1st level assessment 2nd level assessment

Problem Cues

PRESENCE OF WELLNESS CONDITION

Potential for enhanced management of

hypertension

PRESENCE OF HEALTH DEFICIT

Elevated blood pressure S> Oo talangang tumataas yung BP ko Inability to make decisions with respect to taking
nagpapahinga na lang ako appropriate health action due to:

O > BP 140/90 mmHg Low salience of the problem or condition

Lack of insight or knowledge as to alternative
courses of action

PRESENCE OF HEALTH THREATS

Poor home/environmental condition/sanitation
Presence of breeding or resting sites of vectors of
diseases (e.g. mosquitoes, flies, roaches, rodents,
etc.)
S> Yung tubig naming kinukuha sa ubbog
O> pots and pans kept outside the house
uncovered
>presence of cockroach in the kitchen
>presence of flies in the kitchen
Inability to provide a home environment conducive
to health maintenance and personal development
due to:
a. Lack of knowledge of preventive measures.
b. Lack of skill in carrying out measures to improve
home environment

FORESEEABLE CRISIS

Chronic illness S> nung 2011 nastroke ako pero kahit nag
gagamot ako taas baba padin BP ko
O> Everyday BP of 140/90mmHg
>Failure to utilize community resources for health care
related to lack of family resources specifically man
power r Inability to provide adequate nursing care to
the sick, dependent or vulnerable member of the
family related to inadequate family resources for
 specifically financial constraints

>Inability to provide a home environment conducive

to health maintenance and personal development
related to lack of supportive relationship among
family members

>Failure to utilize community resources for health care

related to inaccessibility of required care/service due
to physical inaccessibility, the location of facility

>Failure to utilize community resources for health care

related to lack of family resources specifically
financial resources

sources

JUSTIFICATION OR EXPLANATION OF THE PROB LEM AND PRIORITIZATION

PRIORITIZATION

HEALTH PROBLEM: Potential for enhanced diet and nutrition regarding hypertension

CRITERIA & TOTAL INTERPRETATION & JUSTIFICATION SCORING & ACTUAL SCORE
COMPUTATION

NATURE It is a WELLNESS STATE that serves as a transition from a specific level of wellness to a higher level and 3/3x1= 3
serves as a premium for clients efforts to maintain a high level wellness and public health nurses effort
to assist families in health promotion, health maintenance and disease prevention.

MODIFIABILITY This health problem is considered to be EASILY MODIFIABLE because of the following justifications: 1.5/2x2= 1.5

a. current knowledge, technology and interventions are widely available in providing health education
and awareness on proper diet and nutrition for hypertensive patients, exercise regimen and ways to
manage hypertension .5
 b. the community where the family lives is rich in green leafy vegetables and fruits which are high in fiber
content and meat is not a usual part of the diet which makes it low in fat and sodium, the health center
also gives BP taking. (community resources)

c. the rural health midwife and baranggay health workers are willing and have time and concern to .5
help the family as seen by their desire to help the student nurses in assessing the families in the
community (manpower)
.5

PREVENTIVE POTENTIAL The problem has a LOW PREVENTIVE POTENTIAL because: 0.75/3x1= 0.25

a. hypertension is a severe disease which may cause complications in various organs of the body 0
especially the heart. Certain interventions can be done to resolve it however strict compliance to
treatment regimen is needed (severe)

b. The clients mentioned that they have been experiencing this illness for years already which makes it
chronic (long duration)
0
c. the management instituted by the family is taking of antihypertensive and eating more vegetables
than meat.
0.75
d. hypertension is not a communicable disease however, the diet in a family can be a factor for
development of hypertension. In the clients case, their diet is appropriate and adequate which lessens
vulnerability of other members (exposure or vulnerability of other members)

SALIENCE The problem has a LOW SALIENCE because: 1/2x1= 0.5

a. the mother verbalized that it is just caused by old age. Though they have been taking medications,
they were noncompliant which indicates that the family is aware of the problem but does not consider it
as urgent as it really is.

