Saint Louis University School of Nursing

Family Nursing Care Plan

Carino Family Daldal, Lengaoan, Bugias, Benguet, Philippines

Submitted To: Mrs. Cheryl Danglipen RN Submitted By: Soriano, Kiji Kiel B. Submitted On: January 10, 2012

I.

Introduction:

A society is made up of a community and a community is a group containing families, which is the basic unit of a community. Within a family are people bonded by marriage and blood. A family composes of a father, mother and their offsprings, a family shares happiness and difficulties together, a family shares one culture and one belief though they came other backgrounds, a family lives in one house. A dysfunctional family will lead to a dysfunctional community which will also ultimately lead to a dysfunctional and unproductive society. As nurses we must care and look out for families within the community. We must help empower them to manage their own health problems by way of proper health teaching and coaching using current, practical and evidenced based practices. This is due to the fact that some of these families do not have access to certain necessities found in urban areas, information and medical managements. But before a health worker interacts with a family, the health worker must first build up rapport with the family and immerse himself/herself within the communities norms and culture to therefore be like the community. As one immerses himself/herself, the health worker then soon functions and works with the community identifying health problems and health needs. Community Health Nursing or Public Health Nursing is defined by the World Health Organization Expert Committee of Nursing as a special field of nursing that combines the skills of nursing, the public health program for promotion of health, the improvement of conditions in the conditions in the social and physical environment, rehabilitation of illness and disability. Primary Health Care as described by WHO (World Health Organization) recognizes that this setting can be the first level contact with a health system that is in the close proximity to where people work and live. II. First Level Assessment Health Potentials I. Absence of Health Threat 1. Adequate Family size *cues- one mother and father, three children(spacing of pregnancy is 1-2years), income is adequate to meet families basic necessities every month 2. Adequate Living Space *cues- rooms are approximately 8x8m and about 8 feet high, house is made up of cement and wood (durability wise) 3. Satisfactory Sanitary Environment *cues- drinking and cooking water are placed in plastic containers, utensils for Health Problems I. Presence of Health Threat 1.Unkempt Sharps *cues-sharps(knives and forks) are within easy access to children, sharps are hidden in the cabinet on top of the dinner table in which the children have an easy access of the utensils. 2. Inadequate Nutritional Requirements *cues-food mainly consists of vegetables and rice, rarely do they eat meat(protein) 3. Poor Home Sanitation

cooking and eating are placed in sealed cabinets 4. Adequate Ventilation *cues- approximately 2 windows in each room 5.Sanitary Food Handling and Preparation *cues-drinking and cooking water are boiled for 30min and food is cooked over a gas stove 6. Healthy Life Style and Personal habits *cues- daily food is composed of rice and vegetables, no obesity noted among members of the family, no smoking personnel within the family, active lifestyle (parents farm and children playmost of the day together), Adequate sleep for all members (6-8 hours for parents and 8-10 hours for children), doesnt walk barefoot going to the farm or outside the house, gas stove routinely checked before leaving the house, garbage segregation is practiced, all immunizations of each members of the family are done except for the newborn which is still waiting for the right age for injection, infant is breastfed prn, family goes to church daily.

*cues- presence of flies(forms of vectors for disease transmission) 4. Unhealthy Lifestyle *cues- drinks alcohol(Jun Carino) and family only goes for check up when sick, clients only take a bath 1-3 times a week

2. Presence of Health Deficit *cues- Janicia currently has cough and colds. Has mild fever (38.4 degrees Celcius), is taking in paracetamol syrup. 3. Presence of Stress Point *cues- children are currently not going to school, additional member to the family (newborm Jarica CArino born November 16, 2012) III. Prioritization of Problems 1. Unkempt Sharps CRITERIA AND HIGHEST POSSIBLE SCORE TO BE GIVEN Nature of the Problem=Health Threat=2

SCORE

JUSTIFICATION

COMPUTATION

ACTUAL SCORE

Sharps within easy reach of the children can have detrimental and disabling results. Children are completely unaware of the dangers of being debilitated and wounded

(2/3)x1=

.67

Modifiability of the Condition/Problem=2 Current knowledge (.5) Family resources (.5) HW resources (0.5) Community resources (0.5) Preventive Potential=2.25 Exposure of a risk member(.75) Gravity of Problem(.75) Duration of Problem(.75) Appropriate current management initiated by family(0) Salience of the Problem=0 Family identified/ verbalized problem(0) Feels/ perceives it as needing immediate attention(0)

from the sharp objects that are within easy reach. It is modifiable because they have current knowledge on what unkempt sharps may cause provided by the community norms and healthworker, and they know a better place to put it. They have adequate family resources in the house they can use such as a high shelf out of reach.

