A Family Case Study of

Real Family

A Report Presented
To the College of Nursing
University of Northern Philippines

In Partial Fulfillment
Of the Requirements in
NCM 109 CL

Presented by:
Neo Kyle R. Quarto

Presented to:
Ms. Racel Dela Paz Abero

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 TABLE OF CONTENTS
Title Page………………………………………………………………………1
Table of Contents……………………………………………………………...2

CHAPTER I
Introduction……………………………………………………………………..3

CHAPTER II
Objectives of the Study………………………………………………………....5

CHAPTER III
Initial Data base…………………………………………………………………6
a. Family, Structure, Characteristics and Dynamics/Relational Patterns…….6
b. Socio-economic and Cultural Characteristics…………………………..…7
c. Home and Environment …………………………………………………..8
d. Health Status of each Family member……………………........................9
e. Values, Habits, Practices on Health Promotion, Maintenance and Disease
Prevention………………………………………………………………...13

CHAPTER IV
Typology of Nursing Problems
I. First Level Assessment………………………………………………….14
II. Second Level Assessment………………………………………………16
III. Table…………………………………………………………………….18

CHAPTER V
Prioritization………………………...…………………………………………19

CHAPTER VI -Family Nursing Care Plan…………………………………...22

CHAPTER VII
Community Survey Form…………………………………………………….24
Documentation………………………………………………………………..34

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 Chapter I
INTRODUCTION

In human society, family is a group of people related either by consanguinity (by

recognized birth) or affinity (by marriage or other relationship). The purpose of families is to

maintain the well-being of its members and of society. Ideally, families would offer

predictability, structure, and safety as members mature and participate in the community. In

most societies, it is within families that children acquire socialization for life outside the

family, and acts as the primary source of attachment, nurturing, and socialization for humans.

Additionally, as the basic unit for meeting the basic needs of its members, it provides a sense

of boundaries for performing tasks in a safe environment, ideally builds a person into a

functional adult, transmits culture, and ensures continuity of humankind with precedents of

knowledge.

Community health nursing involves a holistic approach to patient care. Interventions

are aimed at individuals, families and groups within a geographic area. Nursing care focuses

on managing and preventing diseases as well as educating a community about maintaining

well-being. Community health nursing is a discipline that incorporates evidenced-based

research along with advances in science and new approaches for improving health. The

practice takes into consideration the cultural and socioeconomic backgrounds of the people in

the community to ensure appropriate interaction and sensitivity when working with them. As

a result, health-related conditions are identified, and the student nurse is fully informed about

how to intervene in order to provide holistic treatment and strengthen the deficiency.

Community health nursing is essential to the health and welfare of the entire population.

Healthcare should be accessible to everyone. Not only do community health nurses deliver

patient care, they also help reduce the occurrence of injuries, illnesses and deaths by

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informing people about health risks. Through education about healthy choices and advocacy

to reform the imbalance in healthcare, community health nurses can make a difference in the

lives of the disadvantaged in their communities.

The family is the most important unit in our society. It is where people first learned

how to communicate, interact and be a contributor to the society they are living in (Wilson,

2013). Filipinos are traditionally close to their families and children who are reared and

brought up in a traditional Filipino family will most likely get the values and traditions that

his or her family inculcated to him or her. A typical Filipino family is also traditional and

follows cultural norms which influences the values they uphold within the family (Dy, 1994).

In the family, children learn and build values and attitudes that they will bring with them

throughout their lives. The values that they get inside the family will be the basis for their

actions in the future.

According to Maglaya (2004), the community is a group of people that shares

geographic boundaries and/or values and interests. The family as a group generates, prevents,

tolerates and corrects health problems within its membership. The status of each family will

always affect the status of the community as a whole. There are so many factors that affect

the health of a family in the community. Chronic illnesses, accidents, vices like tobacco

smoking, alcoholism and environmental changes that affects health are steadily becoming

major concerns in Community health nursing in our country today.

Community health nursing is a discipline that incorporates evidenced-based research

along with advances in science and new approaches for improving health. The practice takes

into consideration the cultural and socioeconomic backgrounds of the people in the

community to ensure appropriate interaction and sensitivity when working with them. As a

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result, health-related conditions are identified, and the student nurse is fully informed about

how to intervene in order to provide holistic treatment and strengthen the deficiency.

This family was chosen for the case study because it represents a picture of a family

that is rare here in the country, and in need of the most help and attention. A family living

with limited resources, inadequate financial findings and lack of awareness regarding critical

health information, as well as facing other socio-economic related issues. In the light of this,

as a student nurse of 20th century, the researcher has the duty and responsibility to provide

holistic care in the ever changing health status of the community by starting it through its

basic structure—the Family. With the cooperation of the Family, the student nurse will be

able to apply all of the experience and skills learned in community health nursing practice to

this family, guiding them toward achieving their optimum health.

Chapter II

OBJECTIVES OF THE STUDY

The general and specific goals of this family case study are presented in this chapter.

Setting objectives provides direction for planning a family nursing intervention. It facilitates

motivation for the client and the nurse by providing a sense of achievement. (Kozier et.al,

2004)

General Objectives:

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 At the end of the student nurse-family relationship, the family will be able to improve

their way of living, understand the conditions of each members and the family as a whole.

The family will become independent in identifying potential health conditions and achieving

optimum health, creating an environment conducive to health.

Specific Objectives:

After 12 weeks of home visits and student nurse-family interaction, the family should

be able to:

● Identify current and potential threats in their environment which may become a

barrier in attaining optimum health.

● Independently prioritize health problems and avow preventive measures.

● Demonstrate practices in achieving optimum health.

