LICEO DE CAGAYAN UNIVERSITY Rodulfo N. Pelaez Blvd.

Carmen, Cagayan de Oro City COLLEGE OF NURSING

In Partial Fulfillment of the Requirements In NCM501205 Related Learning Experience

FAMILY CASE STUDY Submitted to:

Submitted by: GROUP A5 S.Y. 2010-2011 February ,2011 COMMUNITY HEALTH NURSING CASE PRESENTATION TABLE OF CONTENTS

I.

INTRODUCTION A.) Specific objectives B.) Scope and Limitation of the study

II. III. IV. VI. VII. VIII. IX.

SPOT MAP FAMILY PROFILE FAMILY HEALTH HISTORY PRESENT HEALTH STATUS IMCI HOME AND ENVIRONMENT FAMILY COPING INDEX

X. XI. XII. XIII.

SCHEMATIC PRESENTATION OF FAMILY HEALTH PROBLEM FAMILY HEALTH PLAN ACTUAL IMPLEMENTATION RECOMMENDATION

XIV. EVALUATION XIV. BIBLIOGRAPHY XV. APPENDICES

I. INTRODUCTION

Families are the foundation of society. It is where we come into the world, are nurtured and given the tools to go out into the world, capable and healthy or we arent. While the families have the greatest potential for raising healthy individuals, they can also wound their members in places that will never heal. When families breakdown and fail to provide the healthy nurturing we need, the effects impact not only our own lives, but also our communities. The family is the basic unit of society that consists of those individuals, male or female, youth or adult, legally or not legally related, genetically or not genetically related, who are considered by others to represent their significant persons. As a universal social institution, it may be defined as a group of persons united by ties of marriage, blood, or adoption; constituting a single household unit; interacting and communicating with each other in their respective social roles as husband and wife, mother and father, son and daughter, and creating and maintaining a common culture. Families were special person that would always be there for you throughout life. Blood is thicker than water as they say its because no matter what happen they would always be a bond that connects each one of you, and when there is problem or trials in the family especially if it talks on health, hatred and hurt feelings would taken for granted because all you wanted is to support each other. Every of us need a family, we cant make it alone, even if we are the richest person in the world, you would ask yourself, what will you do with your money? Money cannot buy happiness, and it can never buy true family Family is a part of society, a community in which individual has the same interest, and a community with a goal; to help each one become a productive individual who in return could assist in development. There is a good chance for

success if communications between all the family members are open and honest. Each person's needs must be recognized as being legitimate and important. Each individual must, with mindfulness and intention, make a commitment to the survival of the family. Community Health Nursing is a unique blend of nursing and public health practice woven into human service that properly developed and applied has tremendous impact on the human being. Its responsibilities extend to the care and supervision of individuals and families in their homes, work place, schools and clinics. The primary focus of the community health nursing practice is on health promotion. And the goal of the community health services is raise the level of the health of the citizenry. In this special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health program for the promotion of health and the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability. As part of the requirement of NCM501205, students were asked to have a family Care Study for them to understand more deeply the community health nursing. This aimed for student to study each family, their functions and their ways of living and if this family passed the standards of considered as the health ways of living.

I had chosen Family for this care study and I visited the family for 4 times. All of us were given enough time to visit our families for us to fully appreciate the changes that we had brought to our individual families.

This study is intended to better understand the common diseases as well as the health problems that are commonly encountered by the family in the community. This was purposely done to enhance my knowledge and to help the family in the process. A) OBJECTIVES OF THE STUDY At the end of 5 days Community Health Nursing Exposure, we will be able to: Establish trust and rapport to chosen family Assess the health needs, plan, implement and evaluate care to the family members Provide a quality nursing care to the family members the impact of health

 Reinforce health teachings to family members

This case study will serve as a basis or reference

members B.) SCOPE AND LIMITATION

to evaluate the

nursing

managements and health teachings implemented and imparted to the family

The study was conducted within the parameters of Zone 4-B Carmen, Cagayan de Oro City to the Divina Family. The study focuses on: 1. 2. obtaining the family profile, health history and present health condition, assessing, recording, and gathering of pertinent data about the family, estimating the nursing needs and coping capacity of the family

3. 4.

identify the primary health problems of the family members and the applicable interventions to solve the priority problems. evaluation, recommendation and referrals for the Family.

