II.

First and Second Level Assessment

A. Health Strengths
Health Strengths Supporting Cues
Enhanced capability for health maintenance S> Family claims to adhere to medications
intake of medications prescribed prescribed. Claims also to take medications
(clopidogrel, losartan, lanoxin, carvedilol, every day and not missing any dosages.
& aldazide) O> Blodd pressure is regulated (T. Amdos:
130/80, L. Amdos: 120/80). All records of
checkups are up to date with follow-up
checkup of L. Amdos on October 22, 2018
to Dr. Manalo. With adequate supply of
medications. All medications properly kept.
Knows time when to take medications.
Potential for enhanced capability for S> A. Amdos claims to tend to farm and
healthy lifestyle, everyday exercise animals. L. Amdos claims to do household
chore. T. Amdos walks to and fro to avoid
being stagnant, however does not overexert
himself.
O> A. Amdos looks physically fit, able to
carry and support himself, can tend to farm
and farm animals. T. Amdos walks slowly,
however able to support himself, and is
restricted to some activities. L. Amdos has
the same restrictions as T. Amdos, however
able to do household chores and walks
independently to Bisal Proper if needed.
Presence of outside agency, SLU SON IV- S> Family claims that SLU SON IV-C1 is a
C1 big help in monitoring the blood pressure of
the family and whole of Bisal.
O> Family is compliant. Family adheres
and understands health teaching and
medications.

Enhanced capability for health maintenance S> Family claims that Al. Amdos who is in
adequacy of income Canada is able to support them by sending
them money every month.
O> Family looks well adequate with needs
such as food, water, shelter, and health
needs.
Enhanced capability for health maintenance S> Family claims to have an adequate
availability of support system support system.
O> the family has the head of the house (T.
Amdos) and his son (Ar. Amdos). Ar.
Amdos with his wife and kid.
Enhanced capability for health maintenance S> Family claims to have a good
family dynamics relationship and is caring. With parent child
subsystem, A. & E. Amdos able to give the
needs of JP. Amdos.
O> it is evident that the needs of every
family member are sustained through
interrelationships.

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 Enhanced capability for health maintenance S> family claims very close ties to
type of neighborhood everyone in Bisal, especially in Sitio
Abiban.
O> Family is able to form good
communication throughout the community
and help anyone who needs their help, and
in return, they will help the Amdos family
when in need as well.

B. Health Problems
Health Problem (First Level Supporting Cues Second Level Assessment
Assessment) (Family Nursing Diagnosis)
A. Health Deficits
Illness state: S> “Nung nanganganak lang > Inability to recognize the
Hypertension ako, nagkaroon lang itong presence of the condition
hypertension ko. Wala due to denial about its
naman ganito sa family ko existence, specifically she
eh.” Claims E. Amdos. She claims she doesn’t have any
claims she was diagnosed, predisposing and
PIH during the time and was precipitating factors to
advised to take in hypertension.
antihypertensives as
maintenance. No pain in the
nape was noted.
O> Patient does not look
fatigued, restless. Upon
palpation of the radial pulse,
+2 pulsations were
observed. BP = 140/90.
Illness state: S>claims to have episode of >Inability to provide
Difficulty of breathing difficulty of breathing. Asks adequate nursing care to
L. Amdos to go to the sick member due to present
Barangay Health clinic to condition of other family
ask for meds asks A. Amdos member.
to get Ventolin from relative.
O> T. Amdos seen mostly
walking in a steady but slow
pace. Does not tire himself.
With recent CT Scan
(10/29/18) and X-ray
(10/23/18) showing
emphysema.
B. Health threat
Stress- provoking S> E. Amdos claims that >Inability to make
factors, interpersonal conflicts since she lives in Bisal, decisions with respect to
between family members conflicting cultural beliefs taking appropriate health
have existed and sometimes action due to conflicting
this was the reason why the opinions among family
Ar. Amdos and E. Amdos members
would often be in an
argument.
O> E. Amdos shows
disbelief in some cultural
activities such as more
festivities when there is a
funeral instead of weddings.

