A C K N O W L E D G E M E N T
The study has provided our group opportunities to know the different problems and needs of the family in order for them to develop more in terms of their environment and especially with their health status. But all of these could not be done without the help of those significant people that help us throughout the study.The group would like to thank the following:
First of all, The Lord, we thank you for giving us a chance to live and experience this opportunity. Thank you for making all things possible, for giving us all we needed, and for making us earn insights in this way knowing the worth of our life. For His guidance and safety which He gives every day, for all the blessings that He has showered upon us, and for giving us the strength to pursue everything. Next To our loving parents, thank you so much for helping us with your prayers, for allowing us to be exposed in the community, and for helping us with our needs especially financial matters. To our clinical instructors Mrs. Evangeline Ocop, Mrs. Brenda Morales, Ms. Honeylette Villanueva, and especially Mrs. Anabel Bauzon who were always there to help and support us especially in our activities and programs, and in making our case presentation successful. We are grateful for the encouragement you gave us every time we feel discouraged especially for the outcome of our activities, for the patience, for understanding our differences, for the concern, and for the guidance you gave us. We appreciate it and it inspires us more to continue and pursue and we are happy and blessed to have you as our clinical instructors. We would also like to thank the Rural health unit of Calinan that organized and find a proper and appropriate place for us to have our community exposure. To The barangay health workers at Subasta health center, for their warm welcome and for extending their help and assistance if we needed to. We would also like to extend our gratitude to the Panadero family for accommodating, welcoming, and for trusting us to share their basic and personal information that made our case study successful. Next, to the members of the community for attending and participating in our different activities and programs and for
understanding our purpose in the community. The community was participative and interactive during the activities that motivated us to do our best.
Lastly we would like to thank our classmates and for our group. For the support and friendship, for the team building in our programs and activities and working altogether to make this case study a successful one.
“
It is health that is real wealth and not pieces of gold and silver. ”
A saying that strongly correlates to Community health nursing in such a way that it focuses on the welfare of everybody. Community Health Nursing is a specialized field of nursing, public health and some phase of social assistance and function as well as part of the total public health program for the promotion of health, improvement of the conditions in the social and physical environment, rehabilitation of illness and disability according to WHO. The philosophy of Community Health Nursing is based on the worth and dignity of man (Margaret Shetland). Its goal is to raise the level of health citizenry. The traditional function of the community health nursing is to help other help themselves. To achieve any degree of self reliance, people need to cultivate their own resources, both human and material at all stages and phases of development. The community health nurse, as a practitioner, teacher, interpreter, stimulator, listener and organizer is a significant factor in determining the success or failure of the health effort. The nature of these efforts will be constantly challenged and changed by goals, resources and constraints of the socioeconomic, ideological and political situation. The practice of the community health nursing will need to remain fluid and flexible if it is to be consistent with community needs, available resources, scientific knowledge and capabilities of people being served.
According to WHO, (World Health Organization), a community is a social group determined by geographic boundaries and/or common values and interests. Its members know and interact with one another. It functions within a particular social structure and exhibits and create norms, values and social institutions. It may be a neighborhood or cluster of families, an ethnic group, an industry or a school. With these definitions, it is evident that community is a very important target of health care. Every community has problems to be identified. Communities with poor financial and environmental conditions in particularly, are some concerns of the nation with regards to health.
Davao City is the biggest in Southern Mindanao in terms of population area. The city contributed 22.11 % of the total 5.2 million populations in the region, said National Statistics Office XI We chose Panaderol Family because we had identified problems
that would affect their health and give solutions for them to cope up. We prioritized the problems seen in the family and take methods on knowing the problems. By rendering health teachings and interventions, the family will be able to understand and learn about the existing and potential health problems and the family will be able to take appropriate actions to solve their problems on their own.
GENERAL:
At the end of our 5 week exposure on Barangay Subasta, Calinan, Davao City; we, student nurses of Ateneo de Davao University, BSN 3-D group 2, will be able to apply our learnings in our community health nursing concept and will be able to provide adequate and proper nursing care.
SPECIFIC:
In order to achieve above the general objectives, our group will be able to:
Psychomotor:
Conduct an ocular survey to find a family suitable for the case study;
Gather demographic data and other pertinent information about the client as well as the family to support the case study;
Illustrate the family eco map;
Extrapolate to the family the health teachings applicable to their problems;
Trace the client’s genogram, family diseases and health conditions in a diagram format with a corresponding legend;
Formulate 5 Family Nursing Care Plans for the family;
Cognitive:
Identify observable and underlying problems within the family;
Lay down information about the background of our family case study, its purpose , why the client was chosen and how can they be an attractive and proponent of the study;
Present the initial data base of the client;
List down problems noted in the family;;
Prioritize problems based on the Scale for Ranking Health Conditions and Problems According to Priorities;
Evaluate the results of our interventions if the family improved their condition;
Lay down the contributions of our Case Study to Nursing Education, Research and Practice; and
List down all references used for this particular Case Study.
Affective:
Establish rapport with the family to develop a good working relationship;
A. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS
PLACE OF RESIDENCE OF EACH MEMBER
-The Panadero family is living together in one house, located at purok 1 Subasta, Calinan Davao city.
TYPES OF FAMILY STRUCTURE
According to membership
- The Panadero family is a nuclear type of family because they are living in one household and consisting of a mother, father and their children.
According to Residence
NAME SEX AGE CIVIL
STATUS
EDUCATIONAL
ATTAINMENT OCCUPATION RELIGION
RELATION TO THE FAMILY HOMER
PANADERO MALE MARRIED 1
st yr College Motor driver Roman
catholic FATHER
MARJ
PANADERO FEMALE 26 MARRIED 1
st yr College Vendor Roman
catholic WIFE
BARK
PANADERO MALE 8 SINGLE Grade2 Roman
catholic SON
MAGGIE
PANADERO FEMALE 6 SINGLE Kinder2
Roman
catholic DAUGHTER
STEWIE
PANADERO MALE SINGLE
Roman
- The Panadero family is matrilocal since they live in one compound with Marj’s parents and siblings.