This study is conducted with a minimal time frame of 3 home visitations from February 8, 14, 15, 2011. With the time given, we grasped the opportunity to take a closer look at the environment, nutrition, activities or routines of the family that might threaten their health. However, not all the time all the family members were available due to their occupational activities so the physical assessment of each member was not consistent as to the home visitations correspondingly.

II. SPOT MAP From the point of reference (Liceo de Cagayan), it is approximately 1.5 kilometers from Zone 4B barangay Carmen. From Liceo de Cagayan University, the PUJ travels along the Vamenta BLVD up to the Golden heritage polytechnic College. The house of the Divina Family is two houses away in front of the said school.

III.

FAMILY PROFILE

FATHER Name Sex Birth Date Age Civil Status Nationality Address Religion Educ. Attainment Occupation Monthly Income Allergies : Emmanuel Enloran : Head of the Family : Male : December 25, 1964 : 46 years old : Married : Filipino : Zone 4-B, Carmen, Cagayan de Oro City : Roman Catholic : High School Level : Unemployed : None : No known Food and Drug Allergies Position in the Family

MOTHER Name Sex Birth Date Age Civil Status Nationality Address Religion Educ. Attainment Occupation Monthly Income Allergies : Gina Mae Divina : Mother / Bread Winner of the Family : Female : March 10, 1979 : 32 yrs. old : Single ( Live-in ) : Filipino : zone 4-B, Carmen, Cagayan de Oro City : Roman Catholic : High school Level : Store Owner : 7,000/month (estimated) : No Known Food and Drug Allergies Position in the Family

ELDEST Name Sex Birth Date Age Civil Status Nationality Address Religion Educ. Attainment Occupation Allergies IV. FAMILY HEALTH HISTORY A. FATHER Mr. Emmannuel Enloran, head of the family was born through normal spontaneous vaginal delivery. He is the second among the five siblings. Mr. Emmanuel was not able to remember if he had any immunizations during his childhood years. He verbalized that his family has a history of hypertension and diabetes. He does not have any food allergies. He drinks occasionally and dont smoke. : Sherela Enloran : Eldest : Female : November 13, 2007 :3 yrs. old : Child : Filipino : Zone 4-B, Carmen, Cagayan de Oro City : Roman Catholic : None : N/A : No Known Food and Drug Allergies Position in the Family

B. MOTHER Mrs. Gina Mae Divina, a 32 years old, gravida 1, parity 1, abortion 0, was born through normal spontaneous vaginal delivery. Mrs. Divina was not able to recall if she had any immunizations during her childhood years. She gave birth to her child at home through normal vaginal delivery assisted by the midwife in their barangay. She admitted that she use pills as contraception. Her family has a history of hypertension on both paternal and maternal side. Mrs. Divina has no known allergy in food and drugs. C. Eldest daughter Sherela Enloran is the first and only child in the family. She was born trough normal spontaneous vaginal delivery assisted by the midwife in their barangay. Sherela grew up on the care of her mother at Zone 4 b Cagayan de Oro because her father has other family living in patag Cagayan de Oro. Her mother was able to brought her on the barangay health center and was able to complete the

immunization. Last year, she experienced Dengue Fever and was treated through Paractamol for fever and drinking of Tawa-tawa. Sherela does not have any food and drug allergies and have not received blood or any blood products at the past. V. PRESENT FAMILY HEALTH STATUS First level of assessment has been performed on the 3 members of the family during the 3 home visitations which covered the period starting February 8, 14 and 15. We only met the wife because the husband is on his other family at patag Cagayan de oro city. Mrs. Divina said that her husband visits on their house 2 times a week During the first level of assessment, data has been gathered through interviews conducted through the wife. Her husband does not smoke and drinks occasionally. Her child completed the immunization . With regards to family planning, the couple decide to use pills as their contraception. All members of the family have no known drug and food allergies. With regards to the kind of food they eat, they seldom eat meat, their viand, if theres any, was mostly canned goods, noodles and vegetables.

