Filamer Christian University

A CASE
STUDY ON
FAMILY C
BY: GROUP 3

NAME
TABLE OF CONTENTS

TITLE PAGE

CHAPTER I. ---------------------------------------------------------------------------------------------------------------

Introduction

CHAPTER II. --------------------------------------------------------------------------------------------------------------

Initial Data Base

Family Structure and Characteristics

Socio- Economic and cultural Factors

Environmental Factor

Health Assessment of each family member

Values, Habits, Practices on Health Promotion

CHAPTER III. -------------------------------------------------------------------------------------------------------------

First Level of Assessment

Health Threat

Health Deficit

Foreseeable Crisis

CHAPTER IV. -------------------------------------------------------------------------------------------------------------

Second Level of Assessment

List of Problem identified

CHAPTER V. --------------------------------------------------------------------------------------------------------------

Scale Ranking

Ranking and scoring of each health Problem

CHAPTER VI. -------------------------------------------------------------------------------------------------------------

Family Nursing Care Plan

CHAPTER VII. ------------------------------------------------------------------------------------------------------------

Summary, Conclusion and recommendation

CHAPTER I.

Introduction

The family is given prominence in the 1987 Philippine Constitution as the foundation of

the state and will, therefore, actively foster its overall development and fortify national

cohesion. As a vital pillar of society, it must consider all the different factors that foster and

shape its integrity, along with the diversity that makes it distinctive and multifaceted.

The community shapes the family as it has its own set of values, norms, and

expectations that impact the conduct and relationships of individuals within that community.

These shared beliefs can contribute to a sense of identity and belonging. According to D

Mengistu (2006), Community Health Nursing is the synthesis of nursing and public health

practice applied to promote and protect the health of the population. It combines all the basic

elements of professional, clinical nursing with public health and community practice.

Accordingly, and in an effort to foster self-sufficiency, a group of student nurses

conducted an assessment on family J.D.C dated 29 th day of November 2023 in Sitio Dulunan,

Barangay Mongpong, one of the 47 barangays in Roxas City, Capiz. The family consists of four

members, all of whom are adults. During the interview, it was determined that the family

structure is matriarchal, with the mother at the center. Generally, they are situated in a sitio

with poor sanitation conditions due to its congested neighbourhood and propensity for flooding

with an open canal a few meters away. The area is prone to vectors, notably mosquitos,

because the front of their house was packed with grass and was occasionally used for rubbish

burning. They reside in a rent-free house with adequate sanitary facilities. Family J.D.C has

sufficient appliances, as well as accessible care facilities and drinking water. Therefore, they
have a stable situation in terms of house and environment since they have appropriate

resources and sufficient income.

As they are all adults, it is crucial to manage daily activities and participate in community

events to foster both socializing and physical well-being. It is good to perform a manageable

range of motion because the head of the family has arthritis and finds it difficult to walk.

Furthermore, it is crucial to emphasize the importance of cleanliness and sanitation, thus in

order to manage waste, they must practice reuse, reduce, and recycle in addition to routine

cleaning.

CHAPTER II.

Initial Data Base

This chapter presents the family structure, characteristics, and dynamics such as

the demographic information of each family member outlining their names, age, sex, civil

status, occupation, educational attainment, position in the family, and date and birth of place.

Also, Descriptions of the family with regard to their socio-economic status, physical

environment, past and present history and family assessment based on functional health

patterns.

A. Family Structure and Characteristics

Family Name: JDC

Type of Family: Extended

Family Member Age Sex Civil Status Relationship

Mrs. JDC 58 Female Widow Head of the family

HD 60 Female Single Sister

Child HDC 37 Female Single Daughter

Child JDC 28 Male Single Son

The family, residing in Sitio Dulunan, Brgy. Mongpong, Roxas City, Capiz, is head by Mrs.

JDC, a capable matriarch. Her sister, HD who moved in to live with Mrs. JDC since she was

diagnosed with Glaucoma, provides support and companionship as a single and loving aunt to

Mrs. JDC’s family. HDC, daughter of Mrs. JDC, is a responsible individual who is dedicated to her

family and managing their household.

Family decision-making in the household is a collaborative process, with Mrs. JDC taking the

lead as the head of the family. Healthcare matters are also important in the family, as Mrs.

JDC’s sister, HD, has been diagnosed with glaucoma and requires ongoing medical care and

support. Mrs. JDC ensures that HD receives the necessary medical attention and care. The

family collaboratively manages healthcare matters, with HDC often assisting in coordinating

medical appointments and ensuring that medications are acquired.

B. Socio- Economic and cultural Factors

The family is living comfortably with more than 8,000 pesos monthly income which helps

them afford utilities like water electricity and Wi-Fi and also lets them buy clothes 3 times a

year

They practice sleeping together with 2 people in one room which may be a health hazard when

one or more of them contract communicable diseases. They also do not join in on recreational

activities provided by the barangay but instead they clean their house as a way to combat the
health risks from the surroundings. They also have a lack of ownership of their plot of land

which may be a big restriction to their ability to better their living conditions.

