39160273 family-case-study

FIRST LEVEL ASSESSMENT

I. Family Structure, Characteristics, and Dynamics

DEMOGRAPHIC PROFILE

PARENTS Mother FatherName: Lerma Samilin Dominador SamilinAddress: Purok 6 Brgy. Bagahabag, Solano, Nueva VizcayaMarital Status: Married (Common Law)Birth date: August 6, 1987 October 26, 1984Age: 22 y/o 25 y/oPlace of Birth: Solano, Nueva Vizcaya Solano, Nueva VizcayaReligion: Roman Catholic Roman CatholicEducational Attainment: Elementary level Elementary - undergraduate

CHILDREN 1st 2nd

Name: Melody Samilin Jomar SamilinMarital Status: SingleBirth date: June 6, 2000 April 6, 2004Age: 9 y/o 5 y/oPlace of Birth: Solano, Nueva Vizcaya Bayombong, Nueva

VizcayaReligion: Roman Catholic Roman CatholicEducational Attainment: Elementary – Grade 5 Kindergarten

II. Socio-economic and Cultural Characteristics

Mother FatherOccupation/Job: Housewife “Buy and Sell” of coconutStatus of Employment/Work:

…. Self-employed

Other Source of Income: Labor –tricycle driverIncome (Php): 4, 000.00/month

III. Home and Environment

A. HOUSINGHousing Status: OwnedNature of Housing: One-storeyHousing Materials: WoodenHousing Ventilation and Lighting Facilities Not at all ventilated and they are using

electricityNumber of Bedrooms; # of members/bedroom

There is one bedroom and three members per bedroom

Animals/Pets present in the house (inside and outside):

Dogs, Chickens/Ducks

Pests/Insects present in the house: Mosquitoes, Rats, Cockroach

B. KITCHENFood Storage: They store it coveredOrderliness and Cleanliness of Kitchen Slightly clean and orderly

Availability of Water in the Kitchen Available alwaysWater SourceSource of Drinking Water Supply Pump well

Availability and Accessibility of Water Source per House

It is always available

Water Storage for Drinking Water JugMethods Used in Making Water Safe for Drinking

NONE

Methods of Collection of Water They directly fetch it from the water pump

C. WASTE/GARBAGE DISPOSALMethod of Garbage Disposal They use segregationPresence of Garbage Can/Sacks Biodegradable and Non-biodegradableD. EXCRETA/TOILETTypes of Toilet Water sealed toiletSanitary Condition of Toilet It is not clean, there are scattered plastics

around the toilet and there is no privacy

IV. Health Status of each Family Member

Mother Father ChildrenIllness/Diseases usually encountered

Migraine Seasonal Flue, cough, colds

Nutritional Status They usually prepare rice and vegetablesEating Pattern They eat only two times in a day

V. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

A. Immunization status of Family Members

The two children have completed the vaccines except for the eldest who doesn’t have Hepa-B vaccines

B. Adequacy of rest and sleep They usually sleep 6-8 hours in a dayElimination Pattern Once a day

TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE

First Level Assessment

A. Health Threat

Accident hazards like: - Fire hazards because the house is wooden and they are using a charcoal in cooking and the kitchen is just inside the house.

Faulty healthful nutritional/eating habits- Inadequate food intake because they only eat two times in a day

Poor environmental sanitation- Inadequate living space- Inadequate personal belongings/utensils- Lack of food storage facilities-Air pollution due to the foul odor coming from the piggery near them- Presence of breeding places of insects and rodents

Unhealthful lifestyle and personal habits/practices- Self medication- Engaging in dangerous sports- Lack of immunization status specially of children

B. Health Deficit

- Illness states, regardless of whatever it is diagnosed or undiagnosed by medical practitioner

C. Foreseeable Crisis Situation

- Entrance to school

1st LEVEL ASSESSMENT 2nd LEVEL ASSESSMENT Prioritizing Health ProblemsHealth Problem Cues/Data Family Nursing Diagnosis Criteria Computation Actual

ScoreJustification

1. Accident hazards like: Fire hazards

-the house is made up of wooden materials-they use charcoal in cooking-the kitchen is just inside their house

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. lack of family income b. ignorance of preventive measures

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge

Nature of the Problem

2/3x1 2/3 It is a health threat

Modifiability of the problem

1/2x2 1 The family has insufficient money in making a kitchen outside their house

