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TRANSCRIPT
Family Nursing Care Plan
FAMILY CASE ANALYSIS
Initial Data Base
Family DataFamily ChartEducational AttainmentEconomic StatusHome and EnvironmentHealth Status of the Family MemberValues Habits and Health PracticesSocial IndicesFloor Plan
Family Data
Family X is currently living in Barangay_____________, and has ____ total number of the family members. Approximately, the family is in _____ years of residency in alleged to above address. In terms of the authority, the family is (ex.Egalitaria) wherein the decision is equally distributed to each of them even the members of the family that is not yet employed. Family X is an (ex.extended) family wherein one of the siblings of Mr. and Mrs. X has a recent relation to same sex and now living together. Family X accepted him (gay partner of one of the siblings of Mr. and Mrs. X) as part of the family and one of the source of income related to his work. Family X is also considers a Live-in and Single Parent family.
Family ChartName Age
Sex
Civil Status
ReligionPlace
of Birth
DialectRelation to
Family HeadEmployment Occupation
Mr. M. X 59 M S Catholic GMA Tagalog
employed factory worker
Mrs. Z. X 58 F S Catholic GMA Tagalog live-in-partner unemployed
A. X 50 M S Catholic GMA Tagalogbrother of Mrs. X
unemployed
J. X 48 M S Catholic GMA Tagalogbrother of Mrs. X
employedconstruction
worker
R. X 30 M S Catholic GMA Tagalog son employedconstruction
worker
L. X 28 M S Catholic GMA Tagalog son unemployed
K. X 12 F S Catholic GMA Tagalog granddaughter unemployed
C.X 10 F S Catholic GMA Tagalog granddaughter unemployed
J. X 8 M S Catholic GMA Tagalog grandson unemployed
C 26 M S Catholic GMA Tagalogextended member
employed sales clerk
Educational AttainmentName Elementary High School College
Mr. M. X
Undergraduate
Mrs. Z. X
Undergraduate
A. X
Undergraduate
J. X Graduate
R. X
Undergraduate
L. X
Undergraduate
K. X Grade 6 C. X Grade 4
J. X Grade 2
C Graduate
EXAMPLE
Economic Status
Family’s main source of income is on the related work of each member that has a currently employed. Their monthly family income is approximately 10, 001 – 15, 000, due to unconditional wages because sometimes overtime in work may result to additional amount of salary that may lead to increase in monthly family income but in contrary some circumstances happened like sickness (may lead to absent) or end of contract then lead to decrease in monthly salary income.
Family’s monthly expenditures are above the monthly family
income, approximately 15, 001 – 20, 000. It affects each member of the family especially Mrs. X who is the one budgeting the family monthly income and the children who is still studying. Their budget allocation is 40% to the household (basic needs), 30% for education, 15% for medicines, 10% for clothing, and 5% for recreations.
Family felt needs; their highest priority is food, then education, financial, health needs, support system, housing, clothing, utilities, and recreation and last is spiritual needs.
EXAMPLE Home and Environment
Family X have their own residency in an rural place with a mixed type of housing materials and have an adequate living space, lighting and ventilation enough for the family members. Their water supply is considered in Level I-point source. They owned a private excreta disposal which is in Level I-pit latrines. Electricity is their source of light. Their food and water are properly stored in a covered area. They have cell phone, and letter as their means of communication. They usually use jeepney, tricycle, motor, and bus as means of their transportation. In their social facilities, there is the availability of Barangay Hall, school, wet and dry market, day care center, basketball court as well as playground for children and chapel. There are also Barangay Health Center , Hospital, Clinic and what they call “hilot” present in their community. Accidents are present due to domestic animals that are not vaccinated such as dogs and cats in various places. Pests such as rats and mosquitoes that can cause dengue are also prevented through fumigation in their community.
EXAMPLE
Health Status of the Family Member
Family members (excluding Mrs.. Z. X and her brother J. X) have no severe illnesses present only cough and cold for the past six months. Mrs. X has a present illness (hypertension). Their family has no health insurance and do not undergo family planning. They usually go to albularyo for consultation as their health seeking behavior but they sometimes consult to a doctor in the hospital and to the midwife in their Barangay Health Station.
EXAMPLE
Values Habits and Health Practices
They believe in hilot, wherein they are testified that hilot is effective in curing illnesses of the family. Sometimes, they are consulting to the albularyo rather than go the nearest hospital due to their mind set of “mas makakamura kami rito”, as verbalized by Mrs. Z. X
EXAMPLE
Social Indices
Family X is not yet aware of organizations in their residence since then. As a result of it they are not aware of any organizations that can help them to have a quality healthcare.
Genogram Floor Plan
Measurement
Physical Assessment (example) Assessment
Family Member
Vital SignHeight Weight BMI Normal BMI
Actual FindingTemp. PR RR BP
Mr. M. X 36.1°C91
bpm18 cpm
140/90 mmHg
64 cm. 56 kg. 21.14
18.5-24.9
wt. in pounds x 703
(Ht. in inches)2
N
Mrs. Z. X
36.9°C81
bpm19 cpm
130/90 mmHg
61 cm. 43kg. 17.87 BN
A. X 37.2°C70
bpm16 cpm
100/70 mmHg
63 cm. 56 kg. 21.82 N
J. X 36.8°C70
bpm14 cpm
120/70 mmHg
62 cm. 57 kg. 22.57 N
L. X 36.3°C63
bpm14 cpm
120/80 mmHg
66.5 cm.