Determinant of health based on their situation.

l Income and social status - Their monthly income inhibits them from procuring a better

house as well as a better location. They may also be prone to sickness due to the lack of

preventive tools at their disposal. They also have friends and neighbours who they can

communicate to when the need arises. Their food may also be not very nutritious due to lack of

financial funds and will make them buy less nutritional food in order to get energy they need

for the day.

l Education- Since they are graduates from highschool and college they have the means

to work. But they are not very knowledgeable when it comes to health-related complications

and they rely on the advice of the health center for their health concerns. They are also not

very keen on hygiene which may prove to be a health risk going forward because if they

contract an illness, they might spread the infection due to the lack of knowledge of preventive

measures.

l Physical Environment - As a family their household contains 2 bedrooms which is

inadequate for 4 people which increases the risk of infection due to overcrowding if one

contracts an illness. They may also be restricted from making improvements to the living

quarters due to the congested area and the lack of finances and ownership of the land. Due to

the still water found around the environment mosquitoes breed freely and may spread diseases
like malaria and dengue. The family is also highly susceptible to flooding during strong storms

and high river levels.

l Health Services - They have access to a health center but it is a bit far from their

household which may prove difficult to access due to other of the family members being

susceptible to arthritis and glaucoma. They also lack financial ability to afford proper healthcare

when they have an existing illness or when they need medical intervention when their ability to

ambulate becomes limited. They may rely on their garden to procure medicinal herbs to help

combat the pain and sickness they feel when their health gets compromised.

C. Environmental Factors

The environment serves as the foundation of every aspect of human existence and has a

significant impact on the way a family functions and interacts with one another. The JDC family

lives in a rural and residential area at Sitio Dulunan, Barangay Mongpong, Roxas City, Capiz.

The house structure was observed to be a bungalow type which consists of concrete and

bamboo. It has one bathroom/ comfort room, a kitchen, a living area, a dining area, and two

bedrooms. The first room is for Mrs. JDC, the second room is for her son Mr. JDC. Both

bedrooms have comfortable beds to sleep in. As for her daughter Ms. HDC and her sister Ms.

HC, they both sleep in the living area or “sala” and use “banig” in sleeping.

The house has six windows made of bamboo and a tarp that acts as a cover. One in each

room, while others are in the kitchen and living area. The location of their residence is on

elevated grounds, so the air is fresh and the water supply or “nawasa” is accessible.
The JDC family has access to electricity and has only four types of appliances, including a

refrigerator, a television set, a Wi-Fi, and a battery-operated radio. In terms of cooking, Ms. HC

the daughter of Mrs. JDC uses firewood and charcoal in cooking. She is the one who prepares

the food. The cooking utensils such as pans, pots, and knives are complete. The food they

usually eat is fish as it is one of the most abundant resources in their Sitio and vegetables. The

family uses a stainless spoon and fork, plastic plates, and ordinary glasses while eating.

Mrs. JDC and her family live in a peaceful community in which people have known each

other for a long time. The family sticks to all rules and regulations in their community which

enables their family to have a harmonious relationship with their neighborhood. Although Mrs.

JDC and her family oftentimes do not participate in the community activities held by the

barangay due to circumstances like Mrs. JDC having arthritis making it difficult to walk, Ms. HD

has glaucoma and both Ms. HDC and Mr. JDC are busy with their self-owned business.

The community’s air quality is not at its optimal state as the trash is scattered at the side of

the roads. The community has a small chapel, a market, a basketball/ volleyball court for

recreational venues, a covered gym that is used for special events, and a barangay health

center that offers service once or twice a week.

Positive Environmental Factors (practices Negative Environmental Factors (practices

that promotes health) that leads to illness)

Drinking Water Source – Mineral/Refilling Home Structure – mixed (lot not owned)

Station congested 12 sqm. for 4 members

Excreta Disposal – Water - Sealed Latrine Drainage Facility – Open drainage (flows

anywhere and some rice grain noted)

Garbage Disposal – Sacked and collected

Garbage truck

Food Storage - Refrigerated

D. Health Assessment of Each Family Member

Family Health History

A. Mrs. JDC – Mrs. JDC has arthritis and a hereditary illness (hypertension). Last

November 16, 2023, she was hospitalized for three days in Roxas Memorial Provincial Hospital.

Before she was hospitalized, she said that she was experiencing headaches, blurred vision,

dizziness, and chest pain. These were later determined by the physician to be signs of

hypertension. She is currently taking maintenance such as Losartan and Amlodipine. Mrs. JDC

weighs 88 kg. with a height of 167cm. She belongs to the obesity class 1 with a BMI value of

31.55kg/m2. She doesn’t drink alcoholic beverages and has no allergy to any food. She has also

completed vaccination for COVID-19.

B. Ms. HD – Ms. HD was diagnosed with glaucoma in July 2014. Since then she gradually

lost her vision in the left eye while the right eye has blurred vision. Her last hospital check-up

was on March 23, 2018. She weighs 78 kg. with a height of 152cm. She belongs to the obesity

class 1 with a BMI value of 33.76kg/m2. She has also completed vaccination for COVID-19

except for booster shots.

C. Ms. HDC – She has no present illness. When she was 7 years old, she experienced

chicken pox. She weighs 67 kg. with a height of 165cm. Her BMI reveals normal weight with a

value of 24.61. Ms. HDC has no complaints as of the present time and has not taken any

medications as of the moment. At times of illness, she would just drink over-the-counter

paracetamol for fever and mefenamic acid for pain. She has also completed the vaccination for

COVID-19 except for the 2nd booster shot.

