INTRODUCTION

The family is the basic unit of care. As community health nurses, family is one of the
focus of care to address individual health problems/needs and enhancing family functioning for
growth and development, coping with illness or loss, mobilizing resources and monitoring an
environment that support wellness and health. With the different characteristics of the family,
thus the family is one of the focuses in community health nursing.

As a group who were exposed to Barangay Sta. Asuncion San Nicolas, Ilocos Norte, we
had the chance to work with family Hernandez who was qualified on the criteria set. We had also
asked the help of the barangay official and barangay health workers in identifying families for our
community health nursing. Of the set criteria, 6 were present to the chosen family such as:

The set criteria’s were the following:

1. Family members who are sick at time of visit (cough)

2. Family with 5-8 members
3. Family with low income (monthly income of less than P 5,000.00)
4. Family whose a member is with psychiatric problem
5. Family with a substance abuse member
6. With poor environment/ sanitation
7. Member of the 4P
8. A nuclear type of family

We, the Group III of BSN-II students of Northern Christian College, were able to assess,
implement and render community service through the Hernandez family as our client at Barangay
17 Sta. Asuncion, San Nicolas, Ilocos Norte. We were able to appreciate the role of the
community health nurse in addressing problems and needs of families.

GOAL

After 48 hours (8 days) of community exposure the student nurses’ will be able to develop the
proper attitude, skills and knowledge in rendering quality care to the chosen family.

SPECIFIC OBJECTIVES:
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After 48 hours of community exposure, the student will be able:

1. To set criteria in selecting a family for case analysis

2. To have courtesy call with barangay officials and BHW to discuss the set criteria for
family case study.
3. To establish support with the chosen family
4. To assess the chosen family nursing different methods of gathering data from the family
such as:
5. Assessment data base in family nursing practice DDS
6. To categorize the health problems of the family using the first level assessment/typology
7. To formulate nursing diagnosis utilizing the second level assessment
8. To prioritize identified health conditions/problems
9. To formulate Family Nursing Care Plan with the family
10. To implement interventions with the family
11. To evaluate intervention done with the family

ASSESSMENT DATA BASE FOR FAMILY NURSING PRACTICE

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This composes the family structure and characteristic and dynamics; socio economics and
cultural characteristics; home and environment; and health status of each member and values
habits and practices on health promotion/maintenance and disease prevention.

FAMILY STRUCTURES, CHARACTERISTICS AND DYNAMICS

The family is headed by Mr. Grepalino Hernandez. There are 6 members of the family,
father, mother, and 4 children. They live at Barangay 17, San Nicolas, Ilocos Norte.

Table I. THE SOCIO-DEMOGRAPHIC DATA OF THE FAMILY

Family Ag Se Civi Dat Relations Educatio Incom Occupati Religi Place of
membe e x l e of hip to nal e on on Residen
rs Stat Birt Family Attainme ce
us h nt
Grepali 36 M M 6- HOF College Php. Farmer RC Brgy.
no 26- Level 2,005. and 17 San
82 00 caretake Nicolas
r of , Ilocos
rooster Norte
Regina 40 F M 4- Mother College Php. Making RC Brgy.
22- Grad 890.00 “Pilais” 17 San
77 (Seasona Nicolas
l) and , Ilocos
selling Norte
firewood
Angeli 10 F Chil 7- Eldest Grade 5 RC Brgy.
ne d 25- 17 San
08 Nicolas
, Ilocos
Norte
Jesus 9 M Chil 4- 2nd Grade 4 RC Brgy.
d 2- 17 San
10 Nicolas
, Ilocos
Norte
Lyka 6 F Chil 12- 3rd Grade 1 RC Brgy.
d 14- 17 San
12 Nicolas
, Ilocos
Norte
Mc 4 M Chil 11- Youngest Nursery RC Brgy.
Quinxe d 8- 17 San
y 14 Nicolas
, Ilocos
Norte

The family is considered a nuclear type of family. When it comes to type of family
according to residency, the family is a patrilocal, since they live within the vicinity of the parents
of the head of the family. As to the type of family based on descent, the family is a patrilineal
since the family is closer and is affiliated with the family of the head of the family.

In terms of decision making the family utilizes egalitarian. In case a member of a family
is sick, the mother asks for assistance to her mother-in-law whom she can be able to take care of
her children. As verbalized “no awanak ket ni mother-in-law ko nukwa mangkita kanyada. The

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Head of the family decides on the schooling of their children. He helps into their assignments and
projects. During meetings, card day and other school activities, their mother attends for them.

The members of the family interact, communicate and listen to each other whenever they
have problems. In terms of decision making, the couple decides together in matters of health care
and care tending. In terms of unexpected events related to health, they ask the assistance of the
head-of-family parents such as to take care of the other children as verbalized “no awanak ditoy
balay ket ni katugangak ti mangkita kadakuada”.

The members of the family respect each other. The children call their parents “mama”
and “papa” and calling by their names among the sibling while for the head of the family and his
wife, they call each other Pa or lakay or Ma or Baket respectively.

The couples usually have some conflicts especially when the head of the family is drunk.
As stated by the mother of the head of the family, he usually drinks liquor because his wife
doesn’t know how to clean their house and sometimes the head of the family is being invited by
friend to have some drinking session.

