FAMILY NURSING CARE PLAN
I. INTRODUCTION
AS HEALTH HEAL TH ADVOCATES SOCIETY, , WE HEALTH ADVOCATES IN IN THE THE SOCIETY SOCIETY, WE ARE ARE OBLIGED OBLIGED TO MAINTAIN OR RESTORE THE OPTIMUM HEALTH OF THE THE PEOPLE PEOPLE WITHIN WITHIN THE THE COMMUNITY COMMUNITY AND AND THAT THAT AIM WE HAVE AS ACTIVELY PARTICIPATING STUDENT NURSES OF THIS GENERATION, WE ADHERE TO THE PROBLEMS OF OUR OUR FAMILY, FAMILY FAMIL Y, WHICH WHICH IS IS THE THE BASIC BASIC UNIT UNIT OF THE SOCIETY AND IMPORTANT IMPORT ANT COMPONENT AND A ND THE MOST IMPORTANT COMPONENT OF OUR COUNTRY. WE MET THE FAMILY FOR THE FIRST TIME LAST JANUARY 15, 2010 AT SAN ROQUE SEASIDE, SE ASIDE, LAP LAPASAN, ASAN, CAGAYAN CAGAY CIT Y. THEIR LOCATION TION SEASIDE, LAPASAN, CAGAY CAGAYAN DE ORO CITY CITY. THEIR THEI R GEOGRAPHICAL LOCA IS READILY ACCESSIBLE BECAUSE YOU DON’T TO RIDE A “TRISIKAD” IN ORDER FOR YOU TO LOCATE THE PLACE; INSTEAD, WE TOOK A WALK IN ORDER FOR TO REACH THE PLACE. THE HEAD OF THE FAMILY IS MR. EUSEBIO AGBONG, A 48 YEAR OLD ORIGINAL RESIDENT OF BARANGAY LAPASAN. HE IS LIVING TOGETHER WITH HIS WIFE, MRS. FLORDELIZA AGBONG, 39 YEAR OLD NATIVE FROM TALAKAG, BUKIDNON AND HIS FIVE CHILDREN. THE HEAD HEAD OF OF THE THE FAMILY FAMILY IS IS A A SECURITY SECURITY GUARD GUARD FROM FROM THE THE SAGITTARIUS AGENCY AND CURRENTLY WORKING AT GUSA, MINDANAO TRACKING CORPORATION AND EARNS AT APPROXIMATELY APPROXIMATELY PHP 7,000 PER MONTH REGARDLESS REGARDLE SS WITH THE EXPENSES AT HOME AND DAILY NEEDS. THE HUSBAND SELDOM DRINKS AND SMOKE BECAUSE OF HIS NIGHT DUTY SHIFT WHILE FLORDELIZA IS A PLAIN HOUSEWIFE WHO’S FOCUS IS TO TAKE CARE OF THE CHILDREN ESPECIALLY THEIR YOUNGEST SON WHO ALW ALWA AYS ACQUIRES SUCH ILLNESSES. ILLNE SSES. AS THE REAL AIM OF THE NURSING PROFESSION WHICH IS TO GIVE CARE TO THE PEOPLE, WE TOOK IT AS A STEPPING STONE IN HELPING THE FAMILY IN MAKING THEM REALIZE THE ESSENCE OF A SIMPLE YET HEALTHY LIFE THROUGH MANY WAYS WAYS OF LIVING. WE ARE ALSO ALS O RESPONSIBLE RESPONSIBL E FOR GIVING OUR AMILY AMIL Y THE O UR F FAMIL IMPORTANCE IMPORT ANCE OF PRIORITIZING SUCH HEAL HEALTH TH PROBLEMS WHETHER A HEAL HEALTH TH DEFICIT OR THREAT IN ORDER TO GIVE SPECIFIC ACTIONS FOR US, TOGETHER WITH THE COOPERATION OF THE FAMILY, TO ACHIEVE, SOLVE, REDUCE AND/OR COMPLETELY ELIMINATE THE DIFFERENT KINDS OF PROBLEMS PROBLEMS THROUGH THROUGH ESTABLISHING ESTABLISHING A A GOOD GOOD
II. ACKNOWLEDGEMENT
AS HEALTH PROVIDERS OF THIS SOCIETY, WE OUGHT TO GIVE OUR ALL IN ORDER TO HELP THE PEOPLE IN THIS COMMUNITY ACHIEVE THEIR MAIN GOAL--- THE HEALTH YET JOYFUL LIFE. A BIG AND UNENDING THANKS TO OUR CLINICAL INSTRUCTOR, MS. DOREEN GRACE CONTRERAS, RN, WHO BROUGHT OUR IDEAS AND OUR CLINICAL EXPERIENCES INTO MORE PRODUCTIVE YET HELPFUL TO ALL THE PEOPLE IN THE COMMUNITY BECAUSE THROUGH HR FUN-FILLED WAY OF TEACHING, WE ARE ABLE TO INCULCATE IN OUR MINDS AND MOST ESPECIALLY ESPECIALL Y TO OUR HEARTS HEA RTS THE IMPORTANCE OF HELPING H ELPING FAMILY