Chapter III

INITIAL DATA BASE

Name of the Head of the family: Cornelia R. Real

Age: 70
Birthdate: January 16, 1989
Sex: Female
Address: Sinabaan, Sta. Catalina, Ilocos Sur
Marital Status: Widowed

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 Religion: Roman Catholic
Educational Attainment: High School Undergraduate
Occupation: Farmer
Name Relation Age Sex Civil Educational Occupation Religion
Status Attainment
1.Cornelia R. Head 70 F Widowed 1st Year High Farmer Roman
Real School Catholic
2.Ralf Hart R. Grandchild 13 M Single Grade 7 None Roman
Real Catholic

A. Family Structure, Characteristics and Dynamics/Relational Patterns

The Real Family is considered as a grandparent type of family. A grandparent family

is a family with grandchildren and no parents present in the intervening generation. The role

of grandparents in family life is ever-changing. They play many roles, from mentor, to

historian, to loving companion and to child-care provider. Strong intergenerational

connections can result, giving grandchildren a sense of security of belonging to the extended

family. The degree of the involvement of grandparents varies from one household to the next,

often depending on a variety of circumstances such as proximity to grandchildren,

relationship to parents, type of family structure, health of grandparents and interest.

Mrs. Cornelia R. Real is living with her grandson Ralf Hart R. Real. Both of them are

living happily together even if Ralf Hart’s parents separated and eventually left him in his

grandmother. During the survey, Mrs. Real mentioned that her life with his grandson is happy

even if they encounter many challenges in their life. She even said that she is contented in

their life as long as she can guide her grandson as he grows. They are currently residing in

Sinabaan, Sta. Catalina, Ilocos Sur wherein they have their own house and some properties

that they use in order to sustain their daily living.

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 In terms of decision-making, Mrs. Real is the one who manages their expenses and

provides for the education and financial needs of her grandson. Although she’s at an old age,

she still works as a farmer and even have an extra job in making “miki” or noodles just to

provide for their essential needs. When any health conditions arises, Mrs. Real said that she

follows some customs like going to a talisman whenever one of them has a fever and if

conditions are worsen they immediately go to the health center to have some health

assistance.

Since Mrs. Real’s grandson is still young, she said that she will guide him as long as

she can and give him the love that he need as he is abandoned by his own parents. She also

mentioned that as long as she lives, she will give him the best life that she can give and

provide for his needs.

B. Socio-economic and Cultural Characteristics

Mrs. Real works as a farmer and earns about 3,500 pesos per month. She is also in

charge of their house, and is also in charge with the needs and necessities of her grandson.

Ralf Hart is now at 7th Grade under modular learning in Ilocos Sur National High School.

Majority of their family income goes to their food budget and some of it are dedicated for

the schooling of Ralf Hart. Ralf Hart’s education is free but sometimes have a hard times

passing his modules as he only rides his bike in order to submit it to his nearest teacher

residing in Sta. Catalina. Normally, there is no budget left for other miscellaneous

expenses so Mrs. Real has to have a sideline job in making “miki” or noodles with a salary

that ranges 100 to 150 pesos daily inorder to provide for their other expenses.

With all her works in the farm, Mrs. Real also does the house works including

laundry, cleaning, and cooking. At a young age, she taught her grandson to be disciplined

and resourceful as Ralf Hart sometimes goes to the farm to help and sometimes earns

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 some money by doing some light works. They are both Roman Catholic and are deeply

devoted to their faith as Ralf Hart is a member of the Altar servers in the church. In terms

of their relationship with the community, Mrs. Real has a good relationship with the other

residents as she mentioned them being helpful and handy in times of their needs and she is

also a member of the 4H Club.

C. Home and Environment

The Real family has their own house and lot which was built years ago. Their

home is heavy which is made of concrete floors and walls. They have three bedrooms

which is adjacent to their living room and dining area. Their comfort room which is water

scaled and bathroom are located outside their house as they only have a water pump in

order to have water. Their house is powered by electricity, which runs their television,

electric fan and lights. Mrs. Real uses gas range to cook their food and they mostly eat

vegetable as they have their own vegetable garden at home. When it comes to food storage

they simply cover the leftover food with plates and sometimes goes to their neighbor if

they some food to refrigerate. Water for drinking for their family is delivered by a water

refilling station near the area and is commonly situated in a water jug or pitchers with

cover.

In their own backyard they instill their chickens and dogs as means of protection

and security. In terms of their garbage disposal, they have their own compost pit in their

backyard wherein they put their trashes and then burry it when it is full.

D. Health Status of each Family member

PHYSICAL ASSESSMENT OF RALF HART REAL

System Actual findings Normal findings Remarks

VITAL SIGNS ● Temperature: 36.8°C ● Temperature: 36.5oC - The patient’s vital

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 ● BP: 110/80 mmHg 37.5oC signs are within
● RR: 18 cpm ● BP: 120/80 mmHg the normal range
● PR: 94 bpm ● RR: 12-20 cpm in relation to his
● PR: 60-100 bpm age.
SKIN ● Light brown and ● Skin color ranges from Patient has a
uniform in color pale white with pink, healthy skin and
● No foul ordor yellow, brown, or olive has no problem
● No masses, lesions tones to dark brown or on this.
● No wounds/laceration black. No strong odor
● Skin is moist should be evident, and
● No rashes the skin should be lesion
● Warm and uniform to free.
touch ● Skin should be soft
● Good skin turgor warm, slightly moist
with good turgor and
without lesions and
edema.
HAIR ● Middle Hairline ● Middle Hairline All of the findings
● No scalp lesions ● Fine to course for the hair are
● No masses ● Absence of infestation found to be within
● Fine to course ● No masses the normal range.
● Absence of infestation ● No lesions
NAIL ● Pinkish nail bed ● Nail bed is pink All of the findings
● Concave shape ● Concave shape for the nails are
● Color of the nail bed ● Capillary refill backs found to be within
back to original color in within 1-2 seconds the normal range.
less than three seconds.
HEAD ● Asymmetrical with ● Asymmetrical, rounded Normal findings.
frontal, parietal and
flatted occipital
prominences
● No palpable lymph
nodes ● Uniform consistency;
absence of nodules or