D. Mr. JDC – Mr. JDC has no degenerative, chronic, or infectious disease as of the

present time. He has completed the immunization including vaccination for covid-19. He also

weighs 62 kg. with a height of 159cm. His BMI reveals normal weight with a value of 24.5kg/m2.

Mr. JDC has no complaints as of the present time and has not taken any medications as of the

moment. He also doesn’t smoke and only drinks alcoholic beverages on special occasions.

Family member: JDC

Date of Birth : 01/11/1965

Age : 58

Gender : Female

Family member: HD

Date of Birth : 02/17/1963

Age : 60

Gender : Female

Family member: HDC

Date of Birth : 02/23/1986

Age : 37

Gender : Female

Family member: JDC

Date of Birth : 01/8/1995

Age : 28

Gender : Male

Gordon’s 11 Functional and Health Pattern

1 - Health Perception and Health Management Pattern.

● Mr. JDC drinks during special occasions.

● If someone has a fever in the family, the home remedy done by the family is by drinking

paracetamol syrup for children and biogesic or Bioflu for adults. They also use a bath

towel dipped in warm water with alcohol to be placed on the forehead of the family

member who is sick.

● Energy drinks and healthy meals with soup are also prioritized when someone has a

fever in the family.

● When someone catches a cold or has a cough, they drink Lagundi or Neozep.

● The family has been able to recognize the importance of healthy well-being.

2 -Nutrition and Metabolism Pattern

● The diet of the JDC family consists mostly of fish and seafood to the point that they get

tired of it sometimes. They also often buy easy-to-prepare foods such as in cans or

chopped vegetables.

● The family is not picky for food and states that they eat what they can have.

● The family limits their consumption of foods with too much oil and sugar.

● Ms. HDC doesn’t like sweets that much and foods with a lot of sugar.

● Most foods are allowed in their religion except for pork during the holy week.

● No particular food allergies in the family member.

3-Elimination Pattern

● The color of their urine varies from pale yellow to slightly orange. They urinate an

average of 6-8 times a day. No particular odor or discharge noted in their urine.

● The family doesn't have any urinary problems at the time of the visit.

● The family doesn’t have a problem defecating.

● The family did not use any laxatives or medication for urination and defecation.

4-Activity and Exercise Pattern

● The family works and does their daily chores independently. Less exercise/routine is

observed. Self-care is present in most of the members.

● Ms. HD does daily walks around the house even with eye problems. Mrs. JDC and Ms.

HDC are responsible for chores and work around the house. Mr. JDC often leaves the

house.
● The family doesn’t have any respiratory problems. Have patent airways and breathe at a

normal pace.

● The family did not have a cough at the time of the visit.

● Mrs. JDC has arthritis making it difficult to walk much and limit her activities.

● Mrs. JDC and Ms. HD also avoid difficult activities as it can complicate their health

problems which can lead to further injuries.

5-Cognition and Perception Pattern

● The family is cognitive, aware, and has a good perception of the surroundings.

● The family doesn’t have a problem making a conversation and can create sentences

without stuttering.

● Mrs. JDC and Ms. HD may have slightly less weak memories due to being in old age.

6-Sleep and Rest Pattern

● They sleep before midnight at around 8:00-10:00 PM and wake up between 6:00-8:00

AM. Sometimes, they wake up at 3:00-4:00 AM for work in the fishing boat.

● The family does take naps when they have free time.

● Ms. HDC does use a hammock to rest at noon time.

● Ms. HDC states that they feel well-rested after waking up.

● They don’t have any medication for sleeping.

7-Self-Perception and Self-Concept Pattern

● The family is satisfied with themselves and also possesses some insecurity in other

parts.
● Ms. HDC is caring towards herself and is satisfied with what she possesses and has.

8- Roles and Relationships Pattern

● Mrs. JDC's roles in the family are the decision maker, the head of the family, the

provider, and the one who thinks about what the family needs.

● Ms. HDC's roles in the family are part of the one who provides, helps, and is in charge of

work around the house, and the one who mostly likes to care for everyone in the house.

● The family has a good relationship with the community, is liked by neighbors, and

functions well in society. However, they are distant towards community activities due to

personal and health-related reasons.

● 9-Sexuality and Reproduction Pattern

● The sexuality in the family is in a state of hold.

● Mrs. JDC and Ms. HD already reached their menopause stage.

● Ms. HDC is also single but has a partner in other places. She doesn’t think about

reproduction at the moment.

● Mr. JDC is also single and his girlfriend is abroad.

10-Coping and Stress Tolerance Pattern

● The family spends time together by eating together, consulting with each other,

watching television, keeping communication channels open, doing chores, and working

to cope with stress and problems in life.

● They also use their gadgets, catching up with neighbours, play mobile games and sports,

and even out to relieve some of their stress.

● They do not take any medication for stress.

11- Values and Belief Pattern

● The religion of the family is Roman Catholic

● They sometimes go to church especially when there's a major occasion, however, due to

health problems, they can’t go out too often.

● They offer prayers every time they eat and when there is an occasion.