FAMILY IN A CERTAIN COMMUNITY HE ARTS TO ACHIEVE THEIR OPTIMUM HEALTH WHICH IS PREDOMINANTLY THEIR OPTIMUM OPTI MUM HEALTH HEALTH WHICH IS PREDOMINANTLY PREDOMINANTLY THE THE AIM AIM AI M OF OF THIS THISPROJECT. PROJECT. PROJECT. SHE SHE ENHANCED OUR CAPABILITIES IN GIVING CARE TO THE PEOPLE WHO NEEDED THE MOST OUT OF IT.. IT IN ADDITION, WE CAN’T ALSO FORGET THE ENDLESS EFFORT OF THE HEALTH CARE PROVIDER RESIDING AT SAN JUAN LAPASAN HEALTH CENTER AS WELL AS TO THE BARANGAY HEALTH HEALTH WORKERS AND MOST ESPECIALLY ESPECIALLY ESPECIALLY TO TO THE THE PUBLIC PUBLIC PUBLI C HEALTH HEALTH HEALTH NURSE NURSE OF OF THE THE BARANGAY, BARANGAY, MR. REX RANILE, RN, WHO TAUGHT US HOW TO GIVE IMPORTANCE TO THE FAMILIES ESPECIALLY TO THOSE INDIGENT PEOPLE. THE SAID ACTION WILL NEVER BE ATTAINED WITHOUT THE COURAGE AND SELFLESS EFFORT OF MY GROUP MATES: LYRA, RIEZEL, CRYSTAL, IRISH, HANNAH AND JAIRUS, WHO TOOK THIS CHALLENGE SERIOUSLY AND DID IT WITHOUT ANY HESITATIONS TO HELP A FAMILY WHO NEEDED MUCH CARE FROM US TROUGH THE SLEEPLESS NIGHTS THAT WE HAD, AND THE MONEY, TIME, AND EFFORT THAT WE EXERTED, SHARED AND SACRIFICED, THE PROJECT BECAME POSSIBLE THAT I CAN SAY, IT ALL WORTH IT. WE WOULD NEVER FORGET THE BIG HELP OF OUR ALMIGHTY GOD, THE CREATOR OF ALL LIVING AND NON-LIVING THINGS AND WHO PROVIDED ALL THE RESOURCES THAT WE NEED IN ORDER ORDE R TO GIVE THE AMILY Y. HE MIRACULOUSL MIRACULOUSLY Y MADE THE NECESSARY CARE TO OUR CHOSEN FAMIL THINGS POSSIBLE THROUGH GIVING US KNOWLEDGE, THE ABILITIES AND THE RESOURCES THAT WE NEED. HE HELPED US IN MANY WAYS AND WE UNDOUBTLY APPRECIATE IT AND WE GIVE HIM ALL OUR PRAISES. PRAISES. IN ACCORDANCE TO THE VISION OF THE DEPARTMENT OF HEALTH IN THE PHILIPPINES: “THE LEADER OF HEALTH IN ALL FILIPINOS IN THE PHILIPPINES”, WE, IN THE LEAST THAT WE DID, CONTRIBUTED TO ITS VISION THROUGH GIVING OUR WILLINGNESS AND DETERMINATION TO DEVOUT OURSELVES IN GIVING CARE TO OUR FILIPINO COUNTRYMEN AND
BIOGRAPHICA L DATA
A. FAMILY STRUCTURE AND HARACTERISTICS
HEAD OF THE FAMILY
AGBONG
EUSEBIO
48
LAST NAME AGE
FIRST NAME
ADDRESS:
SEASIDE SAN ROQUE, ROQUE, LAPASAN, LAPASAN, CAGAYAN DE ORO CITY
MEMBERS OF THE FAMILY
NAME
AGE
SEX
CIVIL STATUS
POSITION IN RELATIONSHIP THE FAMILY TO THE FAMILY
PLACE OF RESIDENCE
Flordeliza Agbong
39
F
Married
Wife
Wife
Seaside, San Roque, Lapazan
Marlon Agbong
18
M
Single
Eldest Son
Son
Seaside, San Roque, Lapazan
Candy Agbong17
F
Single
2nd child
Daughter
Seaside, San Roque, Lapazan
Cindy Agbong 16 16
F
Single
3rd child
Daughter
Seaside, San Roque, Lapazan
Mary Jane Agbong
F
Single
4th child
Daughter
Seaside, San Roque, Lapazan
Single
5th child
Son
Seaside, San Roque, Lapazan
Aldren Agbong
8
2
B. BIOLOGICAL AND SOCIOCULTURAL FACTORS 1. What is the family’s source of income? The family’s source of income is from the husband only. only. The husband works as a security guard at Gusa, Mindanao Tracking Corporation from the Sagittarius Agency. He works about an average of 8 hours/day. His monthly income averages Php 7,000 per month.
