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INTRODUCTION A.

Overview The family is a very important social institution that performs two major functions and that is reproduction and socialization. It is generally considered as the basic unit of care in community Health Nursing for many reasons. It may contribute knowingly or unknowingly to the development of health and nursing problems of its members. However, it also performs health promoting, health maintaining, and disease preventing activities. In many cases the family is the locus of decision making on health matters. It is the source of the most solid support and care to its family members. Family is also considered as a unit of society which is affected or influence by some aspects like political, economic and spiritual. Friedman defines a family to be composed of two or more persons who are joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family. Capunhag Family was chosen to be my to be my care study client since the family needs additional education about promotion of health and healthy environment. Also, the family fits with criteria of choosing such one. B. Objectives At the end of 6hours Nursing Care to the family, I will be able to: 1. Explore the concepts of Related Learning Experience and Community Health Nursing specifically about the family health concerns. 2. Ensure family understanding and acceptance of problems. 3. To impart health teachings that would alleviate the health condition of the patient and for health maintenance after hospitalization. 4. To render health care services that would necessitate the needs of the family with basis on the health problems. 5. To provide or secure nursing services that the family needs and cannot provide for itself. 6. To discuss the assessment, diagnosis, planning, implementation and evaluations done to the family along with the health teaching that was being imparted.

C. Scope and Limitation The scope of this study includes: 1. The scope of plan is during the 6hours of duty in the community area wherein the students visited and assessed their chosen family with commutative interaction and good rapport. 2. It includes essential concepts in relation to the said diseases such as the patient s profile and health history, present health status, IMCI, nursing assessment, family coping index, family health plan and actual implementation. 3. The quantity and quality of the information are limited to the data gathered from the client and the family. 4. Rest assured that all the information gathered or derived from the family is limited to researcher s knowledge and be hereby considered confidential and will remain us for case study purpose only.

FAMILY PROFILE

NAME

JUNE MART AMARGA

POSITION IN THE FAMILY

YOUNGEST CHILD OF THE HEAD OF THE FAMILY MALE

GENDER

AGE

1 YEAR OLD

CIVIL STATUS

SINGLE

BIRTH DATE

JUNE 8, 2010

BIRTH PLACE

CAGAYAN DE ORO CITY

CITIZENSHIP

FILIPINO

RELIGION

ROMAN CATHOLIC NONE

OCCUPATION

IMMUNIZATION

FULLY IMMUNIZED

WEIGHT

8 KG

HIEGHT

2 FT.

NAME

ROSLILYN AMARGA

POSITION IN THE FAMILY

WIFE OF THE HEAD OF THE FAMILY

GENDER

FEMALE

AGE

29 YEARS OLD

CIVIL STATUS

MARRIED

BIRTH DATE

DECEMBER 06, 1982

BIRTH PLACE

CAGAYAN DE ORO CITY

CITIZENSHIP

FILIPINO

RELIGION

ROMAN CATHOLIC

OCCUPATION

HOUSEWIFE

IMMUNIZATION

FULLY IMMUNIZED

WEIGHT

35 kg.

HIEGHT

52

FAMILY HEALTH HISTORY

Mr. Rodrigo Capunhag (Head of the Family) Mr. Capunhag is 37 years old, a residence of Zone 6, Gumamela Ext., Carmen for 10 years. Mr. Capunhag had a chronic illness which is hypertension and according to him he had hypertension it was their heredo-familial disease but even if Mr. Capunhag has a hypertension he don t have a maintenance medication for his hypertension and his blood pressure is not taken regularly or every day because he does not go to the health center regularly and he don t have a history of hospitalization even if he had hypertension Talagsa raman ko makapakuha ug blood pressure ayha ra jud kung nay mga estudyante mu anhi diri sa amoa as verbalized. As mention by Mr. Capunhag his blood pressure triggers only when he had a heavy work and in the food that they eat. In general Mr. Capunhag doesn t have a history of surgery, hospitalization and operation.

Mrs. Carolina Capunhag (Wife of the Head of the Family) Mrs. Carolina Capunhag aged 30 years old . Mrs. Capunhag delivered her two children through Normal Spontaneous Vaginal Delivery. She mentioned that she did not undergo prenatal check-ups. She also said that they don t have any familial diseases to both mother and father s side but she has high blood pressure. Maybe this is because of unhealthy lifestyle.The recent illness that she experience is having a cough and colds because due to the weather, then she just take herbal plants as medication for her cough.