According to Authority
- Egalitarian is the authority in Panadero family in which decision lies with both couple.
DOMINANT FAMILY MEMBER IN TERMS OF DECISION-MAKING, ESPECIALLY IN MATTERS OF HEALTH CARE
- Both Marj and Homer are responsible in making decisions with regards to health care. The two of them work hand in hand to provide the family’s health needs. Financial matters are discussed by both Marj and Homer. They help and support each other in making decisions for their family.
GENERAL FAMILY RELATIONSHIP
- The panadero family is peaceful and loving family though sometimes the family experience quarrels but they easily resolve it by talking through it.
ACTIVITIES OF DAILY LIVING
Sleeping pattern
- The couple, Homer and Marj, together with their sons and daughter, sleeps together in one room. There have been regular hours for getting up and retiring every night for the family. They usually sleep at around
8 or 9 pm and wakes up 6am In the morning because marj needs to cook and prepare her children in going to school.
Eating Pattern
- The family shares four meals in a day breakfast, lunch, snacks and dinner. They cook using charcoals/woods because they have no stove. Ellen usually cooks the food since she also cook viands in which she sells during lunch.
Leisure time activities
- During free time, the family would just watch television on their neighbor’s house since their television set is broken. And also, they
SCHEDULE FOODS WHO
PREPARES BREAKFAST Rice, Fish/vegetables ELLEN
LUNCH Rice, meat/vegetables ELLEN
MERIENDA Bananacue ELLEN
DINNER Rice,
fish/meat/vegetables/soup
sleep and clean the house during free time. If they have extra money or they need to buy something, they go to town.
B. SOCIO-ECONOMIC AND CULTURAL FACTORS
INCOME AND EXPENSES
MEMBERS OCCUPATION PLACE OF
WORK
INCOME HOMER
PANADERO
MOTOR DRIVER SUBASTA P300-P500/day
MARJ PANADERO
The family’s income is above minimum wage (referring to Davao’s minimum wage level which is P248), having an income of 400-600 per day. It has an adequacy in meeting family’s basic need such as food and shelter. They can afford to send their children to school and able to eat at least 3-4 times a day.
EDUCATIONAL ATTEINMENT OF EACH MEMBER OF THE FAMILY
Name Educational Attainment
Homer Panadero Undergraduate First yr college
Marj Panadero Undergraduate First yr college
Bart Panadero Currently on Elementary Grade 2
Maggie Panadero Currently on Kinder 2
ETHNIC BACKGROUND AND RELIGIOUS AFFLIATIONS
Basically, our clients are Christians. Both Homer and Marj lived in Subasta.
SIGNIFICANT OTHERS
Each of the family members has its own significant roles in the family. In times of financial crises, they have their neighbors who can help them in some matters matters because most of their neighbours are their relatives,
RELATIONSHIP OF THE FAMILY TO THE LARGER COMMUNITY
. They are active members in their baranggay. Whenever there are activities in the Barangay, they participate.
C. ENVIRONMENTAL FACTORS
HOUSING
- There is inadequate living space for the entire family. The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm.
Sleeping arrangement
- The family altogether sleeps inside the main room. The children sleep on the floor mat while Mr. and Mrs. Panadero sleep on the bed.
Adequacy of furniture
- They have furniture. There is a television set and DVD player but it is broken. They have few kitchen utensils. A dining table and wooden chairs, they have a wooden cabinet wherein they place or keep their clothes and other things.
Presence of insects and rodents
-There were cobwebs noted at their ceilings. There were mosquitoes in the kitchen and their bedroom. There are also small rats and ants noted. It is highly possible for insects to get in because their windows
are not screened.
Presence of accident hazards
-There are large and sharp stones outside their door. Marj verbalized “nadagma dra akong anak, naigo sa bato unya nasamad ang ulo”.
Food storage and cooking facilities
-There is no proper food storage. They have no refrigerator; they store their fresh meats on their mother’s refrigerator. We also noticed the cooking utensils such as plates & cooking pan left unwashed in the washing area. They are using wood and charcoals for cooking.
Water supply
-They get their water supply in water district. This is where they use for taking a bath, washing clothes and use for cooking. In terms of paying they pay their own water bill.
Toilet facility
- The toilet is privately owned and is located inside their house. It is approximately 80x210x300 cm. The toilet is not that clean. The walls of the toilet room are covered with sacks. The type of toilet is an open pit.
Garbage disposal
- There is exposed garbage in plastic cellophane mixed with biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane. There is garbage collector that makes rounds every week. The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present.
Drainage System
- The type of drainage system they have is an open pit.
KIND OF NEIGHBORHOOD
The houses in the community are not congested. They are spaced adequately. The Panadero family lives in a peaceful community. Whenever they need something like they need to put their fresh meats in a refrigerator their neighbors would let them
store their food in their refrigerator. Since some of their neighbors are their relatives, they sometimes watch TV in their relative’s house.
SOCIAL AND HEALTH FACILITIES
Health Center is present where immunizations and check-ups are rendered. Subasta also houses the Subasta Elementary School wherein almost all of the children study. The community has a basketball area and a chapel that is used by the people for recreation and official activities. There are also several sari-sari stores in the area wherein they could buy the things they need.
COMMUNICATION AND TRANSPORTATION FACILITIES AVAILABLE
They own a motorcycle which serves as their transportation and also to earn a living. They have their television but it is broken.
D. HEALTH ASSESSENT OF EACH MEMBER
FAMILY MEMBER WEIGHT HEIGHT
Homer Panadero
Marj Panadero 59kg 156cm
Bart Panadero 20kg 115cm
Maggie Panadero 20kg
Stewie Panadero 11kg 85cm
FAMILY MEMBER Blood pressure
Homer Panadero
Marj Panadero 140/100
Maggie Panadero Stewie Panadero
Mrs. Panadero has an undiagnosed hypertension. After taking her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.”