2. What is their ethnic background? Their religious affiliation? When it comes to their ethnic background, the husband is purely Kagay-anon while the wife is from Talakag, Bukidnon. They are currently residing at San Roque Seaside, Lapasan Cagayan de Oro City. The rest of the members of the family speak Visayan. They are “Philippinista” “P hilippinista” but their first born son separately goes to church at United Christian Church of the Philippines (UCCP).
3. Who are the family’s significant others? What roles do they play in the family’s life? The family’s significant others are their inlaws, siblings of the husband and their children who lived next to their home. The role of their significant others is to help them in times of need just like emotional and most especially during financial problems.
4. Does the family participate in the activities of the community? If yes what are these activities. If no, what are are the reasons reasons why they do not participate? Yes, family participates in the activities of the community like feeding programs; outreach programs and community clean up of the
FACTORS 1. Housing a. Is the family’s living space adequate for their number? The family’s living space is inadequate for their number. It has one room in near their kitchen for the couple and small portion upstairs for their five children. All the children sleep together in one room including the 2 year old boy.
b. Is their furniture adequate for them? Is it enough for their needs? The family’s furniture is enough for their needs. They have one table, small cabinet for their TV and DVD and small sofa for their visitors but their kitchen utensils do not sustain their needs.
c. Are their insects and rodents in their house?
d. Are their accident hazards in and around the house? If yes, please enumerate. The house is made of light materials. They cooked their foods inside the house using liquefied petroleum gas (LPG) but sometimes if they ran out of LPG, they used to cook their food inside the house using the “kahoy” located in the ground beside the wall. This can cause fire and considered as hazardous to well being of all the members of the family. The wirings are too close to each other that might result to a short circuit that will eventually lead to fir The house is always affected by flood due to its location and structure since their house is not elevated, thus, causes the water to go inside and flood their things inside.
e. What are their cooking utensils? What is their storage? Their cooking utensils include only of one small frying pan and pots. They use plastic ware for their food. They don’t have enough storage for their utensils because some utensils are just place in the anywhere. In addition, they have poor food storage because they don’t have the refrigerator, thus, their food must be all consumed in order for the food not to become spoiled.
