Olivarez College Tagaytay

Bachelor of Science in Nursing

A Family Case Study of De Taza Family

In Partial Fulfillment of Requirements in Related Learning Experience

Presented To:

Mr. Alvin Ganuelas RN., MAN

Clinical Instructor

Presented By:

Nikka F. Gatpandan
BSN IV

I N I T I A L
I.

D A T A

B A S E

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

a. Total number of children: 1 b. List of Household members:

NAME

SEX

AGE

CIVIL STATUS

EDUCATIONAL ATTAINMENT

OCCUPATION

RELIGION

RELATION TO THE FAMILY

RODOLFO DE TAZA FELIX TAZA

MALE

70

MARRIED GRADE 4

GARDENER

ROMAN CARHOLIC

FATHER

DE MALE

40

SINGLE

HIGH SCHOOL GRADUATE

CONSTRUCTI ROMAN ON WORKER CARHOLIC

CHILD

PLACE OF RESIDENCE OF EACH MEMBER The De Taza family is living together in one house, located at house number 120 Brgy. Kaypaaba General Emilio Aguinaldo, Cavite. LENGTH OF RESIDENCY The De Taza family is living in Kaypaaba since birth. SOURCE OF INCOME The family source of income is from the father and his son. The father earns money from selling his plants and his son as a part-time construction worker. The average monthly income is less than 2000 per month.

II. FAMILY CHARACTERISTICS

TYPES OF FAMILY STRUCTURE The De Taza family is patrifocal since they only composed of father and child. DOMINANT FAMILY MEMBER IN TERMS OF DECISION-MAKING, ESPECIALLY IN MATTERS OF HEALTH CARE Both Mang Rodolfo and his son Felix are responsible in making decisions with regards to health care. The two of them work hand in hand to provide their health needs. GENERAL FAMILY RELATIONSHIP The De Taza family is a peaceful family though sometimes they experience quarrels but they easily resolve it by talking through it. In terms of health problems, they consult first their baranggay health workers or sometimes when straight to the baranggay health center to provide necessary treatment before going to the hospital. AWARENESS OF COMMUNITY ORGANIZATION The family is aware of different community organization but they are not actively participating on these because of work and distance of the activities to their house.

III.

ECOGRAM

IV.

HOME AND ENVIRONMENT

1. Housing a. Space adequacy for the family The house is made of concrete and woods. A typical house for a province like Kaypaaba. The house and lot was owned by the father. The house only has 2 windows and can sustain the ventilation needed by the family. The house has two rooms, One for Mang Rodolfo and the other one for his son Felix. They used banig for sleeping.

b. Adequacy of furniture

The De Taza family had only two appliances which is a television that sometimes didnt worked and a radio that is battery operated. . A dining table and wooden chairs, they have a wooden cabinet wherein they place or keep their clothes and other things.

c. Presence of insects and rodents The pests Ive noticed here are that there were cobwebs noted at their ceilings. There were mosquitoes in the kitchen and their bedroom. There are also small rats and ants noted. And there is also presence of houseflies in all part of the house. It is highly possible for insects to get in because their windows are not screened

d. Presence of accident hazards The house is mainly made up of light materials. They cooked their foods outside the house at the back portion using charcoal and woods. This can cause fire and consider hazardous to the well being of all the members of the family. The poor sanitation in the area and the disorder arrangement of the furniture in the house might cause accident to them.

e. Food storage and cooking facilities The family uses wood and charcoal in cooking. Mang Rodolfo is the one who prepares the food. He cooks outside their house at the back portion. The food that they usually eat is vegetables which he harvests from their backyard. When it comes to storing their food, they have poor food storage because they dont have the refrigerator; they just cover it with a plate. In terms of cooking facilities the family is equip with pots, sandoks, utensils and knives.

f. Water supply

The main source of their water supply is coming from the barangay water district. This is where they use for taking a bath, washing clothes and use for cooking. In terms of paying they pay their own water bill.