Physical Examination (Head to Toe)

Vital Signs

Ms. JDC:

Blood pressure: 140/90 mmHg

Respiration rate: 18 breaths per minute

Pulse rate: 80 beats per minute

Temperature: 36.8°C

Head-to-Toe Assessment:

Hair: Thick, gray hair with no signs of baldness or hair loss.

Skin: Pale complexion with visible veins. Dry and flaky skin on the arms and legs. No presence of

rashes or lesions.

Nails: Brittle and discolored nails.

Skull and Face: Symmetrical facial features with no obvious abnormalities. No swelling or

deformities on the skull.

Eyes: Pupils equal and reactive to light in both eyes. No discharge or redness. No visual loss due

to hypertension.

Ears: No visible abnormalities or inflammation. Normal hearing.

Nose and Sinuses: No nasal congestion or discharge. No tenderness on sinuses.

Mouth and Throat: Pale and dry oral mucosa. No lesions or sores were observed. Normal

tongue movement. No difficulty swallowing.

Neck: No visible masses or swelling. Neck movement is unrestricted.

Chest: Chest wall symmetrical with no visible abnormalities. Respiratory rate and breath sound

within normal limits. No signs of respiratory distress.

Extremities: Mild swelling in ankles due to arthritis, no signs of infection or injury. No

deformities or discoloration was observed.

Ms. HD:

Blood pressure: 130/80 mmHg

Respiration rate: 16 breaths per minute

Pulse rate: 72 beats per minute

Temperature: 36.5°C

Head-to-Toe Assessment:

Hair: Short and sparse gray hair with no signs of baldness or hair loss.

Skin: Pale complexion with visible veins due to glaucoma. No presence of rashes or lesions.

Nails: Brittle and discolored nails due to aging.

Skull and Face: Symmetrical facial features with no obvious abnormalities. No swelling or

deformities on the skull.

Eyes: Left eye completely blind with a cloudy appearance. Right eye exhibits blurred vision due

to glaucoma. No discharge or redness in either eye.

Ears: No visible abnormalities or inflammation. Normal hearing.

Nose and Sinuses: No nasal congestion or discharge. No tenderness on sinuses.

Mouth and Throat: Pale and dry oral mucosa. No lesions or sores observed. Normal tongue

movement. No difficulty swallowing.

Neck: No visible masses or swelling. Neck movement is unrestricted. No palpable lymph nodes.

Chest: Chest wall symmetrical with no visible abnormalities. Respiratory rate and breath sound

within normal limits. No signs of respiratory distress.

Extremities: Bilateral swelling in hands, possibly due to aging. No deformities or discoloration

observed.

Ms. HDC:

Blood pressure: 120/80 mmHg

Respiration rate: 14 breaths per minute

Pulse rate: 66 beats per minute

Temperature: 37.0°C

Head-to-Toe Assessment:

Hair: Thick, black hair with no signs of baldness or hair loss.

Skin: Even complexion with no visible veins or abnormalities. No presence of rashes or lesions.

Nails: Strong and healthy nails with no discoloration.

Skull and Face: Symmetrical facial features with no obvious abnormalities. No swelling or

deformities on the skull.

Eyes: Pupils equal and reactive to light in both eyes. No discharge or redness. No visual

impairments.

Ears: No visible abnormalities or inflammation. Normal hearing.

Nose and Sinuses: No nasal congestion or discharge. No tenderness on sinuses.

Mouth and Throat: Moist and pink oral mucosa. No lesions or sores observed. Normal tongue

movement. No difficulty swallowing.

Neck: No visible masses or swelling. Neck movement is unrestricted. No palpable lymph nodes.

Chest: Chest wall symmetrical with no visible abnormalities. Respiratory rate and breath sound

within normal limits. No signs of respiratory distress.

Extremities: No swelling or discoloration observed. No signs of abnormalities.

Mr. JDC:

Blood pressure: 110/70 mmHg

Respiration rate: 12 breaths per minute

Pulse rate: 60 beats per minute

Temperature: 36.9°C

Head-to-Toe Assessment:

Hair: Thick, black hair with no signs of baldness or hair loss.

Skin: Even complexion with no visible veins or abnormalities. No presence of rashes or lesions.

Nails: Strong and healthy nails with no discoloration.

Skull and Face: Symmetrical facial features with no obvious abnormalities. No swelling or

deformities on the skull.

Eyes: Pupils equal and reactive to light in both eyes. No discharge or redness. No visual

impairments.

Ears: No visible abnormalities or inflammation. Normal hearing.

Nose and Sinuses: No nasal congestion or discharge. No tenderness on sinuses.

Mouth and Throat: Moist and pink oral mucosa. No lesions or sores observed. Normal tongue

movement. No difficulty swallowing.

Neck: No visible masses or swelling. Neck movement is unrestricted. No palpable lymph nodes.

Chest: Chest wall symmetrical with no visible abnormalities. Respiratory rate and breath sound

within normal limits. No signs of respiratory distress.

Extremities: No swelling or discoloration observed. No signs of abnormalities.

E. Values, Habits, Practices on Health Promotion and Maintenance and Disease

Prevention

They practice sleeping together in two or less sleeping rooms, this type of habit can

cause congestion and may lead to quick spread of diseases. This particular household practices

a close family bond in which the family takes care of one another when one is sick.

