Name: Epifrancia Hernandez Age: 70 years old Sex: Female Civil Status: Widow Position in the family: The

eldest and respected one but not the head. Type of family: Extended Educational Attainment: Elementary Graduate Religion: Roman Catholic Diet: Vegetables and Fish Vital Sign: BP: 140/80mmHg PR:79bpm RR:21bpm.

Family History: Father Side (+) DM ; Mother Side (+) Hypertension Husband died 2 years ago; lung cancer. Medical History: Unable to walk since June 2008 cause of mild stroke because of increase cholesterol, diabetes mellitus and hypertension affected her left side arm and leg. Patient stated difficulty in swallowing and also in speech. Now patient will able to speak clearly and can tolerate eating solid food with precaution. Patients stay in bed since she cannot walk and use bedside bedpan for toileting purposes. She also say they call the barangay health worker for the monitoring of her blood pressure and have a maintenance drug of Simbastatine, Trimetazine, Lemiteride, Amlodipine which she taking for almost 3 years. Type of House: Cocrete Cooking Facility: Woods Water Resources: Cavite District Water Supply (for drinking they boiled it) Garbage disposal: Open main dump pit with presence of flies and uncovered trash can.

Health Problem

Family Nursing Problem

Inability to decide about taking appropriate actions due to failure to comprehend the nature and scope of the problem.

Goal of care

Objectives of Care

Poor environmental sanitation: Improper waste disposal

Within 4 hours of nursing interventions, the family will be able to determine the importance of practicing proper methods on waste disposal.

After two home visits, the family will be able to: 1. identify the different ways on proper disposal of garbage such as: a. use of compost pit with cover; b. segregate the non-biodegradable and biodegradable materials; c. recycling of canbe-used garbage; d. reusing or selling of some garbage like cans, bottles and plastics. 2. enumerate the proper techniques on keeping the surroundings clean and through using proper method of waste disposal;

Interventions Nursing Method of Interventions Nurse Family Contact Provide the family Home Visit
information about the proper ways on waste disposal such as segregation of biodegradable from nonbiodegradable wastes and demonstrate the methods 2. Explore with the family the advantages and disadvantages of the different methods of waste disposal 3. Emphasize the importance of practicing proper garbage disposal with the family

Evaluation

Resources Required

Material Resources: Visual Aids on methods of regulating fertility Human resources: Time and effort of the student nurse and family

Goal met. After 2 home visits conducted with nursing interventions, the family was able to understand the importance o practicing the proper method of waste disposal

3. define the meaning of proper garbage disposal and its advantages; 4. recognize the possible effects of garbage burning; 5. verbalize understanding about the importance of practicing proper waste disposal

4. Emphasize the importance of practicing proper garbage disposal with the family

Criteria o Nature of the problem Health threat

Computation 2/3 x 1

Actual score 0.66

Justification The problem is a health threat, because it can conducive to health and may contribute to develop health problems. The problem is easily modifiable by placing proper waste disposal and perform proper waste segregation.

2. Modifiabili ty of the problem Easily modifiable

2/2x 2

3. Preventive potential

3/3 x 1

The preventive potential highly preventive if the family recognize the importance of clean and healthy environment. The family recognize as problem that needing urgent attention

4. Salience

2/2 x 1

Total Score

4.66

Health Problem Presence of health threat Accident hazard (pointed/s harp objects improperl y kept)

Family Nursing Problem Inability to provide a home environment conducive to health maintenance due to:

Goal of Care

Objectives Of Care -After a nursing intervention the family will take appropriate action to manage proper storage of sharp object out of reach of children. -Be able to learn first aid measure in case of accident sharp injury.

Nursing Intervention -Discuss the family possible ways of providing proper storage of sharp objects. -Explain the sharp objects must keep in safe site that cannot be reached of children. -Caution elderly family member that do not leave sharp object in the surrounding. -Do not let the children to play with the sharp objective. -Emphasize the need Protective precaution When using sharp Objects. -Demonstrates to The family the steps Of first aid in the Case of sharp accident.

