University of San Jose- Recoletos

College of Nursing
Cebu City

A FAMILY CASE STUDY OF

ASTHMA

In Partial Fulfillment of the Requirement in NCM 102-RLE

Family Health Nursing

Barangay Quiot
First Rotation
December 5,2009

Presented to the Faculty

OF
University of San Jose – Recoletos

Submitted to

Mr. Dormedo de Lara

Date

December 5, 2009
University of San Jose- Recoletos
 College of Nursing

COMMUNITY HEALTH NURSING

(Family Case Study (Level II)

I. Introduction:

GENERAL INFORMATION

1. Historical Background

In 1928, early settlers named their place Barrio Kiyot, derived from a name of a insect
very common in the place that used to stay in Mayupay and bamboo tress. During that
time, Teodoro Rago was the Kapitan for the owned the biggest land area. However, it
was Gregorio Ylaya who became the first Teniente del barrio.

Early families who settled in barrio Kiyot were Ambrosio Abellanosa, Frankelina
Sabandeja, Pedro Abellanosa, Luis Llamedo, Mariano Bacalso, Pastor Sabandeja, Nicolas
Sabandeja, Estiban Cabarubias, Fernando Pañibon, Santiago Cabaluna and Maximo
Sadura.

In 1952, Maximo Daculan ruled the barrio. Other leaders after his term were Melicio
Obenieta [3rd teniete del barrio], Ricardo Llamedo [4th tiniente del barrio].

In 1957, barrio Kiyot was recognized officially as a Barangay.

Other officials who have served Barangay Kiyot were Barangay Captains Tereso Canares
in 1972, Celso Diaz in 1982, and Vicente Sabarre in 1988, Attorney Sañara succeeded in
1990 to August 15,2002 and Hon. Vicente B. Ramos,Jr.
Take over August 15.2002 whom until now is the Barangay Captain.

Then the youth sector convincing changed the spelling of Kiyot to Quiot.

2. Physical Characteristics

2.1 Geographic Location

Barangay Quiot is a relatively small Barangay of Cebu City with total land of
approximately 32 hectares. Bounded by the Barangay Basak, Pardo in the North,
Basak Pardo in the East, Toong in the West and Kinasang-an Pardo in the South.

The Barangay is composed of 32 Sites namely Quiot Proper, Qyda, Kmayupay,

Kawayan, Bahanihan, UBCA-I, UBCA-II, UBCA-III, Kalubin, Kalubihan, Honey Ville,
Murillo, Bakilid, Bogo, Genes I & II, Ediang, Lantawan, Kilis, Antuanga, San Carlos
Heights,Suran, upper Suran, Greenbelt, Mountain View, Lower Yati, Uper Yati,
Granada, River Siade, Beltran, Back Japer, Sto. Niño and Kamansi.
2.2 Topography
 The terrain of the areas has rugged hillside, which varies from steep in the upper
portion and rolling slope in the rolling portion. The area lies at an elevation 200 to
300 meters above the sea level with a slope 18 to 13 %.

2.3 Climate and Weather

Two climatic conditions characterize the area dry in the months of January to May
and wet from June to December.

2.4 Geology and Soil Condition

Geology formation in Barangay Quiot is serpentinized peredotite. Its soil condition

is Faraon clay, which is rich in organic matter highly calcareous.

3. Socio-Economic Conditions

3.1 Social
3.1.1 Demography

Based on the Barangay Family Profile Census, Barangay Quiot has a total
population of 18,556, of which 9,397 compromises the male while 9,159
compromise the female.

Approximately, there area 2,470 household with an average of 6 members

per family living in the Barangay.

3.1.2 Livelihood

It is estimated that 60% of the population ore government and private

employees, contract workers, and self-employed. Others are engaged in
business.

3.1.3 Health

Basic health services in the area are well provided by the Barangay health
center personnel. The center has Health Workers, Physician, Midwife, Nurse,
Dentist, and Health Worker Trainees who provide daily health services to its
residents in the Barangay.

Barangay Health record shows that the Eleven leading causes of mortality
are: cancer, pneumonia, TB pulmonary, CVA, Hypertension, myocardial
infarction, liver cirrhosis, Diabetes Mellitus, peptic ulcer disease, sepsis and
status asthamaticus. [Refer to the table below.]