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 ● No tenderness masses
● Symmetrical facial ● Head is non-tender.
expression such as ● Symmetrical facial
smiling, frowning movements
● Posterior and anterior
fontanel is closed.
● The posterior and
anterior fontanel is
closed;
EYES ● Symmetrical ● Eyes are symmetrical All of the findings
● Equal eye lashes ● Hair evenly distributed; for the eyes are
distribution skin intact found to be within
● Eyebrows are ● Eyebrows symmetrically the normal range.
symmetrically aligned aligned
and evenly distributed
● Equal movement
● Equal movement
● No discharge, no
● No discharge, no
discoloration of eyelids
discoloration of eyelids
● When lids are close,
● When lids are close,
sclera is not visible
sclera is not visible
● Sclera white
● Sclera is white
● Pink conjunctiva
● Pink conjunctiva
● No edema or tenderness
● No edema or tenderness
over the lacrimal gland
over the lacrimal gland
EARS ● Symmetrical ● Symmetrical All of the findings
● Color same as facial ● Color same as facial for the ears are
skin skin found to be within
● Aligned to the inner ● Auricle aligned with the normal range.
canthus other canthus of the eye
● No lesions ● Absence of lesions
● Firm and not tender ● Firm and not tender
NOSE AND ● Symmetrical ● Symmetrical All of the findings
SINUSES ● No discharges ● No discharge for the nose and
● No nasal flaring ● Absence of nasal flaring sinuses are found
● Uniform in color ● Uniform in color to be within the

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 ● Not tender ● Nose is non-tender normal range.
● No lesions ● No lesions
● Pink mucosa ● Pink mucosa
● Nasal septum intact and ● Nasal septum intact and
in the midline in the midline
● Sinuses are not tender ● Sinuses are not tender

MOUTH ● Lips is soft, moist and ● Soft, moist, smooth All of the findings
has smooth texture texture of lips for the mouth are
● Gums is pink ● Uniform pink color of found to be within
● Tongue is pink gums, tongue and tonsil the normal range.
● Tonsil is pink at the
middle
● Moist and slightly
rough tongue ● Moist and slightly rough

● Light pink, smooth soft tongue

palate ● Light pink, smooth soft

● Light pink hard palate palate

● Uvula is positioned in ● Light pink hard palate

the midline of soft ● Uvula is positioned in
palate the midline of soft palate
THROAT AND ● Uniform in color ● Generally uniform in All of the findings
NECK color for the throat and
● No palpable lymph neck are found to
● No palpable lymph
nodes in the be within the
nodes
● Neck can move freely normal range.
● Neck can move freely
CHEST & RES- ● Skin is intact ● Intact skin All of the findings
PIRATORY ● Regular interval in ● Regular pattern of for the chest and
breathing breathing the respiratory are
● No lesions ● Absence of tenderness, found to be within
● No tenderness lesions and palpable the normal range.
● No masses masses
● Shoulder height is ● Symmetrical shoulder
symmetrical height

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 ● No observed difficulty ● Absence of dyspnea and
in breathing. There has regular depths of
equal rise and fall of respiration
the chest with regular
depths of respiration.
CARDIOVAS- ● Apical pulse: 93 bpm ● Apical pulse is palpable All of the findings
CULAR AND ● Extremities are within ● Absence of cold for the
PERIPHERAL normal temperature and extremities cardiovascular
no discolored ● No discolored and are found to
extremities noted. extremities be within the
normal range.
ABDOMEN ● Uniform skin color in ● Uniform in color All of the findings
the abdomen for the abdomen
● No lesions are found to be
● Absence of lesions and
● No tenderness within the normal
tenderness
range.
MUSCULO- ● Uniform in skin color ● Uniform skin color All of the
SKELETAL ● Mobile ● Smooth coordinated findings for the
movements musculoskeletal
● Equal size on both sides are found to be
● Equal size on both sides
of the body within the
of the body
● Absence of deformities, normal range.
● No deformities noted
fractures and dislocation
● No fractures and
dislocations noted
● No tenderness and ● Absence of tenderness
swelling ● Absence of swelling
● Does not have tremors ● No tremors
and palpable nodules ● No palpable nodules
LYMPH ⮚ No palpable lymph ⮚ No enlarged lymph Normal findings.
NODES nodes nodes
● No tenderness noted ● Not tender

E. Value, Habits, Practices on Health Promotion, Disease and Prevention

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 Although the Head of the family is at an old age, she emphasized that she is still

strong and can manage the load of works in the farm. The head of the family also emphasized

the importance of adequate rest and sleep and often reminds her grandson to sleep early and

do some chores to contribute in his physical well-being. Mrs. Real also mentioned that they

mostly have vegetables as their meal, which are present in their surroundings in order to help

them maintain a healthy body. Her grandson, Ralf Hart is in fact participating in soccer as it

was introduced by the seminarians who visits the church during Sundays. However, Mrs.

Real mentioned that her grandson have started drinking alcohol at a young age and

sometimes uses e-cigarettes as influenced by his older friends and cousins. Mrs. Real said

that she persuades him from this acts but sometimes she cannot supervise him because her

grandson sometimes leaves their house to sleep in his cousins house and also due to her

morning to afternoon work in the farm.

Chapter IV
TYPOLOGY OF NURSING PROBLEMS
This chapter discusses about the problem that were identified during assessment and

interview with the family. It includes the cues/data, the family nursing problem and the

nursing diagnosis. The problems identified are categorized into presence of wellness state,

health threats, foreseeable crisis or stress points.

A. FIRST LEVEL ASSESSMENT

I. PRESENCE OF WELLNESS CONDITION

The existence of a wellness condition is clearly recognized during the home visit as

Mrs. Real said that they are completely devoted to their faith and Ralf Hart is an altar server.

Via God's harmonious interconnectedness, the Real Family demonstrates the potential for

enhanced Spiritual well-being capability (NANDA 2001). This is because Mrs. Real

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mentioned during the house visit that they always go to church and always have the chance to

thank God for the abundance of life and blessings that they receive.

