Maam-manata-community.docx

FAMILY CASE STUDY

Presented to the Faculty of the School of Nursing Adventist Medical Center College Brgy. San Miguel, Iligan City

In Partial Fulfillment of the Requirements for the Degree BACHELOR OF SCIENCE IN NURSING

Abdullah, Asniah Afable, Jon Mikee Mae Amano, Amirah Chinchuntic, Joan Largo, Ditchen Najeeb, Marwah Padura, Cheryl Pandapatan, Jawaher Paul, Kaizen Meg Alexa Petagara, Elaisa Lyn Sabdula, Norhaide Sarip Mohammad Alnashry Undag, John Arthur Villamor, Ruffa Mae

April,2019

TABLE OF CONTENTS

PAGE

TITLE PAGE

I

TABLE OF CONTENTS

II

LIST OF TABLES

III

LIST OF FIGURES

IV

OBJECTIVES

1

INTRODUCTION

2

FAMILY CASE STUDY NARRATIVE

5

GENOGRAM

11

RANKING OF PRIORITIZED PROBLEM

13

FAMILY NURSING CARE PLAN------------------------HOME-BASED CARE HEALTH EDUCATION PLAN ---------------------------------------------REFERENCES

23 26

LISTS OF TABLES

PAGE

Raking of Prioritized Problem

13

Family Nursing Care Plans

17

Home-Based Care

23

LISTS OF FIGURES

PAGE

Genogram showing the Family Health history of Mister Gemini

11

OBJECTIVES

General Objectives: At the end of one and a half – hour case presentation, the participants will be able to learn the family health history, recognize the actual and potential problems, and their management. Specific Objectives: At the end of one and a half – hour case presentation, the participants will be able to:\ 1. Describe Hypertension; 2. Summarize the Family Case Study; 3. Enumerate the complications, manifestations, risk factors, and treatment ofHypertension; 4. Present the Genogram, and Scale Ranking of the identified family problems; 5. Formulate a family nursing care plan for the identified family problems; and 6. Create a home-based care for the family 7.

1

INTRODUCTION

The family is the smallest unit of the society and the natural fundamental core of the community and consequently, it is considered as the primordial recipient of the nursing effort, which is contributory to the development, and progress of the community through active involvement and self – responsibilities of each constituent. It is composed of persons, male and female, being molded to be as one, working hand in hand to maintain a good atmosphere among the family members ( Pilliteri , 2015) .Conducting a family case study is a means by which student nurse reaches and feels the community through its basic structure the family. It is a tool in determining the health status of a family through assessment and critical inspection. Through this health related problems are identified, thus giving the student nurse a hint on where to act and how to intervene. It is also means towards improving the health of the community, making them more productive. To come up with the family case study gives a sense of fulfilment to a student nurse as she/he was given the opportunity to share the skills, knowledge and time to alleviate and uplift the living condition of a family.

Hypertension is generally defined as a systolic blood pressure greater than or equal to 135 mmHg and/or a diastolic blood pressure greater than or equal to 85 mmHg in individuals who do not have diabetes. The new classification for “normal” adult blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic. Adults with blood pressure of 120 to 139 mmHg systolic or 80-89 mmHg diastolic, considered “normal” under previous guidelines, are now classified as prehypertensive and are in need of lifestyle changes to prevent cardiovascular complications. Other classifications of hypertension are stage 1 hypertension which the systolic is 140-159 mmHg and diastolic is 90-99 mmHg, and stage 2 hypertension which the systolic is more than 160 mmHg and diastolic is more than 100 mmHg. Hypertension also called the silent killer because people who have it are often symptom free. The relationship between hypertension and cardiovascular events is direct and independent of other risk factors. The higher the blood pressure, the greater the chance for coronary, cerebral, renal and peripheral vascular disease. Control hypertension, however, has resulted in significant decreases in cardiovascular morbidity and mortality. Hypertension often accompanies other risk factors for atherosclerotic heart disease, such as dyslipidemia, obesity, diabetes, metabolic syndrome, sedentary lifestyle, and obstructive sleep apnea. The prevalence is also higher in persons who have other cardiovascular conditions, including heart failure, coronary artery disease, and a history of stroke. Cigarette smoking does not cause high blood pressure; however, if a person with hypertension smokes, his or her risk of dying of heart disease 2