G E N O G R A M
MATERNAL LOLA AMPARO DECEASED HYPERTENS ION LOLO MINOY DECEASED MAMA ELIZABETH HYPERTENSIO N ANNABELLE JEANETTE ALVIN DECEASED HYPERTENSION PAPA ROGELIO HYPERTENSION LOUIE Marge HYPERTENS ION LEAH ROJELISA JONREY ARLIE Maggie BartPATERNAL
T Y P O L O G Y
LOLA DECEASED OLD AGE LOLO DECEASED DIABETES NIN NINING MAMA NOEMI HYPERTENSIO N JUN DECEASED HYPERTENSI ON ABRAHAM DECEASED HYPERTENSI ON PAPA JAIME SR. Homer. 29 Y.0 WILSON 26 Y.O MAILAH 12 Y.O StewieDATE CUES FIRST LEVEL ASSESSMENT (Health Problem)
SECOND LEVEL ASSESSMENT (Family Nursing Problem) HEALTH THREAT
November 13, 2010
• The Panadero family is living in a house where there is an inadequate space for household members.
• The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm.
• The family altogether sleeps inside the main room. The children sleep on floor mat while Mr. and Mrs. Panadero sleep on the bed.
Inadequate living space for a family of
five members. •environment conducive to health Inability to provide a home maintenance and personal development due to inadequate family resources specifically financial constraints.
November 13, 2010
• Presence of vectors such as flies and
Poor environmental sanitation due to: •Inability to make decisions with respect to taking appropriate health
mosquitoes as well as their breeding places like used cans, bottles and drums.
• Exposed garbage in plastic cellophane mixed with biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane.
• Noticeable dirty sink and cooking area.
• Pots and pans are not washed properly and are kept at their cooking area which is an open area.
• Flies are evidently noticed over the cooking facilities and foods.
• Uncovered container particularly filled with water seen near the toilet facility
• Presence of flower pots that collects rain water
• Mrs. Panadero verbalized “daghan lamok diri sa amoa, tungod siguro ni sa mga cacao”
a. Presence of breeding and resting sites for flies and mosquitoes.
b. Unsanitary food storage c. Unsanitary cooking facilities
action due to:
a) Failure to comprehend the magnitude of the condition. b) Low salience of the condition. c) lack of knowledge on the
consequences of the problem.
• Absence of a
refrigerator.
• Food supplies need to be bought daily.
• Mrs. Panadero
Lack of food storage facilities manifested by uncovered food on the table
•Inadequate family resources, specifically due to financial resource and physical facilities, i.e living space and water supply.
verbalized “sa lamesa lang ginatakluban ang sobra na pagkaon. Wala man gud mi ref.”
• No food storage facilities such as plastic
container or
tupperwares, refrigerator and etc.
• Mrs. Panadero verbalized “maulaw mi muadto sa Barangay Health Center para makakuha ug libre na tambal ug check-up”
Failure to utilized community
resources for health care •resources for health care due to:Failure to utilize community a) Failure to perceive benefits of
health care
November 13, 2010
• “kung nay magkasakit naga palit ra mi ug tambal sa botika.”
• “ gapalit pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura ug ubang sakit2x”
Self-medication as unhealthy lifestyle and personal habits or practices as health threat.
•Inabilty to recognize the presence of the problem due to:
a) Ignorance of facts
• Inabilty to make decisions with respect to taking appropriate health actions due to:
a) Failure to comprehend the nature or magnitude of the problem
b) Low salience to the problem
• The house is made of wood
• Cooking facilities are improperly kept outside the house.
• The cooking area is
Presence of fire hazards •Inabilty to make decisions with respect to taking appropriate health actions due to:
just inches away from the house
or magnitude of the problem b) Low salience to the problem November 13,
2010
• The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present.
• Biodegradable and non-biodegradable garbage are not properly segregated.
Improper garbage disposal. •Inability to make decisions with respect to taking appropriate health action due to:
a)Failure to comprehend the magnitude of the condition.
b)Low salience of the condition.
• Mr. Panadero smokes and drinks occasionally
Unhealthful lifestyle and personal habits/practices due to cigarette/tobacco smoking
•Inability to recognize the presence of the problem due to ignorance of facts and attitudes.
•Inability to make decisions with respect to taking appropriate health action due to:
a) Failure to comprehend the magnitude of the condition.
b) Low salience of the condition. November 13,
2010
• Water overflows easily when it rains.
• The sink of the kitchen area in the house is directly connected to the drainage system. All
Improper drainage system •Inability to recognize the presence of the problem due to ignorance of facts and attitudes.
•Inability to make decisions with respect to taking appropriate health action due to:
of the wastes are directly thrown in the drainage system.
d) Failure to comprehend the magnitude of the condition. e) Low salience of the condition.
HEALTH DEFICIT
November 13, 2010
• Mrs. Panadero has an undiagnosed
hypertension. After taking her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.”
Presence of health deficits: a) Undiagnosed
Hypertension
•Inability to make decisions with respect to taking appropriate health action due to:
b) Failure to comprehend magnitude of the problem. c) Low salience of health
maintenance. d) inaccessibility of appropriate resources of care, specifically: a. Physical inaccessibility. b. Cost constraints.
DATE CUES FIRST LEVEL ASSESSMENT
(Health Problem)
SECOND LEVEL ASSESSMENT
(Family Nursing Problem) HEALTH THREAT
November 13, 2010
• The Panadero family is living in a house where there is an inadequate space for
Inadequate living space for a family of five members.
• Inability to provide a home environment conducive to health maintenance and personal development due to inadequate
household members.
• The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm.
• The family altogether sleeps inside the main
family resources specifically financial constraints.
room. The children sleep on the bed while Mr. and Mrs. Panadero sleep on the floor mat. November
13, 2010
• Presence of vectors such as flies and mosquitoes as well as their breeding places like used cans, bottles and drums.
• Exposed garbage in plastic cellophane
mixed with
biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane.
• Noticeable dirty sink and cooking area.