II. PRESENCE OF HEALTH THREATS

● ALCOHOL DRINKING AT AN EARLY AGE
During the home visit it was revealed by Mrs. Real that her grandson have

been drinking alcohol due to the influence of his cousins and friends. Alcohol affects the

brain, the kidneys, lungs and liver. The effect on your body depends on your age, gender,

weight and the type of alcohol. People who begin drinking early in life run the risk of

developing serious alcohol problems, including alcoholism, later in life. They also are at

greater risk for a variety of adverse consequences, including risky sexual activity and

poor performance in school.

● EXPOSURE TO CHEMICALS AND PESTICIDES

Mrs. Real is a farmer, she has mentioned that they are using pesticides and

other chemicals in protecting and growing their crops. Pesticides can cause short-

term adverse health effects, called acute effects, as well as chronic adverse effects

that can occur months or years after exposure. Examples of acute health effects

include stinging eyes, rashes, blisters, blindness, nausea, dizziness, diarrhea and

death.

● E-CIGARETTE SMOKING OR VAPING

Mrs. Real said that her grandson has also been using e-cigarettes. An

electronic cigarette is an electronic device that simulates tobacco smoking. It consists

of an atomizer, a power source such as a battery, and a container such as a cartridge

or tank. Instead of smoke, the user inhales vapor. As such, using an e-cigarette is
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 often called "vaping". The aerosol from an e-cigarette can contain nicotine and other

substances that are addictive and can cause lung disease, heart disease, and cancer.

III. PRESENCE OF STRESS POINTS OR FORSEEABLE CRISIS

During the house visit, the Head of the family mentioned that the family’s

monthly income is 3,500 pesos and said that it is not enough because of how much

expensive the essential goods that are sold in the market. She also mentioned that it is

hard to earn money in farming because of the pests that damage the crops and also how

merchants buy at a low price.

B. SECOND LEVEL ASSESSMENT

The family is dealing with a variety of issues, some of which they are unaware of.

They may recognize some problems and want to solve them, but they are hesitant to take

action due to a lack of sufficient information and ability to do so.

I. Inability to recognize the presence of condition or problem due to:

Lack of or inadequate knowledge, Ralf Hart does not have enough knowledge

about the possible consequences he may get from drinking alcohol at a young age.

Denial about its existence or severity as a result of fear of consequences

of diagnosis of problem, specifically on Physical consequences, Ralf Hart

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 does not have enough knowledge about the possible consequences he may get

from using e-cigarettes at a young age.

II. Inability to make decisions with respect to taking appropriate health action

due to:

Fear of consequences of action specifically economic consequences, given that

the family’s monthly income is 3,500 pesos, which is sometimes not enough to

fulfill their needs. Mrs. Real even at an old age, still choose to work as a farmer to

sustain their daily living even if she knew about the harmful effects of pesticides

and chemicals they use in their crops.

III. Inability to provide a home environment conducive to health maintenance

and personal development due to:

Inadequate family resources specifically limited financial resources, the

family lacks financial support and financial findings due to the low income in

farming and the price ranges of financial goods. Furthermore the family’s Head

said that their monthly income which is 3, 500 pesos is not enough for them to

sustain their daily living.

C. TABLE

Health Problem Nursing Problem Cues/Data

1. Presence of ● Potential for enhanced Verbalized by Mrs. Real that
Wellness capability for: they are completely devoted to
Condition a. Spiritual well-being- their faith and Ralf Hart is an
process of client’s altar server.
development of mystery
through harmonious
interconnectedness that
comes from God.
2. Presence of Inability to recognize the It was revealed by Mrs. Real

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 Health Threats presence of condition due to: that her grandson have been
● Alcohol ● Inadequate knowledge drinking alcohol due to the
Drinking at an about the condition. influence of his cousins and
early age friends.

● Exposure to
chemicals and
Pesticides Inability to make decisions with
respect to taking appropriate
health action due to: Mrs. Real is a farmer and she
has mentioned that they are
● Fear of consequences of using pesticides and other
action specifically chemicals in protecting and
economic consequences. growing their crops.
● E- Cigarette
Smoking or
Vaping

Inability to recognize the

presence of condition due to:
● Denial about its existence or
severity as a result of fear of
consequences of diagnosis of During the house to house
problem, specifically on visit, Mrs. Real indicated that
Health consequences. her grandson has been using e-
cigarettes or commonly known
as vape.
3. Presence of Inability to make decisions with The Head of the family
Stress Points or respect to taking appropriate verbalized that their family
Foreseeable health action due to: income is not enough for their
Crisis needs and mentioned about
● Fear of consequences of
● Inadequate how hard it is to earn money in
action specifically
Financial funds economic consequences farming.

Chapter V
PRIORITIZATION

1. Potential for enhanced capability for Spiritual well-being process of client’s

development of mystery through harmonious interconnectedness that comes
from God.

Criteria Computation Score Justification

1. Nature of the 3/3x1 1 This is considered a Wellness

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 problem state because the Head of the
Family said that they always
go to church and always have
time to praise and thank God.
2. Modifiability 0.5/2x2 0.5 Based on the current
of the problem knowledge of the family, the
wellness state is considered not
modifiable because spiritual
well-being is can enhance their
relationship within their family
and the community as well.
3. Preventive .75/3x1 0.25 Spiritual well-being as a
wellness state does not need to
potential
be prevented because it plays a
key role positively in the
development of the family.
4. Salience 0/2x1 0 This nursing problem does not
need immediate course of
action since it’s beneficial to
the family’s growth and
development.
Total Score: 1.75

2. Alcohol Drinking at an Early Age as a Health Threat

Criteria Computation Score Justification

1. Nature of the 2/3x1 0.67 Alcohol drinking in a young
problem age have been identified as a
health threat because it can
lead to alcoholism, violence,
and alcohol poisoning. This
can also cause permanent
damage to areas that control
judgment, impulse control, and
memory.
2. Modifiability 1/2x2 1 Alcohol Drinking is partially
of the problem modifiable since the Head of
the family cannot control every
actions of his grandson
because of her work and Ralf
Hart needs proper guidance
and health teachings for him to
understand the risks of

