CHAPTER 1

INTRODUCTION

A Family is a group of two or more persons related by birth, marriage, or adoption who live
together, all such related persons are considered as members of one family.

The Family is the smallest unit of the society and the natural fundamental core of the community
and consequently, it is considered as the primordial recipient of the nursing effort, which is contributory
to the development and progress of the community through active involvement and self-responsibilities
of each constituent. It is composed of person’s male and female being molded to be as one, working
hand in hand to maintain a good atmosphere among the family members.

The impression or status of each family will always affect the status of the community,
community health nursing is a response to the health of the people. It does not focus on a particular
class or family. It is comprehensive and general in approach. The family is considered as the basic unit of
care in the community health nursing. It is in the family where a member develops his health values,
beliefs, and practices.

The family is a major influence in the health behaviors of an individual. It is important that
families in community are aware of the things and practices pertaining to their health.

It is apt to say that community health nursing has a big role in the nursing education. It is in the
community where the student nurse learns nursing apart from the hospital setting as she was expose to
different level of orientation.

It is in the community where the saying “Nursing is an Art” can be applied as a student nurse
tries to give quality service using the available resources in the health center.

Conducting a family case study is a means by which student nurse reaches and feels the
community through its basic structure- The Family. It is a tool in determining the health status of a family
through assessment and critical inspection. Through this health problem are identified thus giving the
student nurse a hint on where to act and how to interfere.

It is also a means towards improving the health of the community people, making them more
productive to come up which a family case study gives a sense of fulfillment to a student nurse as she
was given the opportunity to share their skills, knowledge, and time to alleviate and uplift the living
condition of a family.
 Chapter II

OBJECTIVES OF THE STUDY

This chapter presents the general and specific objectives of this family case study. Setting
objectives provides direction for planning a family nursing intervention. Its facilities motivation for the
client and the nurse by providing a sense of achievement. (Kozier, Erb et.al., 2004)

General Objectives:

At the end of the student nurse-family relationship, the adopted family will be able to improve
their health status through appreciate intervention in each time frame.

Specific Objectives:

After 1 month of home visit and student nurse-family interaction, the family should be able to:

Plan possible solutions or nursing actions to the prioritized health problems.

Carry out the planned intervention together with the student nurse.

Perform the health teaching taught by the student nurse.

Evaluate the effectiveness of the intervention using the set objectives as a basis, and • Evaluate
changes in condition after giving interventions.

Chapter III

INITIAL DATABASE

Family Structure, Characteristics, and Dynamics

Name Age Sex Civil Position in Occupation Educational

the family attainment

Mr. L 33 Male Single Father Construction High school

(Third year)

Mrs. T 42 Female Single Mother Housewife College

graduate

Child LT 1 month Male Single Child N/A N/A

The family LT is considered as a Cohabitation type of family. A Cohabitation type is an

arrangement where people who are not married, usually couples, live together. They are often involved
in a romantic or sexually intimate relationship on a long-term or permanent basis. This type of family
structure is found in almost all societies, although the length of time in which the family remains in this
form varies even within the same society.

The LT family resident of purok 5, barangay Sinili, Santiago City. They have started living together
since July of 2021. They were a family whose resident in barangay Sinili.

Mr. L and Ms. T go hand and hand in terms of decision-making. They consult each other in terms
of planning budgeting for their family. They discuss matters about their child and with regards to the
emotional problems or aspect within the family. When problem arises, they make sure that both will
handle and solve the problem. But then, in terms of matter concerning health Ms. T is more dominant.
She has greater awareness concerning health matters compared to Mr. L since of course believing it is
her duty as the mother. This health matters include immunization, feeding the right food and caring for
the sick member.

Socio-Economic and Cultural Characteristics

The L & T family source of income is coming from Mr. L's construction work. Mr. L's family is 8600
per month, since Ms. T does not work she is in charge of the house and by taking care of their baby. Ms.
T budget the money in terms of food clothes and other miscellaneous such as electricity bill, other need
of baby and other allowance. Most of it goes to the family's budget for food.

With Mr. L's monthly income, the head of the family strives hard to accommodate everything
they need from food, clothing's, health care and other expenses in their everyday routine. Ms. T told the
student nurse that they have any financial assets at hand in case of emergency.

Mr. L works as a construction worker; he works Monday to Saturday. Ms. T doesn't work and
stays in their house. She is the typical housewife where in you can see her wash clothes, prepare food,
sweep

Significant others in the lives of family L & T include relatives and some neighbors. Ms. T also
confirms how friendly and helpful her neighbors are to them.

C. Home and Environment

The house is made of plywood, hollow blocks, and a little bit bamboo. It is 56 square meters as
Ms. T indicated. The house has 5 windows and can give a proper air as needed by the family.