• Pots and pans are not washed properly
Poor environmental sanitation due to:
d. Presence of breeding and resting sites for flies and mosquitoes.
e. Unsanitary food storage f. Unsanitary cooking facilities
•Inability to make decisions with respect to taking appropriate health action due to:
f) Failure to comprehend the magnitude of the condition. g) Low salience of the condition. h) lack of knowledge on the
consequences of the problem.
and are kept at their cooking area which is an open area.
• Flies are evidently noticed over the cooking facilities and foods.
• Their water supply which is put in a water container is junked in the kitchen area and some are not covered well.
• Absence of a refrigerator.
• Food supplies need to be bought daily.
Lack of food storage facilities •Inadequate family resources, specifically due to financial resource and physical facilities, i.e living space and water supply.
• Mrs. Panadero verbalized “maulaw mi muadto sa Barangay Health Center para makakuha ug libre na
Failure to utilized community resources for health care
•Failure to utilize community resources for health care due to:
b) Failure to perceive benefits of health care
tambal ug check-up” November 13, 2010 • “kung nay magkasakit naga palit ra mi ug tambal sa botika.” • “ gapalit pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura ug ubang sakit2x”
Self-medication as unhealthy lifestyle and personal habits or practices as health threat.
•Inabilty to recognize the presence of the problem due to:
b) Ignorance of facts
• Inabilty to make decisions with respect to taking appropriate health actions due to:
c) Failure to comprehend the nature or magnitude of the problem
d) Low salience to the problem
• The house is made of wood
• Cooking facilities are improperly kept outside the house.
• The cooking area is just inches away from the house
Presence of fire hazards •Inabilty to make decisions with respect to taking appropriate health actions due to:
c) Failure to comprehend the nature or magnitude of the problem
d) Low salience to the problem November
13, 2010
• The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present.
• Biodegradable and non-biodegradable garbage are not properly
segregated.
Improper garbage disposal. •Inability to make decisions with respect to taking appropriate health action due to:
a)Failure to comprehend the magnitude of the condition.
b)Low salience of the condition.
• Mr. Panadero smokes and drinks occasionally
Unhealthful lifestyle and personal habits/practices due to cigarette/tobacco smoking
•Inability to recognize the presence of the problem due to ignorance of facts and attitudes.
•Inability to make decisions with respect to taking appropriate health action due to:
a) Failure to comprehend the magnitude of the condition.
b) Low salience of the condition. November
13, 2010
• Water
overflows easily when it rains.
• The sink of the kitchen area in the house is directly connected to the drainage system. All of the wastes are directly thrown in the drainage system.
Improper drainage system •Inability to recognize the presence of the problem due to ignorance of facts and attitudes.
•Inability to make decisions with respect to taking appropriate health action due to:
i) Failure to comprehend the magnitude of the condition. j) Low salience of the condition.
HEALTH DEFICIT November 13, 2010 • Mrs. Panadero has an undiagnosed hypertension. After taking her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang
Presence of health deficits:
e) Undiagnosed Hypertension
•Inability to make decisions with respect to taking appropriate health action due to:
f) Failure to comprehend magnitude of the problem. g) Low salience of health
maintenance.
h) inaccessibility of appropriate resources of
high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.” care, specifically: c. Physical inaccessibility. d. Cost constraints.
F A M I L Y C O P I N G I N D E X
DATE COPING AREA RATING JUSTIFICATION HEALTH EDUCATION DATE FINAL SCORE JUSTIFICATION N O V E M B E R 1 3 2 PHYSICAL INDEPENDENCE
3 All the family members have the ability to
perform activities of daily living and are able to move about
independently. However, during visits, some members of the family are with dirty clothes on, and unclean, long nails. These signify that there is only a partial provision of basic care to the members of the family.
• Educate the family the importance of good personal hygiene as evidenced by having trimmed nails since untrimmed nails may harbor microorganisms and these may be induced through the mouth.
• Advise members of the family to wear clean clothes to avoid harboring microorganisms that could cause them illness. N O V E M B E R 2 5 2
5 The family has the capacity to move and perform physical activities within their physical limits such as walking, and personal grooming. They now receive the necessary health care as evidenced by trimmed finger and toe nails, and wearing of clean clothes.
0 1 0 0 1 0 THERAPEUTIC INDEPENDENCE
3 The family visits the health care
professionals and avails the health care services, such as for Bart’s colds. They also carry out some needed
medications. Aside from that, the family is
practicing
self-medication as evidenced by the usage of
unrecalled medicines they received from the Health Center. They use herbal medicines like “tawa-tawa” when a member of the family experiences fever but they don’t know the specific use and
• Encourage the family to seek for professional help for illnesses which you are not sure of the cause and cure.
• When taking medications on their own, it is important that they have general
knowledge on when and how to take them. Educate the family on the right time to take their medicines and symptoms that they need to be aware of so as to avoid further 5 There was a significant improvement on the family’s therapeutic independence. They verbalized that Bart was already scheduled to visit the health center and they emphasized that they will do this as soon as possible. The family was able to include that they now became
conscious when it comes to giving self-medications.
preparations. complications.
• Explain to the family that “tawa-tawa” is not approved by the Department of Health as one of the 10 Herbal Medicines and it needs further study.
They watch out for some
unusuallities that may occur after they give the medicines. They are also aware of the fact that most medications should be taken with plenty of water and with a full stomach.
KNOWLEDGE OF HEALTH CONDITION
3 The family has some general knowledge about certain illness and conditions. Marge had her children immunized at the health center.
• Educate the family with regards to common diseases such as cough and colds.
• Frequently visit to
5 They now know what to do if one of them suffer from colds or cough. They were also taught with
However, they are not aware of the underlying principles and the care of illness. For example, hypertension which they know that is very
common in their family and they had not taken preventive actions yet.
health centers and other medical institutions.
• Encourage them to have Marge and Bart’s health be checked at the health center to know if they have hypertension.