Food storages are important for maintaining cleanliness. The family practices

refrigerating as food storages that are usually easily spoiled, they also have a background

garden where they plant vegetables for consumption, as they believe growing their own food

and vegetables can be more efficient and they can save more money in the long run. They

exercise the habit of taking their water source from a refilling station where it is located
approximately 30 meters away from their home. They practice cooking food under the charcoal

or firewood.

Waste disposal is an important factor for Cleanliness and Disease prevention. If not

properly taken care of, it may harbor diseases and can cause sickness to the family. The JDC

Family disposes of their waste using sacks as containers and in which they are disposed through

weekly garbage collection by the Sitio. The Family practices using the water-sealed latrine type

of toilet to dispose of their excrements and is fairly sanitary.

The family lives with a dog in which the dog is kept inside the house without restriction

from going outside, this can cause serious health issues as the animal can harbor diseases and

may bring it back home to their owners. The general condition of the community is poor due to

lack of cemented roads and open water sources where mosquitoes can breed and flourish and

may become vectors of diseases such as malaria and dengue.

The family does not participate in recreational activities provided by the barangay but

they do their own chores while at home such as maintaining cleanliness of the household. The

family is fairly far away from the nearest Barangay health center as it is 715 meters away from

the household. And due to the distance, the Client cannot utilize the health center as she has

difficulty walking due to arthritis. Although far, they still practice going to health centers if

needed. When a family member has an illness or injury, the first person they would consult to is

a medical doctor in which they would go to the Hospital for check-ups.

Overall, though the household is surrounded by health hazards, the family tries to cope

with practices and health promotional remedies to combat the negatives.

CHAPTER III.

FIRST LEVEL OF ASSESSMENT

Health Threat/s - condition/s which are conducive to disease, accident or failure to realize

one’s health potential.

Inadequate Living Space/ Sleeping Quarters

- There are only 2 bedrooms for 4 members of the household.

- Inadequate living space increases risk of infection.

Open drainage system

- The kitchen has an open drainage system, which is unhygienic and unsafe.

- Bacteria from drainage may result to illnes and infection.

Presence of Vector breeding sites

- The residence is surrounded by swampy areas with still waters, which creates a

suitable breeding environment for vectors of diseases, such as mosquitoes.

- Biological vectors, such as mosquitoes and ticks may carry pathogens that can

multiply within their bodies and be delivered to new hosts.

Congested and Flood-prone Area

- The residential area has a congested housing and is prone to flooding during

storms, heavy rains, and high tides caused by an overflowing river near the

residence.

- Congested areas may cause poor ventilation and increase risk of infection.

- Flood-prone areas increase risk for water-borne diseases

Presence of Fall Hazardz

- The sloped pathway leading up to the residence consists of moist clay and

bamboo which is slippery to step on, leading to possible future injuries.

Health Deficit/s - instances of failure in health maintenance.

Family Member with Rheumatoid Arthritis and Hypertension

- The matriarch, Mrs. JDC, who serves as the head of the family, is diagnosed with

arthritis and hypertension, that may affect the functioning of the family and may

reduce quality of life.

Family Member with Glaucoma

- HD was diagnosed with glaucoma that increases risk of injury and affects

activities of daily life.

Foreseeable Crisis/es - anticipated periods of unusual demand on the individual / family or

community in terms of adjustment / family resources.

Hospitalization of Family Member

- Hospitalization of one member may alter the family’s functioning.

CHAPTER IV.

SECOND LEVEL OF ASSESSMENT

List of Problem identified

Cues and Data Family nursing Problem

WELLNESS CONDITION

1. Health maintenance or Health A. Inability to provide a home environment

management – Mrs. J.D.C and HD, are conducive to health maintenance and

susceptible to certain chronic health personal development due to:

conditions such as arthritis and high blood ● Consistent adoption of unhealthy

pressure (Mrs. J.D.C) and glaucoma (HD). lifestyle behaviours by family

Effective management of these conditions members, including poor dietary

is crucial to minimise their impact on daily choices, insufficient physical

activities and overall health activity, and neglect of preventive

healthcare measures.

● Lack of financial resources/

inability to access or afford

essential healthcare services,

leading to inadequate treatment

for the existing health issues.

Health Threat

● Inadequate Living Space/ Sleeping A. Inability to address and resolve issues

Quarters - With only two bedrooms related to inadequate living space

for a household of four, there is a effectively due to:

shortage of living space, which can ● Limited income resources to

increase the risk of infection due to afford necessary repairs or find

overcrowding and poor ventilation. alternative housing solutions.

This can lead to the spread of ● Limited control/ Lack of

respiratory and other ownership may restrict the ability

communicable diseases. to make improvements.

B. Inability to improve living conditions to

mitigate health risks associated with open

● Open Drainage System - An open drainage systems due to:

drainage system in the kitchen is ● Lack of resources or funding to

not only unsanitary but also unsafe construct a more comprehensive

as it allows bacteria from the and enclosed drainage system.

drainage to spread easily. This can ● Limited knowledge about effective

lead to the transmission of drainage design and maintenance.

foodborne illnesses and infections,

especially if the drainage is not C. Inability to implement effective vector

properly covered or cleaned control measures due to:

regularly. ● Inability to invest in preventive

measures.