Table 1. Eleven Leading Cause of Mortality in Barangay Quiot

Causes Number of Deaths
Cancer 12
Pneumonia 12
TB pulmonary 8
CVA 7
Hypertension 7
Myocardial Infarction 7
Liver Cirrhosis 2
Diabetes Mellitus 2
Peptic Ulcer Disease 2
Sepsis 2
Status Ashmaticus 2

As of 2009, The Nutritional Status of Health was the following: Normal 1,708
= 68%, Underweight 635 = 25%, Chronic Mal Stunting 37 = 1.48%, wasting
(acute) 1 = 0.04% and over weight 115 = 5%. Nutritional status monitored
on monthly basis by our Barangay health personnel.

3.1.4 Education and Manpower

At the present there does exist primary school and no secondary schools in
the area. However, the Barangay is accessible to the university to the
University of San Jose Recoletos Basak Campus, Basak Elementary School,
Pardo Elementary School, Holy Rosary High School and Gulas High School.
There is an existing Day Care Center located in the UBCA Sports Complex
and two Private Day Care Centers run by Sacred Heart of Mary Sisters and A-
Z Scholar run by the Born Again Christians.

3.1.5 Housing

Almost 50% of the Barangay residents are living in dwellings made of light
materials like coconut lumber, nipa and bamboo. 30% of the houses are
semi-concrete and 20% are concrete. There are also several subdivision
within the area.

3.1.6 Social Services

 The Day Care Workers in the Barangay is giving services to 80 preschool
children with 48 boys and 32 girls. Classes are being held in the Day Care
Center located in UBCA.

3.1.7 Protective Services

The Police population ratio in the area is 1: 3400. The Barangay has been
request 1 regular PNP to coordinate with the Barangay Tanod Peace and
order operation similarly augment or assist in the delivery of protective
services. The existing two mobile cars are utilized in the peace and order
operation conducted by the Barangay Tanod Personnel. Pardo Police Precinct
and Punta princesa Police precinct 10 is the nearest Police station.

3.1.8 Sports and Recreation

The Barangay has 1 Sports Complex, the venue for various sports and
cultural activities. Interior sitios have their own basketball courts. One of the
highlights in sports during summer is the holding of inter-sitio Summer
League.

3.1.9 Religious Services

Majority of the residents in Barangay Quiot is Roman Catholics. Others are

Protest and Born Again Christians.

3.1.10 Economic

Based on the Department of Trade and Industry Cebu Provincial

Office Directory – Registered Business Names By type/sector in 2002,
residents of Barangay Quiot are engaged in various commercial activities.
These include bakeries, General Merchandise, figurines, aggregates, frames,
construction supply and religious articles.

4. Infrastructures and Utilities

4.1 Power

The Visayan Electric Company is providing power services in the whole Barangay.

4.2 Communication

Almost all types of communication facilities are present in the area such as cellular
phones, telephones [ISLAPHONE], handset radio. Television, radio sets, etc. there
are also telefax counter and telephone booths manned by various communication
companies. The Philippines Postal Corporation also services the Barangay.

4.3 Transportation
 Access to the area is through public utility vehicles, taxi, motorcycle, tricycle and
other means of land transportation via three routes. Highway, Punta Princesa and
Pardo.

4.4 Water

The Metro Politan Cebu Water District has provided water services in the barangay.
There is an existing natural spring, which is one of the water sources in the area.
Three other private deep well supplies around fifty 75% of the total households.
One of this is the Sitio Genes Compound while the rest is servicing Sitio UBCA and
Sitio Mayupay, San Carlos Heights, Granada and Greenbelt respectively. There is
an on going Water Project of the Barangay tapping lower Antuanga source to upper
Antuanga for distribution to the Barangay via gravitational force.

5. Land Classification

The uppermost north portion of the Barangay is classified as timberland. However most
areas are classified as alienable and disposable. A private person owns about 40% of the
total land area of the lower portion of the Barangay.

6. Existing Land Use

Fruit-bearing trees like coconut, jackfruit are planted on the hilly land portion of the
Barangay. There are Mahogany and G’melina species planted along the Barangay road.
Residential use is also evident.

II. Rationale of the Family Case Study

• Why did we chose Sitio Qyda?

Of all the Sitio in Barangay Quiot, we chose Sitio Qyda (Quiot Young Dreamers
Association) as our prioritized Sitio in part of our related learning experience in
Community Health Nursing. We chose this Sitio because e observed that people
living in the Sitio has different problems which needs an immediate action. The
place is one of the depressed areas among the Sitio in Barangay Quiot. A
crowded place where houses are built close to each other which are made of
light, mixed and concrete materials which is the primary cause of fire. We also
observed improper drainage system and most of them are stagnated because
of the plastic that is stucked in the canals which can be a breeding site of
vectors of diseases. According to the Nurses in the Helth Center, Barangay
Quiot is one of the Barangay’s that has an increased number of cases of dengue
and with our Nursing Interventions, we could help minimized these cases.