The house has 3 rooms living room, bedroom, and ventilation stockroom. In bedroom it is where
we can see Mr. and Ms. LT together with their baby. They use bed and foam for comfort of sleeping.

The LT family has a lot of appliances such as radio, television, speaker, and mini refrigerator.
They used sack for their garbage disposal and sometimes they burn in their compose pit.

Ms. T use burner and charcoal in cooking. When her husband is not in the house, she is the one
preparing for the food but when Ms. T gave birth her cousin is the one who is responsible for cooking.
Dirty kitchen is at the back portion of the house. They cook inside the house. The food usually serve’s
warm. They use glass plates and stainless spoons when eating. When it comes to storing their food, they
put on the table and cover it. In terms of cooking facilities, the family is equipment with rice cooker,
frying pan, kettle, and knives.

They wash their clothes using water coming from the deep well. They are buying water from
refilling station and use it for drinking.

They have comfort room inside their house.

The drainage system of the family is an open type where in the drainage flows continuous. It is
dirty and has a stinky smell. There is no obstruction present at the drainage system since it is open and
flows everywhere.

The family owns a transportation which is a single motorcycle.

The family has herbal plants such as oregano and lagundi in front in their house.

Health Assessment of each Family Member

D1. PAST AND PRESENT ILLNESS

1. Health Assessment on each member

Mr. L- The student nurses have never met Mr. L since he was in construction site during the
interview, however Ms. T told us that her husband got vaccinated of sputnik. According to Ms. T that Mr.
L experienced chicken pox and tinea versicolor(kamanaw)when he was 15yrs old. Ms. T said that her
husband is about 60 kg weight and has a 5 feet 5 inches tall. He is also 33 years old. His

BMI reveals normal weight with a value of 22.4. Ms. T told the student nurses that her husband
has no genetic or hereditary illness known. He’s not also a smoker and drinker.

Ms. T- She has no chronic infectious disease as of the present time. But her past illness was she
experienced having a chicken pox when she was 7 years old. She is 5 feet and 4 inches tall and weighs a
48 kg. Her BMI reveals normal weight with a value of 20.2. She has no complaints as of the present time
and has not taken medications. At times of illness, she’s taking a paracetamol for fever and mefenamic
acid for pain, in wounds they used to crush plants coming from their backyard. Ms. T told the student
nurses that they are still using a family planning.

Child LT- He has no chronic or infectious diseases as of present time. He has not yet completed
immunization, but he already got different immunization vaccine such as Diphtheria, tetanus and
whooping cough (pertussis)(DTaP). The baby is 1 foot and 9 inches tall and weighs a 4kg.
FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

1. Health Perception-health management patterns

Before During

With no known vices like smoking and drinking Now Mr.L still drinks occasionally
except for Mr.L who drinks occasionally.
Was able to recognize the importance healthy
Was able to recognize the importance healthy well-being.
well-being.
Uses herbal plants like oregano and lagundi from
Uses herbal plants like oregano and lagundi from their yard when they have fever and cough.
their yard when they have fever and cough.

2. Nutritional-metabolic pattern

Before During

They take vitamins such as ascorbic acid. They take vitamins such as ascorbic acid.

Daily food intake is mainly rice, fish, meat, and Daily food intake is mainly rice, fish, meat, and
vegetables. vegetables.

Should focus of breastfeeding. Should focus of breastfeeding.

3. Elimination Pattern

Before During

According to Ms. T, all the family members have

no difficulty in voiding.

The family members defecate every day and some,

every other day with no

difficulty in defecating noted.

4. Activity-exercise pattern

Before Before

 The family doesn’t perform an actual exercise The family doesn’t perform an actual exercise but
but as for them they said that the chore inside as for them they said that the chore inside their
their house is considered an exercise such as house is considered an exercise such as fetching
fetching water, sweeping the floor and water, sweeping the floor and surroundings and
surroundings and washing clothes. washing clothes.
5. Sleep-rest pattern

Before During

LT family usually has 7-8 hours of uninterrupted  LT family

sleep according to Ms. T.

They usually sleep at around 9 in the evening and

wake up around 4-5 in the morning.

They also take a nap at free time.

6. Cognitive-perceptual pattern

Before During

Was oriented to time, place and able to identify Was oriented to time, place and able to identify
people and significant others by their names. people and significant others by their names.

Memory intact. Memory intact.

No sensory defects. No sensory defects.

7. Self-perception/Self-concept

Before During

Showed apprehension and worry towards a Showed apprehension and worry towards a
specific consequence. specific consequence.

