Group 3

FNCP

Anne Shayne - Introduction

- A family nursing care plan is a guide or framework of nursing care kung saan binibigyan nito ng
focus ang paghahanap ng solusyon o sagot, o bawasan man lang ang mga health problems na
nae-experience ng isang family as a whole.
- Aside from this, ginagamit natin ito upang makapaghatid ng tinatawag nating “most appropriate
care” sa ating client by eradicating barriers to family health development.

Anne Shayne - Overview of the Family

- For the overview of the family: M, P, C is our group’s chosen family. Sila ay kasalukuyang
naninirahan sa Sta. Rita, Guiguinto, Bulacan. Ang pamumuhay nila ay parang normal o tipikal
lang din na pamilyang Pilipino where they are considered to be an extended family. Ang kanilang
pamilya ay binubo ng nine members na sama-sama at tulung-tulong na kumakayod upang may
pantugon sa kanilang araw-araw na pamumuhay.

Initial Data Base

Ellyssa Mari - Characters (Do not read)
- The M, P, C is an extended family that lives together in one household. Si LM at ARP ay
parehong naka-atas sa pagde-desisyon patungkol sa mga bagay na sangkot ang kalusugan ng
bawat miyembro ng kanilang pamilya. Then, when it comes to their relationship with each other,
wala namang kahit anong alitan or conflict na namamagitan sa bawat isa – dahil na rin sa
kanilang maayos na pamamalakad at matibay na pagsasama. When it comes to their daily living
activities naman, they are usually wake up at around 7 in the morning, umiidlip around 12 until 2
in the afternoon and sa gabi naman, sila ay kalimitang natutulog mga bandang 10pm. Sa kanilang
pagtulog naman, sila ay sama-sama. Then, talking about their eating pattern, sila ay kumakain
nang tatlong beses sa isang araw at isang merienda tuwing hapon. Isang miyembro rin ng
kanilang pamilya ay considered to be overweight, which is si AP ngunit wala namang
underweight sa kanila. For their family’s leisure time activities, kadalasan ang ginagawa nila is to
surf on the internet. Sila rin ay nagmo-movie marathon, at nag-aalaga ng bata na isang taong
gulang pa lamang. And these leisure activities that I’ve mentioned, are considered to be suitable
for the sex and age group. Also, with these activities, they help to promote bonding and quality
time where they also share movie marathons as their joint activity for leisure.

Cyril - Family Information & Socio-Economic and Culture Factors (Do not read)
- Now let’s proceed to the family information & socio-economic and culture factors
- The M, P, C family is composed of 9 members in total who live all together in Sta. Rita,
Guiguinto, Bulacan.
- PM, the father and considered the head of the family, is 64 years old and a college graduate. Siya
ay retired AFP soldier and receives a monthly pension worth 20,000 pesos. Samantalang si RP,
ay kapatid na babae ni PM, 78 years old sa kasalukuyan, at isang graduate ng elementarya. LM,
which is also a sister of PM is a 61-year-old and a high school graduate.
- Another household members is AC, which is a son-in-law of PM, 61 years old, and a high school
graduate from TESDA. Si AC ay kasalukuyang nagta-trabaho bilang technician sa Guiguinto,
Bulacan at nakatatanggap ng monthly salary of about 6,000 to 7,000 pesos. Next, is the niece of
PM na si ARP, siya ay a 39-year-old woman na isa ring high school graduate. Then, JPM, which
is anak na lalaki ni PM ay may edad na 32 years old at isang undergraduate of BS IT.

- Sunod naman na aking mga babanggitin ay ang mga apo ni PM. Una ay si AP which is 18 years
old and a college student. Next is si XP, which is a 14-year-old high school student. And last but
not the least, ay si OC na pinakabata sa kanilang pamilya which is 1 year old pa lamang. The
family also manages a small sari-sari store sa harap ng kanilang bahay that adds to their monthly
income of around 10,000 pesos.
- Due to the family's income, naaabot naman nila ang pangangailangan nila as a whole upang
matugunan ang pang-araw-araw nilang pamumuhay at pambayad na rin sa kanilang mga bayarin.
LM and ARP are both in charge of any decisions regarding any money matters.
- Roman Catholic ang relihiyon ng buong pamilya and even though wala silang any positional role
sa community, they still manage to be active members na sumusunod sa mga gawain o batas and
they also practice or exercise their rights as citizens.