• Why did we chose Brosas’ family?

We chose Brosas’ family in our case study because they need more of our
nursing intervention. As their existing problem is known to be genetically
inherited, we want to trace some genetic variants that can trigger asthma. Also
 we want to intervene these that affects their health. Their surroundings is
known to be a breeding sites of vector of disease because of its open drainage,
garbages that clogged on it. Risk for pulmonary disease that includes asthma
because of the factory near the site that trigger asthma because of the polluted
air it release.

III. Objective:

General:

• The client will be able to know the different causes of Asthma.

• Create an environment that can lessen the allergens of Asthma.
• Promote ventilation in their house.
• Avoid extrinsic allergens of Asthma.

Specific:

• The client will be able to know how to provide immediate care of Asthma attack.
• To know the advantages of different medications prescribed by their Physician.
• To know the different preventive measures for Asthma.
• The student nurse will be able to know the different aggravating factors of
Asthma and it’s effects on the body.
• To know the Signs and Symptoms of Asthma.
• To know how to relieve the signs and symptoms of Asthma.
• To enhance the student’s capability in providing care of an Asthmatic patient.
• For the client to know the complications of Asthma.
• To know and identify what triggers Asthma.

IV. Family Assessment:

Normal Findings Actual Findings

1. General Health Survey
a. Weight ↑ 3-5 lb. (1.3-2.2 kg) 18 kg
b. Height ↑ 1-2 in. (2.5-5 cm) 91 cm
c. Vital Signs
c.1.Temperature 37.3 Celcius
c.2. Pulse 70-80 bpm 87 bpm
c.3. Respiration 24cpm
c.4. Blood Pressure 112/60 mmHg 70/30 mmHg
2. Integumentary
a. Skin Texture Skin intact, no lesion Presence of scars, dry skin
b. Hair Evenly distributed, no Evenly distributed hair; no
pediculosis lesions, no dandruff and
absence of pediculosis
c. Nails Concave Concave, pinkish, CRT for 2-
3 seconds
3. HEENT
Head/Neck Head size becomes more
proportionate to the body
Eyes V.A. should be 20/20 by age Eyes are symmetrical, sees
6 the ball of 20ft distance
Ears Hearing intact, tympanic No drainage, able to
membrane intact; no recognize high pitch and low
drainage pitch sounds
Nose Nasal mucosa pink and Absence of any fluid
intact. secretion, nasal mucosa
pink
Throat/Mouth Tonsils are usually large; Presence of dental caries,
oral musosa pink, no tonsils are large, absence of
lesions. Child loses first lesions in oral cavity
teeth during these time.
4. Respiratory Lungs clear R.R: 24 cpm, absence of
wheezing and crackles
5. Cardiovascular Regular rhythm, no extra P.R:87 bpm, no extra sounds
sounds detected such as murmurs
6. Gastrointestinal Abdomen soft, non-tender, Abdomen is soft, non-
no organomegaly tender, no mass found out
7. Urinary External genetalia intact, Absence of pain during
appropriate development for urination, yellow color of
child’s age urine, no blood or no other
color seen.
8. Reproductive External genetalia intact,
appropriate development for
child’s age
9. Musculoskeletal Normal curves noted, no
abnormalities, no weakness
10. Neurological Balance and coordination
greatly improved; with
refinement of fine motor
skills
a. Cranial Nerves
a.1.Olfactory Identified the substance Able to identify the coffee
a.2.Optic Visual acuity intact 20/20
OU
a.3.Oculomotor PERRLA direct and
consensual
a.4.Trochlear
a.5.Abducens
a.6.Trigeminal Client perceives light touch Perceived the cotton
and superficial pain bilaterally
bilaterally
a.7.Facial Able to make faces Able to perform facial
Taste sensation on anterior expressions
tongue Tasted the coffee in the
anterior tongue
a.8.Acoustic Hearing intact Able to respond and didn’t
Negative Romberg’s Test lost his balance
 a.9.Glossopharyngeal Taste on posterior tongue
intact
a.10.Vagus Swallow and cough reflex Able to cough out and
intact swallow
Speech clear
a.11.Accessory Moved against resistance Moved against resistance
without pain without pain
a.12.Hypoglossal Can protrude tongue Able to move tongue
medially medially and bilaterally

V. Physical Assessment/Examination – Gordon’s – (Family)

Gordon’s Functional Pattern

1. Health Perception - Health Management Pattern

I. Client's Perception of Health

The client says that he is healthy but he has a little problem because of his asthma
and due to this problem, he rated his health as 8 out of 10. He also said that the
most important thing to keep him healthy is to eat proper diet with regular
exercise, and that would the clients’ perception of health.