or related disorders increases significantly. For hypertension to occur, there must be a change in one of more factors affecting peripheral resistance or cardiac output. In addition, there must also be a problem with the body’s control systems that monitor or regulate pressure. The tendency to develop hypertension is inherited; however, genetic profiles alone cannot predict who will and will not develop hypertension. In fact, researchers estimate that between individuals in 15% to 70% of cases. Many causes of hypertension have been suggested to be, increased sympathetic nervous system activity related dysfunction of the autoimmune nervous system, increased renal reabsorption of sodium, chloride, and water related to genetic variation in the pathways by which the kidneys handle sodium, increased the activity of renin-angiotensin-aldosterone system, resulting in expansion of extracellular fluid volume and increased systemic vascular resistance, decreased vasodilation of the arterioles related to the dysfunction of the vascular resistance, resistance to insulin action, which may be a common factor linking to hypertension, type 2 DM, hypertriglyceridemia, obesity and glucose intolerance, activation of the innate and adaptive components of the immune response that may contribute to renal inflammation and dysfunctions. The purpose of this case presentation is for us to discover the process of the problem identified, how it is being acquired, clinical manifestation which some was being experienced by our patient and how the environment and the condition of the family relates to the problem. By doing so, we will be able to know the appropriate nursing care for our patient as well as the family. This study will help us student to comprehend not only the disease mentioned but also for the commonalities and differences among other diseases.

3

FAMILY CASE STUDY IN NARRATIVE FORM The Zodiac family is considered as an extended type of family composed of 5 members living together. The family is a common law family resided at Purok 15 Tibanga, Iligan City. They are headed by Mother Gemini, a 62 year old, born on May 27, 1954. Her daughter Libra, , a 29 year old and was born on November 10 ,1989, and son, Scorpio, 23 year old, born on January 05, 1996. Oldest daughter, Libra , has two children, Cancer a 10 year old, born on June 29 in the year 2010, Aquarius, a 6 year old, born on February 05 in the year 2013. They both delivered via normal spontaneous delivery at Grospe lying-in. There was no known complications. She started her menarche when she was 13 years old. She would usually have 28 days cycle with a period duration of three to four days. She got pregnant at the age of 19 and was able to bear two children According to her obstetrical record, she has G2P2T7P0A0L2M0..She decided to leave his live in partner because of “Third Party” which was four years ago. Mrs. Gemini husband died a year ago in the month of April because of Pancreatic Cancer. She grew up and practiced the religion of being a Seventh Day Adventist.. Mrs.Gemini and her daughter go hand in hand in terms of decision-making. They consult each other in terms of planning and budgeting for their family. They also discuss matters concerning her son and grandchildren’s school fee. Scorpio is currently a second year college student at Medical Center College with the course of BS Management. Cancer is grade 3 student at North Central School. Miss Libra was a college undergraduate at Medical Center College with the course of BS Management. She is currently working as online seller with the range income of 8,000-10,000 pesos a month. Her role in the family is a wage earner and financial provider. Nanay Gemini was a 3rd grader at Zamboanga Elementary School. Because her mother died at early age, she decided to stop going to school. She suffered from meningitis when she was 17 years old and was admitted for a year and 3months. She got married at the age of 22 and was blessed with two children. She is a vendor of “chicharron” and would usually gained 600 pesos a week. The family’s source of income per month would range from ₱9,000-15,000. The family is a recipient of the Pantawid Pamilyang Pilipino Program (4Ps). They would usually receive ₱3,200 every 2 months. They have been a member of this program since 2010.