(2/2)x2

2.25

It has a moderate preventive potential since the member does not perceive it as serious and has no further verbalizations about it.Also because they scold their children upon seeing them closing in with the sharps.

(2.25/3)x1

.75

The family does not recognize the problem and does not perceive it as needing immediate attention.

(0/2)x1

Total 2. Unhealthy Lifestyle CRITERIA AND HIGHEST

3.42

SCORE

JUSTIFICATION

COMPUTATION

ACTUAL SCORE

POSSIBLE SCORE TO BE GIVEN Nature of the Problem=Health Threat=2 Modifiability of the Condition/Problem=2 Current knowledge (.5) Family resources (.5) HW resources (0.5) Community resources (0.5) Preventive Potential=2.25 Exposure of a risk member(.75) Gravity of Problem(.75) Duration of Problem(.75) Appropriate current management initiated by family(0) Salience of the Problem=0 Family identified/ verbalized problem(0) Feels/ perceives it as needing immediate attention(0)

2 2

2.25

The problem is a health threat because failure to recognize them can lead to health deficits They are fully aware that the need for annual check up is a necessity as endorsed by the health workers and as advocated by the rest of the community folks. The family has the adequate income to spend for the check up. They also have the resources for bathing such as water and soap. They are also fully aware of the ill causes cigarette smoking can cause such as lung cancer, halitosis, and etc. as expounded by the BHW and the community. It has a moderate preventive potential since the member does not perceive it as serious and has no further verbalizations about it.Because as verbalized hanggang kaya pa, kaya parin.

(2/3)x1 (2/2)x2

.67 2

(2.25/3)x1

.75

The family does not recognize the problem and does not perceive it as needing immediate attention.

(0/2)x1

Total

3.42

3. Inadequate Nutritional Requirements CRITERIA AND HIGHEST SCORE JUSTIFICATION POSSIBLE SCORE TO BE GIVEN Nature of the 2 The problem is a health threat because failure to recognize Problem=Health Threat=2 them can lead to health deficits Modifiability of the 2 They are fully aware that the need of adding protein to their Condition/Problem=2 diet. They have the means of buying meat products of fish and poultry because they have an adequate income. The Current knowledge BHWs also advocate the need for adequate protein intake (.5) so does the community. The community also sells protein Family resources (.5) products like poultry. HW resources (0.5) Community resources (0.5) Preventive Potential=2.25 2.25 It has a moderate preventive potential since the member does not perceive it as serious and has no further Exposure of a risk verbalizations about it.Also because they are contented with member(.75) the food they are eating already. Gravity of Problem(.75) Duration of Problem(.75) Appropriate current management initiated by family(0) Salience of the Problem=0 0 The family does not recognize the problem and does not perceive it as needing immediate attention. Family identified/ verbalized problem(0) Feels/ perceives it as needing immediate attention(0)

COMPUTATION

ACTUAL SCORE

(2/3)x1 (2/2)x2

.67 2

(2.25/3)x1

.75

(0/2)x1

Total 4. Poor Home Sanitation CRITERIA AND HIGHEST POSSIBLE SCORE TO BE GIVEN Nature of the Problem=Health Threat=2 Modifiability of the Condition/Problem=2 Current knowledge (.5) Family resources (.0) HW resources (0.5) Community resources (0.5) Preventive Potential=2.25 Exposure of a risk member(.75) Gravity of Problem(.75) Duration of Problem(.75) Appropriate current management initiated by family(0) Salience of the Problem=0 Family identified/ verbalized problem(0)

3.42

SCORE

JUSTIFICATION

COMPUTATION

ACTUAL SCORE

2 1.5

2.25

The problem is a health threat because failure to recognize them can lead to health deficits They are fully aware that the need for the elimination of the flies around the vicinity of the house. But it is impossible to eradicate them due to their location to a farm. They also dont have the resources to completely eliminate all flies around their place. Although they have a BHW to help them reduce the number of the flies near the vicinity. They also have the community resources to which they can use to reduce flies by community effort. It has a moderate preventive potential since the members does not perceive it as serious and has no further verbalizations about it. For they live with it as if it doesnt pose a threat and that nothing yet has caused them their lives because of the flies,

(2/3)x1 (1.5/2)x2

.67 1.5

(2.25/3)x1

.75

The family does not recognize the problem and does not perceive it as needing immediate attention.

(0/2)x1

Feels/ perceives it as needing immediate attention(0) Total 2.67

5. Presence of Health Deficit CRITERIA AND HIGHEST SCORE POSSIBLE SCORE TO BE GIVEN Nature of the 3 Problem=Health Threat=3

JUSTIFICATION

COMPUTATION

ACTUAL SCORE

Modifiability of the Condition/Problem=2 Current knowledge (.5) Family resources (.5) HW resources (0.5) Community resources (0.5) Preventive Potential=3 Exposure of a risk member(.75) Gravity of Problem(.75) Duration of Problem(.75) Appropriate current management

The problem is a health deficit because the actual member of the family is ill with cough and colds and is only being managed by the use of paracetamol syrup obtained from the RHU. They are fully aware that the need to alleviate their daughter of the cough and colds because if left untreated may lead to complications such as pneumonia. They BHW are present in the community. They also have the means to spend for medications. The community in itself has RHU and hospital.