II. Client's Perception of Illness

Because of the clients’ asthma problem, he feels uncomfortable because he has

this breathing problem. The clients’ daily activities are not affected because he has
maintained a treatment. The client said that he got his asthma problems in their
genes in the paternal side, which mean hereditary. The client strongly believes
that with following the doctor’s prescription, proper intake of medicines and doing
regular exercises, his illness will be treated.

III. Health Management and Habits

The clients consults to a private doctor every time he feels that there something
wrong with his health accompanied by his parents, but with no exact schedule. He
 considered playing as means of exercise. The clients went often for dental check
up every 2 months. "I believe that eating the right kind and the right amount of
food makes u healthy in partnership with regular exercise and proper hygiene as
well”, as verbalized by the patient. He also believes that doing nothing contributes
to illness because you have to keep our self busy to make our life healthy. The
patient doesn’t perform any self-exams and not even use alcohol, tobacco drugs
and caffeine as he believes that he wont get a good benefit as form it.

IV. Compliance with Prescribed Medications and Treatment

The client have been taken his prescribed medication at the right time without
refusing the doctors ordered. The client has been following the doctors prescribed
nursing and medical treatment such as doing the exercise regularly and eating the
right amount and the right kind of food, which are good to me. Yes its been easy
for me to carry the doctors ordered and suggestion through the supervision of my
parents.

2. Nutritional- Metabolic Pattern

I. Dietary and Fluid Intake

The clients eat three times a day of what the parents do give to him such as food
which can be easily cooked or sometimes vegetable and fish but not often. Her
mother feed him foods which can be easily bought and cooked in the sari -sari
store such as can goods and noodles and doesn’t follow a certain type of diet
because what food is easily seen and easily bought by her mother it will be the one
to cooked. The patient doesn't find any difficulties when regards to eating the
meals on time because he eats his meal three times a day at 7in the morning for
breakfast, 12 in the afternoon for lunch and 6 in the evening for dinner. "I just take
my snacks at school during recess time with crackers and juice and I don’t take
any herbal supplements", as verbalized. The client drinks water every time he feels
thirsty with 3-4 glasses a day and doesn’t find any difficulties in chewing or
swallowing the food. He also stated that he has no allergy for a certain kind of
foods.

II. Metabolism

The client stated that he gain weight, from 16 it becomes 18 after he had a check-
up with a doctors clinic. He can only notice if he has gain weight through his body
size without using any instrument. The client stated that, "so far, I haven’t notice
any changes in my eating habits as well as my drinking habits.

Objective data:
Temperature: 37.3 celcius
Pulse: 87 bpm
Respirations: 24 bpm
Height: 91 cm
Weight: 18 kg

3. Elimination Pattern
 I. Bowel Habits

The client usually moves his bowel 2 times a day with a light brown color and soft
consistency of the stool and doesn’t notice any recent changes of his bowel
pattern. He stated that he usually postponed defecation when he is not home
because his feeling not comfortable defecating to others comfort room. The client
stated that he haven’t experience constipation and diarrhea and doesn’t do
anything special to treat or prevent problems with voiding and haven’t had a bowel
surgery as well.

II. Bladder Habit

The client usually voids 6-8 times a day with light yellow color urine with no
bleeding present or any abnormalities found. The client stated that “I haven't
experienced or encounter any problem during urination, such as UTI” as
verbalized. In addition, he hasn’t experience yet inserting a urinary catheter.

4. ACTIVITY-EXERCISE PATTERN

I. Activities of Daily Living

The client usually walks on his way to school, which is approximately 2 km away
from his house. Since he is a seven-year-old child, he usually plays with her
younger sister in their backyard. Her younger sister is also asthmatic and they feel
restless easily. Sometimes, they experience difficulty in breathing after a
prolonged time in playing especially stressful games.

II. Leisure Activities

The client is fond of playing with his toy car in their yard with his sister and they
also watch movies or shows together or sometimes, with their parents.