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 consuming alcohol at a young
age.
3. Preventive 2.25/3x1 0.75 Lack of current management
makes the problem difficult to
potential
achieve modifiability since the
Head of the family can not
guide her grandson every time
due to her work.
4. Salience 2/2x1 1 Alcohol drinking is a serious
problem needing immediate
attention because at a young
age alcohol drinking may be
detrimental to health.
Total Score: 3.42

3. Exposure to Chemicals and Pesticides as a Health Threat

Criteria Computation Score Justification

1. Nature of the 2/3x1 0.67 Exposure to chemicals and
problem pesticides is identified as a
health threat because it can
cause respiratory diseases like
asthma and lung cancer.
2. Modifiability 1/2x2 1 The problem is partially
of the problem modifiable because farming is
part of the family’s life and it
can only be imposed by
wearing preventive equipment
like masks.
3. Preventive 2.25/3x1 0.75 Lack of current management
makes the problem difficult to
potential
achieve modifiability because
the Head of the family is a full
time farmer.
4. Salience 2/2x1 1 The family recognizes the
problem and knows that it is a
serious problem needing
immediate attention.
Total Score: 3.42

4. E- Cigarette Smoking or Vaping as a Health Threat

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 Criteria Computation Score Justification
1. Nature of the 2/3x1 0.67 E-Cigarette smoking or vaping
problem is considered a family health
threat since it can cause
significant ailments in both the
smoker and other family
members. 
2. Modifiability 1/2x2 1 The problem is partially
of the problem modifiable because the Head
of the family cannot control
every actions of his grandson
because of her work.
3. Preventive 2.25/3x1 0.75 Lack of current management
makes the problem difficult to
potential
achieve modifiability since the
Head of the family can not
guide her grandson every time
due to her work.
4. Salience 2/2x1 1 The family recognizes the
problem and knows that it is a
serious problem needing
immediate attention.
Total Score: 3.42

5. Inadequate Financial funds as a Foreseeable Crisis

Criteria Computation Score Justification

1. Nature of the 1/3x1 0.33 Hospitalization of a family
problem member is considered a
foreseeable crisis or stress
point.
2. Modifiability 1/2x2 1 This Problem is Partially
of the problem modifiable because the family
wants to know more how to
improve their way of living
and there are good hearted
residents who are willing to
help.

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 3. Preventive 3/3x1 1 This problem could be highly
prevented because it can be
potential
modified through the help of
other residents and also from
the student nurse.
4. Salience 1/2x1 0.5 This is recognized by the
family as a problem, not in
need of immediate action.
Total Score: 2.83

The List of Nursing Problems ranked according to Prioritization

PROBLEMS TOTAL
1. Alcohol Drinking at an Early Age as a Health Threat 3.42
2. Exposure to Chemicals and Pesticides as a Health Threat 3.42
3. E- Cigarette Smoking or Vaping as a Health Threat 3.42
4. Inadequate Financial funds as a Foreseeable Crisis 2.83
5. Potential for enhanced capability for Spiritual well-being process 1.75
of client’s development of mystery through harmonious
interconnectedness that comes from God.

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 Chapter VI
FAMILY NURSING CARE PLAN

1. Alcohol Drinking at an early age as a Health threat

HEALTH PROBLEM FAMILY  NURSING GOAL OF CARE OBJECTIVES OF CARE INTERVENTION METHOD OF RE-SOU
PROBLEMS MEASURES NURSE-FAMILY REQUI
CONTACT
● Alcohol drinking Inability to make
After the After the nursing ● Discuss the H ● Human
at an early age as decisions with respect
nursing intervention, the family will: importance and Resource
O
a Health threat to taking appropriateintervention, purposes of good
health action due to:the family will and healthy Accurate kn
M
and data f
be able to ● aware and be more lifestyle.
● Fear of E student nu
manage and knowledgeable about the
consequences of relay to the
guide Ralf Hart importance of good and
CUES: action specifically
into a better healthy lifestyle. ● Promote health and
economic V Time and
● The head of the lifestyle and well-being by doing the studen
consequences.
family revealed make him health teaching. I and the
that her grandson understand the ● be able to eliminate members.
S
has been drinking risks and understand the risks and
alcohol at an early consequences consequences of drinking ● Provide guidance I ● Material
age. of drinking alcohol at a young age . and assistance to Resourc
the family on how T
alcohol at a
● Drinking may to follow a lifestyle Visual aids
young age.
cause youth to that is conducive to cost
● Take preventive
have trouble in health. needed
measures to maintain a
school or with demonstrati
lifestyle that is fit to their

23 | Page
 the law. age.
Drinking
alcohol also is
associated
with the use of
other
substances.
Research
shows that
people who
start drinking
before the age
of 15 are at a
higher risk for
developing
alcohol use
disorder later
in life.

24 | Page
 2. Exposure to Chemicals and Pesticides as a Health threat
HEALTH PROBLEM FAMILY  NURSING GOAL OF CARE OBJECTIVES OF CARE INTERVENTION METHOD OF RE-SOU
PROBLEMS MEASURES NURSE-FAMILY REQUI
CONTACT
● Exposure to Inability to make
After the After the nursing ● Do health H ● Human
Chemicals and decisions with respect
nursing intervention, the family will: teachings and Resource
O
Pesticides as a to taking appropriate
intervention, health
Health Threat as a health action due to:
the family will awareness Accurate kn
M
Health threat be able to have about the and data f
● Fear of E student nu
awareness and hazards and
consequences of ● Be aware about the relay to the
ideas about risks in using
action specifically harmful chemicals
some safety chemicals.(eg. Time and
economic that they use in V
measures Respiratory the studen
CUES: consequences farming.
before using diseases like I and the
● The head of the chemicals in asthma and members.
S
family is a farmer farming.. lung cancer)

25 | Page
and mentioned ● Be able to know the I ● Material
about the importance of Resourc
● Recommend the T
chemicals and wearing certain
barangay Visual aids
pesticides that masks such as the
officials about cost
they use in their N95 mask before
the distribution needed
crops. using chemicals in
of N95 masks demonstrati
farming.
● Respiratory and other
illnesses are equipments
among the most that can help
prominent the farmers.
occupational
illness of
agricultural
workers and
may stem from
organic/inorgani
c dusts,
microorganisms,
mycotoxins,
endotoxins,
pollens, mites,
molds, animal
production,
and/or
pesticides, and
other chemicals.