NURSING SYSTEM REVIEW CHART Name: Gina Mae Divina(Mother) Temp.: 37.1 0CPulse Rate: 82 bpm Resp. Rate: 20cpm BP: 110/70 mmhg_ Temp.: 36.9 0CPulse Rate: 66 bpm Resp. Rate: 18cpm BP: 110/70 mmhg_ Temp.: 36.8 0C Pulse Rate: 70 bpm Resp. Rate: 17cpm BP: 110/80 mmhg_ INSTRUCTIONS: Place an [X] in the area of abnormality. Comment at the space provided. Indicate the location of the problem in the figure using [X]. EENT: [ ] impaired vision [ ] blind [ ] pain [ ] reddened [ ] drainage[ ] gums [ ] hard of hearing [ ] deaf[ ] burning [ ] edema [ ] lesion [] teeth Assess eyes, ears, nose throat for abnormalities. [x ] no problem RESPIRATORY: [ ] asymmetric [ ] tachypnea [ ] apnea [ ] rales [ ] cough [ ] barrel chest Untrimmed nails (X) [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic Assess resp. rate, rhythm, pulse blood breath sounds, comfort [x] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachypnea [ ] numbness [ ] diminished pulses [ ] edema [ ] irregular [ ] bradycardia [ ] tingling [ ] absent pulses [ ] fatigue [ ] murmur [ ] pain

Assess heart sound, rate, rhythm, pulse, blood pressure. Circulation, fluid retention, comfort [ ] no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dysphagia [ ] rigidity [ ] pain Assess abdomen, bowel habits, swallowing bowel sounds, comfort. [x] no problem GENITO-URINARY AND GYNE: [ ] pain [ ] urine color [ ] hematuria [ ] discharge Assess urine frequency, control, color, Comfort, gyne bleeding, discharge [ ] no problem NEURO: [ ] paralysis [ ] stuporous [ ] seizures [ ] lethargic [ ] comatose

Dry skin (XXXX)

[ ] vaginal bleeding [ ] nocturia odor,

[ ] unsteady

[ ] vertigo [ ] tremors [ ] confused [ ] vision [ ] grip Assess motor, function, sensation, LOC, strength Grip, gait, coordination, speech [x] no problem MUSCULOSKELETAL AND SKIN: [ ] appliance [ ] stiffness [ x] itching [ ] petechiae [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] deformity [ ] wound [ ] rash [ ] skin color [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic

[ ] moist

Assess mobility, motion, gait, alignment, joint function skin color, texture, turgor, integrity [x] no problem Legend: First assessment: February 8, 2011 Second assessment: February 14, 2011 Third Assessment: February 15, 2011 NURSING SYSTEM REVIEW CHART Name: Sherela Enloran (daughter) Temp.: 37 0CPulse Rate: 90 bpm Resp. Rate: 18cpm BP: N/A Temp.: 36.6 0CPulse Rate: 87 bpm Resp. Rate: 19cpm BP: N/A Temp.: 36.8 0C Pulse Rate: 89 bpm Resp. Rate: 18cpm BP: N/A INSTRUCTIONS: Place an [X] in the area of abnormality. Comment at the space provided. Indicate the location of the problem in the figure using [X]. EENT: [ ] impaired vision [ ] blind [ ] pain [ ] reddened [ ] drainage[ ] gums [ ] Hard of hearing [ ] deaf [ ] burning [ ] edema [ ] lesion [ ] teeth Assess eyes, ears, nose throat for abnormalities. [x ] no problem RESPIRATORY: [ ] asymmetric [ ] tachypnea [ ] apnea [ ] rales [ ] cough [ ] barrel chest [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic Assess resp. rate, rhythm, pulse blood breath sounds, comfort [x] No problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachypnea [ ] numbness [ ] diminished pulses [ ] edema [ ] irregular [ ] bradycardia [ ] fatigue [ ] murmur

[ ] tingling

[ ] absent pulses

[ ] pain

Assess heart sound, rate, rhythm, pulse, blood pressure. Circulation, fluid retention, comfort [ ] no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dysphagia [ ] rigidity [ ] pain Assess abdomen, bowel habits, swallowing bowel sounds, comfort. [x xxx] no problem GENITO-URINARY AND GYNE: [ ] pain [ ] urine color

