First level AssessmentThe process of determining existing and potential health conditions or problems of the family. These health conditions are categorized as:I. Presence of Wellness ConditionStated as Potential or Readiness;a clinical or nursing judgment about a client in transition from a specific level of wellness or capability to a higher level. Wellness potential is a nursing judgment on wellness state or condition based on clients performance, current competencies, or performance, clinical data or explicit expression of desire to achieve a higher level of state or function in a specific area on health promotion and maintenance. Examples of this are the followingA. Potential for Enhanced Capability for: Healthy lifestyle- Ms. Cano prefers to feed her family with vegetables and other organic foods than processed food. They mainly use walking as a means of transportation which serve as their primary exercise. Healthy maintenance/health management- Ms. Cano missed some of her pre- natal check ups. She was one of the clients which I followed up through home visits. Accordingly to her, she doesnt attend to her schedule because of some personal matters Parenting- According to Ms. Cano, the way they discipline their children is the same with the ways of others. The only difference is that they are not too strict but not too loose. Breastfeeding- she practices breastfeeding with her children. Because according to her it is the most economic friendly milk which can be given to her children. B. Readiness for Enhanced Capability for: Healthy lifestyle- preferably walking or using bicycles. Health maintenance/health management- when I followed-up her, she shows the she is interested in her visits at the RHU because after a week, she goes to the RHU for her pre- natal check up and also for the supply of her ferrous sulphate.II. Presence of Health ThreatsAre conditions that are conducive to disease and accident, or may result to failure to maintain wellness or realize health potential. A. Presence of risk factors of specific diseases - B. Threat of cross infection from communicable disease caseC. Family size beyond what family resources can adequately provide- the family size of the family is adequate to the family income of the family. They have only one children who goes to school.D. Accident hazards specify.i. Slippery area especially at their laundry are because based on my home visit, the water there is always overflowing. And there is presence of moss on the floor.E. Faulty/unhealthful nutritional/eating habits or feeding techniques/practices. Specify.i. Inadequate food intake both in quality and quantity- According to Ms. Cano, sometimes if his partner had not yet get his monthly income, they sometimes just have rice porridge for the whole day or if her. They seldom have a meat in their meal because its too expensive according to Ms. Cano.ii. Faulty eating habits- their children often eat junk foods. F. Stress Provoking Factors. Specify.i. Strained marital relationship- Ms. Cano and Mr. Cabugao are domestic partners. Ms. Cano had a child on other man. ii. Strained parent-sibling relationship- Ms. Cano decided to put into a so called adaptation her eldest son because she cannot afford at that time to sustent the needs of her child.G. Poor Home/Environmental Condition/Sanitation. Specify.i. Lack of food storage facilities- The family do not have refrigerator. They just store their foods on the tableii. Due to overflowing of water in their laundry area, there is presence of stagnant water which serves as a breeding place for vector causing diseases such as mosquitoes.iii. The family practices open drainage for their domestic water waste disposal.iv. They have only one light to enlighten their entire house.H. Unhealthy Lifestyle and Personal Habits/Practices. Specify.i. Here are times that her children specially the youngest one walks barefooted. According to Ms. Cano, her child wants to walk without slippers.ii. Poor personal hygieneiii. Inadequate rest or sleepiv. Lack of /inadequate exercise/physical activityv. Lack of/relaxation activitiesI. Health History, which may Participate/Induce the Occurrence of Health Deficit Ms. Cano had a history of abortion.III. Presence of health deficitsThese are instances of failure in health maintenance.A. Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner.i. No illness presence in the family which can lead to a failure to health maintenance.IV. Presence of stress points/foreseeable crisis situationsAre anticipated periods of unusual demand on the individual or family in terms of adjustment/family resources. Examples of this include:A. Marriage Msa. Cano and Mr. Cabugao are domestic partner. They are not married even after having 3 children.B. Pregnancy, labor, puerperium Ms. Cano is currently pregnant. Gravida10 Para4, 30 6/7 weeks age of gestation. B. Abortioni. Out of 9 pregnancy, 5 of them were abortion/ misccariagesC. Loss of jobi. Due to her current conditions, Ms. Cano decide to stop from going to work. She is working as a street sweeper at the DPWHD. Illegitimacyi. Ms. Cano had a child in her first partner.

Second-Level AssessmentSecond level assessment identifies the nature or type of nursing problems the family experiences in the performance of their health tasks with respect to a certain health condition or health problem.I. Inability to recognize the presence of the condition or problem due to:A. Lack of or inadequate knowledge* During my follow- up visit to her, she asked to me what does the importance of the ferrous suplhate and to attend her scheduled pre- natal visit.II. Inability to make decisions with respect to taking appropriate health action due to:A. Failure to comprehend the nature/magnitude of the problem/conditiona. When Ms. Cano is directed to go to the hospital to avail laboratories and ultrasound, she did not go immediately because she said that she does not bring money/ financial to be needed for the said testB. According to Ms. Cano, when someone in her family got ill, she will not immediately seek health professional because according to her, when it is still manageable, it can still cure at home. They will just bring if it cant manage at home/ if it got worse.C. In accessibility of appropriate resources for care, specifically:a. RHU is almost 1km away from their house, while the hospital is mostly 500 meters away from them. The only means of transportation they have is bicycle. When she attends to her pre- natal visit/ when she brings her child to school, she rather walks.III. Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/at risk member of the family due to:A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications, prognosis and management)- B. Lack of/inadequate knowledge about child development and careC. Lack of/inadequate knowledge of the nature or extent of nursing care neededD. Lack of the necessary facilities, equipment and supplies of careE. Lack of/inadequate knowledge or skill in carrying out the necessary intervention or treatment/procedure of care (i.e. complex therapeutic regimen or healthy lifestyle program).F. Inadequate family resources of care specifically: Financial constraintsIV. Inability to provide a home environment conducive to health maintenance and personal development due to:A. Inadequate family resources specifically: Financial constraints/limited financial resources Limited physical resources-e.i. lack of space to construct facilityB. Failure to see benefits (specifically long term ones) of investments in home environment improvementC. Lack of/inadequate knowledge of importance of hygiene and sanitationD. Lack of/inadequate knowledge of preventive measuresE. Lack of skill in carrying out measures to improve home environmentF. Lack of supportive relationship among family membersG. Lack of adequatecompetencies in relating to each other for mutual growth and maturationV. Failure to utilize community resources for health care due to:A. Lack of/inadequate knowledge of community resources for health careB. Failure to perceive the benefits of health care/servicesC. Lack of trust/confidence in the agency/personnelD. Previous unpleasant experience with health workerE. Fear of consequences of action (preventive, diagnostic, therapeutic, rehabilitative) specifically : Physical/psychological consequences Financial consequences Social consequencesF. Unavailability of required care/servicesG. Inaccessibility of required services due to: Cost constraints Physical inaccessibilityH. Lack of or inadequate family resources, specifically Manpower resources, e.g. baby sitter Financial resources, cost of medicines prescribeI. Feeling of alienation to/lack of support from the communityJ. Negative attitude/ philosophy in life which hinders effective/maximum utilization of community resources for health care