They put their water in a big container with cover and sometimes in a small jag. They usually dont sterilize their drinking water supply. g. Toilet facility The family does have a toilet of there own but is somewhat unsanitary. It is a hand-flushed latrine type of toilet with black dirt surrounded it. It is dirty and has a stinky smell. h. Garbage disposal In terms of garbage disposal, they either bury or burn their garbage. i. Drainage System The drainage system of the family is an open where in the drainage flows anywhere and is continuous. The drainage system is smelly and unsanitary. j. Lighting facility The family does have electricity but they sometimes use candles to minimize the electric bills. 2. KIND OF NEIGHBORHOOD The houses in the community are not congested. They are spaced adequately. Most of their neighbors are their relatives. They belong to low-income level family. 3. SOCIAL AND HEALTH FACILITIES In terms of social facilities, the community has a basketball area and a chapel that is used by the people for recreation and official activities Kaypaaba also houses the Kaypaaba Elementary School wherein almost all of the children study.. There are also several sari-sari stores in the area wherein they could buy the things they need. As to health facilities, there is a health center which is near in their house.

4. COMMUNICATION AND TRANSPORTATION FACILITIES AVAILABLE The family does not own any transport facilities. They ride on a tricycle or jeepney to the city proper. When they go to the farm or any place in the Kaypaaba, they usually walk kilometers. The family has a television and a radio as means of communication. They have no cell phone for emergency cases of communicating.

V.

HEALTH STATUS OF EACH FAMILY MEMBER

1. Health history of each family

a. Mang Rodolfo- He has no chronic or infectious diseases as of the present time. His hair is evenly distributed and his head is appropriate in size with no masses noted. His skin is dark brown and dry due to sun exposure when he is doing his household chores. He only complains his vision because it appeared unclear due to his aging conditions. He never been hospitalized and still had a healthy body despite his age. He mentioned that he can still hear everything clearly, even the crackle of cockroaches. All time kind of illness, he would just drink paracetamol for fever and mefenamic acid for pain or treat wounds with crushed plants coming from their backyard.

b. Felix De Taza- The student has never met him since he was in his work during the interview. The father mentioned that his son drinks occasionally and used cigarettes daily for releasing of his tension.

2. Source of Medication The family source of medication is from their backyard. They have some herbal plants that are planted there. And some are coming form the health center such as paracetamol and mefenamic acid.

3. Perception to the health works (e.g. student nurse)] They have high respect for the health professionals. They were contented with the free services given by the health workers since that were treated very well regardless of economic status.

VI.

FAMILY TREE
RODOLFO DE TAZA 70 y/o LETICIA DE TAZA 65 y/o

FELIX DE TAZA 40 y/o

VII.

FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

1. Health Perception-health management problems With discontinue vices liking smoking and drinking alcohol for the father. Was able to recognize the importance of having a healthy well-being. Uses herbal plants, though not approved by the DOH, from their backyard.

2. Nutritional-metabolic pattern Do not take any food supplement or vitamins Daily food intake is mainly rice, fish and vegetables

3. Elimination pattern Eliminates everyday with an average of frequency of urine: 5 times No difficulty in voiding and they defecate everyday with no difficulty in defecating noted. 4. Activity-exercise pattern Gardening, walking and household chores is the daily exercise of the father. The son preferred to stay at home and take a nap if he had a free time because his work is toil and he need to recharge his lose energy. 5. Sleep-rest pattern Family usually has 7-8hours of uninterrupted sleep. They usually sleep at around 9 in the evening and wake up at around 4 to 5 in the morning. They also take a nap at free time.

6. Cognitive-perceptual pattern Was oriented to time, place and is able to identify people and significant others by their first names. Was able to responds accordingly and correctly to questions. Retaliates as soon as he can and was able to rationalize. Memory intact and no sensory defects.

7. Self-perception/self-concept Showed apprehension and worry towards unspecific consequences. Perceived situations (health deficits) to be very stressful but remain passive about things and condition.

8. Roles and relationship Family members have an open communication and able to discuss their problems.

9. Sexual reproductive No active sexual reproductive since the father is separated with his wife and his son is still single at his age. 10. Coping Stress Gains strength in the assurance and guarantee provided by each other.

11. Values. Belief Pattern The family is Roman Catholic in faith. Does not go anymore to church since they are situated far away from the place of worship they attend.