• Teach them how to use the ten
approved herbal medicines by the DOH.
the ten approved herbal medicines and showed comprehension for they were asked questions regarding the herbal medicines and were able to answer them. In addition, they also said that they are going to take necessary action at right time if they have already observed significant symptoms of a disease. They are starting to avoid foods that can
trigger hypertension. APPLICATION OF PRINCIPLES OF PERSONAL AND GENERAL HYGIENE
3 The family secured initial immunization to the children. Though all the members have adequate sleep, there is an
inadequate and improper safe
homemaking habits in relation to storing and preparing foods. They only store them in plastic containers since there is no refrigerator is
available. They have no proper ventilation
because when they
• Advise the family to observe proper hygiene to maintain health such as bathing everyday and proper hand washing before and after eating, in preparing and handling meals and after going to the toilet.
• Emphasize the importance of cleaning their surroundings to
5 The family is able to follow the health teachings that were taught to them. The members are now observant in their personal hygiene. They now always take a bath at least once a day and wash their hands when they handle things that may contaminate them such as
cook, the smoke enters their house. Also, the house and its
surroundings are not properly maintained and cleaned.
avoid pests and rodents in their environment.
• Instruct them to properly store the food in sealed plastic containers.
• Encourage to always wear slippers to protect their feet from the microorganisms on the ground.
when they use the toilet, before and after eating and when handling meals. They are now conscious with their
environment and they show this by always cleaning the inside and outside of their house. They now also have a proper food cover to protect their left-over and some containers that are more secured than before if not, they use the
refrigerator of their neighbor to store food. They are also observed in wearing their slippers.
HEALTH ATTITUDES
3 The family accepts health care in some degree. However, they have some reservations. They accept the need for medical care and the services offered, yet they do not have follow-up check-follow-up afterwards. • Encourage the family to give importance to follow-up check-up. • Explain the importance of follow-up check-up for the proper treatment of the illness.
• Inform that signs and symptoms should be observed and reported so that complications could be avoided. 5 Significant changes occurred after the family received the health teachings. They are now aware of the possible consequences that they may face if they do not submit
themselves for follow-up check-up. They also verbalized that
• Advise the family to visit the health center to lessen their anxiety and to gain information when illness occurs.
• In order to assist with the financial conditions of the family, inform them of the benefits that they can get from their health center.
their confidence towards healthcare professionals has now increased. EMOTIONAL COMPETENCE
5 All the members of the family are able to maintain a degree of calmness. They consider the needs of other
members of the family as well as the
• Advise the family that emotional stability will aid them to decide on matters with confidence.
5 The family as a whole has grown to become more emotionally competent. They verbalized that arguments within
community. However, the couple seems to argue over their financial problems.
them have now become less serious and less frequent.
FAMILY LIVING PATTERNS
3 The family does things together and shared their tasks at home. However, there are also conflicts due to financial problems as verbalized by the mother. Also, most of the family members are unable to finish high school and they have low academic competence.
• Guide the family to budget their income for future purposes such as illnesses that may come in unexpected times, education and food supply. • Be aware of the activities in every member of the family. • If it would be possible, do self-education by reading books with their children.
5 The family was able to share their tasks at home. There was also a decreasing frequency and seriousness of the arguments that occur within them. They now talk things out in order to come out with sound decisions for the whole family.
PHYSICAL ENVIRONMENT
1 The house is in poor condition. The floors are not cemented and unsafe for the children, windows are
unscreened, cooking facilities and toilet is not in good condition. They have no proper
ventilation for cooking. Rodents and other insects are also present which serves as hazards to the members of the family. Aside from that the living space is too small for the family of 5 members. Furthermore, there are a lot of
accident hazards inside and outside the family
• Cleanliness should be observed to shun insects and rodents.
• Compost pit is also advisable for waste disposal. Instruct them to do waste segregation.
• The house should be repaired well for the safety of the family. If is impossible to cement the entire house, advise them to screen some areas for the protection of the family members.
• Maintain the
3 The neighborhood is congested and the air in their environment is not polluted. The cleanliness of the house has improved significantly yet there were still some accident hazards present.
such as the stairs that may cause untoward accidents, and unsafe for children. They also have a poor backyard as evidenced by the
garbage scattered there; a few meters away, scattered dry leaves, muddy area, pieces of rotten wood and untrimmed grasses.
cleanliness of their surroundings. Regularly check and clean the toilet and cooking facilities. • Have a proper ventilation for cooking so as not to suffocate the members of the family. USE OF COMMUNITY FACILITIES
3 They are aware of the services offered in their community and use some of these such as immunizations for the children. However, at certain times, they are unable to avail the services offered since they are busy because
• It would be beneficial to participate in community activities, such as GKK gatherings, fiesta, and other programs offered by the Baranggay officials.
• Provide referrals for
3 They are still not active in the community
gatherings. When there was a health class about
nutrition
conducted at the school gym, the mother was
of work. They don’t attend seminars conducted by the Baranggay.
the family about the services offered by the health care center.
• Encourage the family to continue utilizing the available facilities and
resources in the community.
present in order to learn from the seminar but after the next health class she was not present.
P R I O R I T I Z A T I O N
O F P R O B L E M S
INADEQUATE LIVING SPACE
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE PROBLEM 2/3 X 1 0.66 There is a possibility of acquiring communicable
diseases when a family member is sick. As the children grow older, the more the congested they
are. MODIFIABILITY
OF THE PROBLEM
1/2 X 2 1 It is partially modifiable because the family doesn’t
have enough income to expand their home. However, the furniture can
be arrange to allow more space.