[ ] vaginal bleeding

[ ] hematuria [ ] discharge [ ] nocturia Assess urine frequency, control, color, odor, Comfort, gyne bleeding, discharge [x] no problem NEURO: [ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures [ ] lethargic [ ] comatose [ ] vertigo [ ] tremors [ ] confused [ ] vision [ ] grip Assess motor, function, sensation, LOC, strength Grip, gait, coordination, speech [x xxx] no problem MUSCULOSKELETAL AND SKIN: [ ] appliance [ ] stiffness [ ] itching [ ] petechiae [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] deformity [ ] wound [ ] rash [ ] skin color [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic

Untidy appearance

[ ] moist

Assess mobility, motion, gait, alignment, joint function skin color, texture, turgor, integrity [x ] no problem Legend: First assessment: February 8, 2011 Second assessment: February 14, 2011 Third Assessment: February 15, 2011 Immunization

Immunization Schedule BCG

Sherela Enloran

DPT1 DPT2 DPT3 OPV1 OPV2 OPV3 HEP B1 HEP B2 HEP B3 MEASLES

VI. INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS Date: February 8, 2011 Childs Name: Sherela Enloran Age: 3 years old Ht: 80 cm Wt: 11kg. Temp: 36.8 C ASK: What are the childs problems? None Initial visit: Follow-up visit:__ ASSESS (circle all signs present) CHECK FOR GENERAL DANGER SIGNS YES___NO__ NOT ABLE TO DRINK OR BREASTFEED VOMITS EVERYTHING CONVULSIONS ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES ___NO__

For how long?

Count the breaths in one minute. 18 breaths per minute. Fast breathing?

Look for chest indrawing. Look and listen for stridor.

DOES THE CHILD HAVE DIARRHEA? YES_NO___ For how long? __days Look at the young infants general condition. Is the infant: Abnormally sleepy or difficult to awaken Restless or irritable?

Look for sunken eyes. Pinch the skin of the abdomen. Does it go back : Very slowly (longer than 2 seconds)? Slowly? DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37C YES__NO___ Decide malaria risk Does the child live in malaria area? Has the child visited/traveled or stayed overnight in a malaria area in the past 4 weeks? If malaria risk, obtain a blood smear. LOOK AND FEEL Look or feel for stiff neck Look for runny nose THEN ASK :

For how long has the child had a fever? days. If more than 7 days. Has fever been present almost
everyday? Has the child had measles within the last 3 months? Look for signs of MEASLES Generalized rash and One of these, cough, runny nose, or red eyes. -----------------------------------------------------------------------------------If the child has measles now or within the last 3 months: Look for mouth ulcers If yes, are they deep and extensive? Look for pus draining from the eye. Look for clouding of the cornea. -----------------------------------------------------------------------------------ASSESS DENGUE HEMORRHAGIC FEVER THEN ASK: ---------------------

Has the child had any bleeding from the nose or gums or in
the vomitus or stool? Has the child had black vomitus or black stool? Has the child had persistent abdominal pain? Has the child had persistent vomiting? LOOK AND FEEL: Look for bleeding from nose or gums Look for skin petachiae Feel for cold and clammy extremities Check for capillary refill.___ seconds. Perform tourniquet test if child is 6 months or older AND has no other signs AND has fever for more than 3 days.

DOES THE CHILD HAVE AN EAR PROBLEM? YES__NO__ Is there ear pain? Is there ear discharge? If yes, for how long ___days Look for pus draining from the ear Feel for tender swelling behind the ear. THEN CHECK FOR MALNUTRITION and ANEMIA Look for visible severe wasting. Look for edema of both feet. Look for palmar pallor. Severe palmar pallor ? some palmar pallor? Determine weight for age. Very low? CHECK THE CHILDS IMMUNIZATION STATUS Circle immunizations needed today. ___ BCG ___ DPT1 ___ DPT2 ___ DPT3 ___ OPV1 ___ OPV2 ___ OPV3 ___ HEP B1 ___ HEP B2 ___ HEP B3 ____ MEASLES

No ear infection

No anemia and not very low weight

Return for next immunization on:

Completed (date)

CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or older. Is the child six months of age or older? Yes__No___ Has the child received Vitamin A in the past six months? Yes__No___ ASSESS CHILDS FEEDING If child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years old.