f. What is their water supply? Where is the source? Is it potable? They do not have their own water supply. The source of their drinking water is from the Cagayan de Oro Water District (COWD), government own free for the residents in their place. They wake up early and gather some water and store it in the plastic container, which is slightly dirty.
g. What is their toilet facility? What is its condition? Is it sanitary? The family does have a toilet of their own but it somewhat unsanitary. It is open and located at the corner of their kitchen beside the unprotected stairs. It is water –sealed type of toilet with black dirt surrounded on it. The only barrier to their toilet from the other parts of the house is the bathroom curtains only, thus, when someone defecates, all the family members will know because they can
h. What is the type of their garbage and refuse disposal system? Is it sanitary? They use sack for their garbage, which is collected by the garbage truck every Tuesday. It has no cover and the flies are all around but as we go on with our assessment we found out that there are scattered trashes at the back of their house situated beside the toilet.
i. Describe their drainage system. Is it sanitary? The drainage system is closely sealed but still it is smelly and unsanitary since they do not have the willingness to clean their drainage.
2. What type of neighborhood does the family belong to? Describe. The type of their neighborhood is like squatter’s area. They belong in a low-income level family. It is noisy, crowded and cannot accessed by vehicles especially fire trucks.
3. Are their social and health facilities in the neighborhood? If yes, please enumerate and describe each? In terms of their social facilities, they have basketball court 30 meters away from their house. They also have a Catholic Church in the area. As to health facilities, there is a health center which is appr approx oximately imately 45 meters away from their house
4. What is the family’s mean of communication and transportation? The family has a television and a radio as a means of communication. His oldest son has a cell
. HISTORY 1. Medical and health history of each family member. The children of the Agbong Family already completed their immunization as evidenced by immunization record situated at the San Roque Health Center that was provided by the Barangay Health Worker (BHW). Vaccines given were one dose of BCG, 3 doses of OPV, 3 doses of Hepa B, 1 dose of measles. The youngest son of the family, Aldren experienced hospitalization during the year 2008 because of diarrhea. There is no further passed hospitalization experienced by the children of the said family. Currently, Aldren is suffering from diarrhea but they did not consult yet any doctors because according to the mother it is not yet severe and the child is still responding effectively.
2. Value placed on disease prevention. a. Are the children immunized? What is their immunization status? All of the five children were fully immunized because they availed the immunization program
IMMUNIZATIONS RECEIVED BY THE CHILDREN OF THE SAID FAMILY: Child’s Name
DPT
BCG
OPV
Hepatitis B
Measles
Marlon Agbong Candy Agbong Cindy Agbong Mary Jane Agbong Aldren Agbong
b. Does the family utilize other preventive actions? If yes, what are they? The family does not have other preventive preventiv e actions.
3. What is the family’s source of medication? The family’s source of medication is from their health center. These medications include paracetamol (biogesic) and amoxicillin. If and when that one of their family members will get severe illness they often borrow money with the siblings of the husband.
4. What are their perception of the role of the health professional and their services? What are their expectations of the services of the community health? Nurse? They have high respect for the health professionals. They were contented with the free services given by the health workers since they were treated very well regardless of their economic status.
5. Do they have previous experience with the health professionals? If yes, were they satisfied with the results? Yes, They have previous experience with the health professionals. It was when they consulted at the health center and their youngest son was hospitalized in NMMC. So far all health professionals they have encountered treated them well. They were satisfied of the services.
STRUCTURE Patriarchal
Single Parent
Extended Nuclear
Matriarchal Alternate Family
1. Dominant family members in terms of decision making, especially in health care. The husband and wife often share the obligation of making decisions relative to health care. The father predominantly makes the decision regarding with the activities of the family. But when it comes to caring the sick family member it is the mother who take good care of them.