Perceived situations (health deficits) to be very Perceived situations (health deficits) to be very
stressful but remain passive about things and stressful but remain passive about things and
condition. condition.

8. Roles and Relationship

Before During

 Family members have an open communication  Family members have an open communication
and able to discuss their problems according to and able to discuss their problems according to
Ms. T. Ms. T.

9. Sexual Reproductive

Before During

Both parents are still in the reproductive age. Both parents are still in the reproductive age.

The parents still live-in together. The parents still live-in together.

10. Coping Stress

Before During
 Gains strength provided by family members like  Gains strength provided by family members like
moral support, love and understanding. moral support, love and understanding.

11. Values/Beliefs Pattern

Before During

The family is catholic. Expressed great belief and The family is catholic. Expressed great belief and
faith in God is certain that the divine providence faith in God is certain that the divine providence
would protect them from any unidentified and would protect them from any unidentified and
possibilities of harm. possibilities of harm.

Does not go to church every weekend since they Does not go to church every weekend since they
are situated far away from the place of worship are situated far away from the place of worship
they attend. they attend.

Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

The mother and father have adequate rest and sleep, it depends on the baby if it’ll cry or need to
breastfeed at night, but they usually go to bed around 4:00 to 5:00 a.m. because the father need to get
up early for work. At all times the father is doing the household chores before and after work.

In terms of health problem, the mother and father often use over- the - counter medication like
paracetamol for treating their illness and sometimes they consult in community health service for
checkups. For their baby they use to go to hospital for follow-up checkups or healthcare.

When they have free time do you usually go to their parents’ house to visit because the
grandparents wanted to see the baby or sometimes the grandparents come to visit.

Chapter IV

FAMILY BACKGROUND

This chapter illustrates the family background of the study which includes, Family Tree, Database
of the Respondent, Activities of Daily Living, General Household Data which could be an indicative for the
present health status of the family as it continues to influence the each of the family.

A. Family History
 The Family LT is composed of 3 members only, Mr. L is the father and Ms. T is the mother they
have only 1 child and named LT. Mr. L the head of the family is 33 years of age, Ms. T his wife is 42 years
of age, and their only child LT is a 1-month-old baby.

Mr. L was born and grew up in Quirino Province, his father and mother were both a farmer. He
has 4 siblings, and he is the 1st born. He was able to go to school up to 3rd year high school only, and
after that he did not continue his study to help his parents to look for money to support the needs of
their family.

Ms. T was born in Diffun, Quirino and transfer and grew up in Barangay Sinili, Santiago City since
she was in grade 1. Her mother and father were also both a farmer. She has 5 siblings, and she is also the
1st born, Ms. T is a college graduate with a 2-year course which is the Computer Secretarial. After
schooling she finds work and able to help her parents specially in financial needs.

Mr. L and Ms. T met in the house of their friend through their friends of friends. They become a
couple after 6 months, after few months they decided to live in and build a family, since that they are
now living in Sinili, Santiago city.
 Database of the Respondent

The respondent upon the interview is the mother in the family.

NAME : Ms.T
Age : 42 years old
Gender : Female
Address: Purok 4, Sinili, Santiago City
Birth Place :
Religion: Roman Catholic
Occupation : Housewife
Civil Status : Single
Nationality : Filipino
No. Of Children : 1
Educational Attainment: College Graduate
Estimated Monthly Income: None
Name of Husband : Mr. L
B. Family Tree

MR. L Ms. T

Baby
LT
General Household Data

Total No. of Children

List of Household Members

Members Status Occupation Sex Educational Religion Position in

Attainment the Family

Mr. L S Construction Male High School Roman Father

Worker
Catholic

Ms. T S Housewife Female College Roman Mother

Catholic

Child LT S NONE Male NONE N/A Child

CHAPTER V

FAMILY COPING INDEX

CRITERIA IDEAL ACTUAL JUSTIFICATION

PHYSICAL Concerned with The family are all 4 They are no abnormalities in the
the mother and physical independence of the
INDEPENDENCE able to move
family members. But the mother
father ability to
without assistance is had surgical incision due to
move about to get
and difficulty. childbirth so that she cannot
out of bed, work
move fast after surgery. But in
in the house ,get They are
few days she can move her body
water, wash independent in
clothes moving about and
using their
musculoskeletal
system.

THERAPEAUTIC Includes the Parents make sure 3 The parent is aware of their
COMPETENCE extent to which son is healthy and therapeutic competence. Parent
there has the safe child relationship is to improve.
knowledge and
The family buys medicine without
skill required to
prescription such as paracetamol
deliver a
and mefenamic acid.
treatment to the
standard needed
for it to achieve its
expected effects

KNOWLEDGE Health is referring The family can 4 They have concern with the
of state complete determine if there health condition particularly
OF HEALTH
emotional and is presence of illness.
CONDITION physical well disease and its
effect on them
being
health as a family
To know that Has some general
education knowledge of
attainment is an disease or
inadequate health conditions.
skill.