4

Zodiac family has strong connection with the community . They would actively participate in programs like Gardening, general cleaning and so on. .Mrs. Gemini would go out in the neighborhood and talk with her friends. Their house is made up of light constructions materials and measures approximately 12. 26 square meters of living space. They sleep on cement floor with a “banig” on a horizontal arrangement. There are tall grasses located 4 meters away from their home and stagnant water that makes it a breeding site of mosquitoes, rats and cockroaches. The family does have electricity and usually pay 1000-1500 pesos per month. They have a food cover for their left overs. The family cooks utilizing fire woods in their kitchen located inside their house. They have an access from a water supply through a hose connected from their neighborhood. They have a common open private water-sealed toilet located at the right side 5 meters away from their house. They dispose their garbage by placing it in a plastic cellophane and be collected by the garbage collector once a week. The family has refrigerator, induction cooker, television, laptop, and cellphones.

The family believes in quack doctors before they would seek for medical consultation. Cancer weighs kg, has a height of cm, and Cancer’s BMI as calculated is . Aquarius weighs kg, height of . Aquarius’s BMI as calculated is All of the BMI of the two children falls under the normal category of the KidshealthBMI chart Mr. Gemini weighs kg and has a height of cm. He has a BMI of that falls under the severe underweight category of the Asian BMI chart. Mr. Gemini has blood pressure is 160/100, temperature of 36 degrees Celsius, heart rate of 65 beats per minute, respiratory rate of 25 per minute and a pulse rate of 70 beats per minute. Cancer and Aquarius already had a shot of BCG, Diphtheria, Tetanus and Pertussis (DTaP) vaccine, Oral Polio Vaccine (OPV), Hepatitis-B, and Measles, Mumps and Rubella (MMR) vaccine. The familyhas poor hygiene as they do not take baths regularly. They have foul odor and their nails were dirty and untrimmed. The amount of water intake per day is 2-3 glasses for the granddchildren and 4-5 glasses of water for the adults . Mrs. Gemini is fond of drinking coffee. They can usually consume 2 sticks of nescafee per day. Their usual viands are mixed vegetables, daingtuyo, and ginamos. The children are fond of eating junk foods everyday like andsweet corn,

super

crunch

and

tatto

5

GENOGRAM

Father

Mother

Mimi

Jan-Jan

Grandson

Grandson

1

2

VI

SCALE RANKING OF HEALTH CONDITIONS/ PROBLEMS ACCORDING TO PRIORITIES

Health Problem: PERSONAL HYGIENE 







CRITERIA Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis Modifiability of the problem/ condition o easily modifiable o partially modifiable o not modifiable Preventive Potential o high o moderate o low Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

SCALE 3 3 2 1

SCORE

WEIGHT

TOTAL

2/3 = 0.67

1

0.67

2

2

2 1 0

2/2 =1

3 2 1

3/3 = 1

1

1

2/2 = 1

1

1

2 1 0 TOTAL:

4.67

SCORE

WEIGHT

TOTAL

2/3 = 0.67

1

0.67

2

2

1

1

Health Problem: Poor Environmental Sanitation CRITERIA  Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis  Modifiability of the problem/ condition o easily modifiable o partially modifiable o not modifiable  Preventive Potential o high o moderate o low

SCALE 3 3 2 1 2 1 0

2/2 =1

3 2 1

3/3 = 1

VII

 Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

Health Problem: RIGH SIDED WEAKNESS CRITERIA  Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis  Modifiability of the problem/ condition o easily modifiable o partially modifiable o not modifiable  Preventive Potential o high o moderate o low  Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

2 1

2/2 = 1

1

1

0

SCALE 3 3 2 1 2 1 0 3 2 1

TOTAL:

4.67

SCORE

WEIGHT

TOTAL

3/3 = 1

1

1

½ = 0.5

2

1

1/3 = 0.3

1

.3

2/2 = 1

1

1

2 1 0

TOTAL:

3.3

Health Problem: Malnutrition CRITERIA  Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis  Modifiability of the problem/ condition o easily modifiable o partially modifiable o not modifiable  Preventive Potential o high o moderate o low

SCALE 3 3 2 1

SCORE

WEIGHT

TOTAL

2/3 = 0.67

1

0.67

2

1

1

1

2 1 0

½ = 0.5

3 2 1

3/3 = 1

VIII

 Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

2 1

2/2 = 1

1

1

TOTAL:

3.67

SCORE

WEIGHT

TOTAL

2/3 = 0.67

1

0.67

2

1

0

Health Problem: Risk for Injury CRITERIA  Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis  Modifiability of the problem/ condition o easily modifiable o partially modifiable o not modifiable  Preventive Potential o high o moderate o low  Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

SCALE 3 3 2 1 2 1 0

1/2 = 0.5

3 2 1

2/3 = 0.67

1

0.67

2/2 = 1

1

1

2 1 0 TOTAL:

3.34

5. Health Problem: Unhealthful lifestyle and personal habits CRITERIA



Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis

SCAL E

SCOR E

WEIGH T

TOTAL

1

.67

3 3 2 1

/3 = .67

IX







Modifiability of the problems/ condition o easily modifiable o partially modifiable o not modifiable

2

Preventive potential o high o moderate o low

3

Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

2

1

2

2

1

.67

1

1

/2 = 1

0

2 1

/3 = .67

/2 = 1 1

0 TOTAL SCORE:

3.34

6. Health Problem: Risk for fire hazards CRITERIA



Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis

SCAL E



WEIGH T

TOTAL

1

.67

2

1

1

.67

3 3 2 1



SCOR E

Modifiability of the problems/ condition o easily modifiable o partially modifiable o not modifiable

2

Preventive potential o high o moderate o low

3

1

/3 = .67

/2 = .5

0

2 1

/3 = .67 X



Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

2 /2 = .5 1

.5

1

0 TOTAL SCORE:

2.39

8. Health Problem: Financial problem CRITERIA



Nature of the problem/ condition presented o wellness state o health deficit o health threat o foreseeable crisis

SCAL E





WEIGH T

TOTAL

1

.33

2

1

1

.33

1

.5

3 3 2 1



SCOR E

Modifiability of the problems/ condition o easily modifiable o partially modifiable o not modifiable

2

Preventive potential o high o moderate o low

3

Salience o a condition/ problem, needing immediate attention o a condition/ problem, not needing immediate attention o not perceived as a problem/ condition needing change

2

1

/3 = .33

/2 = .5

0

2 1

1

/3 = .33

/2 = .5

0 TOTAL SCORE:

2.16 XI

SCORE RANKING

SCORE

RANK

Poor Environmental Sanitation

4.67

1

Personal Hygiene

4.67

1

Malnutrition

3.67

2

Risk for Injury

3.34

3

Unhealthful lifestyle and personal habits

3.34

4

Right sided weakness

3.3

5

Risk for fire hazards Financial problem

2.39 2.16

6 7

XII

Health problem

Family Nursing problem

Poor environmetal Inability to provide sanitation as health home environment conducive to health threat maintenance and Cues: personal “Daghankaayogilag development a, ipis, ogmgalamok”

o Unwanted smell of the environment.

o Presence of breeding sites of mosquito due to stagnant water in their laundry area o Unsanitary toilet o Messy room

Goal of care

Objective of care

Nursing intervention Method

After nursing intervention, the family will be able to discuss and understand the importance of proper hygiene

Within 3 days of nursing interventions, the family will be able to.