26 | Page
 3. E-Cigarette Smoking or Vaping as a Health threat
HEALTH PROBLEM FAMILY  NURSING GOAL OF CARE OBJECTIVES OF CARE INTERVENTION METHOD OF RE-SOU
PROBLEMS MEASURES NURSE-FAMILY REQUI
CONTACT

27 | Page
 ● E-Cigarette Inability to recognize After the After the nursing ● Educate the H ● Human
Smoking or the presence of nursing intervention, the family will family about Resource
O
Vaping as a condition or problem intervention, be able to: effects and
Health threat due to: the family will consequences Accurate kn
M
be aware of the of vaping in and data f
● Lack of or E student nu
potential ● Identify the severity of human’s health
inadequate relay to the
illnesses that the problem as well as to condition (e.g.
knowledge, Ralf
vaping could be knowledgeable about respiratory Time and
CUES: Hart does not have V
infiltrate to the different health diseases and the studen
enough knowledge
-During the house to every member threat of vaping not only cancers) I and the
about the possible
house visit, Mrs. Real of the family to the head of the family members.
consequences he S
indicated that her and the health but to the family as a
may get from using
grandson has been risks that whole. ● Discuss possible I ● Material
e-cigarettes at a
using e-cigarettes or nicotine can ways of Resourc
young age. T
commonly known as cause to our providing
Visual aids
vape. body. ● Understand the adequate
cost
advantages of ending the measures in
needed
habit. improving their
demonstrati
-Vaping puts nicotine health.
into the body.
Nicotine is highly ● Express genuine desire to
addictive and can: take part in the process ● Instruct the
slow brain of eradicating vaping as a family using
development in teens habit. visual aids
and affect memory, about the
concentration, different
learning, self-control, positive
attention, and mood. consequences

28 | Page
increase the risk of of quitting
other types of vaping.
addiction later in life

● Emphasize
importance of
having a healthy
lifestyle to
increase
compliance with
the set
implementing
measures.

29 | Page
 4. Inadequate Financial funds as a Foreseeable Crisis
HEALTH PROBLEM FAMILY  NURSING GOAL OF CARE OBJECTIVES OF CARE INTERVENTION METHOD OF RE-SOU
PROBLEMS MEASURES NURSE-FAMILY REQUI
CONTACT
● Inadequate Inability to provide a After the After the nursing ● Conduct H ● Human
Financial home environment nursing intervention, the family will community Resource
O
funds as a conducive to health intervention, be able to: pantries to help
Foreseeable maintenance and the family will the respondents Accurate kn
M
Crisis personal development be able to during this and data f
E student nu
due to: manifest pandemic.
positive insights relay to the
● Inadequate ● manage and eliminate ● Give advice or
CUES: on how to Time and
family resources certain stress points and teachings on V
manage their the studen
- The Head of the specifically limited mental distress. how to manage
financial funds I and the
family mentioned that financial resources mental health
and utilize members.
the family’s monthly and eliminate S
community
income is 3,500 pesos ● Understand how to utilize stress points
Financial fun
resources I
and said that it is not their benefits and the
regarding their
enough because of resources of community. T ● Material
situation.
how much expensive (eg. Senior citizen Resourc
the essential goods discounts)
30 | Page
that are sold in the Visual aids
market. She also cost
mentioned that it is needed
hard to earn money in demonstrati
farming because of
the pests that damage
the crops and also
how merchants buy at
a low price.

-Incomes below
10,000 are considered
in the poor class
according to the social
standards in our
country.

31 | Page
 Chapter VII
DOCUMENTATION
a. Community Health Survey Form

Household Number: _______________ Date: 05/03/2021___________________________

Barangay: ______Sinabaan______________________ Municipality: ___Sta. Catalina_______

INTRODUCTION:

Naimbag nga bigat/aldaw mo Manang, Siak ni Neo Kyle R. Quarto Maysa nga estudyante ti
University of Northern Philippines, Institute of Nursing diay Vigan nga naidestino nga umay
makipagnaed ditoy barangayyo. Kas parte iti aktibidadesmi, masapul nga balay-balayenmi iti
agsurvey. Mabalin kadi nga ikkan da kami iti apagbiit nga orasyo para iti daytoy a panagsaludsodmi
kadakayo? Immay kami ditoy nga addaan pannakanaig iti salun-at tapno iti kasta ket
makapagtitinnulong tayo nga mangkita iti rumbeng nga aramiden maipanggep kadagitoy (no adda
man). No adda saanyo a maawatan, saludsudenyo latta kanyami tapno maiyesplikar mi kadakayo.

I. FAMILY MEMBERS AND CHARACTERISTICS

Manang, siasino kadi ti kaduayo ditoy balayyo? No adda, mabalin kadi nga maammuan iti
naganna/naganda, no ania iti relasyonda kenka, mano iti tawenda, lalaki wenno babai, adda kadin
asawada wenno awan pay, nakagraduar kadin wenno saan, adda kadi trabahoda wenno awan?

(Prompt the respondent for every item/column reflected for each member. Start with the head of
the family.)

Name Relation Age Sex Civil Educational Occupation Religion

Status Attainment
1.Cornelia R. Real Head 70 F Widowed 1st Year High Farmer Roman
School Catholic

2.Ralf Hart R. Real BGrandchil 13 M Single Grade 7 None Roman

d Catholic
3.

4.
5.

6.
7.

32 | Page
8.

9.
10.