VIII. DATA ANALYSIS

A. NURSING PROBLEM IDENTIFIED CUES/DATA The house of De Taza family is composed of mixed structure (wood and concrete). The house is mainly made up of wood. The father usually cooks at the back of the house using wood and charcoal. Father verbalized sanay na kami sa kahoy, ok lang naman magluto basta babantayan at hindi hahayaan ang ginagawa. Masyado mahal ang gasul kaya sa halip na ipambili nun sa pagkain at iba pang gastusin FAMILY NURSING PROBLEM I. Accident hazards specifically fire hazard, as a health threat. A. Inability to provide a home

environment conducive to health maintenance and personal

development due to: a. In adequate family resources; specifically constraints/limited resources. b. Failure to see benefits of financial financial

investment in home environment improvement. B. Inability to make decisions with respect to taking appropriate action due to: a. Failure to comprehend the

napupunta yun pera.

nature, scope, and magnitude of the problem. b. Negative attitude towards the health problem.

c. Low salience of the problem. The income of the family is less than 2000 per month. Father verbalized, Konti lang ang kinikita ko buwan-buwan sa II. Family income beyond daily needs of the family as a health threat. A. Inability to make decisions with respect to taking appropriate health action due to: a. Inaccessibility resources for of care appropriate such as

pagbebenta ng mga halaman ko, wala pa halos 1000. Buti minsan kapag naka-extra aking anak sa

pagpapanday ay nadadagdagan ang aming kita. The hands of the father are unclean when he ate his meal. Father verbalized, sanay na ko kumain ng kamay ang gamit. III.

financial constraints. Unsanitary food handling as a presence of health threat. A. Inability to make decisions with respect to taking appropriate health action due to: a. Low salience of the problem b. Negative attitude towards health problems

The family usually stores their food by covering it with plate and leaves it in the table.

IV.

Poor

home lack

condition of food

specifically

storage facilities as a health threat: A. Inability to make decisions with respect to taking appropriate health action due to:

a. Low salience of the problem b. Negative attitude towards health problem c. Inaccessibility if appropriate

resources for care specifically financial constraints. The familys drainage is an open type. They just throw it anywhere. Water overflows easily when it rains. V. Poor environmental sanitation specifically improper drainage disposal as a health threat: A. Inability to recognize the presence of the problem due to ignorance of facts and attitudes. B. Inability to make decisions with respect to taking appropriate health action due to: a. Low salience of the problems. b. Negative attitude towards health problem. The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present. Biodegradable biodegradable and garbage are nona. Failure not magnitude of the condition. properly segregated. b. Low salience of the problem. to comprehend the VI. Improper Garbage disposal as a health threat: A. Inability to make decisions with respect to taking appropriate health action due to:

Father verbalized, kapag masakit ang katawan ko, bumibili lang ako ng gamot sa tindahan o kaya sa botika. Ganon din ang ginagawa ko kapag may lagnat o ubo.

VII.

Self-medication as unhealthy lifestyle and personal habits or practices as health threat:

A. Inability to make decisions with respect to taking appropriate health action due to: a. Failure to comprehend to

Herbal plants even if not yet approved by the DOH were used as a substitute for medicines.

magnitude of the condition. b. Low salience of the problem. c. Lack of knowledge on the

consequences of the problem.

Presence of vectors such as flies and mosquitoes as well as their breeding places like used cans, bottles and drums.

VIII.

Poor environmental sanitation due to presence of breeding and resting sites for flies and mosquitoes as health threat:

Flies are evidently noticed over the cooking facilities and foods.

A. Inability to make decisions with respect to taking appropriate health action due to: a. Failure to comprehend the

Uncovered particularly filled

container with water

seen near the toilet facility

magnitude of the condition b. Low salience of the condition c. Lack of knowledge on the

consequences of the problem.

B. FAMILY COPING INDEX CRITERIA 1.Physical Independence IDEAL Is concerned with ability to ACTUAL The members are RATING 5 JUSTIFICATION There are no abnormalities in the physical

move all able to move

about to get out of without assistance bed, to take care and of daily grooming, They walking, etc. difficulty. do their

independence of the family members. Every member has no noted disabilities in moving and/or doing their ADL.

activities of daily living without aid. They independent are in

moving about and using their

musculoskeletal system. 2.Therapeutic Competence Includes all of the They are aware procedures treatment or on what to do if a member fells ill. 3 They are aware of their lapses in therapeutic They are

competence.

prescribed for the However due to care such of as illness financial problems giving they provide cannot enough

sentient of their financial difficulties primary having which reason or is for the not the

medications,

following

using appliances, and dressing, exercise,

appropriate

appropriate treatment,

procedure

or

interventions. Although, they

having and for even the

appliances enough children.

relaxation, special use herbal plants diets, etc. that not yet

clothes

approved by the DOH. 3.Knowledge Health Condition of Concerned the health that with The father is 2 Though the father

particular knowledgeable on condition salient is the issues health and

recognizes pertinent health issues, she does not regard it as important at all. This could be detrimental to the

occasion for care responsibilities. such as Yet due to

lives of the members.

knowledge of the financial disease or inability problems, to understand issues health are

communicability of overlooked. diseases mode transmission. Understanding the general pattern of and of

development

newborn baby and basic infants needs of for

physical care.