III. Exercise Routine

He walks regularly to school and play with his friends

5. SLEEP AND REST PATTERN

I. Sleep Habits

Since his class is at 1 o'clock, he usually wakes up at 8 am and sleep at about 7

pm and reported that most of the time, he has a sound sleep but when there is an
asthma attack, it is really difficult for him to sleep.

II. Sleeping Aids

He does not use any medications or pills to fall asleep but he cannot sleep when it
is so hot and needs the aid of the electric fan.

6. COGNITIVE- SENSORY- PERCEPTUAL PATTERN

 I. Perception of Senses

As of now, the client is not suffering from any impairment and he can use his
senses very well but during colds, it is very difficult or him to use his sense of
smell.

II. Pain Assessment

As we go through with our assessment, the client does not complain of any
tenderness of we cannot observe any guarding behavior but during asthma attack,
he complains of chest pain and considers breathing as a hassle. The pain is
relieved when he tries to minimize breathing.

III. Ability to understand

The child can understand some of our questions but sometimes, he is too shy to
answer but generally, he quite understands and can comprehend our questions.

IV. Ability to Communicate

So far, as a seven-year-old child, it is so hard for him to remember his medications

and understand why he is taking such medications.

V. Ability to remember

We asked him about his previous hospitalization and he could still remember it and
he could even recognize the hospital and he could also remember the reason for
the hospitalization.
7. SELF-PERCEPTION-SELF-CONCEPT PATTERN

I. Perception of Identity

Unfortunately, for a child, playing is very important for his development and
socialization and feel a sense of belongingness but for him, he is an ill child and
gets tired easily so, he perceive himself as a loner and a home-buddy.

II. Perception of Abilities and Self- worth

He considers his parents as his strengths and considers his illness as his weakness
and a burden for his childhood

III. Body Image

He may not be that active in physical activities because of his illness, he still
consider himself lucky compared to those people who are amputated or people
with disabilities.

8. ROLE-RELATIONSHIP PATTERN

I. Perception of Major roles and responsibilities in the family

As an eldest child, it is his responsibility to look for her younger sister when their
parents are not home but he is still seven years old and he cant realizes its
significance yet. And usually, they experience sibling rivalry and he feels that all
the blames were always put into him. With the people in their community, he is not
so close to other children because he just goes out of their house really often and
also, because of his illness that he was not able to spend time with them.

Family Genogram:
Crice
Rosalia
Henry Jovito
ncia
Brosas
Brosas
Castro Castr
65 y.o. 52 y.o
Asthma
60
HB
o
A&W 50 y.o

Ivy
Olivia Odisa Dennis
26 y.o.
Perpecto
30 y.o. Bros
28 y.o. Brosas
Asthm
A&W
Asthm as
a a
Driver 34 y.o.
Asthma 29 y.o.

Anna
Dave Vict
3 y.o. oria
Astma
3 y.o.

Legend:

Female

Male

Deceased

Client
9. SEXUALITY- REPRODUCTIVE PATTERN

Since the client is still seven years old and he is still not in the pubertal stage, it is
impossible for him to engage in any sexual intercourse based on his behavior and
physical appearance. When we asked him if he is ready for puberty, he just
answered with a smile and said that it’s still so early for it.

10. COPING AND STRESS TOLERANCE PATTERN

I. PERCEPTION OF STRESS AND PROBLEMS IN LIFE

For him, his illness is really one of the factors that can worsen the stress in school
specially when they have assignments and yet he could not do it suffering from an
asthma attack.

II. Coping methods and support systems

In his age, he is much closer to his mother than with his friends so, when he feels
depressed, he just goes to his mom and cry. In his age, stress is really not the
main problem but rather, emotional disturbance and bullying could be the reasons
for the child's depression.

11. VALUE-BELIEF PATTERN

I. Values, Goals and Spiritual Beliefs

In this age the most important people in his life is his family or specifically his
parents and his parents are the factors that influence him in decision-making and
the source of his hope and strength.

II. Religious and Spiritual Beliefs

According to his parents, they do pray a lot when someone is ill or hospitalize and
they let their child hold and pray the Holy Rosary.