Concerned with
the health
condition that is
the occasion for
care such as
knowledge of the

disease or

inability to
understand
communicability.

APPLICATION This is concerned The parents sleep 4 They are very aware about
with the family well and eats hygiene and cleanliness. The
OF PRINCIPLES
action in relation nutritious food family has an adequate rest and
OF GENERAL to maintaining everyday sleep. They able make meals
HYGIENE family nutrition three times a day and sometimes
especially the
securing adequate they had snacks
mother because
rest and relaxation
she is
for family breastfeeding his
members baby. They always
 carrying out sterilize the things
accepted that will need of
the baby.
preventive
measures such They have box to
put the things that
as
will need of the
immunizations, baby because they
and medical. Safe are
home

making habits in very concern.

relation to storing
and preparing
foods.

HEALTH Concerned the The parents are 3 Parents is very protective to their
concerned about son from any harm. They also
ATTITUDES patient in
the health of the make sure the baby is securely
nutrition into daily
family. They safe and healthy.
maintain healthy
lifestyle. Good
nutrition
especially to the
baby

EMOTIONAL The parents use The family are 3 The parents is responsible for
COMPETENCE assertive style of competent being a good parents to their son
communication. enough.
They are matured
they show to
in thinking
how to be a good
They are positive
always in their life. parent to their
only son

FAMILY LIVING The family is living There has quality 2 It is important to note that any
in their own time, they are family structure, children can
house, and they very thankful to have different relationship with
are support love, God for giving their family members. It has her
and caring for their son. own part or role in the family
each other strong which is well respected.
They maintain a
family.
good
 They manage how communication as
to budget for partners
every day.

PHYSICAL Concerned with The family space is 1 The house is free from pest
the home the enough for the
ENVIRONMENT insecticides falling. they don’t
community and family.
have any trash cans for their
work environment But there is a garbage that’s why they just
as its affect family presence of burned it. They have deep well
health. mosquito. but the water is not clean they
because Their also have stagnant water at side
The condition of
house is near in of their house.
the house is
the pond.
simple but such us
pressure of
accident hazards
like in there floor,
the kitchen, there
roof

USE OF It has to do with The family visit 3 The school and barangay health
the Degrees of the their health centers near there house and are
COMMUNITY
community use centers for follow accessible. The family knows
FACILITIES and awareness of up checkup of when, to whom and where to call
the community each member or approach for help for
community facilities especially in
facilities for
terms of health
education and
welfare.

Chapter VI
Typology of Nursing problems

Cues or Data Family Nursing Problems

Objective data: I. Poor production of Breast milk

as a presence of wellness
-The mother breast milk is not enough for the condition.
baby.
1. Inability to provide adequate
- ml/cc/ounces per day
nursing care to the sick, disabled,
dependent or vulnerable/ at risk
-Difficulty pumping member of the family due to:

a. Lack of/inadequate knowledge

Subjective data: about the disease/ health
condition (nature, severity,
The mother verbalized “kokonti lang yung complication, prognosis and
gatas na lumalabas sa akin”. management)

Objective data: II. Poor environmental condition

as evidence by Accident hazard
Possible accident that can hurt the family such as galvanize as a health
members. threat.

1. Inability to provide a home

Subjective data: environment conducive to health
maintenance and personal
“mag iingat kayo dyan, baka masugat kayo. development due to:
May naka usli kasi minsan”. the mother
verbalized when the student nurses washing a. Lack of the necessary
the dishes facilities, equipment and
supplies of care.
b. Financial constraints/limited
financial resources

2. Inability to provide a home

environment conducive to health
maintenance and personal
development due to:

a. Inadequate family resources

specifically:
- Financial
constraints/limited financial
resources

3. Failure to see benefits of

investments in home environment
improvement.

Objective data: III. Poor home/ environmental

condition as evidence by
Presence of mosquito breeding places such mosquito breeding places of
as dengue, malaria mosquito such as dengue,
malaria as health threat.

Subjective data: 1. Inability to make decisions with

respect to taking appropriate
‘may mga lamok na pumapasok ditto sa health action due to:
bahay” as verbalized by the mother.
a. Failure to comprehend the
nature/ magnitude of problem/
condition

2. Inability to provide a home

environment conducive to health
maintenance and personal
development due to:

a. Lack of/inadequate knowledge

of preventive measures
b. Lack of skill in carrying out
measures to improve home
environment
Objective data: IV. Poor home/environmental
sanitation as evidence by
Stagnant water drainage/ canal/ odorous drainage clogging as a health
canal/ drainage clogged threat.