Preventive Potential

3/3x1 1 It is easily prevented if they have adequate knowledge about this

Salience 0/2x1 0 Low salience because they are used to it already

Total Score 2 2/3


ScoreJustification

2. Inadequate food intake both in quality and quantity

-they only eat two times in a day-they usually prepare vegetables-the husband is the only one who works for the family

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. fear of consequences of diagnosis of problem, specifically: 1. economic/cost implications c. attitude/philosophy in life which hinders recognition/acceptance of a problem

Inability to make decisions with respect to taking appropriate health action due to: a. failure to comprehend the nature of the problem b. low salience of the problem




1/2x2 1 Lack of family income causes them to eat only two times a day


3/3x1 1 It is easily prevented if they know how to balance their diet

Salience 1/2x1 1/2 A problem but not needing immediate attention

Total Score 3 1/6


ScoreJustification

3. Inadequate living space

-they stay in a wooden house approximately 4m x 4m, with only one bedroom, the bedroom also serves as their living room-they are consists of 4 members-the house is divided into 2 parts only, the kitchen and the bedroom

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. inadequate family resources, specifically: 1. financial constraints or limited financial resources 2. lack of space to construct facility b. failure to see benefits of investment in home environment improvement c. lack of skill in carrying out measures to improve home environment




1/2x2 1 Moderate because there is a lack of space to construct facility


3/3x1 1 Transfer of communicable diseases can be prevented if they will increase the living space

Salience 0/2x1 0 Low salience because they are used to this situation and it’s not a felt need or problem

Total Score 2 2/3


ScoreJustification

4. Inadequate personal belongings or utensils

-I noticed that they are lacking of kitchen facilities or utensils

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. inadequate family resources, specifically: 1. financial constraints or limited financial resources b. failure to see benefits of investment in home environment improvement c. lack of skill in carrying out measures to improve home environment




1/2x2 1 The family’s resources are presently not adequate for buying such things


3/3x1 1 The available family resources can be utilized to encourage them in maintaining the good condition of the facilities

Salience 0/2x1 0 It is not a felt need or problem

Total Score 2 2/3


ScoreJustification

5. Lack of food storage facilities

-they do not have a refrigerator to store their foods, even just any food baskets or cabinet-they only save or store it in a bowl or plate and just keep it covered

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. inadequate family resources, specifically: 1. financial constraints or limited financial resources 2. lack of space to construct facility b. failure to see benefits of investment in home environment improvement




1/2x2 1 It will require them financial expenditure in constructing facilities and they lack financial resources


2/3x1 2/3 Resources are limited and there is a lack of space

Salience 0/2x1 0 Low salience because they are already used to this situation

Total Score 2 1/3


ScoreJustification

6. Presence of breeding or resting sites of insects, rodents and other vectors

-there is an irrigation beside their house that can be the breeding place of insects like mosquitoes

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge Inability to make decisions with respect to taking appropriate health action due to: a. failure to comprehend the nature of the problem b. low salience of the problem




1/2x2 1 The family does not recognize the presence of the problem due to inadequate knowledge


3/3x1 1 Communicable diseases can be prevented if they know how to apply the preventive measures and provided that of health teaching

Salience 0/2x1 0 It is not a felt need or problem

Total Score 2 2/3


ScoreJustification

7. Air Pollution -there is a piggery near them and the mother stated that they are annoyed by the foul smelly odor coming from the piggery

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge Inability to make decisions with respect to taking appropriate health action due to: a. failure to comprehend the nature of the problem b. low salience of the problem




1/2x2 1 The family does not have adequate resources and knowledge to solve the problem


3/3x1 1 The foul smelling odor that may cause air pollution can be reduced or removed if the problem is managed adequately as soon as possible

Salience 1/2x1 1/2 The family recognizes it as a problem but it does not see as needing immediate action

Total Score 3 1/6


ScoreJustification

8. Self-medication

-they are used in self medication, the mother uses herbal medicines like oregano for fever and cough-the mother usually takes paracetamol whenever she experiences severe headache

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. attitude/philosophy in life which hinders acceptance of a problem

Inability to provide adequate nursing care to the sick or at risk member of the family due to: a. lack of adequate knowledge about child development and care b. lack of necessary facilities, equipment and supplies for care c. inadequate family resources for care, specifically: 1. financial constraints d. philosophy in life which hinders caring for the sick or at risk member