TOTAL SCORE 5.25

Health problem: Elevated blood pressure

CRITERIA & TOTAL INTERPRETATION & JUSTIFICATION SCORING & ACTUAL SCORE
COMPUTATION

NATURE It is an ACTUAL ILLNESS CONDITON which is an instance of failure in health and illness condition. It needs 3/3x1= 3
an urgent intervention and requires immediate attention to prevent complications like heart failure and
multi-system and organ failure.

MODIFIABILITY This health problem is considered to be EASILY MODIFIABLE because of the following justifications: 1.5/2x2= 1.5

a. current knowledge, technology and interventions are widely available for the treatment of .5
hypertension

b. . the community where the family lives is rich in green leafy vegetables and fruits which are high in
fiber content and meat is not a usual part of the diet which makes it low in fat and sodium, the health .5
center also gives free antihypertensive medications and BP taking. (community resources)

c. the rural health midwife and baranggay health workers are willing and have time and concern to
help the family as seen by their desire to help the student nurses in assessing the families in the
community (manpower) .5

PREVENTIVE POTENTIAL The problem has a LOW PREVENTIVE POTENTIAL because: 0.75/3x1= 0.25

a. hypertension is a severe disease which may cause complications in various organs of the body 0
especially the heart. Certain interventions can be done to resolve it however strict compliance to
treatment regimen is needed (severe)

b. The clients mentioned that they have been experiencing this illness for years already which makes it
chronic (long duration)
0
c. the management instituted by the family is taking of antihypertensive medications and eating more
vegetables than meat.
0.75
d. hypertension is not a communicable disease however, the diet in a family can be a factor for
development of hypertension. In the clients case, their diet is appropriate and adequate which lessens
vulnerability of other members (exposure or vulnerability of other members)

0
SALIENCE The problem has a LOW SALIENCE because: 1/2x1= 0.5

a. the mother verbalized that it is just caused by old age. Though they have been taking medications,
they were noncompliant which indicates that the family is aware of the problem but does not consider it
as urgent as it really is.

TOTAL SCORE 5.25

Health problem: poor sanitary conditions (lack of food storage facilities, questionable potability of water supply, presence of breeding places for mosquitoes and rodents,
improper drainage system)

CRITERIA & TOTAL INTERPRETATION & JUSTIFICATION SCORING & ACTUAL SCORE
COMPUTATION

NATURE It is a HEALTH THREAT which is a risk factor conducive to the development of other diseases like diarrhea 2/3x1= 0.66
due to contamination of food, dengue, etc. These do not require immediate attention as compared to
health deficits.

MODIFIABILITY This health problem is considered to be PARTIALLY MODIFIABLE because of the following justifications: 1.5/2x2= 1.5

a. current knowledge, technology and interventions are widely available to provide awareness and
education to the family on the proper sanitation, garbage disposal, food storage, boiling of water for
drinking and cleaning of surroundings. 0.5

b. the community members are very helpful and approachable, they can help the family in cutting or
trimming down the grasses around the house, digging a hole for biodegradable wastes. (community
resources)
0.5
c. the family have cleaning supplies like bolo, broomsticks, shovel, etc. which they can use in keeping
their surroundings clean and in digging a compost pit. They also have containers inside their house
which they can use to store food and in keeping their pots and pans away from their pets, they also
have pots and containers to boil drinking water. (family resources) 0.5

d. the rural health midwife and baranggay health workers are available but they are focused on
maintaining health by doing check-ups and giving medication; they may not have time to help the
family in cleaning and maintaining sanitary practices due to their busy schedules (resources of health
 workers)

PREVENTIVE POTENTIAL The problem has a LOW PREVENTIVE POTENTIAL because: 1.5/3x1= 0.5

a. Poor sanitary conditions may not be considered as a severe problem because it is not as life 0
threatening as the other problems listed. It is also easily reversible and can be managed easily through
proper encouragement and education.

b. The clients have been living in the same condition for years (long duration)

c.. They sweep their backyard and burn non-biodegradable wastes to prevent it from accumulating 0
(current and appropriate management initiated by the family)
0.75
d. poor sanitary conditions may place any member of the family to acquire an illness.