1. Inability to provide a home

Subjective data: environment conducive to health
‘hindi umaagos yung tubig, mabaho” as maintenance and personal
verbalized by the mother. development due to:

a. Lack of/ inadequate

knowledge importance of
hygiene and sanitation

Objective data: V. Parenthood as a stress

points/foreseeable crisis
-The Mother and Father enters the stage of situation.
Parenthood.
-2 months’ baby boy 1. Inability to provide adequate
nursing care to the sick, disabled,
dependent or vulnerable/ at risk
member of the family due to:

Subjective data: a. Lack of/inadequate

knowledge about child
“unang baby namin ito” as verbalized by the development and care
mother. b. Inadequate family resources
of care specifically:
- Absence of responsible
member
Objective data: VI. Poor home/environmental
sanitation as evidence by
Improper waste segregation. Improper Waste Disposal as a
health threat.

Subjective data: 1. Inability to provide a home

environment conducive to health
“nag iisa lang ang basurahan naming, sa maintenance and personal
sako” as verbalized by the mother. development due to:

a. Inadequate family resources

specifically:
- Financial
constraints/limited financial
resources
b. Failure to see benefits
(specifically long term ones) of
investments in home
environment improvement
c. Lack of/inadequate knowledge
of importance of hygiene and
sanitation.

Chapter VII PRIORITIZING PROBLEMS

This chapter shows the setting of priorities of family health problems that has been identified. It
includes a computation on how priorities were shown with their corresponding justification.

I. Poor production of Breast milk as a presence of wellness condition.

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the 3/3x1 1 The Problem is Health Deficit
problem
2. Modifiability 2/2x2 2 The problem is modifiable, since the
of the mother told her condition.
problem
3. Preventive 2/3x1 0.67 This problem has a preventive potential
potential that can help by proper way of breast
feed or a milk powder formula.
4. Salience 2/2x1 1 The family perceive that this is
considered as a problem that can affect
their child’s health.
Total score: 4.67

II. Accident Hazards, as a health threat.

 CRITERIA COMPUTATION SCORE JUSTIFICATION
1. Nature of the 2/3x1 0.67 This problem is a health threat
problem
2. Modifiability 2/2x2 2 It can easily modify as evidenced by the
of the student nurses. The condition issue
problem involves the financial problem that is
unable to improve their home facilities.
3. Preventive 3/3x1 1 This problem is preventable by
potential maintaining or improving their home
facilities
4. Salience 0/2x1 0 This family did not perceive this as a
problem.
Total score: 3.67

III. Poor environmental condition as evidence by mosquito breeding places of

mosquito such as dengue, malaria as health threat.

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the 3/3x1 1 This problem is a health threat
problem
2. Modifiability 2/2x2 2 The problem is modifiable, since their
of the storage of water in the bathroom has no
problem cover that can cause of breeding of
mosquitoes
3. Preventive 3/3x1 1 This problem has a preventive potential
potential by cleaning the places where mosquitoes
can spread their breeds.
4. Salience 0/2x1 0 The family did not perceive this as a
problem or condition needing to change
Total score: 4

IV. Poor environmental sanitation as evidence by drainage clogging as a health

threat.
CRITERIA COMPUTATION SCORE JUSTIFICATION
1. Nature of the 2/3x1 0.67 This problem is a health threat
problem
2. Modifiability 2/2x2 2 It easily to modify, since the drainage is in
of the front of their house and is evidence by
problem the student nurses that drainage clogged
3. Preventive 3/3x1 1 It is preventable by maintaining a proper
potential cleanliness and should have a proper
garbage and segregation
4. Salience 1/2x1 0.5 The family did not perceive this as a
problem since they’re not giving attention
to it.
Total score: 3.84
V. Parenthood as a stress points/foreseeable crisis situation.

CRITERIA COMPUTATION SCORE JUSTIFICATION

5. Nature of the 1/3x1 0.34 This problem is a foreseeable.
problem
6. Modifiability 2/2x2 2 This problem is easily modified by the
of the worry or complaint of the mother. The
problem mother and father is a first timer parent.
7. Preventive 2/3x1 0.67 This problem is preventive that can be
potential solve by Family planning and health
teaching. The both parents enhanced
capability
8. Salience 2/2x1 1 The Family in readiness for this situation
Total score: 4.01

VI. Improper Waste Disposal as a health threat.

CRITERIA COMPUTATION SCORE JUSTIFICATION
1. Nature of the 2/3x1 0.67 This problem is a health threat
problem
2. Modifiability 2/2x2 2 The problem is modifiable, since their
of the waste disposal was only in the Rice Bag
problem
3. Preventive 3/3x1 1 This problem has a preventive potential
potential by providing a proper waste disposal
such as Recyclable, Biodegradable, and
non-biodegradable.
4. Salience 2/2x1 1 The family perceive this as a problem or
condition that needs to be change.
Total score: 4.67
 CHAPTER VIII
Nursing Care Plan
This chapter show the identified and prioritized problems in a ranking order. This chapter also
presents the family care plan formulated by the student nurse together with the family.