● Lack of awareness about the

● Presence of Vector breeding sites - connection between certain

In areas with still waters, such as environmental conditions and

swamps, mosquitoes can easily vector breeding.

breed and multiply due to the ● Inadequate community

presence of stagnant water. These infrastructure such as poor waste

mosquitoes can carry diseases such management.

as malaria, and dengue fever, as

the pathogens that cause these

diseases can thrive in their bodies. D. Inability to provide and maintain healthy

When these mosquitoes bite and safe environment due to:

humans or animals, they can ● Lack of financial resources to

transmit the pathogens and cause afford the costs associated with

illness. relocating, moving expenses and

potential loss of income during

● Congested and Flood-prone Area - transition

The densely populated residential ● Community ties, including family,

area is susceptible to flooding friends, and social support

during intense rainfall, storm networks may deter them from

surges, and high river levels. This leaving

increases the risk of waterborne ● Lack of alternative housing

diseases due to contaminated options that are both affordable

floodwaters. Poor ventilation in and safe.

crowded housing compounds the

spread of respiratory infections and E. Inability to provide interventions to help

other airborne diseases. families address fall hazards and create

safer environments due to:

● Prioritising immediate survival

concerns over addressing

potential safety hazards in the

home.

● Presence of Fall Hazards - The ● Lack of awareness about the

sloped pathway leading up to the potential risks associated with fall

house of J.D.C is made of moist hazards.

clay, making it slippery when it's ● Lack of resources for necessary

raining. This increases the risk of equipment or services related to

falls and potential injuries, potential fall hazards.

especially during wet weather

conditions.

Health Deficit

● Family Member with Rheumatoid A. Inability to provide adequate nursing care

Arthritis and Hypertension,—Mrs. to the sick, disabled, dependent or

JDC, the family head, has arthritis vulnerable/ at-risk member of the family

and hypertension, which can affect due to:

her daily activities, increase health ● Lack of financial resources impede

risks, and potentially impact the their ability to afford necessary

family's functioning and quality of healthcare services, medications

life. and treatments.

● Lack of health literacy or

● Family Member with Glaucoma - understanding about the nature of

HD have been diagnosed with health deficit.

glaucoma, a condition that ● Lack of necessary facilities,

increases the risk of injury due to equipment and supplies for care.

vision loss and affects their daily

activities.

Foreseeable crisis

● Hospitalization of a family member A. Inability to address and improve the

- family members seem to be overall socio-economic conditions of

involved or have a presence of families dealing with foreseeable crisis

illness that may make them unable due to:

to perform well the responsibilities ● Reduced financial instability

and duties. limiting resources for other needs.

● May impact their ability to engage

in productive activities outside the

home.

● Psychological impact affecting the

overall well-being and

performance of the family.

CHAPTER V.

PROBLEM PRIORITIZATION

A. Scale for Ranking

Criteria Score Weight

1. Nature of the problem

Health Deficit 3
1
Health Threat 2

Foreseeable Crisis 1

2. Modifiability

Easily 2

1 2
Moderate

Not Modifiable 0

3. Preventive/Potential

High 3

2 1
Moderate

Low 1

4. Salience of the Problem

Problems needing urgent attention 2

1 1
Problems not needing urgent attention

Not perceive as a problem 0

B. Ranking and scoring of each health Problem

Compute each health problem and rank

Presence of Vectors of Diseases

criteria Computation Actual score Justification

Nature of the 2/3x1 0.66 Vectors can transmit

problem infectious diseases either

actively or passively (vector-

borne diseases). Biological

vectors, such as mosquitoes

and ticks may carry

pathogens that can multiply

within their bodies and be

delivered to new hosts,

usually by biting. Vector-

borne diseases account for

more than 17% or 700,000

deaths annually, and affect

the poorest population.

Modifiability of the 1/2x2 1 The family’s problem

Problem regarding the presence of

vectors of diseases is

moderately modifiable due

to:

● limited financial

resources that may

restrict the family’s

capacity in

adjustment to control

disease factors.

● lack of awareness

about vector-borne

diseases and

preventive measures.

● inadequate housing

conditions and limited

access to proper

sanitation

● lack of support and

interventions from a

local authorities and

government agencies

Preventive Potential 2/3x1 0.66 Families may have

moderately preventable

potential regarding vector-

borne disease due to:

● limited resources, lack

of education on

preventive measures,

and challenging

conditions.

● some preventive

action may be within

their means, external

factors often impede

their ability to fully

address the risk of

vector-borne diseases

Salience of the 1/2x1 0.5 Prior to the student nurses’

Problem interventions, the family is

aware and considers the

situation a problem not

needing urgent attention

because it may compete with

their priorities for basic

needs.

Congested and Flood Prone Area

criteria Computation Actual score Justification

Nature of the 2/3x1 0.66 Living in a congested and flood-

problem prone area can pose various

challenges for families.

Common issues include:

● flood can contaminate

water sources, leading

to the spread of

waterborne diseases

such as cholera and

dysentery

● flood pose immediate

threat of injuries,

trauma, and drowning

● dampness and mold in

flooded areas can

exacerbate respiratory

problems.

● families may be

displaced during floods,

leading to inadequate

shelter and living

conditions.
Modifiability of the 1/2x2 1 The problem is moderately

Problem modifiable as families in

congested and flood-prone

areas often face challenges

changing their lifestyle due to:

● economic constraints,

limited resources, and a

lack of viable

alternatives.