Radine - Environmental Factors (Do not read)

- For the environmental factors, the family owns one house, and they all live together. Their home
is made with strong construction materials, and it has adequate living space and furniture that the
whole family can fit together. It has 3 bedrooms where each couple occupies. Their water sources
are private, and they use their refrigerator as their food storage. To cook for the family's meal,
they use a gas stove and sometimes firewood. They have an open drainage facility and use the
pail system method. Overall, their sanitary condition is poor even though they live in a non-
congested neighborhood. Their health care facility is available and accessible within 30 minutes
away from their home, and all their garbages is picked up by a garbage collector.

Radine - Health Medical History (Do not read)

For the health medical history, four family members have been diagnosed with different diseases.
- First is PM. He had a stroke before, and as a result, he currently has Left Hemiplegia - meaning
he has paralysis on one side of the body, which is his left side. PM is taking Amlodipine, which
treats high blood pressure and chest pain. 5mg, 1 tablet in the morning.
- Next is JPM. Healso had a stroke, and he ended up having Left Hemiplegia just like PM. JPM is
also taking Amlodipine 5mg, 1 tablet in the morning, with Losartan, an antihypertensive drug
that can reduce the risk of stroke in patients with high blood pressure, 5 mg 1 tablet at night.
- Next is LM. She doesn!t have any past illnesses, but she currently has elevated blood pressure.
She also takes Amlopidine and Losartan, the same dose as JPM.
- Lastly is RP. She also doesn!t have any past illnesses, but she developed a cataract on both eyes
due to her diabetes, resulting in her impaired vision. She!s taking Metformin, 500 mg 1 tablet in
the morning; this is an anti-diabetic medication.

Anne Shayne - Value Placed on Prevention of Disease

- When it comes to their immunization, every member of the family is considered to be fully-
immunized, received, and completed all needed vaccines before turning one year old. Ang
kanilang pamilya ay pumupunta rin sa health center nang isang beses kada taon to receive their
flu vaccines. In addition, lahat ng matatandang miyembro ng pamilya ay kumpleto na sa bakuna
laban sa COVID-19 virus maliban kay XP, na nababakunahan pa lamang ng isang beses at OC,
na isang taong gulang pa lamang. Ang preventive practices na ginagawa ng buong family is
taking maintenance drugs and their sources of health care ay health center.

 Scoring

Robert - POOR HOME SANITATION DUE TO IMPROPER DRAINAGE SYSTEM

- First for our scoring is poor home sanitation due to improper drainage system. This problem is
considered as a health threat dahil alam naman natin na poor home sanitation could lead to
bacterial growth na maaaring makaapekto sa kapakanan o kalusugan ng kanilang pamilya as a
whole. Dahil na rin dito ay magkakaroon sila ng higher risk sa iba’t-ibang klase ng infection
- Ito ay easily modifiable dahil the family has manpower resources na magagamit upang
mabawasan ang problem na ito. Dagdag pa rito, bilang student nurses, we can also provide
proper health education, using their knowledge, kung papaano masosolusyunan ang nasabing
problema.
- The said problem is identified as a highly preventable situation dahil na rin sa mga posibleng
dumaan na problem ana konektado rito, dahil ang mga ito ay madaling maiiwasan if there will be
a proper management when it comes to the cleanliness of their home. Maaari nating i-apply rito
ang mga konsepto ng proper waste disposal at proper sanitation upang ating mai-promote ang
clean and health environment.
- Last for this part is hindi nakikita ng kanilang pamilya ang problem na ito bilang isang sitwasyon
na kinakailangan ng agarang solusyon.
- Sa kabuuan ng aming scoring para sa poor home sanitation due to improper drainage system,
lumabas na meron itong 4.17 sa pinagsama-samang criteria.