1. Assess family’s level of understanding about poor environmental sanitation.

2. Emphasize the importance of a 1. Cite at least 5 clean and healthy importance of environment.. proper sanitation 3. Discuss with the 2. Demonstrate family the ways on effective importance of having proper cleaning drainage sytem. 4. Provide teachings: o Segregating garbage nonbiodegradable from biodegradable o Organizing and arranging things o Cleaning the

H O

Resources

Evaluation

Time and effort of the student nurse and the family

The family was able to

M E

V I S I T

Money for transportation

1. Recognized the the condition and verbalizes the importance of proper environmental. 2. The family identified the disadvantages of poor environmental sanitation. 3. The performed

family

o Frequent cleaning the surroundings o Started to segregate biodegradabl e from nonbiodegradble XIII

drainage thrice a week

o Organizing and arranging things o Cleaning the drainage thrice a wee

XIV

Assessment

Untrimmed nails Foul odor Dirty clothing Messy hair

Diagnosis

Planning

Intervention

Method Resources

Evaluation

Poor Hygiene of The Family as related problem due to:

After 2 hours Nursing Intervention the Family will be able to gain knowledge in the importance of good personal hygiene.

-Assess the Degree of awareness of the community people with the regards to the existing problem.

-Home Visit

-After the health teachings about proper Hygiene the objectives of increasing the awareness of the community is met as evidenced by:



Inability To maintain a good personal hygiene which is conductive to health maintenance due to inadequate Objective knowledge of importance of Within 1 hour of personal hygiene. nursing intervention the Family will be able to:

-Discuss

-Time and effort of the student nurse.

-Soap

-Enumerate 4/4 of health problems that will possibly cause spread of infection and identified ways to maintain hygiene.

-Shampoo -Towel

-They were able to demonstrate the teachings

-Toothpaste

-Gain Understanding about the importance of proper hygiene in the activities of daily living.

XV

-Enumerate at least four health problems that will possibly cause spread of infection and identify ways to maintain proper hygiene

XVI

Health Problem

Family Nursing Problem

Malnutrition as health threat

Inability to recognize the presence of malnutrition in a dependent member due to lack of knowledge

Cues: Father BMI : 15.1 (Severely Underweight) 5th Child: BMI: 10 (Very Severely Underweight)

Inability to decide about taking appropriate action due to failure to comprehend the nature, magnitude and scope of the problem

After 3 days of nursing intervention the family will be able to recognize the importance of having proper nutrition

Objective of Care

Nursing interventions

After 1 hour of nursing intervention the family will be able to:

1. Emphasize the importance of having healthy weight and nutrition

1. Enumerate at least 5 compications of malnutrion

Method H O M E

2.Discuss the consequences of having bad nutrion

2. Plan and prepare balalnced meals which are within the family’s budget.

3. Encourage the family to choose cheap but health foods.

3. List at least nutritious foods for PTB

Such as green leafy vegetables, legumes ,fruts

V I S I

Resources

Evaluation

Time and effort of the student nurse and the family

The family was able to:

Money for transportation

1. Recognized the importance of having proper nutrition and health body weight 2. Chose cheap but healthy and nutritious foods 3. Plan and prepare balanced meals which are within the family’s budget

T

XVII

Health Problem

Family Nursing Problem

Inability to make decisions when Unhealthful Lifestyle as respect to taking health threat appropriate health action due to Cues: addiction of Father prohibited drugs, o Drinking 3-5 sticks of cigarettes and alcohol. nescafee per day o Sleeping 3-5 hrs per day o Drinking alchohol occasionally

Goal o

Objective of Care

Nursing Interventions

After 1 hour of nursing intervention the father will be abl to:

1. Explain to the client how important healthy life style is.

f Care After 3 days of nursing intervention the father will be able to understand the essence of healthy lifestyle

a. Recite at least 3 advantages of having good lifestyle b. Minimize drinking coffee c. Gradual achievin adequate sleep and rest

2. Inform the client for the possible threat of having unhealthy lifestyle. 3. Assess willingness of the family

Method

H O M E

V I

Resources

Evaluation

Time and effort of the student nurse and the family

The husband was able to modify his lifestyle as evidenced by:

Money for transportation

a. Minimizing drinking coffee b. Achieved adequate sleep and rest c. Drinks water at least 810 glasses per day

S I T

4. Conduct health teaching in the family a. Drinking water at least 8-10 glasses per day b. Sleeping at least 8-10 hrs

XVIII

c. Limit drinking alcoho

Health Problem

Risk for injury related to right sided weakness.