PROBLEM LIST

PROBLEM LIST SCORE

Poor production of Breast milk as a presence of wellness condition. 4.67

Improper Waste Disposal as a health threat. 4.67

Parenthood as a stress points/foreseeable crisis situation. 4.01

Poor home/ environmental condition as evidence by mosquito breeding 4

as health threat.

Poor environmental sanitation as evidence by drainage clogging as a 3.84

health threat.

Pointed/ sharp objects Accident Hazards as a health threat. 3.67

 FNCP

Chapter VII PRIORITIZING PROBLEMS

This chapter shows the setting of priorities of family health problems that has been identified. It
includes a computation on how priorities were shown with their corresponding justification.

I. Poor production of Breast milk as a presence of wellness condition.

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the 3/3x1 1 The Problem is Health Deficit

problem

2. Modifiability of the 2/2x2 2 The problem is modifiable, since the mother

problem told her condition.

3. Preventive potential 2/3x1 0.67 This problem has a preventive potential that
can help by proper way of breast feed or a
milk powder formula.

4. Salience 2/2x1 1 The family perceive that this is considered as a

problem that can affect their child’s health.

Total score: 4.67

II. Pointed/ Sharp objects Accident Hazards, as a health threat.

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the 2/3x1 0.67 This problem is a health threat

problem

2. Modifiability of 2/2x2 2 It can easily modify as evidenced by the student

the problem nurses. The condition issue involves the financial
problem that is unable to improve their home
facilities.
 3. Preventive 3/3x1 1 This problem is preventable by maintaining or
potential improving their home facilities

4. Salience 0/2x1 0 This family did not perceive this as a problem.

Total score: 3.67

III. Poor environmental condition as evidence by mosquito breeding places of mosquito such as
dengue, malaria as health threat.

CRITERIA COMPUTATIO SCORE JUSTIFICATION

N

1. Nature of the 3/3x1 1 This problem is a health threat

problem

2. Modifiability of 2/2x2 2 The problem is modifiable, since their storage of

the problem water in the bathroom has no cover that can cause
of breeding of mosquitoes

3. Preventive 3/3x1 1 This problem has a preventive potential.

potential

4. Salience 0/2x1 0 The family did not perceive this as a problem or

condition needing to change

Total score: 4

IV. Poor environmental sanitation as evidence by drainage clogging as a health threat.

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the 2/3x1 0.67 This problem is a health threat

problem

2. Modifiability of 2/2x2 2 It easily to modify, since the drainage is in front of

the problem their house and is evidence by the student nurses
that drainage clogged

3. Preventive 3/3x1 1 It is preventable by maintaining a proper cleanliness

potential and should have a proper garbage and segregation

4. Salience 1/2x1 0.5 The family did not perceive this as a problem since
they’re not giving attention to it.

Total score: 3.84

 V. Parenthood as a stress points/foreseeable crisis situation.

CRITERIA COMPUTATIO SCORE JUSTIFICATION

N

1. Nature of the 1/3x1 0.34 This problem is a foreseeable.

problem

2. Modifiability of the 2/2x2 2 This problem is easily modified by the worry or

problem complaint of the mother. The mother and father is a
first timer parent.

3. Preventive 2/3x1 0.67 This problem is preventive that can be solve by

potential Family planning and health teaching. The both
parents enhance capability

4. Salience 2/2x1 1 The Family in readiness for this situation

Total score: 4.01

CHAPTER VIII Nursing Care Plan

This chapter show the identified and prioritized problems in a ranking order. This chapter also presents
the family care plan formulated by the student nurse together with the family.

PROBLEM LIST

PROBLEM LIST SCORE

Poor production of Breast milk as a presence of wellness condition. 4.67

Parenthood as a stress points/foreseeable crisis situation. 4.01

Poor home/ environmental condition as evidence by mosquito breeding as health threat. 4

Poor environmental sanitation as evidence by drainage clogging as a health threat. 3.84

Pointed/ Sharp objects Accident Hazards as a health threat. 3.67

FNCP

Family Nursing Care Plan

I. Poor production of Breast Milk

CUES ANALYSIS OF THE PROBLEM OBJECTIVE

Subjective data: Insufficient breast milk related to After 3 days of community

inappropriate breastfeeding style exposure, the mother will be
“Kokonti lang yung gatas na
decrease production of breast milk able to:
lumalabas sa akin”, as verbalized
by the mother. Increase milk production and
identify ways to produce more
Objective data:
milk.
 Decrease production of breast
Baby will be able to suck
milk
enough breast milk.