Vitamin A needed today

Yes __No __ Feeding Problems:

Do you breastfeed your child? Yes__No___ If Yes, how many times in 24 hours? ___ times. Do you breastfeed during the night? Yes__No__ Does the child take any other food or fluids? Yes__No__
If Yes, what food or fluids? __rice, vegetables, fish and meat______________________________________________ How many times per day? _3__times. What do you use to feed the child? _____spoon________ If very low weight for age: How large are servings? ______________________________ Does the child receive his/her own serving? ____Who feeds the child and how? _______ Child has no feeding problems

No anemia and not in very low weigh

During the illness, has the childs feeding change?

Yes___No___ If Yes, how? ASSESS CARE FOR DEVELOPMENT: Ask question about how the mother cares for her child. Compare the mothers answers to the Recommendations for Care and Development for childs age. How do you play with your child? How do you communicate with your child? ASSESS OTHER PROBLEMS None Care and development problems

VII. HOME AND ENVIRONMENT a) Housing

The living space of the house is really small and adequate just for them. The house is divided into two rooms, one-fourth of the house is occupied by the store, while three-fourths for the bedroom. They used electricity for lighting. The window of the house is the store itself. It has no living room and a comfort room. They cook outside the house, beside the comfort room. They all sleep together in their bedroom. Presence of breeding sites of vectors of diseases such as mosquitoes are seen outside the house. They store their foods by using food containers. Used clothes just left dumped inside the room and lots of hang clothes are seen. They cook their food at a dirty kitchen outside their house, in front of the laundry area and comfort room, by using firewood. Fire hazards are noted, such as house made of wood and they use firewood in cooking in the house.

a) Water Supply

For the water supply, they use faucet and they are sharing it with the other households near them.

a) The Kitchen

They cook through a firewood, their kitchen is outside their house near the
laundry are and the toilet.

a) Toilet The toilet is shared with the other households near them, since they are only renting the place.

a) Garbage disposal

The place their garbage in sac beside the house, and when the Garbage track arrives they throw it away.

a) Sanitation Condition The area and the house itself have a really poor sanitation. It is very exposed to fire hazards and vector sites that may cause danger to the people living there.

a) Drainage Sytem The drainage system is exposed to the individuals living there, especially
to our chosen family since it is just beside their house, and the drainage are clogged with garbage and leaves.

a) Kinds of Neighbors Low income settlers. Their past time is playing cards, chatting with neighbors, and staying outside their houses. Only a few couples were married, and they seem to be very suspicious of interviews. They are lively neighbors and satisfied with their life.

a) Social and Health facilities available

For their health facilities, they seek health care services at the health
center. There are also stores around the area.

a) Transportation

a. For their transportation, they ride jeepneys and motorcycles.

VIII. FAMILY COPING INDEX

SCALE AREAS 1.)Physical independence - Family providing partially the needs of the members with the support of the separated father of the children 1 3 5 JUSTIFICATION Each member of the family does not have a physical problem that inhibits or affects their activities of daily living.

2.)Therapeutic independence - they have their own traditional treatment whenever diseases occurs

3.) Knowledge of the health condition - the family does not used to go to heath center to seek consultation 4.) Application of principles of general hygiene - Familys views on sanitation and proper personal hygiene and adequate rest and relaxation. 5.) Health attitude - This category is concerned with the way the family feels about health care in general, including preventive services, care of illness and public health measures. 6.) Emotional competence - This category has to do with the maturity and

The family is aware of the right procedure for treatment but the mother wasnt able to grasp its importance, just like when her daughter got sick with symptoms of dengue, she still chose to treat it at home through drinking of Tawa-tawa than taking her to the hospital. They lack knowledge about any condition that might lead them into complications and severity of possible illnesses that they could acquire.

Garbage is not properly disposed; they are not practicing the segregation of wastes. And they do not have a compost pit of their own Lack of storage facilities

Accepts health care advice in some degree but with reservation. The mother seldom consults at the health center. The family gives little importance on their dental care. Some of the water containers use in storing drinking water is uncovered. The family sees life as what it is and although they have a lot of problems in life the family accepts their situation and satisfied with

Legend: 5-complete competence 3-moderate competence 1-incompetent

IX. Schematic Presentation of Family Health Problem

SOCIAL

BIOLOGICAL

Economic

Political

Cultural

Genetic

Physical

Mother : 2nd year high school housewif e.