● relocating may be

financially burdensome,

and employment

opportunities might be

limited in these areas.

● infrastructure and

support systems for

change may be

insufficient, making it

difficult for families to

break the cycle of

vulnerability and adopt

healthier lifestyles.
Preventive 1/3x1 0.66 The problem has a low

Potential preventable potential as

evidenced by the following

criteria:

● lack of financial

resources which hinder

their ability to access

clean water, proper

sanitation. and

healthcare services,

making disease

prevention more

difficult.

● poor infrastructure

leading to insufficient

drainage, sanitation

facilities, and waste

management, creating

an environment

conducive to disease

spread.

● limited availability and

accessibility to

healthcare services can

prevent timely medical

intervention and

vaccinations increasing

the vulnerability to

diseases.

Salience of the 2/2x1 1 Needed urgent attention arises

Problem from the potential for rapid

disease transmission, injuries,

and other health threats during

and after flooding. Swift and

coordinated effort are essential

to mitigate immediate health

risks and ensure the well-being

of the affected family.

Family member with Rheumatoid arthritis

criteria Computation Actual Score Justification

Nature of the 3/3x1 1

Rheumatoid arthritis (RA) is a
problem
systemic autoimmune disease

characterised by inflammatory
arthritis and extra-articular

involvement. It is a chronic

inflammatory disorder caused

in many cases by the

interaction between genes

and environmental factors,

including tobacco, that

primarily involves synovial

joints. This inflammation can

lead to joint damage and

deformities, causing pain,

swelling, and stiffness. Joints

are typically affected

symmetrically, meaning that if

one knee or hand is affected,

the other one is likely affected

as well.

Modifiability of the 1/2x2 1 The lifestyle modification in

Problem the family member suffering

from rheumatoid arthritis is

influenced by a combination
of financial and educational

factors, while the family may

make efforts to adapt, the

extent of these modifications

might be moderate due to:

● limited resources for

the family to make

extensive

modifications, leading

to moderate

adjustments to

accommodate the

needs.

● changes in daily

routines and activities

to support the affected

member in managing

their conditions can

cause excessive

disruption to overall

family lifestyle

● limited awareness and

understanding can

oppose more

comprehensive

adjustments that could

improve the overall

management of the

conditions.

Preventive 1/3x1 0.33 Families may face challenges

Potential in preventing or managing

rheumatoid arthritis in a

family member due to various

reasons:

● Lack of access to the

quality healthcare

services, including

rheumatology

specialist and

medication, can hinder

effective management

of rheumatoid

arthritis.

● treatment for
rheumatoid arthritis

often involves ongoing

medical expenses,

including medications

and regular check-ups.

● Financial constraints

may limit the family's

ability to afford these

necessary healthcare

resources.

● limited access to

education resources

that would help them

understand the

importance of lifestyle

modifications,

exercise, and proper

nutrition in managing

rheumatoid arthritis.

Salience of the 2/2x1 1 This problem needs

Problem immediate attention to

manage pain, prevent

complications, and enhance

the overall well-being of a

family member with

rheumatoid arthritis. Early

intervention can significantly

impact the course of the

disease and improve the

family’s quality of life

Health Problem Ranked According to Priorities

Health Problem Score

Family member with Rheumatoid arthritis 3.33

Congested and Flood Prone Area 3.32

Presence of Vectors of Diseases 2.82

CHAPTER VI.

FAMILY NURSING CARE PLAN

Cues Health Family Goal of Objective of Intervention Expected

Proble Nursing Care Care Outcome
m Problem

Nursing Method Resources

Intervention s of Required
Nurse-
patient
contact

Subjective Data: Presenc Inability to After the Within 1 day of 1. Develop Home Material The family
“Napansin ko e of provide a nursing home visit, The and Visit Resources: will have
man, kadamo gid Breedin home family will be able distribute knowledge
interventio a. Educational
yah sang lamok g sites environmen of the
n provided, to achieve the educational Materials:
sa palibot, lalo na for t conducive causes and
kung gab.i, akon Vectors to health the family following: materials on Brochures, effects of
puya nga bayi of maintenanc will be able a. Increase the risks pamphlets, and vectors on
gani ho, ga Disease e and awareness associated their health
to promote of vector other
rineklamo kay personal with vector- and will take
a home breeding educational
damo may ka developme borne steps to
kagat nga lamok nt due to : environme sites resources on stop
around the diseases
sa iya daw” as a . Low nt that is topics such as disease
household. and where
verbalized by the social conducive health transmissio
head of the concern to b. Address to find their n, such as
to health in safety breeding promotion,
household. the problem promoting
or condition order to concerns sites. safety, and cleanliness
Objective Data: b. Lack eradicate related to 2. Educate stress and
- of breeding breeding the family management. participating
knowledge sites of sites for about Community in
Accumulation of on the vectors of common community
vectors Partnership:
stagnant water in possible disease activitie
particularly breeding a. Establish
and around the cause an c. Determine
house. effect of the mosquitoes ways in sites and partnerships
- Presence presence of promoting encourage with non-
of uncovered vectors an them to government
containers with environme report and al
standing water nt free eliminate organization
from these sites. s (NGOs)
breeding
3. Educate that
sites for
vectors the family in specialize in
d. Understan implementin housing
d the g proper assistance,
importance waste financial
of disposal counseling,
removing practices to and
breeding
reduce community
sites for
vectors potential developmen
[Link] and breeding t.
eliminate all sites
breeding sites 4. Conduct Human
regular resources:
inspections
of the sites a. Time and
that are effort of the
usually nurse and
places for family
breeding
sites.
5. Educate
the family
on the
benefits of
removing
vectors and
breeding
sites.