VI. Anatomy & Physiology – Pathophysiology (sick Family Member)

Asthma is a chronic inflammatory airway disorder characterized by airflow obstruction

and airway hyperresponsiveness to a multiplicity of stimuli. This widespread but variable
airflow obstruction is caused by bronchospasm, edema of the airway mucosa, and
increase mucos production with pluging and airways remodeling that it’s a type of
chronic Obstructive Pulmonary Disease (COPD), along term pulmonary disease
characterized by increased airflow resistant; other types of COPD include Chronic
Bronchitis and emphysema.
CAUSES

Extrinsic allergens
• animal dander
• food additives containing sulfites
• house dust or molds
• ‘kapok’ or feather pillows
• other sensitizing substances
• Pollen
Intrinsic Allergens
• Anxiety
• Coughing and laughing
• Emotional stress
• Endocrine changes
• Exposure to noxious fumes
• Fatigue
• Genetic factors
• Humidity variations
• Irritants
• Temperature variations

Pathophysiology
Environmental factors interact with inherited factors to caused asthmatic reactions with
associated bronchospasms in asthma bronchial lining over react to various stimuli,
causing episodic smooth muscle spasm that severely constrict the airways. On
subsequent exposure to antigen, mast cells degranulate and release mediators. Mast
cells in the lungs interstitium are stimulated to release histamine and Leukotrienes.
Histamine attaches to receptor sites in larger bronchi, where causes swelling of smooth
muscles. Mucus membranebecome inflamed, irritated and swollen. The patient may
experience dyspnea, prolonged expiration and an increased respiratory rate.

Leukotrienes attached to the receptor site in the smaller bronchi and can cause local
swelling of the smooth muscle. Leukotrienes also caused prostaglandin to travel through
the blood stream to the lungs, where they enhance the histamine’s effect. A wheeze
maybe audible during coughing – the higher the pitch, the narrower the bronchial lumen.
Histamines stimulates the mucos membranes to secrete excessive mucusto further
narrow the bronchial lumen. Goblet cells secrete viscous mucus that is difficult to cough
out resulting in coughing, rhonchi, increase pitch wheezing and increases respiratory
distress. Mucosal edema and thicken secretions further block the airways. On inhalation,
the narrow bronchi lumen can still expand slightly, allowing air to reach the alveoli. On
exhalation, increase intrathoraxic pressure closes the bronchial lumen .

SIGNS AND SYMPTOMS

• Sudden dyspnea, wheezing and tightness in the chest
 • Coughing that produces thick, clear or yellow sputom
• Tachypnea
• Rapid pulse
• Hyperresonant lung fileds from air trapping
• Demenish breath sounds

DIAGNOSIS
• complete blood count
• chest x-rays
• arterial blood gas analysis

TREATMENT

MEDICAL INTERVENTIONS
• desensitization to specific antigens
• bronchodilators
• corticosteroids
• leukotriene modifiers and leukotriene receptor antagonists
• anticholinergic bronchodilators

NURSING INTERVENTIONS

• Relaxation exercises like yoga to increase circulation and help the patient relax
and relieve stress.
• Identification and avoidance of precipitating factors (environmental antigens or
irritants) to prevent asthma attacks.
• Use a facemask to cover their nose and mouth to prevent them in inhaling the
smoke or polluted air.
• Educate the mother on the effects of the smoke from the factory to her family’s
health.
VII. Prioritize of Health Problem

VIII. FNCP (Follow Format)

IX. Conclusion

Therefore, base upon initial and periodic assessment and monitoring, avoiding extrinsic
allergens that triggers asthma, appropriate pharmacologic therapy and enhancing the
educational partnership should reduce the burden of asthma in the patient and their
family as well. A family with an asthmatic member affects a person's activities of daily
living and could be a burden during hospitalization, absence during school days and work
days and also their restricted activities, which prevents the parson’s ability to achieve
optimum functioning.

In our patient's case, asthma was not just genetically acquired because during our
assessment, we observed different risk factors like the factory beside their house, open
drainage, poor ventilation, and presence of allergens. With proper care, love and
encouragement from his parents, he can live his life happily just like any other children.
 X. Recommendation

Family is considered as the basic unit of the society. The person's ability as a social
being starts at home with his/her family. Having an asthmatic member of the family is
sometimes a burden specially that they are experiencing global economic crisis. Love,
care and encouragement could help the child reach his optimum potential despite of
having such illness. A child with asthma also needs special attention not just emotionally
but also medical check-ups and pharmacologic therapy is really needed to promote and
prolong the child’s life.

XI. Bibliography

Maternal and Child Health Nursing (Care of the childbearing and childbearing family)
Adelle Pilliteri Vol.2 Chapter 31

Nursing Health Assessment 2nd edition; Patricia Dillon Chapter 26

XII. Documentation