Father: High school graduat e Unemploye d

Mother seldom attends the community meetings & gatherings The familys knowledge about some services provided by the government is limited only.

The mother believes that taking certain herbal plants and maintaining her diet treats her disease.

Paternal and maternal sides have both history of hypertension

Father: drinks occasio n-ally. He had an history of Stroke last year 2010.

Mother: When she has headache she relieves it through taking Paracetamo

Financially unstable

ENVIRONMENTAL

Drainage Improper clogged with leaves garbage and disposal: garbage segregation not practiced

Toilet type: water-sealed

Presence of improper food storage

Drainage and stagnant water beside the house, kitchen, and laundry area

Lots of clothes hanged around the bed room.

open store window

Flies seen over the area and possible for rodents

Presence of breeding sites of mosquitoes and rodents

Susceptibility to transmission of harmful microorganisms or vectors within family members Health threat: Improper garbage disposal; Presence of breeding or resting sites of insects, rodents and other vectors; Poor personal hygiene; Accident hazards; Unsanitary food handling and preparation

Health deficits: HYPERTENSION

IX. FAMILY NURSING CARE PLAN

Priority #1 CUES HEALTH PROBLEM FAMILY NURSING PROBLEMS Inability to provide a home/ Environment which is conducive to health maintenance and personal development due to -inadequate knowledge of importance of hygiene and sanitation, -lack of skill in carrying out measures to improve sanitary condition GOAL OF CARE OBJECTIVES OF CARE INTERVENTION MEASURES METHODS OF NURSEFAMILY CONTACT Home Visit EVALUATION

Subjective: Presence of daghan breeding lamok labi or resting na sites of pagkagabii insects, rodents, as and other verbalized vectors by the mother

After nursing intervention the family will be able to improve environmental condition to eliminate risk of vectorborne and carrier diseases.

After nursing intervention the family will be able to: a. identify possible breeding sites of insects, rodents and vectors. a. take measures in maintaining sanitary surroundings. b. identify and demonstrate ways of eliminating breeding sites of insects, rodents, and

1. Discuss with the family the importance of maintaining clean surroundings. 2. Educate the family about possible breeding sites of insects, rodents and other vectors. 3. Provide sufficient information about diseases brought about by insects and other vectors. 4. Demonstrate methods in eliminating breeding sites.

1. The family was able to identify breeding sites of insects, rodents and vectors. 2. Identified ways of eliminating breeding sites of insects, rodents and other vectors.

Objective: -stagnant water

other vectors.

Priority #2 CUES HEALTH PROBLEM FAMILY NURSING PROBLEM GOAL OBJECTIVES OF CARE INTERVENTION MEASURES METHODS OF NURSEFAMILY CONTACT EVALUATION

Subjective: Diretso na ibutang sa basurahan as verbalized by the mother. Objective: Scattered garbage outside their house No garbage can

Improper garbage disposal as a health threat.

1. Inability to properly segregate and dispose due to lack of awareness on proper waste disposal. 2. Inability to appreciate the importance of garbage disposal.

After nursing intervention the family will be able to demonstrate correct ways of garbage disposal.

After nursing intervention the family will be able to: a. Identify and classify types of waste as biodegradable and nonbiodegradable.

1. Provide teachings about the correct ways in garbage segregation

Home visit

At the end of nursing intervention, the mother started to clean the home environment and sorroundings atleast once a day and place a sack for their garbage to be placed.

b. Practice proper method of waste management.

2. Educate the family about the risks and effects of improper garbage disposal to promote better compliance.

3. Encourage the family to maintain environmental sanitation by utilizing proper garbage containers.

Priority #3

CUES/ DATA

HEALTH PROBLE M Poor Drainage System as a health threat.

FAMILY NURSING PROBLEM Inability to provide a home environment conducive to health maintenance and personal

GOAL OF CARE At the end of 20 minutes, the client will be able to acknowle dge the

INTERVENTION PLAN OBJECTIVES OF CARE NURSING INTERVENTI ON Health teachings about the ff.: a. Benefits of having a clean drainage system. METHOD NURSEFAMILY CONTACT Home Visit RESOURCES NEEDED / REQUIRED -Expenses for transportation of the student nurses that will go to the family.