Cues Health Family Nursing Objective of Intervention Expect

Problem Care
Problem Outcom
Nursing Methods of Nurse- Resources
Intervention Patient Contact. Required
Health Inability to make After 1 hour of Home visit Material
● Discuss to the
Deficit: decisions to nursing resources:
Rheumatoid taking appropriate interventions, Mrs. family what
are the signs ● Visual aids
Arthritis health actions JDC as well as all
due to: other family and and videos
a) Lack of members will be symptoms of
● Clipboard
financial able to: rheumatoid
assistance arthritis. ● Ballpen
● Identify
to support ● PHN Bag
the clients causes and ● Inform
of symptoms of
patient to
medication rheumatoid
seek medical Time and effort of
. arthritis. advice for both student nurse
b) Lack of proper and family
knowledge ● Enumerate diagnosis, members.
about the management
ways and
signs and , and Knowledge of
remedies to
symptoms prescription. student nurse
alleviate
that causes about the
symptoms of
rheumatoid problem.
rheumatoid ● Instruct
arthritis.
arthritis.
family of
different
● Verbalize interventions
they can use
the
when pain
importance
occurs, such
of proper
as hot and
medical
cold
consultation.
compress.
● Encourage
● Limit patient to
consumptio move or do
n of foods light range-
and habits of-motion
that could exercises
aggravate every
the attacks morning.
of arthritis
3RD FNCP ?
CHAPTER VII.

Summary, Conclusion and recommendation

Summary and Conclusion

The family J.D.C is regarded as an extended family. Anyone connected to the head other

than parents, siblings, or children is considered an extended family. They lived in Sitio Dulunan,

Brgy. Mongpong, Roxas City where they have coexisted peacefully with sufficient funds and

resources.

The house is owned by family J.D.C is a bungalow-style consisting of bamboo and

concrete. Along with a kitchen, living and dining areas, two bedrooms, and a comfort room, it

offers one bathroom. Six bamboo windows with a tarp covering serve as windowsills in the

house; the first room is for Mrs. JDC and the second is for her son, Mr. JDC. Some are in the

kitchen and living area, and one in each room. Since their house is situated on an elevation

area, they can access the "nawasa," or fresh water supply. They only have four different kinds

of appliances—a refrigerator, a television, Wi-Fi, and a battery-operated radio—but they do

have access to electricity. With regards to cooking, they use charcoal and firewood. They

frequently consume fish and veggies since it is one of the most plentiful resources in their Sitio.

While eating, the family used a stainless spoon and fork, plastic plates, and regular glasses. The

family has a dog, which is kept inside the house with no restrictions on going outdoors. This

might cause major health problems since the animal can harbor infections and bring them back

home to their owners. The community's overall state is poor owing to a lack of paved roads and

open water sources where mosquitoes may nest and thrive, potentially becoming vectors of

illnesses such as malaria and dengue.

The family expenses are shouldered by three members of the household. The monthly

income of J.D.C, a fish vendor, falls between ₱6,000 and ₱10,000. H.D.C, a businesswoman,

makes between ₱4,000 and ₱5,000 a year. J.C., a moneylender, makes between ₱4,000 and

₱6,000 a year. As a family, they are able to conduct health promotion since they have enough

money to meet their fundamental necessities. In addition to planting vegetables in their

backdrop garden for eating, the family uses refrigeration to preserve food that would otherwise

quickly deteriorate. They feel that producing their own food and veggies can be more cost-

effective in the long term. The refilling station, which is around 30 meters from their house, is

where they practice taking their water supply.

Upon assessment, the group determined a number of issues impacting their well-being.

Mrs. J.D.C. and HD are prone to specific long-term medical disorders including glaucoma in HD

and arthritis and high blood pressure in Mrs. J.D.C. Additionally, they are vulnerable to a

number of risks, chief among them being inadequate living and sleeping quarters. Their

household has only two bedrooms, which results in a lack of living space and raises the risk of

infection from overcrowding and inadequate ventilation. Respiratory and other communicable

illnesses may spread as a result. Furthermore, open drainage, presence of vector breeding sites,

congested and flooded-prone areas and presence of fall hazard poses great risk in injuries and

illness.

Recommendation

With the family, the student nurses identified and assessed problems and concerns. In

order to meet the family's needs, the student nurses devised a nursing care plan on how to
provide the optimum nursing care possible. The following are recommendations and

encouragements provided by the student the nurse and family members:

The JDC family should maintain a healthy and clean environment. They should discard

any open containers that contain stagnant water to avoid the presence of vectors of diseases.

The family should prioritize their well-being by consistently saving and investing in their

maintenance medication and regular checkups.

To motivate and promote a healthier lifestyle, the family should consider engaging in

exercise together as a means to inspire and support each other.