SOCIO-ECONOMIC AND CULTURAL CHARACTERISTIC

Their main source of income is farming in which they can produce 14 sacks (Php. 364.00
per sacks) of palay for 2 season; 2 sacks (Php. 480.0 per sacks) of corn. Aside from farming, the
head of the family receives Php. 1,500.00/month as a caretaker of roosters (cock fighting).

Aside from the income, the wife also earn Php 600.00 by cooking “pilais” and Php.
200.00 by selling a fire wood for the needs of the children in school.

They are also members of 4P’s which the 3 members of the family are receiving every 2
months in amount of Php. 3,600.00 which are mainly used for the schooling of the children and
medical assistance. The family argue most of the time regarding “ta kwarta na maam ket
paggatang na ngamin nukwa ti gin ken sigarilyo na iso ti pagapapaan mi nukwa ti gin ken
sigarilyo na iso ti pagapapaan mi nukwa ti panaginom inom na”as verbalized by the wife.

The family is affiliated to Roman Catholic and all members are Ilocano Ethnic
background. When family experienced financial crisis they borrow an amount of cash money to
their significant others who also lives in vicinity of the head of the family parents.

Table II. SOURCE OF INCOME

Occupation Income per Month
Farmer
Palay Php. 425.00
Corn Php. 80.00
Caretaker of Rooster for Cockfighting Php. 1,500.00
Making Pilais (Seasonal) Php 650.00
Sell Fire Wood Php. 240.00
TOTAL Php. 2,895.00

As reflected in Table II, the income of the family is Php 2,895.00 which comes from
farming and other sources.

Table III. ALLOCATION OF BUDGET PER MONTH

Foods

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Rice Php. 1,500.00
Condiments Php. 100.00 Php. 1,850.00 38.06%
Canned Goods Php. 250.00
Shampoo, Soap, Toothpaste Php. 300.00 6.17%
Charcoal Php. 300.00 6.17%
Cigarettes Php. 960.00 19.75%
Liquor Php. 1,350.00 27.8%
Medicine Php. 100.00 2.05%
TOTAL Php. 4,860.00 100%

MONTHLY EXPENSES

2.05%

6.17%
27.8%

6.17%

19.75%

38.06%

LEGEND
Food, rice, condiments, canned goods
5 Liqour
Cigarettes
Shampoo, soap, toothpaste
Charcoal
medicines

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FIGURE I. ALLOCATION OF MONTHLY EXPENSES

Figure I present the allocation of monthly expenses. Most of the allocation is on the vices
of the head of the family like liquor, which has 27.8% and cigarettes which has 19.75%. the
highest expenses of the family is on the allocation of food which is 38.06% and medicines which
is the least percentage of 2.05%

III. HOME AND ENVIRONMENT

The house is a hut type with an approximate area of 4.5 by 5 meters. The walls of
the house are made up of woods and the roof is galvanized iron. The floor of the house is
not pave but it is covered with floor mat.

The house does not have room. There is a durabox, a cabinet where their
belongings are kept. A small table is beside the cabinet where the TV and radio are place.
The bed area consists of 2 bed foams where they sleep together. Another table and a
mono block chair.is placed near the door where kitchen wares are placed. The house has
four windows, two windows located at the eastern part of the house and the other two are
located at the western part of the house. A bulb is placed inside the room and the other
one is located near the kitchen. Some clothes are hanged in a long wood at the northern
part of the room. There are sacks present at the western of the house. The house is
illuminated by a bulb which is located at the center and the other one is located outside
which lights the kitchen.

The toilet is located at the eastern part of the house with an unpleasant odor.
Regina verbalized, the toilet is not working, we share toilet with our neighbors who are
also their relatives to do their personal necessities. There are scattered sharp, woods, rusty
cans and broken bottles and some galvanized iron which is located at the eastern part. As
observed during assessment, they have a waste disposal area 10 meters away from the
house but wastes are not segregated.

The kitchen is located outside the house, near the door before entering the house.
They use earthen stone and fire woods and charcoal are stored under the earthen stone.
Sometimes they also used charcoal in cooking their foods; kitchen utensils like plate,
glasses, spoon and forks are placed in a dish rack without cover are placed inside the
house. Other kitchen utensils are placed in a small table made up of wood. Foods are
covered with plates on the table.

Spring is the source of their water supply which is located 15 meters away from
their house. This is use in washing the dishes drinking water. They sometimes boil their
water before drinking especially rainy day.

Most of their neighbors are the relatives of the head of the family. The family
utilizes the services of the midwife in which she visit. The barangay Health Station is

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4km away from their home. They use counter drugs when common sickness occur but
when it get worst, that’s the time they go to the health center.

The family also involve themselves in community activities like programs of the
barangay. The children are enrolled at the Elementary school located near the barangay
hall. The wife (Regina) usually attends meeting at the school during community
assemblies. They participate also during the barangay YCAP. As the member of 4P’s, the
family, particularly they attends activities of the 4P’s.