Subjective: Sa makita ninyo ang kanal namo walay tabon ug usahay ra

At the end of 20 minutes, the family will be able to: a. Identify the benefits of having a clean and

-Time and effort of the student nurse and family members.

malimpyoha n as verbalized by Mrs.

development due to: a. Inadeq uate knowle dge about the importa nce of sanitati on and preventi ve measur es. b. Lack of skills to improve home environ ment

Objective: -Open Drainage made out of soil -Presence of scattered barbecue sticks,cellophanes -Pungent odor

importan ce of having a clean drainage effectivel y.

close drainage system. b. Enumerate the disadvantag es of unclean drainage c. Emphasize the importance of keeping the drainage clean.

b. Disadvan tages of unclean drainage. c. Importan ce of keeping the drainage clean.

-Broomstick,

Priority # 4

XI. ACTUAL IMPLEMENTATION FIRST VISIT

Date: February 8, 2011 Our first exposure in the area, we were tasked to assess six families in each pair. We were able to survey the area and assess and interviewed six families, and we noticed that some families are not open to give data about their families. Our chosen family for the care study should be under the required qualities. Since day one was the first meeting with the family, we focused more on establishing trust and rapport with the family members. We introduced ourselves and explained the purpose of our visit and succeeding visits. We were able to collect data needed stated in the assessment sheet. We also observed the environment and identify specific applicable problems in their area. At first, the mother was not that open to talk about her family, since she was another woman of her live-in partner, and for her its a private data. Since, only the mother and child were available during that time, the fathers data are provided by the mother alone. A simple physical assessment was also done and we were able to impart health teachings to them SECOND VISIT Date: February 14, 2011 In our second visit, we were not able to conduct a continued assessment and interview due to limited time, because we were busy preparing for our micro-teaching on the next day. In this day, We focused on distributing our invitation cards for our micro-teaching on the next day and buy the needed materials and foods. We also gave invitation card to our FCP family and THIRD VISIT Date: February 15, 2011 During third visit, We continued assessing the family and identified heath threats and provided them with additional health teachings. We also took pictures of the area and the family members, we were not able to meet the head of the family again.

XII. RECOMMENDATION

The rest of the family is advised to go to the nearest health center for more consultations if they would acquire any illness. The health center can also be helpful in the prevention of any diseases. I also told them to go to the Germans Doctor if they need check up because it is free and the doctors there can help them.

XIII. EVALUATION

As part of our requirement as nursing students of Liceo de Cagayan University, we were exposed at Bulao, Iponan, Misamis Oriental. I was able to render care to the Caler family for 5 home visits Bulao, Iponan, Misamis Oriental. During those visitations, the family was being assessed and various problems were being identified which needed attention in order to improve the family living condition. In those problems I had able to identified, I was able to give nursing care based on the knowledge that I learned from school. After giving them the interventions, the family became knowledgeable of the importance of ones health and the importance of having a clean safe and disease free environment. This experience made me realized the true essence of being a health care provider. I was able to experience rendering care not just to this certain family but also to the community people and its not easy. But even if this is so, I felt challenged and I enjoyed the times when we were walking under the scorching heat of the sun. Blending with the community people and mingling with them gave me a feeling of satisfaction to be accepted as health care providers. I was able to touch and made even a difference to the lives of the family I cared for and so with those people in the community.

XIV. BIBLIOGRAPHY

Community Health Nursing Service Section, National League of Philippine Government Nurses, Inc.,Community Health Nursing Services in the Philippines, 9th Ed.

Maglaya, Arceli, Nursing Practice in the Community, 4th Ed.Argonanta Corporation, Marikina City, Philippines, 2004.

Kozier et al, Fundamentals of Nursing, 5th Ed. Pearson Education Asia Ptc. Ltd., Singapore, 2002.

Lippincott et al, Manual of Nursing Practice, 7th Ed. Philippines Edition. Gopson Papers Ltd, Noida, India, 2001.

Integrated Management of Childhood Illness, Department of Health

Sparks and Taylor. Nursing Diagnosis Reference Manual; 6th Edition. Copyright 2005 by Lippincott Williams and Wilkins