PRESENT HEALTH STATUS Name: Rodrigo Capunhag Vital Signs: Pulse Rate: 70 bpm Temperature: 36.5 C
EENT: [] impaired vision [] blind [] pain [] reddened [] drainage [] gums [] hard of hearing [] deaf [] burning [] edema [] lesion [] teeth Assess eyes, ears, nose, throat For abnormality [x] no problem RESPIRATORY [] asymmetric [] tachypnea [] apnea [] rales [] cough [] barrel chest [x] bradypnea [] shallow [] bronchi [] sputum [] diminished [] dyspnea [] orthopenea [] labored [] wheezing [] pain [] cyanotic Assess resp.rate, rhythm, depth, pattern Breath sounds, comfort [] no problem CARDIOVASCULAR [] arrhythmia [] tachycardia [] numbness [] diminished pulses [] edema [x] fatigue [] irregular [] bradycardia [] murmur [] tingling [] absent pulses [] pain []assess heart sounds, rate, rhythm, pulse, bp, Circulation, fluid retention, comfort [] no problem GASTRO INTESTINAL TRACT [] obese [] distention [] mass [] dysphagia [] rigidly [] pain [] assess abdomen, bowel habits, swallowing [x] bowel sounds, comfort or no problem GENITO-URINARY and GYNE [] pain [] urine color [] vaginal bleeding [] hematuria [] discharge [] noctoria []olyguria []Assess urine freq., control, color, odor,[] comfort []Gyn-bleeding, discharge [x] no problem NEURO [] paralysis [] stuporous [] unsteady [] seizures [] lethargic [] comatose [] vertigo [] tremors [] confused [] vision [] grip []Assess motor function, sensation, LOC, strength, Grip, gait, coordination, orientation, speech [x]no problem MUSCULOSKELETAL and SKIN [] appliance [] stiffness [] itching [] petechiae [] hot [] drainage [] prosthesis [] swelling [] lesion [] poor turgor [] cool [] deformity [] wound [] rash [] skin color [] flushed

Blood Pressure: 130/80mmHg Respiratory Rate: 20 cpm

Hypertension

[] atrophy [] pain [] ecchymosis [] diaphoretic [] moist Assess mobility, motion, gait, alignment, joint function/ Skin color, texture, turgor, integrity [x] no problem

Name: Carolina Capunhag Vital Signs: Pulse Rate:67 bpm Temperature: 36.6 C
EENT: [] impaired vision [] blind [] pain [] reddened [] drainage [] gums [] hard of hearing [] deaf [] burning [] edema [] lesion [] teeth Assess eyes, ears, nose, throat For abnormality [x] no problem RESPIRATORY [] asymmetric [] tachypnea [] apnea [] rales [] cough [] barrel chest [x] bradypnea [] shallow [] bronchi [] sputum [] diminished [] dyspnea [] orthopenea [] labored [] wheezing [] pain [] cyanotic Assess resp.rate, rhythm, depth, pattern Breath sounds, comfort [] no problem CARDIOVASCULAR [] arrhythmia [] tachycardia [] numbness [] diminished pulses [] edema [] fatigue [] irregular [] bradycardia [] murmur [] tingling [] absent pulses [] pain []assess heart sounds, rate, rhythm, pulse, bp, Circulation, fluid retention, comfort [x] no problem GASTRO INTESTINAL TRACT [] obese [] distention [] mass [] dysphagia [] rigidly [] pain [] assess abdomen, bowel habits, swallowing [x] bowel sounds, comfort or no problem GENITO-URINARY and GYNE [] pain [] urine color [] vaginal bleeding [] hematuria [] discharge [] noctoria []olyguria []Assess urine freq., control, color, odor,[] comfort []Gyn-bleeding, discharge [x] no problem NEURO [] paralysis [] stuporous [] unsteady [] seizures [] lethargic [] comatose [] vertigo [] tremors [] confused [] vision [] grip []Assess motor function, sensation, LOC, strength, Grip, gait, coordination, orientation, speech [x]no problem MUSCULOSKELETAL and SKIN [] appliance [] stiffness [] itching [] petechiae [] hot [] drainage [] prosthesis [] swelling [] lesion [] poor turgor [] cool [] deformity [] wound [] rash [] skin color [] flushed [] atrophy [] pain [] ecchymosis

Blood Pressure: 130/80mmHg Respiratory Rate: 20 cpm

Hypertension

[] diaphoretic [] moist Assess mobility, motion, gait, alignment, joint function/ Skin color, texture, turgor, integrity [x] no problem

