FAMILY EXERCISE PROBLEM

Examine the antenatal mother in your

allotted family and suggest on diet and
other antenatal advices and give your
recommendation at the individual level,
family level, community level.
 INTRODUCTION
• FAMILY TYPE : Nuclear
• HEAD OF
THE FAMILY : Purna Chandra Pal
• ADDRESS : Teghoria , Sonarpur ,
Kolkata-700150
• RELIGION : Hindu
• LANGUAGE : Bengali
• AREA : Semi-Urban
• FAMILY
INCOME : Rs. 8000
• PER CAPITA
INCOME : Rs. 2000
Sl. Name Age Sex Relation Marital Literacy Occupation
No. (yrs) with HOF status

1. Purna 65 Male HOF Married _

Chandra Pal Shopkeeper

2. Chaina Pal 45 Female Wife of 1 Married _ Housewife

3. Gopal Pal 28 Male Son of 1 Married Secondary Shopkeeper

4. Rinki Pal 20 Female Wife of 3 Married Secondary Housewife

Sl. Name Income Nature of Addiction Health status
No. work Present illness Past illness

1. Purna Chandra Rs.4000 Sedentary Smoking -

Pal

2. Chaina Pal _ Sedentary Pan Ovarian cyst

3. Gopal Pal Rs. 4000 Sedentary _ -

4. Rinki Pal _ Sedentary _ -

 OBSERVATION
• Mrs.Rinki Pal, aged 20 years is the antenatal
mother in my allotted family. Her duration of
marriage is 1year 9 months.
• LMP- 05.12.2010
• EDD- 12.09.2011
• At the time of pregnancy she was registered at
KPC Medical College and Hospital.
• She had 5 antenatal visits.
 Patient Particulars
• Height – 151 cm
• Weight – 65 kg
• Booked case- 5 visits
• Registration date- 28.01.2011
• Two doses of tetanus toxoid – Taken
• 1st dose – 20.04.11, 2nd dose – 20.05.11
• IFA tablets -Taken
 Investigations
• ABO/Rh- ‘O’ +ve
• Haemoglobin -12.1 g/dl
• PCV- 36.8%
• Platelet -2,16,000
• FBS - 72 mg/dl
• PPBS - 89 mg/dl
• R/E Urine – Normal findings
• R/E Stool – Normal findings
• Anti HIV – non reactive
• HBsAg – non reactive
• VDRL - negative
 General Survey
• Build – Average
• Nutrition – Good
• Pallor – Absent
• Cyanosis – Absent
• Clubbing – Absent
• Icterus – Absent
• Edema – Bilateral pitting edema in inferior extremity
• Pulse – 84/min,regular,equal,no delay
• Blood Pressure – 130/85 mm of Hg
• Respiratory rate – 20/min
• Neck glands – not enlarged
Foodstuff Item Quantity Calorie Protein Fat (mg) Iron
(kcal) (gm) (mg)
Cereals Rice 1 kg 4325 80 5 50
250gm
Wheat 2oo gm 698 23.6 3.4 9.8
Muri 150 gm 519 9.6 0.9 6
Animal pr Fish(rohi) 500 gm 485 83 7 5
Fish(puti) 200 gm 216 36.2 4.8 20
Oil Mustard 100 gm 900 100
Vegetable Brinjal 500 gm 120 7 1.5 4.5
Roots Potato 500 gm 485 8 0.5 3.5
Onion 2oo gm 100 2.4 0.5 1.4
Sugar Sugar 100 gm 400

Total 8543 249.8 123.6 100.2

 CONSUMPTION UNIT(C.U.)
• Calorie requirement of an adult sedentary worker male
between the age of 18 to 29 years, weighing 60 kg, with a
height of 1.73 m and BMI of 20.3, and is free from disease
and physically fit for active work is one consumption unit.
• 1 consumption unit = 2320 kcal
• CONSUMPTION UNIT
OF MY ALLOTED FAMILY : 3.6
Calorie per consumption unit =
Total calories/Total consumption units

8543/3.6 = 2373 kcal

Nutrients Daily Daily Excess/
requirements consumption Deficiency
Energy(kcal) 8352 8543 +191

Protein(gm) 235 249.8 +14.8

Fat 100 123.6 +23.6

Iron(mg) 90 100.2 +10.2

 Knowledge, Attitude & Practice of the Family

• They have the knowledge about taking more food during

pregnancy and they do so.
• She also knows about personal hygiene.
• She was not aware of danger signs of pregnancy.
• She takes salt in her thali.
• They are not aware of harmful effects of pre lacteal feed.
• They know about beneficial effects of early initiation of
breast feeding, colostrum feeding, and immunization.
• Regarding family planning they follow coitus interruptus
method.
• They are not aware of harmful effects of breast milk
substitutes.
 RECOMMENDATION
• At the individual level:
• She is recommended to have more of calorie per day along with
protein rich diet which would include more of rice, dal, egg,
soyabean, fish, liver,etc.
• I advised her not to take salt in her diet other than the required,
during cooking.
• I advised her to avoid heavy work and take rest and sleep (at least 2
hrs during day and 8 hrs during night)
• She is advised to take bath regularly and keep herself clean.
• I advised her to beware of the danger signs of pregnancy and
immediate transfer to hospital on notice of any one of them.
• She can avail the services of the anganwadi centre for health check-
up, supplementary nutrition and health education.
At the family level:
• I advised them to take care of her and let her
take rest.
• They are advised not to give pre lacteal feed
to the new born.
• They are advised ‘exclusive breast feeding’
and not to give infant milk formula.
• Avoidance of refined, processed and
preserved food and hydrogenated
oils/vanaspati
At the community level:
• Through Behaviour Change Communication and community
mobilisation emphasis will be on exclusive breast feeding,
institutional delivery, immunization of child, delaying age at
marriage, gender bias.
• Pregnant women belonging to BPL families are assisted
under Janani Suraksha Yojna.
• Provision of services at health institutions of new born care,
skilled attendants at birth and post partum care.
• Anganwadi worker is required to maintain a register of the
pregnant women in that area.
• They must pay home visits during the antenatal period.
• Ensuring fixed day ANC clinic in the community and
facilities.