2. Describe the general family relationship. relationship. As what we have observed, the family has a good, harmonious relationship. The husband does not have any vices but drinks occasionally like during fiestas and birthdays. The husband is responsible enough to provide the family’s needs while the wife is taking good
IIV. V. A TIVITIE FOR F R DAILY DAILY ACTIVITIES LIVING A. SLEEPING SLEEPI NG PA PATTERN 1. Are there hours for retiring and getting up? All of the family members wake up at 5 am because they have their own chores to do and they prepare themselves for school.
2. Do the family nap during the day? Only the mother and her youngest son can nap during the day because the husband is working while the rest are at school. They usually nap at around 2 pm of the day after house hold chores and after watching noon time show.
3. Do the members of the family sleep together? The couple sleep together in their bed beside the kitchen while the children sleeps together also in the other
B. EATING PATTERN
1. How many meals do the family have each day? The family can eat three meals a day. Their meals usually consist of vegetables, sardines and dried fish. They eat snacks sometimes during afternoon. But sometimes when they are out of budget, they take their meals twice only.
2. Does anyone of the family appear over weight or under weight? Who they are?
Members
Age
Weight
Height
BMI
Classific ation
Eusebio (father)
48
61 kg
160 cm
23.82
Normal
Flordeliza (wife)
39
52kg
158 cm
20.82
Normal
Marlon
18
48kg
157cm
19.47
Normal
Candy
17
39kg
155cm
16.23
Underwe ight
Cindy
12
26 kg
138cm
13.65
Underwe ight
Mary Jane
8
24 kg
133cm
13.56
Underwe ight
Aldren
2
10kg
14.87
underwei ght
82cm
C. LEISURE TIME ACTIVITIES
1. How does each member spend his/ her leisure hours? Is the leisure time appropriate for the sex and age group of the individual? The father does not have leisure time because he is at work and when if it’s his off day he spent it by resting in the house. He leaves early for work and went home late. The mother does not also have leisure time because she’s so busy doing laundry and giving care to the children.
2. Does any member have an all- consuming hobby? If yes, What affects does this on the family. Any of the family does not have any all- consuming hobbies because they prioritized their work rather than their hobbies.
3. Does the family have any joint activity for leisure? What is it? How often do they do this limited activity?
WHAT ARE THE PROBLEMS THAT WERE IDENTIFIED?
2. PRESENCE OF UNSANITARY BREEDING PLACES TOILET OF INSECTS AND RODENTS
1.
4. IMPROPER GARBAGE DISPOSAL
3. MALNUTRITION
5.
FAM AMIL ILY Y HI HIST STORY ORY OF SPECIFIC CONDITION (HYPERTENSION)
6.
INADEQUATE LIVING SPACE
.
7.
ACCIDENTAL HAZARDS
WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE
9. LACK OF FOOD STORAGE FACILITIES
10. INADEQUATE PERSONAL BELONGINGS UTENSILS
VIII. RANKING OF THE 10 FAMILY HEALTH PROBLEMS RANK
SCORE
FAMILY HEALTH PROBLEMS
1
4.17
UNSANITARY TOILET
4.17
PRESENCE OF BREEDING PLACES OF INSECTS AND RODENTS
2
4
MALNUTRITION
3
3.84
IMPROPER GARBAGE DISPOSAL
4
3.83
FAMILY HISTORY OF SPECIFIC CONDITION (HYPERTENSION)
5
3.17
INADEQUATE LIVING SPACE
6
2.84
ACCIDENTAL HAZARDS
2.84
FAMLY BEYONG WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE
2.67
LACK OF FOOD STORAGE FACILITIES
2.67
INADEQUATE PERSONAL BELONGINGS UTENSILS
7
NURSING CARE PLAN
Health Problems
Family Nursing Problem
Goall of Ca Goa Care re (Ge (Gene neral ral))
Object Obje ctive ive of car caree (specific)
Intervention Measures
Method of Nurse-Family Contact
- Inability to recognize - After the nursing -After a month of nursing Home Visit the problem of intervention, the family will intervention intervention,, the family -Emphasize the malnutrition due to: be able to: will be able to: importance of Perform the Improve the weight proper nutrition Ignorance of facts that some of the family -Teach the family importance of nutrition of the malnourished members are among the family child with the help of on proper food malnourished members through their the health teachings preparation Fear of Consequences actions of abstaining - Enumerate the being taught to eat 16.23 of diagnosis of problem unhealthy food. various kinds of food. advantages and =Cindy (12 related to economic. disadvantagess of Identify cheaper yet Demonstrate the disadvantage years old) - Inability to make nutritious and healthy proper way of preparingmalnutrition 13.65 decisions with respect to foods - Identify cheaper nutritious food. =Mary Jane (8 taking appropriate health nutritious and years old) actions due to: healthy foods 13.56 Low salience of the =Aldren (2 family about the existing years old) problem of malnutriti malnutrition on 14.87 in the family. Inability to decide which action action to take among the list alternatives I order to be healthy. Fear of consequences of action related to economic.