IV. HEALTH STATUS EACH MEMBER OF THE FAMILY.

The family has a hereditary disease such as asthma, diabetes mellitus and
hypertension. The father of the head of the family has hypertension and asthma. Mr.
Hernandez got the hypertension from the lineage of the head of the family. However, the
father of Mrs. Hernandez has diabetes mellitus as shown in Figure II.

The Hernandez family experienced illnesses such as fever, common colds,

headache, stomach ache and they treat it with over-the-counter drugs (OTC) such as
salbutamol for cough and paracetamol (Biogesic) for fever and headache. They also have
alternative practice to alleviate the illness, if one member of the family has a fever, the
mother would do sponge bathing to lower the temperature and give plenty of water to
drink. According to Mrs. Hernandez, they also consult to Dr. Kwak Kwak (albularyo).

PHYSICAL ASSESSMENT OF EACH MEMBER OF THE FAMILY

GREPELINO HERNANDEZ (36 years old) with a physical built of ectomorphic, with vices such
as drinking liquor and claimed that he can consume 1 bottle of gin per day. Likewise, he also
smokes and can consume 8 pieces of cigarette per day.

Vital signs:
T-36.8 C
PR-94bpm
RR-19
BP-130/100mmHG
 Weight-51kg
 Height-1.73 square meter
 BMI-16.9
 Red eyes
 With alcohol breath
 Scars below the knees
 Skin rashes at occipital area
 Burning sensation at the lower part of the chest

REGINA HERNANDEZ (40 years old) with a body built of ectomorphic, uncombed hair,
unpleasant odor and looks untidy

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Vital signs

T-36.5 C
PR-87
RR-18
BP-120/100
 Weight- 45kgs
 Height-1.61 square meter
 BMI- 17.3
 Presence of lice and nits
 Dental caries at the upper and lower incisors and canine
 With a scar below the knee

ANGELINE HERNNADEZ (10 year old) July 25, 2008 uncombed hair

Vital signs:

T-37.0 C
PR-75bpm
RR-21
WT-25kgs
HT-137cm
UA- 17cm
 Presence of lice and nits
 With cough and colds with wheezing sound
 With presence of rales
 With unpleasant odor

JESUS IMMANUEL HERNANDEZ (9 years old) April 2, 2010

Vital signs:
T-36.8 C
PR-86bpm
RR-22
WT-28Kgs
HT-131cm
UA-18cm
 With dental caries at the lower incisors
 Skin rashes at the occipital area
 With unpleasant odor

LYKA HERNANDEZ (6 years old) December 14, 2012 uncombed hair, pale in appearance

Vital signs:
T-36.5 C
PR-70
RR-22
WT-18kgs
HT-111cm
UA-16cm
 Presence of lice and nits

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 With dental caries at the upper incisors
 Scars below the knees
 With productive cough and colds with wheezing sound
 With presence of rales
 With unpleasant odor

MC QUINXY HERNANDEZ (4 years old) November 8,2014

Vital signs:
T-36.8 C
PR- 80bpm
RR-24
WT-19kgs
HT-105cm
UA-16CM
 With dental caries at the lower molars
 Scars above and below the knees
 With unpleasant odor
 Presence of cough and colds with wheezing sound
 Presence of rales, heard upon auscultation of the chest/thorax

DEVELOPMENTAL TEST

Denver II Development Test of Mc Quinxy, the child refused most of the task
given and there is no opportunity in doing the screening test.

NUTRIONAL STATUS

Table III. ANTHROPOMETRIC MEASUREMENTS OF EACH MEMBERS OF

THE FAMILY.
Family Height Weight Mid-upper BMI Remarks
member arm
circumference

Grepalino 5’7 51 kgs 16.9 Underweight

Regina 5’3 45 kgs 17.3 Underweight

Angeline 137 cm 25 kgs 17 cm Normal

Immanuel 131 cm 28 kgs 18 cm Normal

Lyka 111 cm 18 kgs 16 cm Underweight

Quinxy 105 cm 19 kgs 16 cm Normal

V. VALUES, HABITS, PRACTICES ON HEALTH

PROMOTION/MAINTENANCE AND DISEASE PREVENTION

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According to Regina, the children received complete immunization from the Rural health
center as reflected in the yellow card of the children. She also received Tetanus toxoid during her
pregnancies. The family usually took a full bath in the morning with soap and shampoo.
Sometimes they take a bath without soap and shampoo.

As observed during the home visit they do hand washing without soap before eating.
They also do washing their hands with water before cooking. The family eats three times a day;
they just drink water if they are thirsty.

The sleeping time of the family is at 8:30-9:00 at night and wake up at around 6:00-7:00
in the morning. They seldom take a nap in the afternoon for 30 minutes to 1 hour. The children
usually play rather than taking a nap. The family use herbal plants such as oregano for cough. The
mother prepares the leaves through soaking in boiling water then squeeze and the sap given to the
children.

