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Our Lady of Fatima University College of Nursing

Family Health Nursing Family Nursing Care Plan

Submitted By: BSN 2Y1-21D Stephen Liza Macaraeg Danilo Malana Job Lorejas Nicole Valerie Pagilagan Janine Mateo Leslie Anne Legaspi Rea Cladel Manosca Joane Lintao Manilyn Narag Kyla Magbago

Submitted To: Mr. Jerico G. Alicante USRN,CRN,RN

I.

Family Structure and Dynamics

No.

Name

1

Herminio Fancubila

2

Adima Fancibula Hedlyn Fancubila Hanilyn Fancubila Herlyn Fancubila Hazelyn Fancubila

3 4 5 6

Relation to the head of the family Head

Gender

Birthday

Age

Civil Status

Religion

Highest Educationa l Attainment

Employment

Welde r

Mont h

Year

Male

05-25

1 973

36

Married

Roman Catholic

Elementar y Graduate

Wife

Female

05-30

34

Married

Daughter

Female

03-24

8

Single

Daughter

Female

11-8

6

Single

Daughter

Female

12-26

Single

Female

06-21

2yrs. 5 mos. 1yr. 10 mos.

Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic

Elementar y Graduate Elementar y Elementar y _________

Daughter

1 973 2 001 2 003 2 006 2 008

Single

_________

Languag e/ Dialect

Ethnic Backgrou nd

Bisaya, Tagalog, Ilonggo

Ilonggo

Visayan

Student

Bisaya, Tagalog Tagalog

Student

Tagalog

Tagalog

____________

Tagalog

Tagalog

____________

Tagalog

Tagalog

Type

Place

Great Asia Comp . Full time mom

Tagalog

Genogram (Fancubila Family)

They are currently residing at #29 P. Gregorio St. Lingunan Valenzuela since 2006, their Family posses the characteristics of a nuclear type. Mr. Fancubila, being the father, makes decisions for the family most of the time, while

Mrs. Fancubila, the mother, is the one responsible for house keeping, health status monitoring and nursing care for the sick family member. II.

Socio-Economic & Cultural Characteristic Mr. Fancubila works as a welder in Great Asia Company factory at Velenzuela, while Mrs. Fancubila is a full time mom. She is taking care of everything that needs supervision at home, while her husband provides for the financial and patriarchal needs of the family. They have a monthly income of P8,000 which is obviously not enough for their two gradeschoolers and two toddlers, even though Mr. Fancubila had been loading his back of overtimes at the factory. Both of them are an elementary graduate only, which is why it is a bit difficult for them to find a descent job with a higher pay. The couple had been married for 8 years, and still are going strong, sharing life’s consequences each day and living through sickness and in health. They go to church during Sunday’s, a weekly family routine, but refused to attend to church activities primarily because of Mr. Fancubila’s exhausting work loads during the rest of the week, and special parenting needs of their children. They usually work together and make decisions on the budget to make ends meet. Mr. Fancubila is the bread and butter of the family, while Mrs. Fancubila does household chores and everything that needs supervision at home; Hedlyn, being the eldest, helps her mom do the chores and looks over her younger sisters whenever mom is busy. They usually spend leisure watching T.V., listening to the radio, and sometimes talking to each other to open up problems and find solutions to those problems. Although young and not mature enough Mr. and Mrs. Fancubila had already opened up their children’s awareness of their family status, which is why they never had problems in explaining to the girls why sometimes the budget is too tight.

III. Home and Environment The studio type apartment they are residing at is made up of concrete, almost a good place for a home in spite of the fact that the apartment is located at the vicinity of the welding factory. The place has its good light source and it is also well ventilated, but, there is a canal located behind their kitchen—a source of foul smell due to the irrigation that comes from a piggery. The electricity and water supply will never be their problem, because they are provided with adequate NAWASA water supply, and subsidized, equally distributed electricity throughout the place, reason why it is already included on the rent and why it will be more unlikely for them to experience electricity shortage. They live in a studio type apartment, with a multi-purpose room (living room, dining room, and sleeping place; same room with different functions at during different times of the day.) and a functional kitchen. Although their apartment has presence of vectors, still they maintain the cleanliness and orderliness by habitual cleaning and disinfection. Their functional kitchen also maintains its