Failure to utilize community




2/2x2 2 Resources are available and intervention is possible


3/3x1 1 Health teaching will provide them adequate knowledge for giving the correct medications or giving the right care

Salience 1/2x1 1/2 The family recognizes the existence of the problem but it does not see as needing immediate action

Total Score 4 1/6

resources for health care due to: a. unavailability of required care/service b. inaccessibility of required care/service due to: 1. cost constraints c. lack of family resources: cost of medicine prescribed


ScoreJustification

9. Engaging in dangerous sports

-“umaakyat siya ng buko tapos itinitinda niya..” as verbalized by the mother when we asked her the work of her husband-the husband is at-risk for fall

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. inadequate family resources, specifically: 1. financial constraints or limited financial resources b. lack of adequate knowledge of preventive measures c. philosophy in life which hinders recognition of the problem




1/2x2 1 There is no other available work for the father so he need to continue this kind of job until he finds another job that is more convenient


3/3x1 1 Accidents are prevented if health teachings are given

Salience 1/2x1 1/2 The family recognizes it as a problem but does not see it as needing immediate action

Total Score 3 1/6


ScoreJustification

10. Lack of immunization/ inadequate immunization status specially of children

-the first child doesn’t have a Hepa B vaccine

Inability to make decisions with respect to taking appropriate health action due to: a. failure to comprehend the nature of the problem b. low salience of the problem c. inaccessibility of appropriate resources for care, specifically: 1. financial inaccessibility




1/2x2 1 There is a financial inaccessibility for appropriate resources for care


3/3x1 1 It is easily prevented if they have adequate knowledge on the importance of immunizations

Salience 1/2x1 1/2 It is a problem but immediate action is not needed

Total Score 3 1/6


ScoreJustification

11. Illness states, regardless whether it is diagnosed or undiagnosed by medical practitioner

-Mrs. Samilin’s father has been hospitalized before because of some complications, she stated, “nalaglagan siya ng buko noon, ooperahan na sana pero wala naman kaming perang pangpa-opera-her father is in need of an operation

Inability to make decisions with respect to taking appropriate health action due to: a. fear of consequences of actions like economic consequences b. inaccessibility of appropriate resources for care, specifically: 1. financial inaccessibility

Failure to utilize community resources for health care due to: a. lack of awareness of community resources for health care b. failure to perceive the benefits of health care c. lack or inadequate family resources like financial resources


3/3x1 2/3 It is a health deficit and requires immediate intervention


1/2x2 1 Admitting her father for surgery will cause them to spend too much money but they lack financial resources or income


2/3x1 2/3 Moderate because they lack family resources, specifically the financial constraints

Salience 2/2x1 1 A serious problem and immediate attention needed

Total Score 3 2/3


ScoreJustification

12. Entrance to school

-the mother stated that her problem is money for the schooling of their children-Mrs. Samilin is an elementary graduate only while her husband is undergraduate in elementary

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. philosophy in life which hinders recognition of a problem


1/3x1 1/3 It is a foreseeable crisis


1/2x2 1 The family does not have adequate financial resources to spend for the expenses of the children in school


2/3x1 2/3 Resources are limited and intervention is not possible

Salience 1/2x1 1/2 A problem but not needing immediate intervention

Total Score 2 1/2

The Prioritized Health Problems

The list of health condition or problems ranked according to priorities is presented:

Self – medication 4 1/6Illness states, regardless whether it is diagnosed or undiagnosed 3 2/3by medical practitionerEngaging in dangerous sports 3 1/6Inadequate food intake both in quality and quantity 3 1/6Air Pollution 3 1/6Lack of immunization status specially of children 3 1/6Inadequate living space 2 2/3Presence of breeding sites of insects, rodents and other vectors 2 2/3Fire hazards 2 2/3Inadequate personal belongings/utensils 2 2/3Lack of food storage facilities 2 1/3Entrance to school 2 1/2

The Prioritized Health Problems:

1. Self – medication 4 1/62. Illness states, regardless whether it is diagnosed or undiagnosed 3 2/3 by medical practitioner3. Engaging in dangerous sports 3 1/64. Inadequate food intake both in quality and quantity 3 1/65. Air Pollution 3 1/6

FAMILY NURSING CARE PLAN

Health Problem Family Nursing Diagnosis

Goal/Objectives of Care Nursing Intervention Methods of Nurse and Family Intervention