CATEGORIES OF HEALTH PROBLEM/FIRST LEVEL ASSESSMENT

Health Problem Problems Cues Second Level
1. Presence of A. Healthy Lifestyle
Wellness 1.Family takes a bath once a 1.The family
condition day practice take a
bath once a day
with soap,
shampoo and
2.The family eats 3 times a water
day

3.The family has complete

immunization especially the
children

Members with Inability to

2. Presence of Presence of cough
cough: recognize the
Health Deficit
presence of a
Angeline, 10 problem
years old,
presence of rales

Lyka, 6 years old,

presence of rales
and productive
cough

Mc Quinxey, 4
years old,
presence of rales
and productive
cough

Presence of nits and lice Members with Inability to

nits and lice: provide a home
environment

10
Regina, 40 years conducive to
old health
Angeline, 10 maintenance and
years old personal
Lyka, 6 years old development

Presence of dental caries Members with Inability to

dental cariers: provide a home
environment
Regina, 40 years conducive to
old, presence of health
dental caries on maintenance and
the upper and personal
lower incisors, development
upper and lower
canine teeth

Emmanuel, 9
years old,
presence of
dental caries on
the lower incisors

Lyka, 6 years old,

presence of
dental caries on
the upper incisors

Mc Quinxey, 4
years old,
presence of
dental caries on
the lower molars

Inability to
Presence of skin rashes Members with recognize the
skin rashes: presence of the
condition or
Grepalino, 36 problem
years old, rashes
on the occipital
area

Emmanuel, 9
years old, rashes
on the occipital
area

B. Failure to Grepalino Inability to

Thrive/Develop BMI: 16.9 provide a home
According to Normal (underweight) environment
Rate Regina conducive to
BMI: 17.3 health
(underweight) maintenance and
personal
Angeline development
BMI:

Emmanuel:

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Lyka:

Mc Quinxey:

3. Presence of A. Presence of Risk

Health Threat factors of Specific
Diseases
Inability to
1. History of Gregorio recognize the
Hypertension Hernandez presence of a
(Grepalino’s problem
father)

Inability to
2. History of Diabetes Macario Deuz
Mellitus recognize the
(Regina’s father) presence of a
problem

3. History of Asthma Inability to

Gregorio recognize the
Hernandez presence of a
(Grepalino’s problem
father)

B. Threat for Cross-

infection
Members with
1. Presence of cough Inability to
cough:
recognize the
Angeline, 10
presence of a
years old
problem
Lyka, 6 years old
Mc Quinxey, 4
years old

Members with
2. Presence of Nits and Inability to
nits and lice:
lice provide a home
Regina, 40 years
old environment
Angeline, 10 conducive to
years old health
Lyka, 6 years old maintenance and
personal
development

Family size of 6
C. Family size beyond Inability to
members with a
what family provide a home
monthly income
resources can environment
of Php. 2,895.00
adequately provide conducive to
health
maintenance and
personal
development

Presence of
D. Accident Hazard Inability to
rusting sharp
edges of provide a home
galvanized iron environment
and rusty cans conducive to
health
Presence of sharp maintenance and

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woods personal
development
Presence of
broken bottles

The knives are

being stored in
the roof

Inadequate food
Inability to
E. Faulty/Unhealthy intake both in
recognize the
nutritional eating quality and
presence of the
habits or feeding quantity
condition or
techniques, practices
problem
Faulty eating
habits

Alcohol drinking
F. Stress-provoking and cigarette Inability to
factors smoking of the recognize the
head of the presence of the
family condition or
problem

Inadequate living Inability to

G. Poor space provide a home
home/environmental environment
condition/sanitation Presence of conducive to
breeding or health
resting sites of maintenance and
mosquitos personal
development
Improper garbage
disposal
No drainage
system

Unsanitary toilet
facility

Vices of the head

H. Unhealthful lifestyle of the family
and personal Drinking alcohol
habits/practices Smoking
cigarette

Walking Inability to
barefooted or recognize the
inadequate presence of the
footwear: condition or
Regina problem
Angeline
Emmanuel
Lyka
Mc Quinxey

Poor personal Inability to

hygiene: provide a home
Grepalino environment

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Regina conducive to
Angeline health
Emmanuel maintenance and
Lyka personal
Mc Quinxey development

Inadequate rest or Inability to

sleep: recognize the
Grepalino presence of the
Regina condition or
problem

Mc Quinxey Failure to utilize

4. Presence of Entrance at school entering Pre- the community
Stress Kindergarten this resources for
Points/Foresee coming school health care
able year

FAMILY COPING INDEX

CRITERIA/AREAS DESCRIPTION RATE JUSTIFICATION

Physical Dependence Concerned with the 5 As observed during the

ability to move about, home visit, the
to get out of bed, to members of the family
take care of daily are able to perform
grooming, walking their activities in daily
living without the
assistance from others.
We were able to
witness the children
taking a bath and
brushing their teeth on
their own. At present,
none of them have
disability.
Therapeutic Includes all of the 3 The family is aware of
Competence procedures or their sources and uses
treatments prescribed it properly. According
for the care of illness to the mother, they
such as giving visit the RHU for
medication , using check-ups, they consult
appliances, dressing, doctor when their
exercises and children get sick and
relaxation and special they adhere to
diet medications strictly
when it comes to
children. However, the
parents do not consult
the doctor when they
feel sick and do self-
medications. “Nu adda
agsakit ket patumarek
dagus ti paracetamol,
nu madi latta ti
kabigatan ket iso