Family Nursing Problem

Goal of Care

Objective of Care

Nursing Interventions

Inability to provide

After Nursing

After 1 hour of rendering proper nursing intervention the patient will be free from possible injury.

1 The nurse will educate the patient on how to use braille call light when asking for assistance.

a home Environment Conducive to heath maintenance and personal development due to :Lack of knowledge on dangerous construction materials that can cause damage

intervention, the family will think of necessary action to reduce potential hazards in to the home environment

2 Teach the client to keep the room clutter free at all times.

Method H O M E

Resources

Evaluation

Time and effort of the student nurse and the family

After 1 hour of rendering proper nursing intervention the patient will be free from possible injuries as evidence by ability to explain the safety precautions.

Money for transportation

V I S

3 Teach the client to keep any sharp objects from the room.

I T

4 Asses the patient ability to ambulate safely with or without assistive devices. 5 Thoroughly XIX

orient the patient to environment. 6 Ask the significant others to always stay with the client. 7 Instruct the client to call for assistance when moving. 8 Ensure that the patient wears proper shoes.

XX

HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVE S OF CARE

NURSING INTERVENTIONS

METHOD OF FAMILY CONTACT

RESOURCES REQUIRED

EVALUATION

Body weakness as a health threat

Inability to recognize the presence of health problem due to:

After nursing intervention the family will make necessary measures to properly manage, control, and lessen the risk factors of hypertension

After nursing intervention the family will be able to:

> assess the family level of understanding regarding the health problem.

home visit

>visual aids and low cost materials needed for demonstration

Partially met after the nursing intervention the client will verbalized understanding of disease process and treatment regimen

a. lack of or inadequate knowledge.

Cues: vital signs taken: BP: 160/100mm Hg

>inability to make decision with respect taking appropriate health actions due to: - failure to comprehend the nature/ magnitude of the problem -lack of adequate knowledge as to alternative courses of action open to them

a. have adequate knowledge a good proper nutrition that reduce hypertension and prevent the occurrence of relative complications in the future.

> discuss with the family the nature signs and symptoms and complication that might arise due to hypertension.

>time and effort on the part of the student nurse and family.

> discuss with the family/client the risk factors of hypertension.

b. Be able to determine the risk factor that XXI

contribute hypertension such as family history, age.

Health Problem Risk for fire hazard as health threat Cues: o o

o

Family Nursing Problem

Inability to provide home environment conducive to Light construction health maintenance and materials Presence of small personal children 2 and 3 development due to: years old Kitchen inside the house

Goal of Care

Objective of Care

After 3 days of nursing interventions, the family will have an awareness to prevent fire

Afte one hour of nursing interventions the family will be able to: a. Cite at least 3 ways in preventing fire b. Have self awareness

Nursing Interventions

Method H

1.. Demonstrate to the family the ways on how to prevent fire accidents within family’s available resources.

O M E

Resources

Evaluation

Time and effort of the student nurse and the family

The family was able to:

Money for transportation

- To recite at least 3 ways for preventive measues - Have self awareness

V I

2. Educate the family some preventive measures:

S I T

- Keeping their candle in the XXII

safest place during no electricity

- Instruct the children to stay away and avoid playing the lamp, matchsticks etc.