PREVENTIVE POTENTIAL
3/3 X 1 1 Increasing the living space provides privacy and reduces possibility of accidents and transfer of communicable diseases. SALIENCE OF THE
PROBLEM
1/2 X 1 0.5 The family sees it as a problem. However, it does
not see the problem as needing immediate action. TOTAL SCORE: 3.16
LACK OF FOOD STORAGE FACILITIES
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 The problem is a health threat that requires action in order to avoid possible health problems from lack
of food storage. MODIFIABILITY
OF THE PROBLEM
1/2 X 2 1 The problem is
partially modifiable since the family could make use of various improvised ways of temporary food storage. The
best possible solution to this problem would be to increase their finances in order to purchase more efficient storage devices. PREVENTIVE POTENTIAL 3/3 X 1 1 Acquiring proper food storage facilities will help prevent the family
from acquiring communicable
diseases, prevent food poisoning and spoilage as well as
save family resources. SALIENCE OF THE
PROBLEM
2/2 X 1 1 The family seems to recognize the some
disadvantages of not being able to preserve their food.
TOTAL SCORE: 3.66
FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE PROBLEM 2/3 X 1 0.66 It is a health threat because this condition is a hindrance to the realization of one’s health potential. It also obstructs the members of the family from achieving their optimal health potential. MODIFIABILITY OF THE PROBLEM 2/2 X 2 2 It is modifiable
because the family can avail freely to the resources that barangay health
center gave to them. PREVENTIVE
POTENTIAL
3/3 X 1 1 Utilizing community resources for health
care can help lessen the cost of
the medicines or treatments. This will also make the family
be more aware of their health status. SALIENCE OF THE
PROBLEM
0/2 X 1 0 The family doesn’t
see this as a problem.
TOTAL SCORE: 3.66
SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 It is a health threat because when the family doesn’t know
principles of right medication (dosage,
route, frequency), instead of recovering from the
disease/illness this could worsen this
condition. MODIFIABILITY
OF THE PROBLEM
2/2 X 2 2 It is modifiable
check-ups in the clinic/health center
are free for them and they can avail it
anytime they want. PREVENTIVE
POTENTIAL
2/3 X 1 0.66 The family needs to be informed about the right medications or treatments on certain health problems, by this
way they would know the proper medication must be
given. SALIENCE OF THE
PROBLEM
0/2 X 1 0 The family doesn’t
view it as a problem.
TOTAL SCORE: 3.32
PRESENCE OF FIRE HAZARDS
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 It is a health threat because this has
the potential to cause future
accidents, particularly fire-related incidents, if
not immediately resolved. MODIFIABILITY OF THE PROBLEM 1/2 X 2 2 The problem is partially modifiable because even though there are
immediate interventions that
can be done the family do not have
the income to modify this problem
and they have a hard time thinking of
an alternative interventions. PREVENTIVE POTENTIAL 3/3 X 1 1 The preventative potential is high if safety measures and precautions are
promoted in the family. Elimination of fire hazards will also reduce the risk
of injury and subsequent family stressors due to
fire-related accidents. SALIENCE OF THE
PROBLEM
0/2 X 1 0 The family doesn’t view this condition
as a problem. TOTAL SCORE: 2.66
IMPROPER GARBAGE DISPOSAL
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 It is a health threat because the manner in which they dispose of their
waste can be detrimental to their health which is conducive to disease. MODIFIABILITY OF THE PROBLEM 1/2 X 2 0.50 It is partially modifiable because
they do not know the proper disposal
of garbage. PREVENTIVE POTENTIAL 3/3 X 1 1 The preventative potential of the problem is high, since the implementation of proper waste disposal will prevent
the formation of possible reservoirs
of disease. SALIENCE OF THE
PROBLEM
0/2 X 1 0 The family does not perceive the waste
disposal as a problem and are content with their method since it
saves time and energy.
TOTAL SCORE: 2.16
UNHEALTHFUL LIFESTYLE AND PERSONAL HABITS/PRACTICES
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 It is a health threat since unhealthy lifestyle can greatly
affect the health of the family. MODIFIABILITY
OF THE PROBLEM
1/2 X 2 1 It is partially
modifiable because the family has to change their lifestyle
to prevent acquiring illnesses/diseases. PREVENTIVE POTENTIAL 2/3 X 1 0.66 The preventive potential is moderate
because the family needs to understand
the bad effects of unhealthy lifestyle.
They have to start changing their lifestyle within themselves. SALIENCE OF THE
PROBLEM
1/2 X 1 0.5 The family sees it as a problem but doesn’t
action. TOTAL SCORE: 2.82
IMPROPER DRAINAGE SYSTEM
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 It is a health threat since it can cause
diseases to the members of the household and It
can also be potential breeding
place for insects and rodents MODIFIABILITY
OF THE PROBLEM
1/2 X 2 1 The lack of funds and facilities as well as man power makes this
only partially modifiable. PREVENTIVE POTENTIAL 2/3 X 1 0.66 The preventative potential of the problem is moderate, since the
establishment of a proper drainage system will prevent
the formation of possible reservoirs
of disease. SALIENCE OF THE 0/2 X 1 0 The family does not
PROBLEM perceive drainage as a problem.
TOTAL SCORE: 2.66
UNDIAGNOSED HYPERTENSION
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
3/3 X 1 1 It is a health deficit because if the illness will not be treated, it could get
worse. MODIFIABILITY OF THE PROBLEM 1/2 X 2 1 Problem is partially modifiable because it is dependent on Mrs. Marj compliance to the health teachings given to him to alleviate discomforts felt such as headaches and giving priority and importance to such health problem. PREVENTIVE POTENTIAL 3/3 X 1 1 The possibility of complications of hypertension can be prevented if health actions are done. SALIENCE OF THE 1/2 X 1 0.5 The family sees it as
PROBLEM a health problem but is not considered as the priority among the family’s problems.