Resources

1. Self – medication Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. attitude/philosophy in life which hinders acceptance of a problem

Inability to provide adequate nursing care to the sick or at risk member of the family due to: a. lack of adequate knowledge about child development and care b. lack of necessary facilities, equipment and supplies for care c. inadequate family resources for care, specifically: 1. financial

After an effective nursing intervention and health teachings, the family will be able to: a. learn the importance of going for check – ups b. learn the disadvantages of self medication c. learn the advantages or importance of using medicines that is prescribed by a physician d. have an idea about health promotion, prevention and health maintenance e. consult the physician for the prescription of alternative medicines and the correct usage

- Provided health teaching to the family on the disadvantages of self medications

- Provided health teaching to the family on the importance of going for check – ups

- Provided health teaching to the family on the importance and advantages of using medicines that is prescribed by a physician

- Provided health teaching to the family about health promotion, prevention and health maintenance

- Provide information on

Home Visit Material Resources- book- visual aids

Human Resources- time and effort of the

nurse and the family

Financial Resources- transportation fee of

the student nurse-

constraints d. philosophy in life which hinders caring for the sick or at risk member

Failure to utilize community resources for health care due to: a. unavailability of required care/service b. inaccessibility of required care/service due to: 1. cost constraints c. lack of family resources: cost of medicine prescribed

the consultation hours of the physician



Resources

2. Illness states, regardless whether it is diagnosed or undiagnosed by medical practitioner

Inability to make decisions with respect to taking appropriate health action due to: a. fear of consequences of actions like economic consequences b. inaccessibility of appropriate resources for care, specifically: 1. financial inaccessibility

Failure to utilize community resources for health care due to: a. lack of awareness of community resources for health care b. failure to perceive the benefits of health care c. lack or inadequate family resources like financial resources

After an effective nursing intervention and health teachings, the family will be able to: a. learn the disadvantages of not undergoing a surgical operation for his “luslus” and the damage made by the accident b. learn the importance of community health center or clinic visit c. learn how to manage or maintain the wellness or health of at-risk member of the family d. ensure that her father will have a regular check-up at the clinic e. decide on a surgical operation for her father

- Provided health teaching to the family on the disadvantages of not undergoing a surgical operation

- Provided health teaching to the family on the importance of community health center or clinic visit

- Provided health teaching to the family on how to manage and maintain the wellness or health of at-risk member of the family

- Provided health teaching to the family about health promotion, prevention and health maintenance

- Discuss with them the courses of action open to them, and the consequences of the health actions on the family





the student nurse-



Resources

3. Engaging in dangerous sports

Inability to provide a home environment which is conducive to health maintenance and personal development due to: a. inadequate family resources, specifically: 1. financial constraints or limited financial resources b. lack of adequate knowledge of preventive measures c. philosophy in life which hinders recognition of the problem

Inability to make decisions with respect to taking appropriate health action due to: a. failure to comprehend the nature, magnitude/scope of the problem b. low salience of the problem c. negative attitude towards the health problem- by negative

After an effective nursing intervention and health teachings, the family will be able to: a. learn the consequences about the work of the husband which is a dangerous one b. apply measures taught to prevent accidents c. learn the diseases or injuries that may happen or occur d. reduce the risk of accidents that may happen e. implement safety rules to prevent injuries

- Provided health teaching to the family on the consequences about the work of the husband which is a dangerous one

- Provided health teaching to the family on applying measures taught to prevent accidents

- Discuss with the family the diseases or injuries that may happen or occur

- Explore with the family the ways of reducing the risk of accidents that may happen

- Emphasize the importance of the preventive measures and the proper body mechanics in relation to the work of the husband





the student nurse-

attitude meant one that interferes with rational decision making d. inaccessibility of appropriate resources for care, specifically: 1. physical inaccessibility, e.g. location 2. cost constraints or economic/financial inaccessibility



Resources

4. Inadequate food intake both in quality and quantity

Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. fear of consequences of diagnosis of problem, specifically: 1. economic/cost implications c. attitude/philosophy in life which hinders recognition/acceptance of a problem


After an effective nursing intervention and health teachings, the family will be able to: a. plan and prepare balanced meals which are within the family’s budget b. learn the importance of eating the balance diet c. learn the disadvantages of skipping meals or not completing the three meals in a day d. learn about nutrition and diet therapy e. know the food supplements that contains the needed vitamins and minerals of the body f. reduce the risk of malnutrition