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 C. Foreseeable crisis
Location of health S> family claims that health >Failure to utilize
facility facilities are very far and it community resources for
is needed to hike for an hour health care due to
to actually arrive to the unavailability of required
RHU. service
O> BHC seems to be
unusable. BHC only used
scarcely. SLUHSH is more
accessed by the family.
III. Prioritization of Health Problems
A. Criteria Evaluation
Problem: Illness state: Hypertension
Criteria Computation Score Justification
1. Nature of the 3/3*1 1 A raw score of 3 because she
Problem already has an existing
condition. I have specified it as
the symptom, because there is
no evidence on what her medical
diagnosis really is
2. Modifiability (0.5+0.5+0.5+0)/2*2 1.5 The family is knowledgeable in
modifying. The family as well
has available resources and the
nurse be able to modify.
However, there are limited
supplies from the community to
be able to modify E. Amdos’
condition.
3. Preventive (.75+0+0.75+.75)/3*1 0.5 The blood pressure of E. Amdos
Potential is maintained and considered not
severe. She has been
hypertensive for 4 years already
so it is considered as chronic.
She has maintenance. She is not
exposed to a vulnerable member.
4. Salience of the ½*1 0.5 She recognizes the problem
Problem however she has medications to
help her, thus not needing
immediate attention
TOTAL SCORE 3.5

Problem: Illness state: Difficulty of breathing

Criteria Computation Score Justification
1. Nature of the 3/3*1 1 It is classified as a health deficit
Problem since there was check-up done
with diagnostic tests done such
as CXR on the lung fields of T.
Amdos. There is no clear
evidence as to what was the
medical diagnosis.

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 2. Modifiability (0.5+0.5+0+0)/2*2 1 There is the availability of the
current knowledge of the family
as they know what medications
are to be administered thus
family resources is also given a
score. However, for the nurse
resources & community
resources, the needed medication
was Ventolin and there was no
available medication
3. Preventive (0.75+0+0.75+0)/3*1 0.5 It is not that all severe anymore
Potential since the symptoms have already
been alleviated however, some
symptoms were assessed during
the initial visit such as crackles
upon auscultation. It started in
December, thus it is chronic. T.
Amdos has medication, Ventolin.
And since it is a communicable
disease, there is the exposure of
vulnerable members in the
household such as L. Amdos.
4. Salience of the ½*1 0.5 T. Amdos recognizes the
Problem problem however, it does not
need immediate action since
some of the symptoms have been
alleviated.
TOTAL SCORE 3

Problem: Stress- provoking factors, interpersonal

conflicts between family members
Criteria Computation Score Justification
1. Nature of the 2/3*1 0.67 It is a health threat because it
Problem may affect the decisions made
by the family members due to
cultural indifferences.
2. Modifiability (0.5+0.5+0.5+0.5/2)*2 2 E. Amdos is the only one
adjusting since she is the only
different one therefore scored
0.5. the family is present
therefore 0.5 is given to family
resources. The nurse is available
therefore 0.5 is given to
reseources of the nurse. The
community is available too
therefore 0.5 is given to
resources of the community.
3. Preventive (0+0+0+0.75/3)*1 0.25 0 is given because it is severe
Potential and E. Amdos is able to give
way to “some” cultural
differences. 0 was given since it
was long in durtation ever since
E. Amdos moved to Bisal. 0 is
given since there is no
management just a one sided
understanding from E. Amdos.

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 0.75 is given since there is a
vulnerable member and that is
JP Amdos
4. Salience of the 1/2*1 0.5 They recognize the situation but
Problem they don’t recognize it as a
needing attention.
TOTAL SCORE 3.42

Problem: Location of health facility

Criteria Computation Score Justification
1. Nature of the 1/3*1 0.33 It is considered as a foreseeable
Problem crisis since the location of the
health facilities may increase the
episodes of panic and may
decrease the chances of survival
of the patient.
2. Modifiability (0.5+0.5+0+0.5/2)*2 0.75 The family knows the health
facilities are far away and the
family has an extra family
member who can help in
evacuating the emerging
emergency. The nurse may not
be able to help since a midwife is
only available in the community
and the outside organization such
as the SLU SON IV-C1 won’t be
there for long to assist in
evacuating. However, the
community folk may help as well
in evacuating the patient in
danger.
3. Preventive (0+0+0+0)/3*1 0 This is severe since it may
Potential deteriorate the case of the patient
and decrease the survival of the
patient. And it has always been
far away so given a 0 on
duration, there are no current
management in bringing the
RHU closer however, there is a
BHC located a bit nearer but still
far. And there is exposure of
vulnerable groups since the
family/majority of Bisal are the
old and are unable to walk that
quick without any assistance.
4. Salience of the ½*1 0.5 The family recognizes the
Problem situation however, not needing
immediate action since there are
no impending dangers yet.
TOTAL SCORE 1.58

B. List of Prioritized Health Problems

Health Problem Rank Total Score
Illness state: Hypertension 1 3.5
Stress- provoking factors, 2 3.42

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 interpersonal conflicts
between family members
Difficulty of breathing 3 3
Location of health facility 4 1.58

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