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nukwa tay panangipan
ko idiay center nga
ipacheck-up” as
verbalized by the
mother.
Knowledge of Health Concerned with 3 The family only knows
Condition particular condition that high fever, cough
and colds are
symptoms of a disease.
They take medications
because it is prescribed
and they do not know
the pharmacologic
actions that can
alleviate their
condition. “Nu adda
aggurigor ma’am ket
paracetamol met ti
reseta da nukwa iso
nga iso ti ipatpatumar
ko kadagita annak ko,
ken nu adda aguyuyek
ket solmux ma’am.”
They only know some
causes or predisposing
factors to their
condition such as
weather changes.
“Detoy pudot na
ma’am ti rason nu apay
a agpapanateng da
kada aguuyek” as
verbalized by the
mother.
Application of Concerned with 1 The family diet recall
Principles of General family action in were inadequate in
Hygiene and Nutrition relation to maintaining quantity and quality as
family nutrition, observed. The cooking
securing adequate rest area was found messy
and relaxation for the and unorganized as
family members observed. “Agsida
kami ma’am ti noodles,
inabraw a bulong ti
marunggay ken duwa
de lata ti agmalem,
manmano kam ng
agsida ti karne ken
ikan”. According to the
mother, they also have
faulty eating habits as
sometimes they eat
meals late especially
her children who sleep
at noon time.
Health Attitudes Concerned with the 3 The family is
way the family feels concerned on how to
about health care in prevent diseases by
general including immunizations as
preventive services, manifested by the
care of the ill and the children’s complete
disease and public immunization status
health measures because of the program

15
of the RHU in
informing about the
mother about the
importance of it.
However, they only
consult the doctor
when the OTC drugs
that they use were not
effective to them.
Emotional Has to do with 1 As claimed by the
Competence maturity and integrity mother-in-law of
with which the Regina, Regina is a
members of the family nagger. She nags to her
are able to meet the husband every time he
usual stresses and is drunk and that starts
problems of life and to their fight. The
plan for happy and husband sometimes hit
fruitful living his wife and even his
children. The children
were afraid to their
father when he is drunk
because he trips (kiss
and hugs) them when
they are sleeping.
“Ngem nu haan a
nabartek ma’am ket
haan a maun uni nukwa
ken haan na met nga
babaoten digita
ubbing”, as verbalized
by the mother.
Family Living Concerned largely 3 Members of the family
with the interpersonal don’t have a good
or group aspects of relationship since they
family life – how well argue with each other
the members of the most of the time
family get along with regarding socio-
one another, the ways economic status. “Ta
in which they make kwarta na ma’am ket
decisions affecting the paggatang na ngamin
family as a whole nukwa ti gin ken
sigarilyo na iso ti
pagapapaan mi nukwa
deta panaginom inom
na”, as verbalized by
Regina. When they
lack money, Regina
would go to the field
and work to earn for
their living. “Innak
nukwa ijay talon
ma’am wenno innak
mangayo ta adda
ilakok napia a adda
igatang mi ti sida mi
ma’am”. However,
decision making is
shared by the husband
and wife and somehow
they were able to settle
their problems.
Physical Environment Concerned with the 1 The whole structure of

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home, the community the house can cause
and the work accidents that could
environment as it result to fatal and
affects family health nonfatal injuries. As
observed, there are so
many accidental
hazards like presence
of rusting sharp edges
of galvanized iron,
broken bottles and
rusting cans. They also
burn their garbage
beside their house
which can cause fire
and it may burn their
house since it is made
of woods. To sum all
the observations the
house is on poor
condition.
Use of Community Has to do with the 5 The family is aware of
Facilities degree of the family’s the available
use and awareness of community facilities.
the available The family uses the
community facilities facilities they need
for health education appropriately and
and welfare promptly but not all the
times. Of these
facilities are the RHU
where they visit for
their monthly check-up
that is required for their
4P’s. They know when
or who to call for help.
They approach the
barangay health
workers for some
concerns if they are
around. The school
where their children
attends to their classes.

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SCALE FOR RANKING HEALTH PROBLEMS ACCORDING TO PRIORITIES

CRITERIA WEIGHT
1. Nature of the condition or problem
presented

Scale: Wellness State 3

Health Deficit 3 1
Health Threat 2
Foreseeable Crisis 1
2. Modifiability of the condition or
problem

Scale: Easy Modifiable 2 2

Partially Modifiable 1
Not Modifiable 0
3. Preventive

Scale: High 3 2
Moderate 2
Low 1
4. Social Concern

Scale: a condition or a problem needing 2

immediate action: 1
A condition or a problem that not needing 1
immediate action:
Not perceive as a problem or condition 0
needing change.