- Discuss with the family on how to plan and prepare balanced meals

- Provided health teaching to the family on the importance of eating the balance diet

- Provide health teaching to the family on disadvantages of skipping meals

- Provided health teaching to the family about the nutrition and diet therapy

- Discuss with the family the food supplements that contains the needed vitamins and minerals of the body

- Emphasize what malnutrition is about and the factors causing it





the student nurse-



Resources

5. Air Pollution Inability to recognize the presence of the problem due to: a. lack of adequate knowledge b. fear of consequences of diagnosis of problem, specifically: 1. economic/cost implications c. attitude/philosophy in life which hinders recognition/acceptance of a problem


Inability to provide a home environment conducive to health maintenance and personal development due to: a. lack of adequate

After an effective nursing intervention and health teachings, the family will be able to: a. learn the disadvantages of having a piggery near them b. know the factors that may affect the respiratory system of each member c. learn the diseases that may appear from the odor coming from the piggery d. know the factors causing the air to be polluted e. learn some preventive measures to avoid respiratory diseases that may appear f. reduce the risk of having a respiratory tract infections

- Discuss with the family the disadvantages of having a piggery near them

- Provided health teaching to the family on the factors that may affect the respiratory system of each member of family

- Provide health teaching to the family on the diseases that may appear from the odor coming from the piggery

- Provided health teaching to the family about the factors causing the air to be polluted

- Explore ways in applying preventive measures to avoid respiratory diseases and the spread of infection

- Provided health teaching to reduce the risk of having a respiratory tract infection





the student nurse-

knowledge of importance of hygiene and sanitation b. inadequate knowledge of preventive measures c. lack of skill in carrying out measures to improve home environment

Situation:

We are tasked to do a home visit in a family, so when we arrived in Brgy. Bagahabag, my

partner and I chose to interview a family in Purok 6, there we spotted this house, but before we get in

there, we need to walk in the “pilapil” and cross a “little bridge” because there is an irrigation in their

place. We also noticed a piggery in the neighborhood. When we got in there, they are very hospitable

and kind. Then we start interviewing and obtain their demographic profile.

Only Mrs. Samilin is the one who entertained us because her husband is not around. They only

have two children. Mrs. Samilin is a housekeeper while her husband is a vendor of coconut, they call it

“Buy and Sell”, Mrs. Samilin added that her husband is climbing a coconut tree and sell what or how

many he gets. Mr. Samilin is also a tricycle driver and they have a weekly allowance of 1,000.00. We

requested Mrs. Samilin to let us enter their house for evaluation. As we entered the house, the space is

just enough for them, it is made up of wooden materials and it’s not at all ventilated. The first one that

approach us is the bedroom, I guess it also serves as their living room. The house is divided into two

parts only, the bedroom and the kitchen. The floor of their house is not cemented. In the kitchen, we

noticed that they have inadequate utensils and they lack in food storage facilities. They are also using a

charcoal in cooking. But they store the foods or left-over covered. It is slightly clean and orderliness of

the kitchen is good. They are using a water jug for drinking and a plastic drum for household use. We

asked Mrs. Samilin their method in collecting water and she stated that they directly fetched it from the

water pump 5 m away from their house. We also requested them to let us see their C.R. We were

shocked by the scene in their C.R. because it is not clean, the surroundings of the toilet is dirty, there are

scattered pieces of plastics around and there is no privacy. As we continue interviewing Mrs. Samilin, I

noticed that she’s a little bit shy to share problems when we asked her what problem is usually occurring

in their family. She said that their primary problem is money. They are lacking of financial resources

because Mr. Samilin is the only one who works for the family. We also asked what illnesses is usually

encountered by family members, she said that she has a migraine and the two kids usually experience

seasonal flue, coughs and colds. She added that her kids easily gets cough and colds. We found out that

they are eating two times in a day only. One more thing, she told us that her father has been hospitalized

before because of some complications like his “luslus” and “nalaglagan siya ng buko noon”. Mrs.

Samilin said that her father hasn’t yet undergone an operation because of financial problem.

FAMILYCASE

STUDYSUBMITTED TO:

Ms. Erika Medrano

SUBMITTED BY:

Alma Vanessa M. Zapatero

BSN II - F

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39160273 family-case-study

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