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Family health Nursing level of CHN practice directed to the CHN as the unit of care with HEALTH as the

goal and NURSING as the medium. 2 of more individuals joing by ties of blood, marriage, or adoption.

Focus: primi gavida, heart condition, mental disorders

Community: geographic and sociocultural connotations

Family case Load: the number and level of families a nurse handles at any given time

Types of families: Nuclear, Extended, 3 generations, dyad, single-parent, step-parent, blended, single

adult living alone, living-in, no-kin, compound, gay, commune

Stages of Family life cycle: newly married couple, childbearing, preschool age, school age, teenager,

middle-age, retired and death

Health tasks of family:

1. Interruption of health or development2. Seeking health care3. Managing health and non-health crises4. Providing nursing care to the sick, disabled, and dependent member of the family5. Maintain reciprocal relationship with community and health institution

Family nursing problems: arises when the family cannot effectively perform health tasks

Nurses role in family health nursing:

1. Health Monitor2. Provider of care3. Coordinator4. Facilitator5. Teacher6. Counselor

Initial database for family nursing practice: Family structure, characteristics and dynamics

1. Members of the household and relationships to the head of the family2. Demographic data age, sex, civil status3. Place of residence4. Type of family structure5. Dominant family member in terms of decision making, especially in matters of health6. General family relationship/dynamics, presence of any conflicts between members.

Socio-economic and cultural characteristics

1. Income and expensesa. Occupation, place of work and each income

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b. Adequacy to meet basic needsc. Who makes decisions for spending

2. Educational attainment of each other3. Ethnic background and religious affiliation4. Significant other- roles they play in the family5. Relationship of the family to larger community

House and environment

1. Housinga. Adequacy of living spaceb. Sleeping arrangementc. Prescence of breeding or resting site of vectors of diseased. Presence of hazardse. Food storage and cooling facilitiesf. Water supple source, ownership, portabilityg. Toilet facilities type, ownership, sanitary conditionsh. Drainage system type, sanitary condition

2. Kind of neighborhood3. Social and health facilities available4. Communication and transportaition facilities available

Health status of each family member

1. Medical and nursing history indicating current or past significant illnesss or belief and practiceconductive to health illness

2. Nutritional assessmenta. Anthropometric data: measure of nutritional statusb. Dietary history specifying quantity and quality of feed/nutrients intake per dayc. Eating/feeding habits

Development assessments of infants, toddlers, and preschoolers

- Risk factor assessment indicating presence of major and contributing modifiable risk factors forspecific lifestyle (cigarettes, obesity, etc)

- Physical assessment indicating presence of illness state- Result of laboratory.diagnostic and other screening procedure supportive of assessment findings

Values, habits, practices on health promotion, maintenance and disease prevention

1. Immunization status of family members2. Healthy lifestyle practices3. Adequacy of: rest/sleep, exercise, use of protective measures4. Use of promotive preventive health services

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A typology of Nursing Problems in family nursing care

First level assessment

1. Presence of wellness condition potential.readiness is a clinical judgement about a direct intransmition from specific level of wellness or capability to a higher level.

a. Wellness potential nursing judgement on wellness state based on clients performance,but NO explicit expression of clients desire

b. Rediness for enhanced wellness expression of desire to achieve a higher level of statefunction in specific are on health promotion and maintenance.

i. Potential for enhanced capability for:1. Healthy lifestyle2. Health maintenance3. Parenting4. Breastfeeding5. Spiritual well-being

ii. Rediness for enhanced capability for:1. SAME ^

2. Presence of health threats conditions that are conductive to disease, accident or failure torealize ones health potential

a. Family history of hereditary conditionb. Threat of cross infection from a communicable diseasec. Family size too big to resourced. Poor home conditione. Stress provoking factorf.

Family nutritional habitsg. Accident hazrdsh. Poor home conditions

i. Inadequate spaceii. Lack of food storageiii. Polluted water supplyiv. Presence of breeding site for vectorsv. Improper garbagevi. Unsanitary drainage system

vii. Poor ventilationviii. Air/noise pollution

i. Unsanitary food handling and preparationj. Unhealthy lifestyle and personal habits

i. Alcoholii. Smokersiii. Inadequate footwareiv. Raw meat

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v. Self-medicationvi. Sex habits

vii. Dangerous sportsviii. Inadequate rest

ix. Lack of exercisex. Lack of relaxationxi. Non-use of protective equipments

k. Inherent personal characteristics (poor impulse control)l. Health history which induce the occurrence of health deficit (previous hx of difficult

labor)

m. Inappropriate sole assumption (child assuming role of parent)sn. Lack of immunization.inadequate immunization status specifically of childo. Family disunity

i. Seld-oriented behavior of memberii. Conflictsiii. Intolerable disagreements