II. FAMILY HEALTH STATUS AND PRACTICES

A. Immunization and Nutritional Status (for children 0-5 years)

Manang dagitoy sumagmamano nga saludsod ket para kadagiti annakyo nga agtawen iti 0-5
years.

(List the names of the child/children referred to, then ask the following questions for each child)

1. Adda kadi yellow card na?

(If YES, request to see the card then copy the immunization and nutrition data from it. If NO,
ask the following questions :)

a. Nabakunaan kadin wenno saan?

(If YES, ask: Ania kadi iti bakuna nga naited kaniana?

Name of Child Yellow Immunization Nutritional Attendance Reason for

Card Status Status at Birth Preference

(Prompt if respondent cannot remember. List all immunizations given to each child on the margin.
If you have a weighing scale with you, weigh each child after the interview.)

B. MORBIDITY (past 6 months) and MORTALITY (past 2 years)

1. Adda kadin nagsakit a miyembro ti familyayo bayat iti napalabas nga innem a bulan?

33 | Page
 If YES: Ania iti naikagapo?)

(For each person mentioned, ask the following questions then log in the answers in the
appropriate column/space)

a. Ania ti sakitna?
b. Mano iti tawenna idi nagsakit
c. Impaagas/impakonsultayo kadi isuna?
d. (If YES: Sino iti nagpaagasanna/nagpakonsultaanna?
e. Ania ti agas/tumaren nga naited kenkuana?

Illness Causes Sex Age Who Attended Meds/Rx used

2. Adda kadin natay nga miyembro ti pamilyayo kadagitoy napalabas nga dua tawen?

If YES, ask the following questions for each member who died then log in the answers on the
spaces provided for.

a. Ania kadi iti impataty na?

b. Mano iti tawenna idi natay?
c. Impaagasyo kadi sakbay a natay?

Death Sex Age Who Attended

C. NUTRITION

(Ask the following questions for mothers with child/ren below 3 years old. If there is more
than one child in the age group, ask for the youngest child).

1. Nagpasuso ka kadi kadagiti annakmo? (Breastfeeding)

/___/ Yes (go to question number 2)

/___/ No (go to question number 3)

34 | Page
2. Ania ti taw-en ti ubing idi nagsardengka nga nagpasuso?

(Specify in months ___________ bulan (months)

3. Ania ti rason ta apay nga saanka nga nagpasuso?

_____ Awan ti tubbog ti suso _____ Adda trabahok

_____ Nagsakitnak _____ Masikognak

_____ Dakkel ti ubingen _____ Dadduma pay nga rason

4. Idi insardengmo ti nagpasuso, ania nga makan ti intedmo kaniana? Mano ti taw-enna idin?

Bulan ken taw-en ti ubing Bulan ken taw-en ti ubing

Am / Segget _____________________ Ebaporada _____________________

Lugaw _____________________ Kondensada _____________________

Innapoy _____________________ Infant Formula (Name: _______________

Kamote _____________________ Inasukaran a danum

Saba _____________________ Dadduma pay:

___________________________

Karabasa _____________________

D. FAMILY PLANNING (For Women at Reproductive Age 15-45)

1. Mano ti taw-enmo idi umuna a panagsikogmo? ___________ taw-en

2. a. Mano iti annakmo? (total children) _________
b. Nami-anoka nga nagsikog? (total pregnancies) ____________

c. Mano ti natay? (miscarriage) ____________

d. Namin-ano ka nga naalisan? ____________

3. a. Ania nga wagas iti sinurotyo kabayatan iti inkay panagan-anak? (natural or artificial)
b. Ania kadi kadagitoy nga klase iti Family Planning iti inkay us-usaren?

Methods

35 | Page
 Panagayunar (abstinence) _____________ Ligation_____________

Pills _____________ Vasectomy _____________

IUD _____________ Injection _____________

Rhythm _____________ Withdrawal _____________

Condom _____________ Dadduma pay _____________

Awan
_____________

4. Makaapektar kadi iti relihiyonyo bayat iti inkay panagdesisyon iti pnagusar iti family planning
methods?

/___/ YES /___/ NO

5. Ania nga family planning method ti kayatmo nga maamuan ken kayatmo nga usaren tapno
maikkanka iti naan-ayat nga impormasyon maipanggep ken daytoy?
________________________________________

E. BELIEFS AND PRACTICES

Ania kadi iti pammatiyo ken inkay sursuroten maipanggep kadagitoy nga ban-banag?

1. Panagpili iti makan (Choice of food for the family)

Awan_______________________________________________________________________
_

2. Panagsikog ken panaganak (Pregnancy and Birth in terms of Nourishment and Care of the
Mother)
___________________________________________________________________________
_

3. Panagtaripato iti masakit (Care of the sick)

_Agpatako___________________________________________________________________
______

4. Panagpakan iti ubing (Child feeding)

____________________________________________________________________________

5. Ania a makan iti saan nga pagayatan ti pamilyam?

Makan Rason

36 | Page
F. ENVIRONMENTAL CONDITIONS

1. Ania nga klase ti kasilyas ti inkay us-usaren?

__________ Flush toilet __________ overhang

_______✅____ water scaled __________ none

__________ Antipolo type

2. Kasano met iti pagayusan ti danum nga aggapo iti lababo?

__________ Open _____✅_____ Blind

3. a. Ania kadi ti pagibelbelenganyo ti basurayo? (collection)

__________ open receptacle (Awanan ti kalub)

_____✅_____ covered receptacle (addan ti kalub)

__________ none (awan)

b. Kasano ti pampamay-anyo ti basurayo?

_____✅_____ Composting __________ riverside dumping

__________ burning __________ open dumping

__________ burying __________ dadduma pay a wagas:

________________

4. a. Adda kadi dimguenyo (animalesyo)?

/_✅__/ YES /___/ NO

Bulos kadi? ________ wenno nakapupok? _____✅_____

5. a. Sadino met ti pagal-alanyo ti danum nga in-inumenyo?