Malnutrition Underweight BMI of the following family members: = Candy (17 years old) -
•
•
•
•
Resources Required
Evaluation
-Time -Effort Goals partially -Money met: -Camera -Weighing Scale -They are able to -Tape Measure perform the (for BMI) importance of -Notebook nutrition through -Pen abstaining -BMI chart unnecessary food like “junk” foods. and able to identify cheaper nutritious and healthy foods but fail to demonstrate the importance of food preparation due to the location of their kitchen and the lack of necessary utensils.
Health Problems
Family Nursing Problem
Goall of Care Goa Care (Ge (Gener neral) al)
Unsanitary Toilet
- Inability to make decisions with respect to taking appropriate health action due to: Fear of consequences of action secondary to economic -Inability to recognize the presence of a problem due to: Ignorance of facts that unsanitary toilet might cause the spread of any kinds of infection.
- After the nursing -After an hour of -Provide proper Home Visit intervention, the family nursing intervention, Health teachings will be able to: the family will be able in maintaining good hygiene To demonstrate the to: • within their effects of unsanitary To perform • scope of toilet to the health of the proper waste family. disposal (feces and environment. -provide To perform the urine) • proper use of toilet To identify and effective • information facility and keeping it differentiate the clean and therapeutic to advantages of proper about the various diseases that the all the family members. waste disposal in preventing the spreadfamily can acquire with of communicable unsanitary toilet diseases. -d
Objective Object ive of care care (specific)
Intervention Measures
Method of Resources Nurse-Family Required Contact
-Time -Effort -Money -Camera -Weighing Scale -Tape Measure (for BMI) -Notebook -Pen -BMI chart
Evaluation
Goals partially met: -They are able to verbalize the importance of nutrition and able to identify cheaper nutritious and healthy foods but fail to demonstrate the importance of food preparation due to the location of there kitchen.
Health Problems
Family Nursing Problem
Goal Go al of of Care Care (G (Gen ener eral al))
Presence of Breeding Places of Rodents and Insects
- Inability to recognize - After the nursing the problem of having intervention, the family will breeding places of be able to: To rodents and insects due to: demonstrate on how to Ignorance of facts that prevent the numbers of these rodents could rodents and insects in cause different kinds their house. of disease. To know what Fear of consequences diseases will be acquired of diagnosis of in having these insects problem secondary to and rodents. economic. -Inability to make decisions with respect to taking appropriate health actions due to: Inability to decide which action to take among the list of alternatives. Fear of consequence of action secondary to economic. •
•
Object Obje ctiv ivee of ca care re (specific)
Intervention Measures
Method of Resources Nurse-Family Required Contact
-After an hour of nursing -Perform to the Home Visit intervention, the family family the various will be able to: yet very effective Earn a sufficient strategies in eliminating these knowledge on what rodents and insects things to be done in order for these rodents through promoting a clean to be eliminated. environment. identify the advantages of having a -Provide proper clean environment in health teaching about the relation to the advantages and elimination of these. disadvantages of having breeding places of insects and rodents. •
•
-Time -Effort -Money -Camera (for Documentation) -Good sound Conversation
Evaluation
Goals met: -Each of the family members were able to demonstrate correctly the ways in preventing the increase of these rodents as well as able to know the disadvantages disadvantag es of having these rodents around.