4.Application of Principles of General Hygiene

Concerned family relation action

with The family sleeps in well and eats

Even

though

aware

of

hygienes importance, the family does not practice

to vegetables

maintaining family everyday. They do nutrition, securing not practice nor

good hygienic skills. Yes they take a bath everyday but their eating habits and maintenance of healthy

adequate rest and sterilization relaxation family carrying accepted preventive measures (immunizations, medical appraisal, safe home-making in relation to and

for healthy habits in

members, food storage and out preparation.

lifestyle are not taken into consideration that much.

storing

preparing of food.) 5.Health Attitudes Concerned with The father is 1 They lack money and

the way the family concerned

about

information for them to carry out the right health care for the family.

feels about health the health of the care in general, members of the including preventive family yet they do not participate

services, care of actively illness, and public maintaining health measures. optimum due to

in

health financial Also

constraints.

the family lacks information regarding healthy lifestyle healthful toward improvement life. 6.Emotional Competence Has to do with the The maturity integrity which family are 5 The family lives of and ways

and competent with enough the emotionally. The

harmoniously at home. Even though conflicts arise, they really see to it that they would discuss each concern in a calm manner.

members of the father

discipline

family are able to and teach her son meet the usual the morals of life. and

stresses

problems of life, and to plan for happy and fruitful living. The degree to which

individuals accept the necessary

disciplines imposed by ones family culture. The development the of

individuals

responsibilities and decision. to

Willingness meet

reasonable to

obligations, accept

adversity

with fortitude, to consider the

needs of others as well as ones own. 7. Family Living Concerned the with There is high 3 Others respect of the individual each family.

interpersonal concern within the especially regards to

relationships member of

or group aspect of family, family family life. The with

Decision-making is shared among its members. Each has his own part or role in the family, which is wellrespected.

members their

get along with one interrelationship another, the ways with others. They in which they both discuss

make

decision decision-making.

affecting

the

family, the degree to which they one and do

support another

things as family, the degree of and

respect

affection, and the ways in which the

manage budget. 8.Physical Environment Concerned home, community the

with The family house the space is good

The house environment is not fitted for them because of the presence of pests and accident hazards in their community. Also their house is poor conditions that they can possibily acquire

and enough. There are work presence of rodents,

environment as its insects, affect health. condition house of

family and other vectors. The They cook their the food outside their as house wherein just pot wood use and as

serious diseases. Their food storage is unsanitary.

such

pressure accident they hazards, screening, facilities cooking, earthly used

Though it is covered with plate or cloth, sometimes the insects and other small animals could crawl inside the dish. The storage of

of fuel. They live in a privacy, place wherein its

level community, transportation schools availability.

of not congested but then the distance of between their

water has a cover but is still unsanitary due to presence of dirt on the outside of the container. Having a earthly pot near the house is really a fire hazard because some of the coal fire might come in contact with their wood wall.

and neighbors are not that so far from each other.

9.Use Community facilities

of Degree family

of use

the They are aware of and the services in their

They are still not active in the community gatherings.

awareness of the offered available community facilities education welfare.

community. However, at

for certain times, they and are unable to avail the services

offered since they are busy because of dont seminars conducted by the Baranggay. work. They attend

IX.

FAMILY NURSING CARE PLAN

a. Prioritizing Health Condition I. Accident hazards specifically fire hazard Criteria 1.Nature problem 2.Modifiability of the x 2 problem 1 of Computation the 2/3 x 1 0.67 Score This Justification problem is a

health threat The partially problem is

modifiable.

The only way to solve this problem is to

renovate the house, thus it needs money. 3. Preventive potential 2/3 x 1 0.67 The problem could be moderately prevented. This could be done if the family will be very alert in watching out

especially if they are cooking since the

house could catch fire anytime. 4.Salience x1 0.5 The compared problem with the

other problems does

not need immediate attention requires money. TOTAL SCORE: 2.84 since time it and

II.