Intervention Plan Method of nurse family contact Home Visit

Resources Required -Material Resources: Visual Aids to teach proper precaution in handling sharp objects. -Effort and Time of the student nurse and family.

After a nursing intervention the family will understand the need of preventive Lack of measure in protecting knowledge from injury of of sharp preventive object. measure

Accident Hazard (Sharp/pointed objects improperly kept)

Criteria 1. Nature of the problem - Health threat

Computation 2/3 x 1

Actual score 0.66

Justification The problem is a health threat, because it can be a potential for accident

2. Modifiabili ty of the problem - Easily modifiable

2/2x 2

The problem is easily modifiable by placing sharp objects in a safe place and container. Make sure that is unreachable by children.

3. Preventive potential

3/3 x 1

The preventive potential highly preventive if the family recognize the potential accident it will cause. The family recognize as problem but not needing urgent attention

4. Salience

1/2 x 1

Total Score

5.66

Name: J. M Age: 53 years old Date of birth: January 28, 1959 Gender: Male Civil Status: Married Position in the family: Head of the Family Type of family: Extended Educational Attainment: College undergraduate (2nd year) Criminology Religion: Roman Catholic Vital Sign: BP: 140/100 PR: 83 bpm RR: 21 bpm

Medical History: (+) Hypertension (+) Diabetes Mellitus Laboratory Results: (+) gallbladder polyps creatinine

Medicines : 1. 2. 3. 4. 5. 6. Human Insulin 18 before meal (am) Ditiazem 60 mg 1 tab. 2x a day Sodium Carbonate- 650mg 1 tab 3x a day Allupurinol- 100mg 1 tab after lunch Catapres- 150 mg 1 tab bedtime Follic Acid 1 capsule bedtime

Before meds: Herbal med: - tubu-tubuhan - guyabano House Background: Mr. J.M. have a 3 siblings. The eldest is 19 years old taking up tourism at Cavite State University, the second to eldest is 18 years old taking up Engineering at PUP and the youngest is 14 years old high school . The type of house is concrete and has a good ventilation. They most likely eat sea foods, meats, preservative foods, and fish. The drinking water came from alkaline water. Mr. J.M. work is piggery and presently he has a 10 pieces of pigs.

Family Health Proble m

The Head of the Family has a diabetis mellitus

Family Nursing Problem

Ineffective Therapeutic regimen management related to: family patterns of health care verbalizes desire to manage the illness failure to include treatment regimens in daily routines. Failure to take action to reduce risk factors

Goal of Care

Objective Nursing of care Intervention

-Ascertain clients understanding of condition and treatment needs

Rationale

Method of family Contact

-Home Visit -Nurse/ Patient interview

Resourc es required
Human Resources : Time and effort of both the nurse and the clients. Financial Resources : Money for the nurses transportat ion.

Evaluation

After 30 minutes of nursing intervention the head of the family will be able to : Demonstrat e behaviors in lifestyle necessary to maintain therapeutic regimen. - Verbalize acceptance of need to change in actions to achieve agreed- on health goals -

After nursing intervention the head of the family which is the father will be able to: Verbalize acceptance of need to desire to change actions to achieve agreed- on health goals - Participate in problem solving of factors interfering with integration of therapeutic regimen .

-so that he can make informed decisions about managing self care. -to assist client to problem solve solution. - to encourage continuation of desired behaviors - enhances commitment to plan, optimizing outcomes. -Promotes early recognition of changes, allowing proactive response.

- Use therapeutic communication skills - provide positive reinforcement for efforts - Promotes client participation in planning and evaluating process. - assist client to develop strategies for monitoring therapeutic regimen.

After nursing intervention the head of the family was able to : Demonstrate behaviors in lifestyle necessary to maintain therapeutic regimen.