__________ NAWASA __________ Shallow dug well

__________ water pump __________ protected spring

__________ deep well __________ unprotected spring

__________ Dadduma pay; (Specify) _____ Water Refilling Station __

b. Ania ti pagik-ikkanyo iti danumyo? Water Jag, Pitcher__________________________

c. Adda kadi kalobna daytoy? /__✅__/ YES /___/ NO

37 | Page
 d. Basta kadi lattan nga inumenyo? (Diretsoyo kadi nga in-inumenen?)
/___✅_/ YES /___/ NO

e. No saan, ania kadi ti ar-aramidenyo (pampamay-anyo)

__________ chlorinate (ikkan iti chlorine)

__________ boiling (pagbureken)

6. Ania kadi ti pagiduldulinanyo ti makmakan?

__________ kabinet __________ refrigerator

______✅_____ natakkaban a plato (covered plate) __________ basket a naibitin

__________ uneg ti lakasa __________ Dadduma pay:

____________

III. SOCIO-ECONOMIC, POLTICAL AND CULTURAL FACTORS

1. a. Ania kadi ti nangnangruna a pagsapulanyo (trabaho)?

_____✅____ Farming __________ Own farm __✅_ Tenanted

__________ Fishing

__________ Laborer (trabahador)

__________ Empleyado __________ Government __________ Private

__________ Karpintero

__________ Aglaklako (Small industries: Sari-sari store, shop, karinderya, pagmikian,

pagsinanglawan)

Specify:
___________________________________________________________

________ Dadduma pay: ______________________________

b. Manu met ti masapulanyo iti makabulan? P ___3,500___________ kada bulan

2. Food Production Activities

(Prompt the respondent for every food production activity. Check the appropriate item in
each column)

a. Adda kadi gardenyo (pagnatengan)? Babuyan? Manukan? Pagprutasan?

b. Para kadi iti inaldaw-aldaw a pagbiagyo wenno para lako?

Resource Family Use For Selling

38 | Page
 Vegetable Gardening ✅

Piggery
Poultry

Fruit Trees
Fishery (pagikanan)

Others:

5. Real Property

a. Sino ti akinbagi ken daytoy nagbalayanyo?

1. ______✅_____ sika wenno ti asawam

2. __________ kabagiam wenno ti asawam

3. __________ ni-rentaam (rented)

4. __________ pakitaltalunam (tenanted)

5. __________ gobyerno/komyunal

6. __________ dadduma pay: ____ _______________________

b. observe the type of house construction and circle the number of the best description:

1. __________ light (house made of light materials: i.e. nipa or cogon roof,

bamboo/hut wall, earth or bamboo floor)

2. __________ Medium (house made of mixed materials: i.e. nipa roof but with

wooden walls and floor)

3. _____✅___ Heavy (house made of strong materials: i.e. galvanized sheets

roofing,

wood or cement walls, wood or cement floor)

c. Adequacy of living space: __________ width

__________ length

_____3_____ # of bedrooms

6. Utilities:

39 | Page
 a. Nakapakonektar kay kadin ti koryente? /_✅__/ YES /___/ NO

7. Appliances:

a. Ania dagiti appliancesyo nga inkay us-usaren?

_____ radio (transistor) ___✅__ electric fan

_____ AM/FM cassette player ___✅__ gas range

_____ refrigerator ___✅__ television

_____ Betamax/VHS/VCD/DVD _____ Dadduma pay: _______________

8. Decision Making

Sino ti agdesisyon kadagitoy sumagmano a banag?

a. Panaggastosan ti pamliya Head________

b. Inaldaw-aldaw Head
c. Panag-eskwela (Edukasyon) Head
d. Panagatendar ti aktibidades ti barangay Head
e. Dadduma pay a bambanag: ______ Head __________________

9. Community Needs and Problems

a. Malaksid ti saksakit, ti panagkunayo, mangted ka man ti tallo (3) nga gagangay nga
problema nga mapaspasaranyo nga makaapektar ti linawas a panagbiagyo ditoy a
barangay?

1. Awan ti Street Light

2.
___________________________________________________________________

3.
___________________________________________________________________

b. Ania kadi ti mairekomendaryo nga solusyon dagitoy nga problema ditoy

barangayyo?

40 | Page
 1.”Tulong aggapo ti munisipyo wennu aggapo dagiti barangay
officials”____________

2.
___________________________________________________________________

3.
___________________________________________________________________

10. Community Resources

a. No adda maysa a proyekto ti barangay, kas koma ti panagaramidan ti kasilyas,

panagaramidan ti basuraan ken dadduma pay, ania kadi dagiti materyales nga adda
ditoy nga ammoyo nga usaren?
______Barusok, Kumpay _______________________________

_____________________________________________________________________
__

b. Sino kadi ti mairekomenda nga dua (2) a tao nga maibalintayo a pagpatulungan para
ti nasao a proyekto? Ania kadi ti posisyonna?

Name Position
Larry Realin Barangay Kagawad

Myrna Ragasa Barangay Captain

c. Ania kadi nga organisasyon ti inkayo nakaikappengan ditoy barangayyo?

______4H Club_____________________________________

CONCLUSION:

Ag-Dios ti Agngina kami Manang iti oras ken kooperasyon para iti daytoy nga
panagdamdamagmi a “survey” ditoy barangayyo. Kalpasan ti sumagmamano nga aldaw,
maamuanyonto met laeng ti resulta daytoy nga panag-survey ket yamanenminto no makaatendar
kayonto iti maysa a paanagtitipon nga mai-schedule iti masanguanan nga aldaw.
Mapagpapatanganto dagiti bambanag nga makaapektar ti inaldaw-aldaw a panagbiagtayo ken no
anianto ti maiyanatup nga aramidentayo maipanggep kadagitoy.

Kastan Manang ket agyaman kami.

41 | Page
 ________ NEO KYLE R. QUARTO_ _

(Signature of Student over printed

name)

Date: ___05/03/2021____ Time: 6:30

P.M

b. Pictures taken during the house visit

42 | Page
43 | Page