HEALTH DEFICIT
A. PRESENCE OF COUGH
Cue: 4
Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 This is a health deficit
problem because the 3 children
were experiencing
runny and clogged
noses with the
presence of nasal
discharges.
2.Modifiability of the 2/2x2 2 This problem is easily
problem modifiable because the
nurse’s skill is limited
and is not sufficient to
solve it. Also. Many
problems cause this
and this condition is
self-limiting. The
sudden changes of
weather may also be
cause and their
lifestyle.
3.Preventive potential 2x3/1 0.67 The preventive

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potential is moderate
since the problem
exists for about 2
weeks. Resources of
the health center as
well as the health
teachings provided by
the student nurses are
available.
Complications such as
pneumonia and asthma
can be prevented if
proper interventions
are given.
4.Salience of the 1/2x1 0 The family does not
problem recognize it as a
problem that did not
continue medications
due to lack of financial
resources.
TOTAL 4

B. PRESENCE OF NITS AND LICE

Cue: 4
Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health threat
problem that does not
demand immediate
action
2.Modifiability of 2/2x2 2 Increasing the living
the problem space will require
the families are
presently not
adequate considering
the other problem
even it is a
transferable
3.Preventive 3/3x1 1 Increasing the living
potential space will reduce
possibility of
transferability of lice
4.Salience of the 0/2x1 0 Condition needing
problem change immediate
attention
TOTAL 4

C. PRESENCE OF DENTAL CARRIES

Cue: 4
Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health deficit
problem that requires
immediate attention
and adequate

19
management to the
rest of the family
member
2.Modifiabilty of 2/2x2 2 The resources and
the problem interventions needed
to solve the problem
are available to the
family
3.Preventive 3/3x1 1 Dental carrier of
Potential tooth decay to the
other family member
is reduced or
eliminated if the
problem is manage
4.Salience of the 0/2x1 0 Condition needing to
problem change and
immediate attention
TOTAL 4

D. PRESENCE OF SKIN ALLERGY

Cue: 4
Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health threat
problem does not demand
immediate action
2.Modifiability of 2/2x2 2 The problem is a
the problem health deficit and
require more
immediate
intervention
3.Preventive 3/3x1 1 Skin rushes of
potential allergies to the other
family member is
reduce or eliminated
if the problem is
manage
4.Salience of the 0/2x1 0 The family needing
problem immediately
attention for the
problem existence
does not recognize
TOTAL 4

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HEALTH THREAT

A. History of Heredity Disease

Criteria Computation Actual Score Justification
1.Nature of the 2/2x1 1 The problem is a
problem health threat and
require more
immediate action
intervention
2.Modifiability of 1/1x2 2 The resources and
the problem interventions needed
to solve the problem
are available in the
family
3.Preventive 2/2x1 1 The possibility of
potential complications and
occurrence the
disease is eliminated
as early
4.Salience of the 2/1x1 0.5 The family
problem recognize as a
problem that the
condition needing an
immediate action
TOTAL 4.5

B. ALCOHOL DRINKING AND SMOKING

Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 The problem is a
problem health threat and
requires an
immediate
interventions
2.Modifiability of 3/3x1 1 Limit/Lessen the
the problem vices will require
counseling of the
family. However, the
vices must be lessen
to
3.Preventive 3/3x1 1 Limiting/Lessening
potential the vices will prevent
the disease such as
asthma
4.Salience of the 2/2x1 0 The family does not
problem recognize it as a
problem that the
condition needed an
immediate action
TOTAL 2.67

21
C. INADEQUATE LIVING SPACE
Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a health threat
problem because it makes
communicable
diseases easily
transmitted.
2.Modifiability of 1/2x1 1 Increasing the living
the problem space will require
quite a financial
expenditure. The
family’s resources
are presently not
adequate
considering the other
problems; however,
the family can be
taught of how to
arrange and organize
their things in the
house.
3.Preventive 3/3x1 1 The family has a low
potential preventive potential
since the family had
adapted to the place
and they have no
plans in transferring
to another places.
Increasing the living
space will:
a. Reduce the
possibility of
transferability of
communicable
diseases
b. Provide for
privacy to members
c. Provide bigger
space to allow
adequate movements
when performing
housework and joint
recreational, leisure
or play activities
4.Salience of the 0/2x1 0 The family did not
problem perceive it as a
problem that the
condition needs
change.
TOTAL 2.67

22
D. PRESENCE OF BREEDING AND RESTING SITE OF MOSQUITOS
Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is health threat
problem
2.Modifiability of 2/2x2 2 Resources are
the problem available and
interventions are
feasible
3.Preventive 3/3x1 1 Occurrence of
potential mosquito that may
lead to disease such
as dengue can be
prevented
4.Salience of the 2/2x1 1 The family
problem perceived it as a
problem that the
conditions need an
immediate action.
To prevent those
diseases that is
transferred by the
mosquitos.
TOTAL 4.67

E. IMPROPER WASTE DISPOSAL/UNSANITARY WASTE DISPOSAL

Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a Health threat
problem
2.Modifiability of 2/2x2 2 Resources are
the problem available and
interventions are
feasible
3.Preventive 3/3x1 1 Occurrence of
potential parasitism and other
communicable
diseases can be
reduced or
minimized.
4.Salience of the 0/2x1 0 The family did not
problem perceive it as a
problem that the
condition needs
immediate action.
To prevent those
communicable
disease transferred
by insects and
rodents.
TOTAL 3.67

E. TOILET FACILITIES
Criteria Computation Actual Score Justification
1. Nature of the 2/3x1 0.67 It is a health threat
problem that does demand
immediately action