Criteria 1. Nature of the problem - Health deficit

Computation 3/3 x 1

Actual score 1

Justification The problem is a health deficit, because there are instances of failure in health maintenance

2. Modifiability of the problem - Easily modifiable

2/2x 2

Current knowledge, interventions and resources are available to solve the problem

3. Preventive potential

2/3 x 1

0.66

The preventive potential is moderate; resources can be utilized to maintain health and prevent further complications The family recognized the problem as serious and it needs immediate attention

4. Salience

2/2 x 1

Total Score

5.66

General Data Patients Name: P.I Address: Baranggay Lumipa Age: 76 Sex: Male Civil Status: Married Occupation: Barbeque stick maker

Chief complaint: Hypertension Family Assessment

Name I.I J.I D.I E.I A.I J.I

Relation Wife Son Son Son Son Daughter

Age 72 53 47 43 40 36

Sex F M M M M F

Occupation Barbeque stick maker Labor Construction worker Construction worker Construction worker Pabrika (electronics)

Educational Attainment High school undergraduate High school graduate High school graduate High school graduate High school graduate High school graduate

Heredo Maternal: (+) hypertension (+) arthritis

Inability to provide adequate nursing care to the family Criteria 5. Nature of the problem - Health deficit Computation 3/3 x 1 Actual score 1 Justification It is a health deficit that needs proper management to avoid outward consequences in the future.

6. Modifiability of the problem - Easily modifiable

2/2x 2

The problem can be easily modified, the resources needed of the family for managing the condition can be provided by the health center.

7. Preventive potential

2/3 x 1

0.66

Since the condition is already present to the family member, it is to avoid it from worsening.

8. Salience

x1

0.5

Family recognized it as a problem but doesnt need immediate attention

Total Score

4.16

FAMILY HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION NURSING INTERVENTION Educate patient as well as other family member about the complicati ons and manageme nt RATIONALE METHOD OF FAMILY CONTACT Home visit RESOURCES REQUIRED

EVALUATION

Arthritis as a health defecit (rheumatoid arthritis)

Inability to provide adequate nursing care to the family member who has arthritis due to: Lack of adequate knowledge about the disease, complicatio ns, prognosis and manageme nt

After nursing intervention the client will have a lesser attack of arthritis within 4 months

After the nursing intervention the client as well as the family member will: Be knowledgea ble about the disease and have an appropriate action with regards to the condition

It could help them understan d more the nature of the disease and how it can be prevente d. For proper assessme nt, managem ent and prescripti on.

Tell the patient to seek for medical consultatio n.

Photocopy of information about arthritis and its manageme nt including medication s and diet Time and effort of the student nurse and family members.

Goals are met. The client and family members understand the need of proper medical consultation for proper treatment of arthritis.

Criteria

Computation

Actual Score

Justification

Name: A.I Age: 76 years old Sex: Female Civil Status: Married Position in the family: The eldest and respected one but not the head. Type of family: Extended Educational Attainment: High School Graduate Religion: Roman Catholic Diet: Vegetables, Fish, Meat, Chicken Vital Signs: BP:130/80 PR:76bpm RR:19bpm.

Medical History: She stated that last November 2012, she slipped and fell on her left wrist which caused it to be broken. She has not seen any doctors regarding her left broken wrist. Instead, she is putting efficascent oil on the broken wrist and wrapping it with a cloth. Her wrist has edema. She cannot move her left wrist at times because of the pain. She thinks that it will get well on its own. After this incident, she is unable to do chores around the house and cannot carry heavy objects.

1. Nature of the Problem Health Deficit

3/3 x 1

2.Modifiability of the Problem

2/2 x 2

3. Preventive Potential

3/3 x 1

4.