Robert - PRESENCE OF RISK FACTORS OF SPECIFIC DISEASES (OVERWEIGHT)

- Next, which is the presence of risk factors of specific diseases, which mainly focuses on obesity
or overweight, it is labeled as a health threat. This is for the reason that being overweight has a
lot of potential consequences on the health of a person gaya ng hypertension, stroke, diabetes,
and even mortality, to name a few.
- This specific problem is considered as easily modifiable for the reason na sa pamamagitan ng
pagtuturo sa ating client ng mga possible actions na pwede niyang gawin gaya nga ng
pagkakaroon ng weight management plan – kung para saan ba ito at kung paano ito nagbe-
benefit sa sarili natin, makatutulong tayo sa ating client na maging knowledgeable and aware sa
factors nito. With this, it could serve as an encouragement for the client to pursue the said
solution to avoid the negative impacts of being overweight.
- It is highly preventable dahil na rin sa mga bagay na pwede nating ituro or gawin ng client na
makatutulong upang maiwasan niya na magkaroon ng iba pang mga sakit dahil sa pagiging
overweight. With the help of a proper management of the problem, it will be an effective way or
solution for the current problem.
- And last but not the least, the client specifically doesn’t consider it as a problem at hindi naman
nila nararamdaman or ng client mismo na kailangan itong hanapan ng solusyon upang ito ay
maging maayos.
- Para sa scoring dito, ito ay mayroong total ng 3.67 para sa lahat ng criteria na meron tayo for this
table.

Robert - ILLNESS STATE (ELEVATED BLOOD PRESSURE)

- For elevated blood pressure naman, which is an illness state, the problem has been found to be a
health deficit kung saan kinakailangan ang pagsasagawa at pagkakaroon ng maayos na health
maintenance at management upang maiwasan ang iba pang mga sakit na maaaring makuha nang
dahil sa pagkakaroon ng health problem na ito.

 - For the next criteria naman, it is partially modifiable. Partially modifiable ito dahil na rin sa
kakulangan ng pamilya or ng client to be specific, sa resources na kinakailangan to solve the
problem. Pati na rin sa pagiging willing ni client to take meds for the condition at pagpapa-check
nito ng kaniyang blood pressure lalo na sa tuwing siya ay nahihilo.
- This problem can be moderately prevented. Ito ay maiiwasan if mayroong maayos na health
teaching at awareness na maibibigay tayo sa ating client in a way na madali para sa kaniya na ito
ay maunawaan.
- Samantala, nakikita ng client na ang problemang ito ay hindi kinakailangan ng agarang
paghahanap ng solusyon o lunas upang ito ay maiwasan na or mawala.
- So sa scoring naman naming, 3.17 ang total for the 4 criterias that we have.

Eunique - ILLNESS STATE (CATARACT DUE TO DIABETES)

- With this problem, it is considered health deficit as cataract is a disease resulting from having
diabetes that made the client unable to see and affect her day-to-day life.
- Ito ay partially modifiable because it can still be change if papayag yung family na mag undergo
yung patient sa surgical removal of the cataract but still, with the help of avoiding eating certain
foods and iniinom every day yung maintenance medicines, mababawasan yung risk for
complications.
- Next is low preventive ito because this problem is a health deficit kung saan ito ay hindi na
maiiwasan. However, as nursing students, maaari pa rin tayong makapagbigay ng proper health
teaching to prevent further complications.
- Gaya ng mga problema kanina, the family views this as a problem na hindi naman kailangan
bigyan ng immediate attention and that they consider this as not a problem to worry about
because even though the client cannot see anymore, she proceeds with her day-to-day life with
the guidance of her family.
- 2.83 naman ang score na meron para sa specific na health problem na ito.