Know the proper positioning of

the breast feeding.

INTERVENTION

NSG. RATIONALE METHOD RESOURCES EXPECTED OUTCOME

INTERVENTIONS REQUIRED
Encourage mother To boost their H Manpower After 3 days of community
to take soup with breast milk supply resources exposure, goal met. Mother
O
green leafy through a such as was able to identify ways to
vegetable and combination of M time and increase milk producti on and
fruits. dietary and lifestyle effort. the proper positioning and
E
changes. baby was able to suck enough
Advise mother to
V breast milk.
not skip For the first few
breastfeeding weeks, the baby I
sessions. must be
S
breastfeeding at
Teach mother to be
least every 2-3 I
alert to feeding
hours round the
problems such as T
clock. Breast-
proper positioning
feeding less often
of breast feeding
can contribute to a
low milk supply.
Frequent nursing
Promote sleep/rest
sessions stimulate
as well as a healthy
the body to produce
diet and the proper
more milk.
positioning of the
baby.

Be sure to offer
both breasts at each
feeding

It's okay for the

baby to nurse on
only one breast at a
feeding but if this
happens regularly,
the milk supply will
decrease. Teach
mother to pump the
other breast to
relieve pressure and
protect milk supply
until the baby
begins taking more
at each feeding.

An exhausted
underfed mom is
 not an efficient milk

machine. And so the

baby can get

enough breast milk
from the mother.

II. Poor environmental condition due to presence of breeding places

CUES ANALYSIS OF THE OBJECTIVE

PROBLEM

Subjective data: "May mga Inability to provide a Short Term:

lamok na pumapasok dito sa home environment
After two hours of nursing interventions, the
bahay” as verbalized by the conducive to health
family will be able to demonstrate
mother. maintenance and
understanding of the health teachings
Objective data: personal regarding the possible causes and effects of the
development. presence of the insects and pest.

Inability to recognize Long Term:

 Presence of mosquitoes the possible diseases After 2 days of community exposure, the family
that could be acquired will be able to show compliance on measures on
Breeding places of
 through the presence how to maintain the clean surroundings in order
mosquitoes
of rodents, insects or to eradicate breeding sites of mosquitoes and
mosquitoes. other insects.

INTERVENTION

NSG. RATIONALE METHOD RESOURCES EXPECTED OUTCOME

 INTERVENTIONS REQUIRED

Discuss possible Knowing the causes of the H Visual aids about Short Term:
sources of the problem makes managing the effects of
O The family was able to
presence of the easier presence of
demonstrate
mosquitoes. M insects and pests.
To increase their knowledge understanding of the
Explain to the and awareness regarding E Materials of health teachings with
household members the presence of the visual aids. regards to the possible
V
all the possible breeding sites so as to causes and effects of the
Time and effort
disadvantages and persuade them in doing I presence of insects and
of both the
harmful effects that actions that would avoid pest.
S student nurses
these organisms can perpetuation of these
with their clinical Long Term: The family was
bring about to the organisms and acquiring I
instructor and able to show behavior and
health of the family. diseases.
T the clients. compliance on measures
Assist the family in To provide initial action on how to maintain a
Broom, trash
cleaning the house, necessary for the clean environment in
bags, mop, rags,
removing spoiled intervention of diseases that order to eradicate
dust pan for
food, cleaning the might arise by increasing breeding sites of insects
cleaning the
drainage system, the family’s awareness and pest.
house and the
removing its clog so through the nurse’s
surroundings.
as to avoid breeding initiative.
places for these Insect repellent
To prevent these organisms
organisms.
to perpetuate and be able
Encourage to cause disease.
maintenance of
cleanliness by regular
cleaning of the
surroundings.
SUMMARY, EVALUATION, AND RECOMMENDATION

Community service is one of the best ways to benefit the public especially the chosen adoptive
family in a community. It does not only have positive effect on society, but it will bring benefits to the
life and personal development.

Community service is important because it helps connect to the community, giving back and
assisting other is the basis of the community service or volunteering. Thus, it teaches us how significant
it is to help the ones in need, one who are less fortunate than us. The importance of community service
is the fact that it connects us to the community by improving it and making it a better place for all of us
to live in. It raises social awareness and broadens our horizons by helping us understand the needs of
the society and the population we are trying to help through the project or service we are doing.
Because hearing and reading about issues is not quite the same as getting personally involved. It brings
us closer to the families and individuals in need and gives us experiences and understanding of the
conditions they are in.

