VI. FAMILY NURSING PLANS
PROBLEM # 1: PRESENCE OF BREEDING PLACES FOR MOSQUITOES, FLIES AND RODENTS 1ST LEVEL ASSESSMENT: Health threat
2ND LEVEL ASSESSMENT: Inability to make decisions with respect to taking appropriate health action d/t insufficient knowledge
Cues Analysis Objective Interventions Rationale Method of
contact Resources required Evaluation S>”Ø O>Presence of open area inside their house > Presence of cockroaches was seen on the kitchen area. > Presence of mosquitoes on the bedroom > Leftover foods were stored in an open can which is just near the vicinity of their house. > stagnant and uncovered The problem of is due to its: > Inability to provide a home environment which is conducive to health maintenance and personal development > Inability To recognize the possible diseases that could be acquired through the presence of rodents, insects or mosquitoes Short Term: After 2 hours of nursing interventions, the family will be able to demonstrate understanding of the health teachings with regards to the possible causes and effects of the presence of these vectors. Long Term: After 3 weeks of home visits, the family will be able to show behavior and compliance on •Assessed condition of the house and level of knowledge •Discussed the possible sources of the presence of rodents, insects and mosquitoes. •Explained to
the family all the possible harmful effects that these vectors can cause to the health of the entire family. • To have baseline data to plan the appropriate interventions to be done. •Knowing the causes of the problem serves as one way to manage it. •To increase their awareness regarding the presence of the breeding sites so as to persuade them in doing actions that would avoid •Home visits •Interview Method •Observation • Health teachings • Time and effort of the student in discussing health teachings and assisting the mother in cleaning the house. • Cooper ation of the family. • use of broom and dustpan Short Term:
The family was able to demonstrate understanding of the health teachings with regards to the possible causes and effects of the
presence of these vectors.
Long Term:
The family was able to show behavior and compliance on measures on how to maintain a clean environment in order to eradicate
drainage system > Inability to produce sufficient financial means to replace the damaged area of the house. > Lack of willingness to do an action due to the fact that they don’t own the house. Thus leaving the problem to the owners. > Owner’s lack of awareness that the problem may cause harm to his/her boarders. measures on how to maintain a clean environment in order to eradicate breeding sites of mosquitoes, flies and rodents. •Assisted the family in cleaning the house, removing the spoiled foods and providing a cover on each trash can so as to avoid breeding places for these vectors. •Encouraged maintaining cleanliness by regular cleaning of the surrounding area of their house. them from acquiring diseases. •To provide initial action necessary for the prevention of diseases that might arise by increasing the family’s awareness through nurses’ initiative. •To prevent vectors to breed breeding sites of mosquitoes, flies and rodents.
PROBLEM # 2: POOR PERSONAL AND DENTAL HYGIENE AND DENTAL 1ST LEVEL ASSESSMENT: Health threat
Cues Analysis Objectives Interventions Rationale Method of contact Resources Required Evaluation S> ∅
O> Upon the assessment made, it was observed that the family members have dirty and untrimmed fingernails and toenails. >The children have dirty clothes. > Children have yellowish teeth, with dental caries > Children is always seen walking without any footwear inside and outside the house. Poor hygienic care is contributed by the family’s Inability to provide a home environment conducive to health maintenance and personal development due to lack of adequate knowledge and skills in carrying out action for proper hygiene regimen. Short Term: After 3 hours of nursing interventions the family will demonstrate understanding on the health teachings given regarding the importance of maintaining proper personal hygiene. Long Term: After 3 weeks of Home visits the family will be able to show compliance on the health teachings given. •Established good working and therapeutic communicatio n among the members of the family. •Stressed the importance of maintaining proper personal hygiene. •Encouraged the children to take a bath everyday in the morning and before going to sleep •Advised the family to • To gain familiarity and to establish a good working relationship with the family.
• In order to motivate them to improve their hygiene. • To provide comfort and soothing feeling which promotes proper blood circulation; cleansing the body helps removes dirt from skin thus protecting them from invading microorganism • To keep free from microorganisms • Home Visits •Interview Method • Obser vation • Time and effort of the student nurses to render proper hygienic care and practices to the family. • Cooper ation of the family members especially the mother. • Use of water, soap, cotton buds, slippers, powder, nail cutter, clean clothes, towel basin, and toothbrush. • PHN bag Short Term: The family was able to demonstrate understanding on the health teachings given regarding the importance of maintaining proper personal hygiene. Long Term: The family was able to show compliance on the health teachings given.