orderliness although they do not have enough storage for plates, casserole and other kitchen utensils. However, they use a public toilet and a public laundry place not far away from their apartment. They store water in jars, bottles and pails with cover so that it would be available whenever water is needed. The problem with their place is that it is too small for 6 people and the foul smell of the surrounding during afternoons because that is the usual time the pens are cleaned. The family doesn’t raise any domestic animals, but there are cats around the place. The area doesn’t have any trees but the apartment ventilation is good. They dispose their garbage through dumping at the canal behind their kitchen. They have a mini-library at the second floor of the apartment building with books available for the use of the children living there. There are health programs for the families of factory workers, which somehow contribute to the enhancement of health of the worker’s children. The Barangay center is also located just in front of the factory, that is why their children have regular check-ups and their immunization is somehow updated. The family doesn’t have their own transport facilities, that is why they usually use a public vehicle like jeepneys, tricycles, and the multi-cab provided by the factory. They use a public telephone and cell phone as means of communication.

IV. Health Assessment for Each Member Name

Age

Height

Weight

Herminio

36

155cm.

60kg

BMI (kg/m2) 24.97

Adima

34

147cm.

62kg.

28.69

Hedlyn

8

110cm

20kg.

17.14

Hanilyn

6

95cm.

18kg.

19.4

Herlyn

2

80cm.

10kg.

15.62

Hazelyn

1

69cm.

7.5kg.

15.75

Status

Overweig ht Underwei ght Normal

Normal

Underwei ght Underwei ght

Vital Signs BP Temp. 120/90 36 110/80

37.7

-----------

37

-----------

36.5

-----------

37.9

-----------

37

Pulse 73beats/mi n. 68 beats/min 93beats/mi n. 119beats/ min. 128beats/ min 97beats/mi n

Significant Findings

RR 15 14 18 18 23 26

Malnourish ed Malnourish ed

Previous illnesses of the family include cough, fever, flu and states that are no serious or major. Mr. Fancubila is a smoker, he consume 2 to 4 sticks daily, smokes usually after meals and he is a social drinker. The family eats three times a day, primarily fish and rice. They often eat vegetables and meat that is why their children are unusually thin.

V.

Values and Practices on Health Promotion/ Maintenance and Disease Prevention

No family member obtained a complete immunization. Although, the health center is near their place, mom is not seeing the mere fact that disease control and protection is of great importance. The family usually seeks for health care whenever they think it is needed, they do not usually go to health centers for regular check-ups due to money matters; they would prefer consulting an “albularyo” or “manghihilot”. Their hygiene is somehow maintained. Like any other Filipino family, their routines are greatly influenced by most of our superstitious beliefs. They don’t sweep floors or cut nails during the night. Mom doesn’t take baths during her menstrual period. Mr. Herminio sleeps 5-8 hours a day, as well as Mrs. Adima while the rest of the children sleeps 8-10 hours.

Floor Plan

Sofa

Family size beyond what family resources can adequately provide Criteria

Computatio n 2/3x1

Actual score 2/3

2/2x2

2

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

Preventive potential

3/3x1

1

Salience of the problem

2/2x1

1

The possibility of increasing family size will be reduced; the available family resources can be utilized to encourage growth promoting experiences for members. The family perceives it as a problem needing attention to ensure that this 4th pregnancy would be the last so that all their needs would be somehow met.

Nature of the problem Modifiability of the problem

Total Score

4 2/3

Justification A perceived health threat

VI. Family Nursing Care Plans Family Health Care Plan Health Threat: Family size beyond what family resources can adequately provide

CUES

HEALTH PROBLEM

DATA ANALYSIS

“Nahihirapan na kami pagkasyahin ang kinikita ko buwan-buwan, dalawa pa lamang ang aking pinagaaral kong anak ngunit kami ay gipit na gipit na sa mga gastusin pangarawaraw”

Family size beyond what family resources can adequately provide …perceived as a health threat

1. The family was not able to recognize the presence of this specific health threat due to their unawareness of the possible outcomes of having many children.

Objective: The apartment they are living at is really small for 6 people, they have appliances but are not very functional and most of their clothes are worn out.