Family income beyond daily needs of the family Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 0.5 The problem could be modified at all. The family could earn

2.Modifiability of the 1/2 x 1 problem

extra income if they engaged to another work or business. 3. Preventive potential 2/3 x 1 0.67 The problem may be prevented by earning extra money. 4.Salience 0/2 x 1 0 The problem is not perceived as a

problem at all by the family. TOTAL SCORE: 1.84

III.

Unsanitary food handling Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 2 The condition can be highly modifiable. If the the family right receives health

2.Modifiability of the 2/2 x 2 problem

teaching, attitude can be changed for the better. 3. Preventive potential 3/3 x 1 1 The problem can be prevented if the family is educated on the importance of hand washing. 4.Salience x1 0.5 The problem is not perceived problem immediate according as a

requiring attention to the

family since there are other health problems more important. TOTAL SCORE:4.17

IV.

Poor home condition specifically lack of food storage facilities Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 1 This partially problem is

2.Modifiability of the x 2 problem

modifiable

since the family lacks resources specifically in the financial aspect. However, appropriate health teachings may correct this problem. 3. Preventive potential 1/3 x 1 0.33 The problem is low preventive potential

since there is lack of appropriate resources that could solve this. 4.Salience 1.2 x 1 0.5 The family is aware of the existing potential of a health threat but they are taking this as problems that need not much attention

and immediate action. TOTAL SCORE: 2.5

V.

Poor environmental sanitation specifically improper drainage disposal Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 2 The problem is easily modifiable teaching the the by family of

2.Modifiability of the 2/2 x 2 problem

importance a

having drainage. 3. Preventive potential 2/3 x 1 0.67 This

proper

is if

highly the

preventable

family has learned the importance of having a clean drainage. 4.Salience x1 0.5 With regards to the familys perception,

the problem does not need attention. TOTAL SCORE: 3.84 immediate

VI.

Improper garbage disposal Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 0.50 It is partially because

2.Modifiability of the x 2 problem

modifiable

they do not know the proper garbage. 3. Preventive potential 3/3 x 1 1 The preventative potential of the problem is high, since the implementation of proper waste disposal will prevent the formation of possible reservoirs of disease. 4.Salience 0/2 x 1 0 The family does not perceive the waste disposal of

disposal as a problem and are content with their method since it saves energy. TOTAL SCORE: 2.17 time and

VII.

Self Medication and unhealthy lifestyle Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 2 It is modifiable

2.Modifiability of the 2/2 x 2 problem

because the checkups in the clinic/health center are free for them and they can avail it anytime they want

3. Preventive potential 2/3 x 1

0.67

The family needs to be informed about the right medications or treatments on certain health problems, by this way they would know the proper medication must be given.

4.Salience

0/2 x 1

The

family

doesnt

view it as a problem. TOTAL SCORE: 3.34

VIII.

Presence of resting sites of vectors of diseases such as insects and rodents. Criteria Computation the 2/3 x 1 0.67 Score This Justification problem is a

1.Nature problem

of

health threat. 2 It is easily modified since it only needs effort, knowledge, and cooperation family. of the

2.Modifiability of the 2/2 x 2 problem

3. Preventive potential 3/3 x 1

If proper sanitation of environment is practiced, diseases and infection can be prevented.

4.Salience

1/2 x 1

0.50

The family is aware of the existing potential of a health threat but they are taking this as problems that need not much attention

and immediate action. TOTAL SCORE: 4.17

THE PRIORITIZED NEEDS PROBLEMS UNSANITARY FOOD HANDLING PRESENCE VECTORS OF OF RESTING DISEASES SITES SUCH OF AS SCORE 4.17 4.17

INSECTS AND RODENTS POOR ENVIRONMENTAL SANITATIONS SPECIFICALLY DISPOSAL SELF-MEDICATION LIFESTYLE ACCIDENT HAZARDS SPECIFICALLY FIRE HAZARD POOR HOME CONDITION SPECIFICALLY LACK OF FOOD STORAGE FACILITIES IMPROPER GARBAGE DISPOSAL FAMILY INCOME BEYONG DAILY NEEDS OF THE FAMILY 2.17 1.84 2.50 2.84 AS UNHEALTHY 3.34 IMPROPER DRAINAGE 3.84