0.75

SALIENCE The problem has a LOW SALIENCE because: 0/2x1= 0

a. the family perceived dumping of biodegradable waste in their backyard as a usual practice

b. they do not consider it as urgent because nothing bad has occurred due to these practices

c. they have been used to drinking water from the spring so it no longer bothers them

TOTAL SCORE 2.66

CRITERIA JUSTIFICATION COMPUTATIO ACTUA

N L
SCORE

NATURE It is considered as health threat because it may lead to health deficit (2) (2/3) 1 = 0.67 0.67

MODIFIABILITY It is partially modifiable because of the following justifications: (1/2) 2 = 1 1

The problem of the family requires technology to address the problem (.5)
There are no sources given by the community to help this problem (0)
 The family has no budget (.5)
Barangay health workers are not capable of providing materials to be used to address
their problem (0)
PREVENTIVE It is a low preventive potential because of the following justifications: (1.5/3) 1 = .5 0.5
POTENTIAL It is a severe problem because it can affect their health (.75)
It was made for a long period of time, but there are no accidents reported. (0)
The family does not make any management to provide a healthy home. (0)
An unsteady stairs can cause accident (0.75)
SALIENCE It is a low salience because the family know it but does nothing (1) (1/2) 1=0.5 0.5

TOTAL SCORE 2.67

JUSTIFICATION COMPUTATIO ACTUA

N L
CRITERIA SCORE

NATURE It is considered as health threat because it may lead to health deficit (2) (2/3) 1 = 0.67 0.67

MODIFIABILITY It is partially modifiable because of the following justifications: (1/2) 2 = 1 1

The problem of the family requires technology to address the problem (.5)
There are no sources given by the community to help this problem (0)
The family has no budget (.5)
Barangay health workers are not capable of providing materials to be used to address
their problem (0)
PREVENTIVE It is a low preventive potential because of the following justifications: (1.5/3) 1 = .5 0.5
POTENTIAL It is a severe problem because it can affect their health (.75)
It was made for a long period of time, but there are no accidents reported. (0)
The family does not make any management to provide a healthy home. (0)
An unsteady stairs can cause accident (0.75)
SALIENCE It is a low salience because the family know it but does nothing (1) (1/2) 1=0.5 0.5

TOTAL SCORE 2.67

CRITERIA JUSTIFICATION COMPUTATIO ACTUA

N L
SCORE

NATURE It is considered as health threat because it may lead to health deficit (2) (2/3) 1 = 0.67 0.67
 MODIFIABILITY It is partially modifiable because of the following justifications: (1/2) 2 = 1 1
The problem of the family requires technology to address the problem (.5)
There are no sources given by the community to help this problem (0)
The family has no budget (.5)
Barangay health workers are not capable of providing materials to be used to address
their problem (0)
PREVENTIVE It is a low preventive potential because of the following justifications: (1.5/3) 1 = .5 0.5
POTENTIAL It is a severe problem because it can affect their health (.75)
It was made for a long period of time, but there are no accidents reported. (0)
The family does not make any management to provide a healthy home. (0)
An unsteady stairs can cause accident (0.75)
SALIENCE It is a low salience because the family know it but does nothing (1) (1/2) 1=0.5 0.5

TOTAL SCORE 2.67

health problem: Chronic illness

CRITERIA & TOTAL INTERPRETATION & JUSTIFICATION SCORING & ACTUAL SCORE
COMPUTATION

NATURE It is a FORESEEABLE CRISIS which is an anticipated period of unusual demand, hence, there is time for the 2/3x1= 0.66
family to make adjustments.

MODIFIABILITY This health problem is considered to be EASILY MODIFIABLE because of the following justifications: 1.5/2x2= 1.5

a. current knowledge, technology and interventions are widely available for the prevention of chronic 0.5
illnesses especially those that are related to hypertension and old age.

b. . the community where the family lives is rich in green leafy vegetables and fruits which are high in
fiber content and meat is not a usual part of the diet which makes their diet nutritious and low in fat, the 0.5
health center also gives free medications, check-ups, BP taking and home visits to ensure the health of
the community residents. (community resources)

c. the rural health midwife and baranggay health workers are willing and have time and concern to
help the family as seen by their desire to help the student nurses in assessing the families in the
community (manpower)
 0.5