Salience of the Problem

2/2 x 1

It is a health Deficit. Because of the condition of the accident which was caused by the fall, the patient is limited on the daily activity being done every day. The patient cannot be able to lift heavy objects which can cause more damage to the injury. If the patient was able to be seen by the doctors, the condition of the patient will be able to be improved by the treatments being done. The condition can be improved if the patient was able to have a general check up. Because of the idea that it will get well on it own. The patient was not able to get a checkup. But with her condition, the patient is limited on her daily activities, not allowed to carry heavy objects and stress. The condition needs to be seen in order to improve the well being of the patient. If the patient has a limited immobility, he/see may not be able to do as much things as before. However, if the patient was able to have a check-up and improve the condition then, the patient will be able to continue the daily activities

Total Score

Family Health Problem Presence of Health Deficits *Broken Wrist (left):

Family Nursing Problem Inability to make decisions with respect to taking appropriate health action due to : Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner

Goal of Care

Objective Of Care

Nursing Intervention

Rationale

Method of Family Contact Home visit

Resources Required

Evaluation

After Nursing intervention, the family will take necessary action to have the condition check by a medical practitioner.

After 1 hour of home visit the following: 1)The family will ensure that the condition of the patient should be checked immediately 2)The family will know the importance of having medical check-ups

1)Provide knowledge about the important for medical check-up 2)Discuss the type of health resources provided in the community

1)It can increase the awareness about how important it is to have a check up 2)It can mobilize the community to utilize the health resources

1) Time and effort of both student, public health nurses and clients family.

Goals partially Met The broken wrist of the client may cause future health problems if unseen.

Name: Myrna, Ampila Age: 80 years old Sex: Female Civil Status: married Position in the family: The eldest in the family, No. of family members: 4 Type of family: nuclear Educational Attainment: 3rd year high school Religion: Catholic Diet: rice, chicken, fish and vegetables Vital Sign: BP:150/80 PR:72bpm RR:16bpm. Temperature:36.4

Family History: Father Side (+) DM Mother Side (+) Hypertension Medical History: Myrna has history of stroke in 2006, has vision problems and cannot speak since patient had a stroke, patient has hypertension and drinks amlodipine once a day for high BP. Patient is unable to clean their house due to disabilities and the children of the patient do not have regular schedule of cleaning the house. Type of House: concrete and wood Cooking Facility: LPG

POOR ENVIRONMENTAL SANITATION

CRITERIA 1. Nature of the problem -health threat

COMPUTATION 2/3 x 1

ACTUAL SCORE 0.67

JUSTIFICATION The problem is a health threat because a dirty environment/ surroundings may cause communicable diseases

2. Modifiability of the problem -easily modifiable

2/2 x 2

The problem is easily modifiable because the family can easily maintain a clean environment by regular cleaning of their house The problem is highly preventable if the family members comply with the instructed cleaning schedule of their house

3. Preventive potential -high

3/3 x 1

4. Salience of the problem -a condition or problem not needing immediate attention

2/2 x 1

The problem does not need immediate attention since the family cleans their house but not on a regular basis.

TOTAL SCORE

4.67

Family Health Problem -poor environmental sanitation as a health threat -dirty walls and sleeping areas, presence of many flies and bugs, and dusty walls and furniture, pieces of garbage, dried leaves and other trash around the house.

Family Nursing Problem Inability to provide a home environment conducive to heath maintenance and personal development due to: Lack of knowledge of the importance of hygiene and sanitation

Goal of Care

Objective Of Care

Nursing Intervention

Rationale

Method of Family Contact Home visit

Resources Required

Evaluation

After 30 minutes Nursing intervention, the family will be able to effectively promote and maintain an environment with good sanitation.

After 30 minutes of home visit the ff: 1.) The family will be able to demonstrate effective cleaning of the different parts of their house and their environment

1.Reinforce a cleaning schedule that should be done at least once a day

2. Emphasize the importance of a clean and healthy environment.

3. Discuss the techniques and methods used in cleaning and sanitizing

-The family should follow a cleaning schedule to promote and maintain a clean environment -knowing the importance of a clean and healthy environment will motivate the family to clean -so that family will be able to properly clean the different parts of their house and environment.

Time and effort of the student and the family.

. Goals are met. The family was able to demonstrate effective cleaning of the different parts of their house and their environment.a