23
2.Modifiability of 2/2x2 2 The family have the
the problem adequate resources
to solve the problem
3.Preventive 3/3x1 1 Clogged and
potential uncovered toilet can
be prevented
because the
resources are
available
4.Salience of the 0/2x1 0 The family
problem recognizes it as a
problem. However,
it does not see the
problems that need
immediate attention
or action.
TOTAL 3.67

F. FAMILY SIZE OF 6 MEMBERS WITH MONTHLY INCOME OF PHP

2,895.00
Criteria Computation Actual Score Justification
1.Nature of the 1/3x1 0.33 It is a Health Threat
problem
2.Modifiability of 2/2x2 2 Current knowledge,
the problem interventions and
resources are
available to solve
the problems
3.Preventive 3/3x1 1 The possibility of
potential increasing family
size is reduced; the
available family
resources can be
utilized to
encourage growth
promoting
experiences
members.
4.Salience of the 2/2x1 1 The family
problem perceives it as a
serious problem
needing attention.
TOTAL 3.33

G. ACCIDENTAL HAZARD
Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a health threat
Problem because there is an
improper placement
of sharps and
cooking equipment
within the reach of
the children. It may
cause harm and burn
to the members of
24
the family especially
to children.
2.Modifiabilty of 2/2x2 2 The problem is
the problem partially modifiable.
The family does not
have adequate
knowledge on the
remedy of the
problem. They are
somehow aware to
the problem, but do
not recognize it as a
felt need. And
through the health
teachings,
knowledge about
interventions, of the
student nurses tye
family had come to
realize such
interventions in
minimizing the
problem. No
financial resources
are needed for them
to resolve the
problem.
Willingness and
cooperation by the
family is very vital.
Also, no community
resources are needed
to solve the
problem.
3.Preventive 3/3x1 1 The problem is
potential highly preventable.
Sharp objects can
lead to accidents and
injury of the
members of family
mostly to children.
This problem is not
that severe and it
exists in a short
duration.
Management to the
problem is currently
available.
4.Salience of the 0/2x1 0 The family did not
problem perceived it as a
problem that the
condition needed an
immediate action.
TOTAL 3.67

25
H. FAULTY/UNHEALTHY NUTRITIONAL EATING HABITS OR FEEDING
TECHNIQUES AND PRACTICES
Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health deficit
problem that requires
immediate
management to
eliminate untoward
consequences.
2.Modifiability of 1/2x2 1 The problem is
the problem partially modifiable.
The family doesn’t
eat together as
claimed by the
mother especially
when the children
eat first and the
parents eat later.
3.Preventive 3/3x1 1 Vulnerability to
potential other diseases and
infections can be
prevented of
malnutrition is
eliminated, normal
growth and
development can
thus can be
4.Salience of the 2/2x1 1 The family
problem recognized it as a
problem. However,
it does not see the
problem as needing
immediate action
TOTAL 4

PRESENCE OF RISK FACTORS AND SPECIFIC DISEASE

Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health deficit
problem that requires
immediate attention
and adequate
management to
reduce probability of
transfer of the
disease to the
2.Modifiability of 2/2x2 2 The problem is
the problem easily modifiable.
Insufficient of living
space and water
supply are barriers
to achievement,
which is important
in the management
and prevention of
specific diseases

26
3.Preventive 1/3x1 0.33 Susceptibility and
Potential transferability of
specific diseases to
other family
members is reduced
or eliminated if the
problem is managed
adequately as soon
as possible
4.Salience of the 0/2x1 0 The family does not
problem perceived as a
problem or
condition needing
change
TOTAL 3.33

THREAT FOR CROSS INFECTION

Criteria Computation Actual Score Justification
1.Nature of the 3/3x1 1 It is a health deficit
problem that requires
immediate attention
and adequate
management to
reduce probability
of transfer infection.
2.Modifiability of 2/2x2 2 Resources are
the problem visible and
interventions are
feasible.
3.Preventive 3/3x1 1 Cross Infections can
potential be prevented if the
problem is managed
adequately as soon
as possible.
4.Salience of the 0/2x1 0 The family does not
problem perceived it as a
problem that the
condition needed an
immediate action
TOTAL 4

UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES

Vices of the Family
Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a health threat
problem
2.Modifiability of 2/2x12 2 Interventions are
the problem feasible
3.Preventive 2/3x1 0.67 Drinking alcohol,
potential smoking, and
quarrelling of the
family can be

27
reduced and
minimized to
prevent such
diseases. However,
good values and
other good practices
can be learned by
the family.
4.Salience of the 0/2x1 0 The family did not
problem perceive it as a
problem however it
needs an immediate
action.
TOTAL 3.34

WALKING BAREFOOTED OR INADEQUATE FOOTWEAR

Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a health threat.
problem
2.Modifiability of 2/2x2 2 Interventions and
the problem resources are
available to solve
the problem.
3.Preventive 3/3x1 1 Infections and other
potential diseases can be
prevented if the
problem is managed
adequately as soon
as possible.
4.Salience of the 0/2x1 0 The family does not
problem recognize the
existence of the
problem
TOTAL 3.67

POOR PERSONAL HYGIENE

1.Nature of the 2/3x1 0.67 The problem is a
problem health threat as it
could cause disease
condtition such as
pediculosis to the
family especially to
the children.
2.Modifiability of 2/2x2 2 The problem is
the problem partially modifiable
since the family
does not have the
knowledge of how
communicable
disease are
transmitted and