TOTAL SCORE: 3.5
Presence of resting sites of vectors of diseases such as insects and rodents
CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION NATURE OF THE
PROBLEM
2/3 X 1 0.66 The problem is classified as a health
threat because this condition is conducive to disease. MODIFIABILITY OF THE PROBLEM 2/2 X 2 2 It is easily modified since it only needs effort,
knowledge, and cooperation of the family. PREVENTIVE POTENTIAL 3/3 X 1 1 If proper sanitation of environment is practiced, diseases and infection can be
prevented. SALIENCE OF THE PROBLEM 1/2 X 1 0.5 The family is aware of the existing potential of a health threat
but they are taking this as problems that need not much
attention and immediate action. TOTAL SCORE: 4.16
THE PRIORITIZED NEEDS
PRESENCE OF RESTING SITES OF VECTORS OF
DISEASES SUCH AS INSECTS AND RODENTS 4.16
LACK OF FOOD STORAGE FACILITIES 3.66
FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH 3.66 SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND
PERSONAL HABITS/PRACTICES 3.32
INADEQUATE LIVING SPACE 3.16
UNDIAGNOSED HYPERTENSION 3.5
UNHEALTHFUL LIFESTYLE AND PERSONAL HABITS/PRACTICES 2.82
PRESENCE OF FIRE HAZARDS 2.66
IMPROPER DRAINAGE SYSTEM 2.66
F A M I L Y N U R S I N G C A R E
P L A N S
PRESENCE OF RESTING SITES OF VECTORS OF DISEASES SUCH AS INSECTS AND RODENTS
Cues Health Proble m Family Nursing Problems Goal of Care Objective s of Care Nursing Intervention Meth od of Nurs e Famil y Cont act Resourc es Required Evaluation Subjecti ve “”dagh angyud dinhisa amoa, siguros a cacao ningaka hoy” Objecti ve Presenc e of resting sites of vectors of diseases such as insects and rodents Inability to perform appropria te health actions due to: A. Lack of knowledge in identifying possible unwanted outcomes. B. They do not have control After nursing intervent ions, the family will be able to recogniz e and perform appropri ate measure s in order to After nursing interventio n, the family will: A. Understan d the effects of the presence of breeding sites in the area. 1. Inform the family members the possible consequences of neglecting the problem of rodents and insects inside their home R: In order to inform the family about the problem and broaden H O M E V I S I T Material Resource s Th ey need the followi ng materi al s in order to get rid or Goal achievement on process The family was able to learn the importance of preventing the formation of breeding sites of vectors however; they are still
P resen ce of mosq uitoe s insid e and outsi de the hous ehold . U ncov ered conta iners partia lly filled with water seen near the toilet facilit y. P resen ce of over the situation. Inability to provide a healthy environm ent due to financial crisis. minimiz e or prevent the formatio n of breeding sites of vectors. B. will be able to spot the places in their house where insects and pests reside. C. Implement agreed upon measures to reduce the breeding sites of vectors in their environme nt. their knowledge about it. 2. Discuss to the family ways on how to promote proper extermination of pests. R: For the family to avoid from getting diseases. 3. Explain to them the importance of having a clean and pest free living environment. R: To provide them a healthy environment and to maintain their area clean. 4. Teach the family how to get rid of the insects and rodents in lessen pests inside their house: Mouse traps, mosquito nets, “katol” or bug spray. Hu man Resou rces Time and effort of the nurse and cooperati on of the family. Financial Resource s M oney on the process of fully implementing such preventive measures in their environment.
flowe r pots that colle ct rain water . their house. R: Rodents and insects are carriers of certain diseases. 5. Assess the house for any openings where rodents or insects may enter. R: To be able to know where the portal of entry of rodents and insects for repair. 6. Explore for home remedies for pest control. R: To be able to help the family find cheaper materials if they have financial constraints. 7. Search the house for for the transp ortatio n of the nurse and the mone y for the family to buy materi als to exter minat e pests.
likely breeding sites like dark corners or stagnant water etc. R: To be able to find the source of the pests to eliminate them completely. 8. Encourage them to maintain proper environmental sanitation. R: proper sanitation measures serve as a safeguard to various illnesses.
LACK OF FOOD STORAGE FACILITIES Cues Health problem Family nursing problem Goal of care Objectives of Care Nursing Intervention Metho d of Nurse Family Conta ct Resourc es Required Evaluation SUBJECTI VE: Mother verbalized, “SA lamesalan gginabuta ngangsubr anapagka on, wala man gud me ref.” OBJECTIE : NO food storage facilities such as plastic Lack of food storage facilities manifest ed by uncover ed food left on the table. Inability to recognize the presence of a problem due to economical constrains. After 12 days of communit y exposure, the family will be able to provide storage facilities for their food. After 12 days of community exposure, the family will be able to: Find alternative food storage facilities by improvising and recycling used cans, plastic containers; asking from someone 1, discuss with the family the importance of maintaining a conducive environment for health maintenance such as having storage facilities. R: Proper food storage facilities contribute in ensuring the safety of the food consumed by the family, Home
visit Human resources : -time and effort of both the nurse and family -people who could give unused tin cans, container s, etc. -cooperati on of the members of the GOAL ACHIEVEM ENT IN PROCESS. Although the family was able to recognize potential health conditions that might occur if food will be contaminat ed due to improper storage, however they haven’t
containers , refrigerato r, ect. Noted who might give; or buy a new but cheap one. Recognize potential health condition that might occur if food will be contaminat ed due to improper storage. thus contributing directly to their health. 2, Cite the possible diseases that members of the family will acquire such as diarrhea, parasitism, ect. And the possible food poisoning If foods will be contaminated or spoiled due to improper storage. ®harmful pathogens that could cause a variety of infections such as diarrhea, etc. are likely to be found in contaminated foods. This barangay health team, particularl y the barangay health workers. Material sources: -food, storage facilities, bought or recycled. Financial resources : -money for the nurse transport ation -money if food storage facilities are going to be bought. found alternative food storage facilities yet.
could also cause poisoning. 3. Identify the family’s
reason for the lack of food storage facilities. ®identifying the motives behind the identified problem aids in coming up with appropriate solutions. 4. recognize how the family perceives the problem. ®knowing if the family’s concern with the identified problem could enhance the family’s participation in solving the
problem. 5. identify measures that have been implemented to alleviate the problem or see if there is any. ®for the student nurse to have an idea with what measure still needs to be implemented and what measure implemented by the family needs to be continued. 6. explore with the family the courses of action available for them to solve the problem specifically:
a. using recycled tin cans, plastic containers, used plastic jars as food storage facilities. ®to provide materials that are free without the need of spending money. b.looking for people whom they could possibly ask the above mentioned items. ®identifying possible people who could help in obtaining the necessary materials will be of help to save time.