2. The family was not able to make effective decisions on effective family planning & accurate contraceptive usage. 3. The family was not able to utilize community resources for health care due to their own neglecting of their needs. 4. The family was not able to provide adequate living space and basic health and wellness needs of each

GOALS & OBJECTIVES Goal: After the nursing intervention and health teaching, the family will be able to understand the importance of effective family planning and practice proper use of contraceptives Objective: After 1 hr. of health teaching, the family will be able to: 1. Be knowledgeable of the outcomes of having too many family members.

1.

2. Giv

INTERVENTION

EVALUATION

Developmental

…Effectiveness Discuss the outcomes of having too many children and the consequences they could possibly face with regards to providing the needs of their children

Explain the basic concepts of family planning and birth control so that they may have a view on how to use contraceptives accurately and how to effectively plan a family.

Was the family able to enumerate and understand basic concepts of family planning and birth control? Yes__

No__

Was the family able to identify and cite examples of the basic health care needs and the health care services available in the community to meet those needs? Yes__ No__

member primarily because of poverty, and failure to seek for government assistance (programs that are usually created by government officials to help meet the needs of poor Filipino families).

e the imp ort anc e of eff ecti ve fa mil y pla nni ng and acc ura te con tra cep tive usa ge

Discuss the basic health care needs of each member, especially their children and the availability of the health services in the community.

Provide them a print out about the government programs available for children, and spouses regarding health and wellness promotion.

Was the family able to understand the importance of seeking government assistance for health and wellness promotion? Yes__ no__

Was the family able to enumerate /cite examples of government healthwellness programs for children? Yes__ no__

2.

3. Be abl e to eff ecti vel y utili ze co m mu nity res our ces .

3.

4. Be abl e to

pro vid e, at lea st, the bas ic hea lth and wel lne ss nee ds of eac h me mb er wit h the kno wle dge abo ut gov ern me nt pro

gra ms tha t are me ant for enh anc ing the hea lth and wel lne ss lev el of Fili pin o fa mili es so tha t the y cou ld eff ecti

vel y see k for ass ista nce reg ard les s of the ir sta ndi ng in the soc iety . Our Lady of Fatima University College of Nursing BSN 2Y1-21D

Family Health Teaching Plan Family size beyond what family resources can adequately provide Topic: Effective Family Planning Time allotment: 1 hour LEARNING OBJECTIVE LEARNING CONTENT After the Health Family Planning… Teaching Program, the Effective spacing and family will be able to : use of birth control 1. Understand what is methods to choose the Family Planning and number and timing of Birth Control. children born into a family. Birth Control or Contraception… Deliberate prevention of pregnancy using any of several methods. Birth control prevents a female sex cell (egg) from being fertilized by a male sex cell (sperm) and implanting in the uterus. In the United States, about 64 percent of women aged 15 to 44 years practice some form of birth control.

STRATEGY Home Visit PowerPoint presentation and further discussion of topics that need specified explanations for clear and effective understanding.

RESOURCES Visual Aids, PowerPoint presentation of the topic and examples of contraceptives available in the market Manpower: Danilo Malana Nicole Valerie Pagilagan Stephen Liza Macaraeg

EVALUATION 1. Was the family able to understand what is Family Planning and Birth Control Yes__ No__ 2. Was the family able to Identify at least types of contraceptives, enumerate their side effects, effectiveness, and availability? Yes__ No__ 3. Was the family able to enumerate the importance of effective family planning and birth control methods? Yes__ No__ 4. Was the family able to enumerate the contributing factors on

2. Identify the types of contraceptives, their side effects, effectiveness, and availability.

• • • • • •

• • 3. Give the importance of effective family planning and birth control methods.