28
resoucces of the
family and
community with the
limited knowledge
of the nurse is not
sufficient to solve
the problem
3.Preventive 3/3x1 1 The problem is high
potential preventive potential.
Since the student
nurse is there to give
some interventions
that can help the
family improve their
personal hygiene
such as nits and lice,
tooth decays and
toothaches and body
odor can be reduced
or minimized
4.Salience of the 1/2x1 0.50 The family
problem perceived it as a
problem however it
does not see the
problem as needing
immediate action
TOTAL 4.17

INADEQUATE REST OR SLEEP

Criteria Computation Actual Score Justification
1.Nature of the 2/3x1 0.67 It is a health threat
problem
2.Modifiability of the 1/2x2 1 The resources and
problem interventions needed
to solve the problem
are available in the
family
3.Preventive 2/3x1 0.67
Potential
4.Salience of the 1/2x1 0.50 The family did not
problem perceive it as a
problem that the
condition needed an
immediate action.
TOTAL 2.84

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PRIORITIZATION OF PROBLEMS
RANK PROBLEMS SCORE
1 Presence of breeding and 4.67
resting site

2 No drainage system 4.17

3 Poor personal hygiene 4.1
4.5 Presence of nits and lice 4
4.5 Presence of dental carriers 4
4.5 Presence of rashes 4
4.5 Faulty/unhealthy nutritional 4
eating habits or feeding
techniques practice

4.5 Threat for cross infection 4

10.5 Adequate living space 3.67
10.5 Unsanitary improper waste 3.67
of disposal
10.5 Toilet facilities 3.67
10.5 Accident hazard 3.67
11 Walking barefooted or 3.6
inadequate footwear
14 Presence of Cough 3.5
16 Family size of 6 members 3.38
with monthly income

17 Presence of risk factors of 3.33

specific disease
18 Unhealthy lifestyle and 3.2
personal habits and practice

19 Inadequate rest or sleep 2.67

20 Alcohol drinking 2.7

30
TABLE OF CONTENTS
INTRODUCTION

GOAL

SPECIFIC OBJECTIVES

I. Assessment Data Base for Family Nursing Practice..........................................................

II. Table I: Socio Demographic Data ...................................................................................

III. Socio Economic and Cultural Characteristics .................................................................

IV. Table II: Source of Income............................................................................................

V. Table III. Allocation of Budget per Month ......................................................................

VI. Monthly Expenses........................................................................................................

VII.Values,Habits,Practices on Health Promotion/Maintenace and Disease Prevention......

VIII.Categories of Health Problem/First Level Assessment ................................................

I.Presence of Wellness Condition

II. Presence of Health Threat

III. Presence of Stress Point/Foreseeable

IX.Family Coping Index

I. Physical Dependence

II. Therapeutic Competence

III.Knowledge of Health Condition

IV. Application of Principles of General Hygiene and Nutrition

VI. Health Attitude

VII. Emotional Competence

X. Scale for Ranking Health Conditions and Problems According to Priorities

I. Nature of the Condition or Problem Presented

II. Family Living

III. Physical Environment

I. Analysis

31
The family we chose for this case study has met four criterias, first criteria is big
family which has 6 members of the family.Second, Income.Third,Housing Condition.
Fourth family with morbid cases. Lastly, Family with diagnosed medical condition, like
hypertension, diabetes mellitus and ashtma.

We all know that the family is the basic need of society, meaning if there no
family, there is no society. We never expected to learn this much from a family whom we
never met before, and were just strangers at one point as well from one another.

This family case analysis proved to show that this is not just report that is required
to pass. But a report where you get so caught up and involved us to find ourselves
understanding the real reason. This study has given us meaning why communicating and
interacting is so important. Communicating takes place so much in everyday life but this
time is felt different those words became actions and actions made a difference

The community is just not a place to live in, but a place where many people are
affected as one, and being with the family we are able to gain their trust .

We learn that there are a lot of people who are less fortunate and health education
can teach them important information to help prevent certain infections, disease or
unwanted outcomes. We can make difference in people action and it is possible to change
the way they perceive live.

With this study , it enhanced our social skills, and getting all the information
we've acquired showed that we can get along with people. How many can go up and
asked all this questions, not to mention when some of them are very personal. We were
able to gain the families trust and that gave us a plus factor feeling that were doing a good
job with them. And that they enjoy our company.

Socially, we are able to develop better therapeutic communication skills,

physically, we finally had time to exercise by going up to the family's house,
psychologically, we use our minds to come up with possible writings and emotionally,
we learned how to be thankful with what we have and share our blessings with other
people, who are in need.

32
Northern Christian College
''The Institution for Better Life''

Laoag City

FAMILY CASE ANALYSIS

Presented by:

BSN II- Group 111

Agbayani, Angelica E.

Bawingan, Rose Marie P.

Domingo, Queenie Rose

Garvida, Candace Lynette

Mabalot, Steve Myrwine C.

Manipon, Shiena C.

Pasion, Daisy Mae T.

Sensano, Amethyst Joelle E.

Presented to:

Panelists

33