FAILURE TO UTILIZED COMMUNITY RESOURCES FOR HEALTH cues Health proble m Family Nursing Problem Goal of care Objective of care Nursing Intervention s Metho d of Nursin g- Family Conta ct Resourc es required evaluation subjective : ‘maulaw mi adto sa health center kay bag’o ra man gud mi nag renta ug balay diri.” Failure to utilized commun ity resource s for health care A. Failure to perceive benefits of health care due B. Inadequa te knowledge about the available community resources of health care. After 8 hours of Nursing Interventio ns, the family will be able to verbalized understan ding about the benefits they can get in the communit y health center. After 8 hours of nursing interventio ns, the family will be able: A. To verbaliz ed underst anding about the availabl e commu nity resourc es for health. a.Educate the family about the beneficiaries of the available community health resources. Rationale: To give further information about the benefits of available community health resources. B. Introduce H O M E V I S I T Human resource s: Time and effort of both the nurse and the family Knowled ge of the Nurse he/she could impart Financial resource s: expenses Goal met. The family is now aware that they can avail the government programs offered in their community.
B. Lear n further informat ions about availabl e health services . to the family the government programs offered in the community. Rationale: To let the family sort the available health services regarding to their needs. C. Inform the family that they can avail the services offered in the community. Rationale: it will help them gain confidence to seek help and avail the health facilities in their community. on trasportat ion
SELF-MEDICATION AS UNHEALTHY LIFESTYLE AND PERSONAL HABITS/PRACTICES Cues Health Proble m Family Nursing Problem Goal of care Objective of care Nursing intervention Metho d of Nurse -Famil y Conta ct Resourc es required Evaluation Subjective : “ kung nay magkasak it naga palit ra mi ug tambal sa botika.” “ gapalit pud mi ug kanang suroy suroy lng gud na mga ugat para sa kalintura Self-medicati on as unhealth y lifestyle and personal habits or practice s as health threat. Inabilty to recognize the presence of the problem due to:
A. Ignoranc e of facts Inabilty to make decisions with respect to taking appropriate health actions due to: B. Failure to compreh end the nature or magnitud After 1 week Nursing Interventio ns, the family will be aware of the possible effects and complicati ons of self-medicating , After 1 week of nursing intervention s, the family will be able: A. To recognize the importanc e of consultin g with health care providers. B. The family should A. Inform the client about 10 herbal medicine s approved by DOH. Rationale: Give them alternative medication that is assured and approved by DOH. B. Inform the client H O M E V I S I T Human resources : Time and effort of both the nurse and the family Knowledg e of the Nurse he/she could impart Financial resources : expenses Goal Met. The family recognized the importance of consulting health care providers as they verbalized “ mas nakablo nami karon na importante man gyud mag pa consulta o mag pa
ug ubang sakit2x” e of the problem C. Low salience to the problem not easily comply to any medicatio n without prescripti on of a health care provider. the importanc e of having a consult action with a health care provider before using any medicatio n. Rationale: this will help the family be aware of what underlying condition on trasportati on check up.” They also verbalized understand ing about using the 10 herbal medicines approved by DOH “ dili man diay tanan herbal medicines ky pwede lng gamiton.”
INADEQUATE LIVING SPACE CUES HEALT H PROBL EM FAMILY NURSING PROBLEM GOAL OF CARE OBJECTIV E OF CARE NURSING INTERVENTI ON METH ODS RESOUR CES EVALUATI ON Family Verbalized : “Pasensya han niyo na among balay kay guot kayo” Objective: - The Panadero family is living in a house where there is an inadequat e space for household members. - The Inadequ ate living space for a family of 5 member s. Inability to provide a home conducive to health maintenance due to inadequate family resources, specifically limited financial resources. Within one meeting of community exposure family will be able to maximize the living space without renovating the house. After nursing intervention the family will be able to: a. obtain knowledge on what areas to maximize b. understand the importance of maximizing the living space. c. know the things that are important inside the house 1. Establish rapport. R: To gain trust and cooperation of the family. 2. Teach the family on the importance of having adequate space. R: Having adequate space enables the family to move freely in their house. 3. Encourage the family to arrange their things properly to H O M E V I S I T Human resource s: • Ti m e an d eff ort of bo th th e nu rs e an d th e fa mil y GOAL MET After providing the appropriate nursing intervention s the family was able to: a. obtained knowledge on what areas to maximize b. understand the importance of maximizing the living space
house consists of a multifuncti onal room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311 cm x 250 cm x 300 cm. They have a separate room for their comfort room which has a floor area 80 cm x 100cm x 300 cm. The maximize their living space. R: Arranging things properly will maximize their living space. 4. Encourage to maintain the family size since they have inadequate space for living. R: Since the house is too small if they will add another member in their family the chances is they will be more crowded inside their house. 5. Instruct the family to dispose • Kn ow led ge of th e nu rs e he /sh e co uld im pa rt Financial resource s: • Ex pe ns es on tra ns po rta tio n c. know the things that are important inside the house
cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm. -The family altogether sleeps inside the main room. The children sleep on the bed while Mr. and Mrs. Panadero sleep on the floor mat. unnecessary things in their house. R: Disposing unnecessary things will help them to maximize their house. 6. Instruct the family not to buy things that are unnecessary. R: If they will add more things in their house the chance is they will be fuller. 7. Instruct the family to clean always the house. R: Cleaning the house will prevent them from getting disease.
C O N C L U S I O N
The family Panadero cannot provide adequate resources for their needs because of their low income. They couldn’t even afford to buy a refrigerator to keep their food fresh. The family member, especially the children are susceptible to the disease that the rats, mosquitoes, and cockroaches may harbor because of the scattered garbage outside their house. Fire hazards in their home shows because cooking facilities are improperly kept outside the house and their house is made up of wood.