Eunique - DISABILITY (LEFT HEMIPLEGIA)

- For the last health problem, we have left hemiplegia. This health condition is identified as a
health deficit because this is a disability where a person has paralysis on one side of the body, in
the case of our patient, it is his left side which is nagre-resulta sa pagiging hirap sa pag galaw o
pagkilos.
- Due to left hemiplegia resulting in poor mobility, it is not modifiable. Bilang nursing students,
wala na rin tayong magagawa upang magamot ang kaniyang disability but we can give health
education base sa kung ano ang mas makatutulong para sa kanya.
- Gaya nang nasabi ko kanina, dahil disability na ito, wala na tayong magagawa for this to be
healed kaya it is considered as low preventable. But as a nursing student, we can still give
interventions upang kahit papaano ay maiwasan ang pagkakaroon ng pressure ulcers at iba pang
mga potential cases na maaaring makuha kung ito ay hindi mamo-monitor from time to time.
- Lastly, this problem also doesn’t need to be given an attention of. And dahil na rin ito sa nangyari
na and wala nang magagawa. But still, the client still do exercises or interventions upang
maiwasan ang mga komplikasyon ma maaari o possible pang makuha.
- The score for left hemiplegia is 1.33 considering the 4 different criterias that we have for this
scaling.

 Family Nursing Care Plan

Micah - Overview of FNCP

Upon assessing the family’s living conditions and scoring of identified problems, we created a
family nursing care plan that aims to solve the family’s problem on poor sanitation.

Micah - Health Problem

The health problem identified is poor home sanitation due to improper drainage system as health
threat. The client verbalized “Oo nga eh kaso kasi matagal na kami nakatira dito kaya hindi na kami
masyadong nababahuan o nadudumihan. Kahit naman ganyan yung bahay namin, wala
nagkakasakit kaya ok lang siguro.” which acts as our subjective cue and open drainage, presence of
flies in the house, presence of stagnant water on drainage, foul-smelling environment and
disorganized home belongings and furniture as observed by the nurse can prove the statement given
by the client.

Sofia - Family Nursing Problem

After doing the 2nd level of assessment, we concluded that the family experiences these types of
nursing problems. Inability to make decisions with respect to taking appropriate health action due
to:
A. Failure to comprehend the nature/magnitude of the problem/condition
B. Low salience of the problem/condition

During the interview, the nurse noticed that the family is failing to see or comprehend the severity
of the problem which leads to low salience. This is probably because the family has been living
with poor sanitation for so many years that they have grown used to it already. Because of this, they
are unable to create decisions conducive to their health.

Next is, Inability to provide a home environment conducive to health maintenance and personal
development due to:
Failure to see benefits (specifically long term ones) of investments in home environment
improvement
B. Lack of/inadequate knowledge of importance of hygiene and sanitation
C. Negative attitudes/philosophy in life which is not conducive to health maintenance and personal
development

Due to improper drainage management, they are unable to create a clean and organized
environment conducive for their health maintenance. The family is also not able to see the benefits
of having a good sanitized home because as I have said earlier, they are already used to it that as
long as no one in the family gets sick or infected due to poor sanitation, they can live with this kind
of environment without knowing the importance of proper hygiene and possible consequences that
can pose a danger in their lives. This kind of mentality also gives them an attitude/philosophy in life
that negatively affects their health and well-being.

Micah - Goal of care

The goal of care is that within 3 weeks of nursing intervention, the family will be able to choose
and demonstrate appropriate measures to eliminate, if not reduce problems to improve their home
sanitation.

 Sofia - Objectives of care

Objectives of care includes recognizing that poor sanitation is a threat that can potentially damage
their health, Enumerate at least 3 disadvantages of having an improper drainage system, State at
least 3 vector-borne illnesses (dengue, leptospirosis, amoebiasis) that the family may acquire
because of their poor home sanitation due to improper drainage , cite at least 3 advantages of having
an improved drainage system to their overall daily living, identify at least 3 courses of action to
correct the improper drainage system and apply newly-acquired knowledge and maintain the
cleanliness or proper drainage management.