(3/3)x1

(2/2)x2

Elimination of cough and colds will help achieve better nutrition and have better growth and development achievement.

(3/3)x1

initiated by family(.75) Salience of the Problem=2 Family identified/ verbalized problem(1) Feels/ perceives it as needing immediate attention(1)

The family has identified the condition as a problem through verbalization. The family also has taken appropriate action by going to the nearest RHU for check up and having to buy the prescribed medication. They are now currently feeding the medication to their child.

(2/2)x1

Total 6. Presence of a Stress Point CRITERIA AND HIGHEST SCORE POSSIBLE SCORE TO BE GIVEN Nature of the Problem= 1 Foreseeable Crisis1

JUSTIFICATION

COMPUTATION

ACTUAL SCORE

Modifiability of the Condition/Problem=2 Current knowledge (.5) Family resources (.5) HW resources (0.5) Community resources (0.5) Preventive Potential=2.25 Exposure of a risk member(.75)

The problem is a foreseeable crisis because the addition of a new family member may need several necessities that the whole family has to adjust to such as increasing expenses for food, medications and clothing for the baby. They are fully aware that the addition of a new family member would entail new challenges and needs so as adjustments. The BHW is present to help them immunize and help properly rear the child into maturity. The family also has the means to nurture the child. The community also has RHU and a Hospital for use during a crisis occurs.

(1/3)x1

.33

(2/2)x2

.75

It has a lowpreventive potential since the member does not perceive it as serious and has no further verbalizations about it.Also it is only seen as a foreseeable crisis

(.75/3)x1

.25

Gravity of Problem(.0) Duration of Problem(.0) Appropriate current management initiated by family(0) Salience of the Problem=0 Family identified/ verbalized problem(0) Feels/ perceives it as needing immediate attention(0)

The family does not recognize the problem and does not perceive it as needing immediate attention.

(0/2)x1

Total Final List of Prioritized Problems: Number Problem 1 Presence of Health Deficit: Jancia has Cough and Colds 2 Unkempt Sharps 3 Inadequate Nutrition: Decreased Protein Intake 4 Unhealthy Lifestyle: No annual check ups, Cigarettes smoking, bathing 1-3 per week 5 Poor Home Sanitation: Presence of Flies around the vivinity of the House 6 Presence of Stress Point: Additional Family Member

2.58

Score 5 3.42 3.42 3.42 2.67 2.58

SECOND LEVEL ASSESSMENT Presence of Health Deficit: Jancia has Cough and Colds Unkempt Sharps Inadequate Nutrition: Decreased Protein Intake Unhealthy Lifestyle: No annual check ups, Cigarettes smoking, bathing 1-3 per week Poor Home Sanitation: Presence of Flies around the vicinity of the House Presence of Stress Point: Additional Family Member

Inability to provide adequate nursing care to the dependent member of the family due to inadequate knowledge and skill in carrying out the necessary interventions/ treatment/ care Inability to recognize the presence of the problem due to lack of knowledge Inability to make decisions with respect to taking appropriate health action due to low salience of the problem Inability to provide a home environment conducive to health maintenance and personal development due to lack of knowledge of importance of hygiene and sanitation Inability to provide a home environment conducive to health maintenance and personal development due to lack of knowledge of importance of hygiene and sanitation

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FNCP PROPER
HEALTH PROBLEM FAMILY NURSING PROBLEM GOAL OF CARE OBJECTIVES OF CARE NURSING INTERVENTIONS Illness state:Cough and Colds Inability to provide adequate nursing care to the dependent member of the family due to inadequate knowledge and skill in carrying out the necessary interventions/ The goal is to let the clients parents understand and perform appropriate and independent procedures in managing cough and colds After nursing interventions, the client will be able to: a. verbalize understanding of importance of maintaining normal temp 37.0 C b. demonstrate a. Assess Temp b. administer prescribed medications c. Do tepid sponge bath observing proper strokes d. Demonstrate proper INTERVENTION PLAN METHOD EVALUATION

Home visits, return demonstration

Objectives are fully met since the client was able to perform the objectives stated.

treatment/ care

proper TSB c. enumerate ways to promote cooling of the body

TSB to parents e. Discuss importance of maintaining proper body temp f. Emphasize importance of compliance to therapeutic regimen g. Encourage proper hygiene h. Discuss ways to promote body cooling