NCM 101 –RLE -Community

FORMAT: FAMILY CASE STUDY

l. Front page

l. Inroduction:

Ref: CMO 14, concepts of NCM 101

ll. Narrative:

a story or an account of a sequence of events in the order in which they happened

lll. Initial Data Base

A. Family Structure, Characteristics, and Dynamics

1. Demographic Data

Household members Position in the family Birthdate/age Se Civil status Residence of each member
x

2. Type of the family structure-e.g. Matriarchal, nuclear or extended with justification

3.. Dominant family members in terms of decision-making, especially in matters of health care with justification (Paragraph form)

4. General family relationship/dynamics-presence of pf any obvious/readily observable conflict between members; characteristic communication/interaction patterns among members

with justification. ( Paragraph form)

B. Socio-economic and Cultural Characteristics

a. Educational attainment of each member

b. Ethnic background and religious affiliation

 c. Occupation, place of work and income of each working member

1. Family profile ??

Household members Position in the family Educational Ethnicity Religion Occupation Place of work Income per member
attainment

2. Income and Expenses (Daily, Weekly/Monthly)

3.. Adequacy to meet basic necessities (food, clothing, shelter)

4. Who makes decision about money and how it spent (with justification)

5. Significant Others-role(s) they play in family’s life

6. Relationship of the family to larger community-nature and extent of participation of the family in community activities

C. Home and Environment (Paragraph form with documenatation)

1. Housing (Describe and justify each what is being asked below)

a. Adequacy of living space

b. Sleeping arrangement

c. Presence of breeding or resting sites of vectors of disease (e.g. mosquitoes, roaches, flies, rodents, etc.)

d. Presence of accident hazards

e. Food storage and cooking facilities

f. Water supply-source, ownership, potability

g. Toilet facility-type, ownership, sanitary condition

h. Garbage/refuses disposal-type, sanitary condition

i. Drainage system-type, sanitary condition

2. Kind of neibhorhood, e.g. congested, slum, etc.

 3. Social and Health facilities available

4. Communication and Transportation available

D. Health Status of each Family Member (Tabulate the information systematically)

1. Medical and nursing history indicating current or past significant illness or beliefs and practices conducive to health and illness

2. Nutritional assessment (special for vulnerable or at-risk members)

a. Anthropometric data:

Measures of nutritional status of children-weight, height, mid-upper arm circumference;

Risk assessment measures for obesity*:

 body mass index

Household members Weight Height BMI

 waist circumference (WC: greater then 90 cm. In men and greater than 80cm. in women),
 waist hip ratio (WHR+waist circumference in cm. divided by hip circumference in cm.
 Central Obesity: WHR equal to or grater than 1.0 cm. in men and 0.85 in women).

b. Dietary history specifying quality and quantity of food/nutrient intake per day

c. Eating/feeding habits/practices

3. Developmental assessment of infants, toddlers, and preschoolers-e.g., Metro Manila Development Screening Test (MMDST).

4. Risk factor assessment indicating presence of major and contributing modifiable risk factors for specific lifestyle diseases-e.g hypertension, physical inactivity, sedentary lifestyle,

cigarette/tabacco smoking, elevated blood lipids/cholesterol, obesity, diabetes mellitus, inadequate fiber intake, stress, alcohol driking and other substance abuse

5. Physical assessment indicating presence of illness state/s (diagnose or undiagnosed by medical practitioners)

6. Result of laboratory/diagnostic and other screening procedures supportive of assessment findings

E. Values, Habbits, Practices on Health Promotion, Maintenance and Disease Prevention.

 1. Immunization status of family members (Tabulate the informationbelow systemetically)

2. Healthy lifestyle practices. Specific. (Paragraph form)

3. Adequacy of: (Paragraph form)

a. Rest and sleep

b. Exercise/activities

c. Use of protective measures-e.g. adequate footwear i parasite infested areas; use of bednets and protective clothing in malaria and filariasis endemic areas

d. Relaxation and other stress management activities

4. Use of promotive-preventive health services (Paragraph form)

lV. List of Health Problems According to Priority: ( Derived from initial data base)

Health Problems Total Score

1.

V. First and Second Level Assessment:

1st Level Assessment 2nd Level Assessment Typology of Nursing Problem , its Weight and Prioritization
 Actual
Ques/Data Health Problem Family Nursing Diagnosis Criteria Typology Computation Justification
Score

Nature of the
Problem

Modifyability
of the
problem

Preventive
Potential

Salience

Total Score

Vl. Nursing Care Plan

Goal Objectives Intervention Plan Method of Nurse- Resources

 Family Contact Required
Nursing Intervention Rationale Evaluation

Vll. Bibliography:
1. References
2. Data gathering methods and tools
3. Scale for ranking family nursing problem

*** Place it in an acetate folder.

Prepared By: Julita J. Rodriguez RN,MSN