Name: Jennifer Capunhag Vital Signs: Pulse Rate:66 bpm Temperature: 36.9 C
EENT: [] impaired vision [] blind [] pain [] reddened [] drainage [] gums [] hard of hearing [] deaf [] burning [] edema [] lesion [] teeth Assess eyes, ears, nose, throat For abnormality [x] no problem RESPIRATORY [] asymmetric [] tachypnea [] apnea [] rales [] cough [] barrel chest [] bradypnea [] shallow [] bronchi [] sputum [] diminished [x] dyspnea [] orthopenea [] labored [] wheezing [] pain [] cyanotic Assess resp.rate, rhythm, depth, pattern Breath sounds, comfort [] no problem CARDIOVASCULAR [] arrhythmia [] tachycardia [] numbness [] diminished pulses [] edema [] fatigue [] irregular [] bradycardia [] murmur [] tingling [] absent pulses [] pain []assess heart sounds, rate, rhythm, pulse, bp, Circulation, fluid retention, comfort [x] no problem GASTRO INTESTINAL TRACT [] obese [] distention [] mass [] dysphagia [] rigidly [] pain [] assess abdomen, bowel habits, swallowing [x] bowel sounds, comfort or no problem GENITO-URINARY and GYNE [] pain [] urine color [] vaginal bleeding [] hematuria [] discharge [] noctoria []olyguria []Assess urine freq., control, color, odor,[] comfort []Gyn-bleeding, discharge [x] no problem NEURO [] paralysis [] stuporous [] unsteady [] seizures [] lethargic [] comatose [] vertigo [] tremors [] confused [] vision [] grip []Assess motor function, sensation, LOC, strength, Grip, gait, coordination, orientation, speech [x]no problem MUSCULOSKELETAL and SKIN [] appliance [] stiffness [] itching [] petechiae [] hot [] drainage [] prosthesis [] swelling [] lesion [] poor turgor [] cool [] deformity [] wound [] rash [] skin color [] flushed [] atrophy [] pain [] ecchymosis [] diaphoretic [] moist

Blood Pressure: 100/60mmHg Respiratory Rate: 20 cpm

Asthma

Joint pain Pain Scale 5/10

Assess mobility, motion, gait, alignment, joint function/ Skin color, texture, turgor, integrity [x] no problem

Name: Keith Lawrence Capunhag Vital Signs: Pulse Rate:120 bpm Temperature: 36.0 C EENT:
[] impaired vision [] blind [] pain [] reddened [] drainage [] gums [] hard of hearing [] deaf [] burning [] edema [] lesion [] teeth Assess eyes, ears, nose, throat For abnormality [x] no problem RESPIRATORY [] asymmetric [] tachypnea [] apnea [] rales [] cough [] barrel chest [] bradypnea [] shallow [] bronchi [] sputum [] diminished [] dyspnea [] orthopenea [] labored [] wheezing [] pain [] cyanotic Assess resp.rate, rhythm, depth, pattern Breath sounds, comfort [x] no problem CARDIOVASCULAR [] arrhythmia [] tachycardia [] numbness [] diminished pulses [] edema [] fatigue [] irregular [] bradycardia [] murmur [] tingling [] absent pulses [] pain []assess heart sounds, rate, rhythm, pulse, bp, Circulation, fluid retention, comfort [] no problem GASTRO INTESTINAL TRACT [] obese [] distention [] mass [] dysphagia [] rigidly [] pain [] assess abdomen, bowel habits, swallowing [x] bowel sounds, comfort or no problem GENITO-URINARY and GYNE [] pain [] urine color [] vaginal bleeding [] hematuria [] discharge [] noctoria []olyguria []Assess urine freq., control, color, odor,[] comfort []Gyn-bleeding, discharge [x] no problem NEURO [] paralysis [] stuporous [] unsteady [] seizures [] lethargic [] comatose [] vertigo [] tremors [] confused [] vision [] grip []Assess motor function, sensation, LOC, strength, Grip, gait, coordination, orientation, speech [x]no problem MUSCULOSKELETAL and SKIN [] appliance [] stiffness [] itching [] petechiae [] hot [] drainage [] prosthesis [] swelling [] lesion [] poor turgor [] cool [] deformity [] wound [] rash [] skin color [] flushed

Blood Pressure: N/A Respiratory Rate: 30 cpm

Skin Allergy/ Skin Rashes

[] atrophy [] pain [] ecchymosis [] diaphoretic [] moist Assess mobility, motion, gait, alignment, joint function/ Skin color, texture, turgor, integrity [x] no problem