Health Problem

Risk for Fall hazard as health threat Cues:

Family Nursing Problem

Goal of Care

Objective of Care

Nursing Interventions

Inability to provide

After Nursing

After 1 hour of nursing interventions

1. Provideinformation

a home

:1.) The familywill the family will know theimportance think of necessary of action to reduce asafeenvironmentfree potential hazards fromhazards andaccident. in to the home environment

Environment Conducive to

o Unguarded stairs o 145 cm length, has 57 heath cm in width, 27 cm maintenance spacing for every and personal steps

development

intervention,

2.) The familywill be awareand

of safety need or injury prevention andmotivation to prevent.

Method H O M E

V I

Resources

Evaluation

Time and effort of the student nurse and the family

The family was able to:

Money for transportation

a. Identified the importance of a safe environment that free from accidents or injury b. Having self awareness for safety c. Encourage to put side rails on their stairs

S 2. Encourage the XXIII

due to

knowledgeable of thehazards in their home includingits preventivemeasures

:Lack of knowledge on dangerous construction materials

family to put side rails on their stairs

I

3. Instruct the family to be careful on stepping the stairs

that can cause damage

Health Problem Financial Problem as Foreseeable Crisis

Family Nursing Problem

Inability to decide about taking appropriate Cues: actions due to o Estimated income failure to ₱6000-9,000 for a comprehend the nature and scope month o 8 members of the of the problem health threats family

Goal of Care

Objective of Care

Nursing Interventions

After 3 days of community visit the family will be able to decide about the appropriate actions to solve the problem.

After one hour of community visit the family will be able to :

Asses level of awareness

Method H O M

1. Choose ways saving foods

E 2. Asses overall general condition

Resources

Evaluation

Time and effort of the student nurse and the family

After2 days of nursing intervention the couple enacted appropriate action to address the problem.

Money for transportation

V I XXIV

o Not able to meet because of financial problem. daily needs

S I 3. Discuss some alternative ways that they can do to solve their problem(i.e. budgeting, saving)

XXV

HEALTH TEACHING PLAN OBJECTIVES After 1-2 students-client interaction, the client will be able to; 1. Enumerate the different healthy food for a preschool child; 2. Identify the multiple methods in improving environmental sanitation and 3. Compare the advantage and disadvantage of proper hygiene. RESOURCES 1.Time and effort of the student nurse and family 2. Visual Aids GENERAL HEALTH TEACHING HYPERTENSION - LOSE WEIGHT

- REDUCE SODIUM INTAKE

- HEALTHY DIET

SPECIFIC HEALTH TEACHING

If overweight. Maintain body mass index of 18.5-24.9 kg/m2. For every 10 kg of weight loss. BP drops by approximately 5-20mmHg. < 2 grams of sodium or approximately < 6 grams of sodium chloride •Consume a diet rich in vegetables, fruits and low fat dietary products. Reduce dietary saturated fat and cholesterol intake for overall cardiovascular health. Reducing fat intake also help reduce calorie intake. •Maintain adequate dietary potassium, calcium and magnesium intake. Avoid Tyramine foods (Protein) •Aged cheese, liver, beer, wine, chocolate, yogurt, pickle, sausage, soy sauce Avoid Stimulants •Caffeine, Alcohol, Cigarette Eat more Fiber •Recommend amount of dietary fiber is 20-35 grams of fiber per day Eat more Fish •Eating for fish may help to lower blood 26

pressure, especially when combined with weight loss.

-REGULAR AEROBIC EXERCISE

MEDICTAION

-

MANAGE STRESS

Once BP is controlled. At least 30 minutes per day, most days of the week. Brisk walking is good exercise.

Take your medication religiously and consult to the health center for medication. Regular visit may help to control the increased of blood pressure Reduce stress as much as possible. Practice healthy coping techniques such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and plenty of sleep can help. •Don’t share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Handwashing

HYGIENE

NUTRITION

•Careful hand-washing helps prevent the spread of germs. Especially before eating and after using toilet, spending time in a crowded public place or petting animals

•Maintain your immune system by getting enough rest, exercising regularly and eating a healthy diet with plenty of fresh fruits vegetables and whole grains.

27

REFERENCES

28