•

4. Enumerate factors contributing to the ineffectiveness of Family planning and Birth control.

•

•

• •

Barrier Method Intrauterine Device Hormonal Contraceptives Surgical sterilization Emergency Contraception Fertility awareness method Withdrawal Continuous Abstinence Effective child upbringing Enhanced childparent bonding Cultural and social values Availability of the resources Knowledge on appropriate usage of contraceptives

Our Lady of Fatima University College of Nursing BSN 2Y1-21D

Family Health Care Plan Health Deficit: Malnutrition

CUES

“Madalas silang nagkakasakit, lalo na sila Herlyn at Hazelyn. Madalas ko din napapansin na matamlay sila ngunit ang pagkaka-alam ko ay dahil lang yun sa pagkapagod nila sa paglalaro sa labas. Hindi rin sila masyado nakakakain ng masusustansyang pagkain dahil isda lang madalas ang inuu-ulam naming, ngunit sa tingin ko ay maayos naman

HEALTH PROBLEM

Malnutrition as a health deficit

DATA ANALYSIS

1. The family failed to perceive this condition as a major health problem that needs immediate intervention and management 2. The family was not able to effectively decide about taking appropriate actions due to failure to comprehend the harm of this health problem 3. The family failed to provide adequate nursing

GOALS & OBJECTIVES

INTERVENTION

EVALUATION

Goal: After the nursing intervention and health teaching, the family will be able to understand the seriousness and urgency of needed care for the member suffering from malnutrition. Objective: After 1 hr. of health teaching, the family will be able to: 1. Identify ways on how to acquire their

…Effectiveness 1. Discuss the implications of signs and symptoms of malnutrition and its possible consequences

Was the family able to enumerate the signs, symptoms, and possible consequences they might face if the problem is not perceived? Yes__ No__

ang lagay nila kahit ganun pa man.”

Objective: Herlyn, Hazelyn and Hedlyn are unusually thin, they are pale and are not that playactive.

measures to a member suffering from malnutrition due to: i) Lack of knowledg e about the condition ii) Lack of knowledg e about the conseque nces and harm the condition could possibly bring iii) Lack of resources for care

Our Lady of Fatima University College of Nursing BSN 2Y1-21D

children’s nutritional needs in spite of the limited budget

2. Avail itself food supplements provided by government health agencies for malnourished children. 3. Feed Herlyn, Hazelyn and Hedlyn cheap nutritious food that will keep them healthy and increase their growth and development 4. Increase their children’s weight at least one pound a month.

2. Discuss with the family the reasons and possible causes of malnutrition

3. Discuss with the family the nutritional needs of children, specifically, vitamin supplementations and immunizations

4. Inform the family about the feeding programs present in the community.

Was the family able to cite possible causes of malnutrition? Yes__ No__

Was the family able to enumerate the basic nutritional needs of children? Yes__ No__

Family Health Teaching Plan Malnutrition Topic: Malnutrition: a serious physical harm Time allotment: 1 hour LEARNING OBJECTIVE LEARNING CONTENT STRATEGY After the Health Malnutrition… Home visit Teaching Program, the dietary condition PowerPoint presentation family will be able to : caused by a and brief discussion of 1. Give the importance deficiency or excess certain topics that the of having an Optimum of one or more family would find hard level of Functioning essential nutrients in to comprehend (Health-Wellness)

the diet. Malnutrition is characterized by a wide array of health problems, including extreme weight loss, stunted growth, weakened resistance to infection, and impairment of intellect. Severe cases of malnutrition can lead to death. Two types of Malnutrition: • Under nutrition • Over nutrition

2. Identify ways on how to acquire and maintain child nourishment

• • •

Balanced diet Exercise Vitamin Supplementation

RESOURCES Visual Aid (Manila Paper, Markers) Manpower: Janine Mateo Job Lorejas Leslie Anne Legaspi

EVALUATION 1. Was the family able to give the importance of having an Optimum level of Functioning? Yes__ No__ 2. Was the Family able to identify ways on how to acquire and maintain child nourishment? Yes__ No__ 3. Was the family able to enumerate Factors that are possible causes of malnutrition? Yes__ No__ 4. Was the family able to enumerate the Factors that promote an optimum level of Functioning? Yes__ No__ 5. Was the family able to cite the effects of malnutrition on children and their families? Yes__ No__

• •

Immunization Regular Checkups

3. Enumerate Factors that are possible causes of malnutrition

• • •

4. Enumerate the Factors that promotes an optimum level of Functioning (HealthWellness) 5. Cite the effects of malnutrition on children and their families

• • •

Poverty Famine Disease outbreaks DOH programs UNICEF programs WHO programs

• •

Physiologic Effects Psychological Effects

Our Lady of Fatima University College of Nursing BSN 2Y1-21D