Presented in this case study is the different characteristics and health condition of the adopted
family LT. This study presents the family structure, socio-economic, and cultural factors, home and
environmental factors, and health assessment of each members. It also contains data about identified
problems or the living condition of the family.

SUMMARY AND EVALUATION

The family is considered a cohabitation type of family. A cohabitation family is usually living
together outside marriage or having sexual relationship without being married. It is composed of a
father, mother and a child. The LT family resides in Purok 4 Barangay Sinili Santiago City. They started
living to the said place since 2019.

This house is made up of concrete cement but is not well furnished and the kitchen has a
galvanized wall. The house is enough to accommodate only for the family. The house has two small
rooms, kitchen and a bathroom inside, a small living room, a total of 5 windows that can sustain the
adequate ventilation needed by the family.

The family main source of income is coming from Mr. L’s job. He works as a laborer in a
construction firm and earns about 8000pesos a month. While Ms. T is in charge of the house, and takes
care of their only child. With Mr. L’s monthly income, the family strives to accommodate everything
they need for them to live and survive. With the amount earned each month by Mr. L, according to
them, it is just enough for their need but is still considered being to a poor family.

Ms. T also informed student nurses that they do not have any financial assets at hand in case of
emergency. She said that they typically borrow money from their relatives.

They are affiliates to Catholic church and according to Ms. T, they seldom go to church for the
reason that they just pray inside their house believing that going to church and not is just the same
thing.
 The family main source of water is the deep well installed outside their house about 5 meters
away but is not suitable for drinking because the water quality is not safe as it pumps an amount of
sediments and sometimes sands.

The family get their clean water at their neighbor’s water well pump for their cooking purposes
and usage and putting it to a container. They said they don’t sterilize their drinking water because they
buy it from the nearest water refilling station.

The drainage system of the family is an open type where in the water flows and is continuous.
The family LT is identified to have a little of environmental problems in which it is evident that they
consider to have a practice of poor environmental sanitation. With this kind of situation and condition
of the family, there are problems that are identified such as health threats like fire hazards, poor home
and environmental sanitation, and improper drainage system as well.

A nursing care plan is formulated to address the different problems identified.

Nevertheless, the family still has the chance to improve their condition especially environmental
health condition. They still have the ability to meet the desired characteristics in their structure and
maximize their health potential of optimum wellness. The family is cooperative and participates to the
different issues and interventions they are confronted. Hence, they are willing to submit themselves for
the impartation of important information and basic knowledge regarding family health.

The objectives of identifying problems in the family were fully met and partially achieved due to
security reasons on the part of the student nurses. Together with the family, the student nurse has
helped the family through motivation and support to change their lifestyle and improve their health
status as well.

Some of the environmental sanitation problems are identified although the allotted time for our
group as student’s nurses was not enough to attend to all those problems, the family is now equipped
with fair knowledge which they could use anytime as the need arises.

The student nurses also provided the things that are very important for the family need at home
as a solution for the problems that are seen and lacking inside the house.

RECOMMENDATIONS

The student nurses have identified and prioritized problems with the family. Student nurse also
created a care plan on how to deliver the best nursing care for the family to address their needs.

The following below are propositions and commendations recognized by both the student nurse
and the adopted family.

The family should maintain a healthy and clean environment. They must regularly clean their
surroundings to avoid the presence of vectors of diseases.

The family should also maintain proper hygiene such as taking a bath regularly, trimming their
nails, frequent changing of clean clothes and refrain from walking barefooted, brushing teeth and
proper and regular handwashing.
 They must also organize their cooking practices in terms of food preparation and handling as
well as keeping their kitchen utensils in a covered storage to avoid getting it contaminated by insects or
pests. They should also cover their food storage all the time.

If in case of getting sick, the family is also advised and reminded to not wait for the ailment to
become severe or worst before seeking medical help.

The family must also be educated and follow the proper preparation of herbal medicines as it
was presented during the interview of Ms. T.

The family should persevere to perform proper way of segregation and disposal of their garbage
as it was presented during community service.

The family should be aware that organizations in the community are open and present for their
problems to be address properly. They are encouraged to verbalize their concerns with regard to the
community so that resolutions can be made.

The family is also advised to attend community meetings and seminars so that they are fully
informed of their surroundings and events that are important to the community for their own good, to
become a good example of citizen.

The family should also join and participate in any community activities in order to enhance their
capabilities as a citizen.
 FAMILY
HOUSE

TRICYCL
E AREA

SINILI ELEMENTARY
SCHOOL