
TSR<TSA = adequate

*REFERENCE: Untalan, A, (2005). CONCEPTS and guidelines in Copar 1st Edition.


Educational Publishing House, United Nations ave., Ermita, metro manila

Weight (KG) for Age‡ of Boys and Girls, 0-72 Months


International Reference Standards (IRS), NCHS/WHO Reference Data, 1978
Age as of last birthday
The age of the child is computed to the nearest month as of his/her last birth date, thus, the
number of days is not included in the computation of age-in-months. For example, a child born
on 01 October 1998 and weighed on 31 August 2001 is 2 years, 10 months and 30 days. So
multiplying 2 years by 12 and adding 10 months, the month is 34 months since we disregard
the number of days.
NOTE: The symbol "<" means less than; and ">"greater than.

FOOD AND NUTRITION RESEARCH INSTITUTE


D epartment of Science and Technology
Gen. Santos Ave., Bicutan, Taguig