HOME AND ENVIRONMENT


A. HOUSING The house is not owned by the family. They rented it for pHp30.00. And the house is made up of mix materials such as nipa, coco lumber and some woods and cement. There are no rooms or divisions for sleeping area, the entire area inside the house serves as the area for dining, sleeping, and cooking. They used amparilya for lighting and they don t have their own electrical connection. The house is dirty and disorderly due to the presence of scattered unwashed clothes and their unwashed kitchenware is place in the floor. B. WATER SUPPLY For drinking water they just buy from their neighbor and pay it five pesos per pale. The portability of water is not safe because it is not sterilized not they are not sure if the water is not contaminated. The water source is about 10meters from their house and the faucet is connected to a private source inside the house and they just used pales and galloons for water storage. C. TOILET FACILITY They don t have their own toilet facility but they have a public toilet facility in their community which is a pail system . The toilet facility is about 15 cm away from their house. The sanitary of the toilet facility is dirty and there are presence of flies and mosquitoes .

D. KITCHEN They use firewood or charcoal for cooking and it has a poor sanitary condition due to the presence of unwashed kitchen utensils and there is no drainage system in their kitchen then the waste water is flowing directly to the ground. E. GARBAGE DISPOSAL They just put their garbage in cellophane without segregating it and throw it outside the house. DRAINAGE SYSTEMS No presence of drainage system.

F.

G. DOMESTIC ANIMALS There is no domestic animal around the house. H. NEIGHBORHOOD

The nearest neighbor is about a meter away from their house and most of the families in the neighborhood are low income settlers and the sanitation and don t have knowledge about the importance of sanitation. I. COMMUNITY FACILITIES The community facilities are very accessible for them because the health center, day care center and covered court is near from their house it s just about hundred meters away from their house.

FAMILY COPING INDEX The purpose of the family coping index is to provide basis for estimating the nursing needs of a particular family. It also helps nursing students to organize and plan nursing care with precision so that care given is tailored to fit the particular family situation. Areas Scale Justification Both the wife and the husband are capable of doing their daily activities. They function well in order to meet their daily needs.

Physical Independence

Therapeutic Competence

According to Mrs. Amarga they only uses lemon to cure cough and colds and paracetamol for fever because they don t have enough money to buy medicine. According to them they are both aware of their health condition but still they just have limited knowledge about health and they don t monitor their health status regularly. They both take a bath and brush their teeth but not regularly especially Mr. Amarga and the children, they doesn t take a bath everyday but they wash and change their clothes regularly and maintaining their self comfortably. Whenever there is one member of the family who got sick they always find remedies to the existing problem. If the condition is not been alleviated with the use of herbal plants then, they just go to the health center for consultation. They both believe that any problem that they encounter has a solution and they value respect and neutralized temper especially they are already in the old adulthood stage. Mr. Amarga is just a laborer to any companies and Mrs. Amarga is just an ordinary housewife who care their children. The house is near from the ideal location, because it is far from all of the facilities that they need in order to have assistance in health care and

Knowledge of Health Condition

Application of Principles of General Hygiene

Health Attitudes

Emotional Competence

Family Living

Physical

Environment

developing social interaction with the people in the community, but even if they are far in all the facilities the house itself show signs of health threat. The family were able to make use of the available resources given by the health center like free consultation, immunization and free medicines.

Use of Community Facilities

ACTUAL IMPLEMENTATION During my visit in the community, I was able to find an ideal family for my care study that fits the criteria of having a need in health teaching and guide in order to raise the level of wellness in their family, afterwards I chose the family of Mr. Ato be my patient in my care study. During the first hour of visitation I introduced myself, established rapport to the family and explain the purpose of my visitation and after that I gathered data and do the assessment in each member of the family and site some problems that needs immediate action and implement the family care plan regarding to the problem that are present.

RECOMMENDATION Based on the data hat I gathered, my clients for my care study is advised to go to the health center in order to have a consultation regarding to their health status and also advise to monitor their eating lifestyle because both parents has a cardiovascular problem and they are also encourage to have at least ten minutes cardio exercise and for Mrs. Capunhag. She is advise to increase fluid intake and avoid stressful activity. They are also encourage to observed proper sanitation in their environment and do not take for granted the bad effects having no drainage system.

EVALUATION At the end of 2 days, the family was able to apply the health teachings given as evidenced by their improvement in hygiene and environmental sanitation on the third visit.

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