PREVENTIVE POTENTIAL The problem has a LOW PREVENTIVE POTENTIAL because: 1.5/3x1= 0.5

a. chronic illness is a result of diseases which have occurred at an earlier period and progresses as the 0
patient age. Chronic illnesses can be considered as a severe problem because these may lead to
debilitation and even death (severe)

b. The clients mentioned that they have been experiencing hypertension for years already which makes
this illness chronic (long duration)
0
c. the management instituted by the family is taking of antihypertensive medications and eating more
vegetables than meat.
0.75
d. chronic illnesses associated with old age are often non-communicable and may not place members
of the family at risk. However, if the patients acquire chronic diseases which will make them debilitated
and unable to perform self-care, it may affect the quality of life of the other family members especially
of the caregivers assigned to the patient (exposure or vulnerability of other members)

0.75

SALIENCE The problem has a LOW SALIENCE because: 1/2x1= 0.5

a. Though they have been taking medications, they were noncompliant which indicates that the family
is aware of the problem but does not consider it as urgent as it really is.

b. the family also has no idea of the complications that may be brought by hypertension and what
chronic illness is all about

TOTAL SCORE 3.66

LIST OF PRIORITIZED HEALTH CONDITIONS/ PROBLEMS

HEALTH CONDITIONS/ PROBLEMS ACTUAL SCORE DATE

IDENTIFIED RESOLVED

Potential for enhanced diet and nutrition regarding 5.25 11/22/17 11/29/17
hypertension

Elevated blood pressure 5.25 11/22/17 11/29/17

Chronic illness 3.66 11/22/17 11/29/17

Poor sanitary conditions (unsanitary garbage 2.66 11/22/17 11/29/17

disposal, lack of food storage facilities, house is
surrounded by tall grasses and shrubs, questionable
potability of water supply, presence of breeding
places for mosquitoes and rodents, improper
drainage system
 FNCP PROPER

HEALTH
CONDITIONS/PROBLEMS AND
FAMILY NURSIDNG DIAGNOSIS
GOAL (LONG TERM AND SHORT Intervention Plan Evaluation Plan
TERM/ OBJECTIVES OF CARE)
Method of contact, Resources required and
proposed actions, available OUTCOME METHODS/TOOLS
methods of teaching CRITERIA

Health problem: LTO: Within the whole Home visit Nurse Open sharing Instant feedback
Hypertension as a community rotation, the Small group and
health deficit family will be able to discussion Teaching plan acceptance of
manifest evidences of Facilitating skills to own criteria Direct
ability to provide impart and evoke States the observation
adequate home nursing to correlate importance of
Inability to provide Content of discussion: concepts to
care to Miranda Bagalit these potentials
adequate nursing familys
Brief discussion to
care to the sick, experiences to
STO: During the home of hypertension health/wellbein
dependent or motivate
visits, the family will agree Importance of g maintenance Feedback from
vulnerable member of
to listen to the discussions Diet and Agreement to the neighbours of
the family related to
about Stroke nutrition, change existing the family
inadequate family
relaxation Family condition
resources for
Objectives of care: techniques, Sustainability of
specifically financial
During the home visit the exercise, Positive attitudes expected
constraints
responsible family proper hygiene during discussions behaviours and
Inability to provide a
member will be able to: and, rest and be open-minded, actions
home environment
Gain knowledge about sleep focus
conducive to health
stroke Time in attending
maintenance and
Gain knowledge on the discussion
personal development
management of a patient Responsible
related to lack of
with hypertension (Diet, member willing to
supportive relationship
relaxation techniques listen
among family
members exercise, proper hygiene Venue for
Failure to utilize and, rest and sleep) discussion house
community resources of the family
for health care related
to inaccessibility of
required care/service
due to physical
inaccessibility, the
location of facility
Failure to utilize
community resources
for health care related
to lack of family
resources specifically
financial resources
 Saint Louis University
School of Nursing

(FAMILY NURSING CARE PLAN)

Submitted by:

ACOSTA, Rose Angela R.

Submitted to:

Mr. Elmer Ivan Calaustro