54 kg. 18.88 N
B. X 36.2°C 74bp
m15 cpm
110/70 mmHg
61 cm. 56kg. 17.87 BN
K. X 36.1°C79
bpm18 cpm 57 cm. 46 kg. 21.90 N
C. X 37.2°C75
bpm17 cpm 53 cm. 30 kg. 16.52 BN
J. X 36.8°C84
bpm17 cpm 54 cm. 43 kg. 22.81 N
C 36.3°C71
bpm16 cpm
120/85 mmHg
60.5 cm.
61 kg. 25.77 AN
Mr. M. X Mrs. Z. X A. X J. X L. X B. X K. X C. X J. X C
Assessment Normal Finding/s Actual Finding/s Justification HEADEYES EARSNOSE NECK MOUTH SKIN
THORAX AND LUNGS
MUSCULOSKELETAL
NEUROLOGIC
BREAST AND AXILLA
CARDIOVASCULAR
ABDOMEN
Past and Medical History (example)
Family X has a history of hypertension wherein it is presently manifested to Mrs. Z. X She is not taking any medication due to financial instability. According to her, it is much better to prioritize taking at least 3 times a day of food than to take any medication for her condition. Some of the family members’ chief complaints are cough and cold, this is the main concern of the family due to intermittent condition of the said complaints. The children are not fully-immunized, so they are prone to any kind of sickness or illness secondary to financial instability that cannot provide a budget for consultation or check-up to a doctor to the nearest hospital. Additionally, they even not consult to the Barangay Health Station even though they are aware for free consultation or check-up. They much believe to the hilot or albularyo.
Gordon’s Functional Health Pattern
1. HEALTH PERCEPTION AND HEALTH MANAGEMENT PATTERN 2. NUTRITIONAL AND METABOLIC PATTERN
3. ELIMINATION PATTERN 4. ACTIVITY EXERCISE PATTERN
5. SLEEP – REST PATTERN 6. COGNITIVE PERCEPTION PATTERN 7. SELF PERCEPTION AND CONCEPT 8. ROLE – RELATIONSHIP 9. SEXUALITY AND REPRODUCTIVE 10. COPING –STRESS TOLERANCE 11. VALUE BELIEF
Family Coping IndexFamily: Family X Address: Health Department:
Family Coping Index
Point Scale Assessed ProblemsJustification Statement
Physical Independence
1 2 3 4 5
Therapeutic Competence
1 2 3 4 5
Knowledge of Health Condition
1 2 3 4 5
Application of Principles of General Hygiene
1 2 3 4 5
Health Attitudes
1 2 3 4 5
Emotional Competence
1 2 3 4 5
Family Living
1 2 3 4 5
Comments:
Nurse’s Signature
Cues and Data (example)
Cues/Data Family Nursing Problem Subjective:“Malimit na masakit ang batok ko,” as verbalized by the patient. Objective: T – 36.7˚CP – 78 bpmR – 16 cpmB/P – 150/90 mmHg
- facial grimace- guarding
1. Inability to recognize the presence of the condition or problem due to: §lack of knowledge§denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specially:
- economic implication- emotional concerns- psychological concern
2. Inability to make decisions with respect to taking appropriate health action due to: §low salience of the problem/condition§inadequate knowledge of community resources for care
Listing of Potential Health Problem
Family Name : Family XName of Family Heads : Mr. M. XAddress :
List of Health Problems Nature of Problem Hypertension Health Deficit /
Health Threat Inadequate Ventilation Health Threat Inadequate Living Space Health Threat Presence of resting sites of Vectors of Diseases Health Threat Alcohol Drinking Health Threat Smoking Health
Threat Loss of Job Foreseeable
Crisis
SCORINGHypertension
Criteria Computation Actual Score Justification
1. Nature of the Problem3/3 x 1 1
It is a Health deficit.
2. Modifiability of the problem
1/2 x 2 1
The resources and interventions needed to solve the problem are slightly available to the family
3. Preventive Potential
2/3 x 1 2/3
The possibility of complication of the condition may prevent in maintaining the blood pressure low by taking the patient’s medication regularly and by using alternative like bawang.
4. Salience of the Problem 0/2 x1 0
The family does not recognize it as a problem
Total Score 2 2/3
Scoring
Hype
rtension
Ranking
Priority Problem Score
1 Presence of Resting Site of Mosquito
3 1/3
2 Inadequate Ventilation 3 1/6
3 Inadequate Living Space 3 1/6
4 Smoking 3
5 Loss of Job 3
6 Alcohol Drinking 3
7 Hypertension 2 2/3
Family Nursing Care PlanHealth problem Family Nursing
ProblemsGoal of Care Objectives of
CareIntervention Plan
Inadequate Living Space as Health treat
1. Inability to provide a home environment conducive to health maintenance and personal development due to:
•Inadequate family resources specifically: financial constrains and limited physical resources.•Lack of skill in carrying out measures to improve home environment..
After the nursing interventions, the family will decide on appropriate actions in improving home environment.
After nursing interventions, the family: 1.will understand the risks/ disadvantages of having inadequate living space.2.can state possible actions in improving their home environment3.will identify available resources that could help them.4.will choose the most appropriate actions for the improvement of their home.
Nursing Interventions
Method of Nurse –Family
Contact
Resources required
1. Discuss with the family the risks of having inadequate living space.2. Discuss with the family on actions preventing possible effects of inadequacy of living space.3. Encourage the family to use resources available within their vicinity in improving their living space.
Home Visit
Human Resources: the availability and effort of the nurse and the family