The goal and objectives of care are directly aimed for the family to recognize that poor sanitation
due to improper drainage is indeed a threat to their health, even if they still have not experienced
any diseases caused by it. Allowing the family to know and understand both benefits and risk can
increase their comprehension of the severity of the problem and can further motivate them to try
and reduce or as much as possible, eliminate the problem to create an environment that can help
them facilitate improved health maintenance most especially that the household members have
existing comorbidities. Encouraging them to maintain cleanliness and proper drainage management
once they have done proper interventions to solve the problem does not only benefit their health but
also will enhance their quality of life.

Intervention & Rationale

Jezz
Now for the intervention and its rationale. The first one is to establish rapport and a good
therapeutic relationship. It is for us to gain the cooperation and trust of the family. Next is to state
the purpose of the action so that we can boost the awareness and motivation of the family to do the
needed interventions. Next is to assess the family's willingness to participate in solving the problem
to determine the family's willingness to solve the problem. Next is to assess the family's awareness
in comprehending the conditions to determine how well the family understands the severity of the
problem. Then, discuss with the family their present condition and allow them to verbalize their
perception about the problem to determine how well the family understands the severity of the
problem.

Arnel
The next one is to enumerate and discuss with the family the disadvantages of having an improper
drainage system, such as foul odor, presence of vectors that can cause disease, the possibility of
overflowing that can lead to flood during the rainy season. Explain natin sa family yung mga
potential consequences para mas maintindihan nila na yung pagkakaroon ng improper drainage
system ay mag cause pa ng mas madaming problema pag hindi na solve. Then, discuss with the
family the examples of vector related illness that the family may acquire if improper drainage
system will not be corrected such as diarrhea, dengue, amoebiasis and leptospirosis. By that, we can
emphasize the negative impact of improper drainage system sa kanilang kalusugan.

Jezz
The next one is to discuss with the family the importance of having a good sanitation at home
system such as prevention of possible breeding sites of vectors, prevention of acquisition of vector-
related illness, and providing a home environment that is conducive for health. With these, we can

 facilitate the importance and benefits of good sanitation practices for their health and well-being.
Next is to discuss and demonstrate alternative courses of action to correct/manage poor sanitation
due to improper drainage such as yung araw araw na paglilinis ng bahay, covering the drainage with
stagnant water para maiwasan natin yung pag breed ng mga mosquitoes and maintain clean
arrangement ng mga kagamitan sa ating bahay. This is to provide ways to manage the problem more
effectively.

Arnel
Next is to encourage family participation in managing poor sanitation and improper drainage
system. Sa pagtutulungan ng pamilya mapapadali natin yung pag solve sa problem. The last one for
our nursing intervention and rationale, do a follow-up home visit to see if the family have applied
their newly-acquired skills to solve the problem and maintain proper drainage management so we
can evaluate the effectiveness of the interventions as well as the participation of the family in
executing courses of actions to improve their drainage system.

Jezz - Methods of Nurse-Family Contact

For our methods of nurse-family contact, we used home visitation and video conference.
- We did the initial home visit noong November 8, 2021 to gather the family’s Initial Data Base.
We also decided, as a group, to use this for our FNCP.
- After making the FNCP, nag home visit ulit kami noong November 10, 2021 to do the
interventions and health teachings for the family.
- And lastly, for our follow-up ginawa namin yung farewell video conference with the family
noong November 28, 2021

Arnel - Resources Required

Now, the resources required are visual aids and materials needed, time and effort of both nurse and
the family and also money for the nurse transportation.

Micah - Evaluation
For our evaluation, after 3 weeks of nursing interventions, the family recognized the condition and
verbalized the importance of good sanitation at home and a proper drainage system. The family also
identified the disadvantages of having poor sanitation and an improper drainage system. The family
was also able to enumerate vector-related illnesses that may occur if the condition is not
appropriately managed. Then, the family was able to arrange or organize home belongings and
furniture. The family also regularly cleans the house and practices irrigation of stagnant water and
covering it with sand to prevent breeding sites of vectors. Overall, the goal was met.