change their clothing regularly, every after bath or when the need excessive sweating in playing or doing household chores) •Instructed the family to trim their finger and toe nails regularly. •Instructed the family to brush their teeth regularly, three times a day is recommende d after eating their meals. •Emphasized causing body odor due to excessive perspiration and unchanged clothes. It is also to prevent complications like pneumonia. • Having untrimmed finger and toe nails carries a higher risk of developing complications. Having dirty nails may lead to parasitism. • When food
sticks longer on the teeth, dental problems may occur such as the build up of tartar, dental caries, and halitosis, etc. • To prevent cross-
the importance of proper hand washing regularly especially: - before eating - after eating - after handling unclean objects - after bowel and bladder elimination •Stressed the importance of wearing footwear in and out of the house. contamination of microorganisms
•
Wearing foot wears reduces the risk of being contaminated with certain microorganisms . It reduces the risk of possible accident like stepping on sharp objects.PROBLEM # 3: POOR ENVIRONMENTAL SANITATION: IMPROPER GARBAGE DIPOSAL
1st LEVEL ASSESSMENT: Health Threat2ND LEVEL ASSESSMENT:
Inability to provide a home environment conducive to health maintenance
Cues Analysis Objectives Interventions Rationale Method of
contact Resources Required Evaluation S: Ø O:>candy wrappers, soiled plastic bags are present and scattered inside the house >absence of garbage containers, inside and outside the house Inability to provide a home environment conducive to health maintenanc e due to: >failure to comprehend the nature of the problem >lack of knowledge on the consequenc es of poor environment al sanitation in one’s health Short-term: After 2 hours of nursing intervention, the family will verbalize understanding of the actual condition that exist within the family and know how of the proper disposal techniques with the consequences of disregarding it. Long-term: After 3 weeks of home visits, the family will demonstrate the use and maintenance of >establish rapport >discuss importance of waste segregation >explain the effects of untidy environment to a healthy living >encourage the family to utilize resources like empty rice sacks or cans as
>to gain the trust and cooperation of the family >Determined products which can be recycled and utilize by the family members like empty bottles and newspapers which can be sold or organic waste material as fertilizer >facilitates the importance of proper garbage disposal system >maximizing the community/family’ s resources while minimizing the cost of Home visits Observation Family resources: >initiative, time and full participation of family members in applying the segregation system >garbage cans and sacks Student-nurse resources: >knowledge , skills and proper attitude in discussing the nature of the Short-term: The family was able to verbalize understanding of the actual condition that exist within the family and know how of the proper disposal techniques with the consequences of disregarding it. Long-term: The family was able to demonstrate the use and maintenance of a clean
a clean environment and proper garbage disposal system in compliance with the health teachings provided.
garbage containers, making sure that they are left covered. >point out the result of piles of garbage settled along the river to the health of the people by using water on the river, adding up to air, land and water pollution.
purchasing garbage containers
>to make the family members realized the consequences of irresponsible throwing of garbage to the riverside which serves s breeding sites of rodents, thereby increasing the possibility of water-borne infection or other diseases.
problem. and proper garbage disposal system in compliance with the health teachings provided.
PROBLEM # 4a: PRESENCE OF COUGH AND COLDS 1ST LEVEL ASSESSMENT: Health Deficit
2ND LEVEL ASSESSMENT: Inability to make decisions with respect to taking appropriate health action due to lack of adequate knowledge.
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S> “Sinisipon at inuubo sila” verbalized by Cuttma O> >Cuttwana has productive cough and colds > Cuttu has colds and productive cough with rales on both lower lobe of the lungs upon auscultation > Cuttri, Cuttfour and Cuttfive have colds. Inability to make decisions with respect to taking appropriate health action due to: a. Lack of adequate knowledge as to alternative courses of action open to them b. Failure to comprehend the nature or scope of problem. Lack of ability to provide a home environment which is Short-term: After 3 hours of nursing interventions in one home visit, the family will be able to demonstrate understanding on the health teachings given regarding on the nature, causative factors and proper management and prevention of cough and colds. Long-term: After 5 days of home visit, the family will be able to show compliance on
•
Established therapeutic relationship with the family.•
Made a thorough assessment of a family member with cough and colds.•
Monitored and recorded vital signs.•
Auscultated the lungs for the presence of adventitious breath sounds such as rales and wheezes.•
Instructed and •To gain familiarity and to establish a good working relationship with the family. •To determine whether the current status of the condition is already progressing or not. •To have a baseline data. •This procedure may indicate presence of mucus plug or airway obstruction. •These Home visits. Interview method Observation •Knowledge and skills of the student nurses. •Therapeutic Communicatio n Skills. •Health teachings rendered. •Participation and cooperation of the family members with the student nurse.•Time and effort of the student nurses and the family
members. •PHN bag
Short-term: The family was able to demonstrate understanding on the health teachings given regarding on the nature, causative factors and proper management and prevention of cough and colds. Long-term: The family was to show
compliance on the
conducive to health and maintenance to personal development due to a. Inadequate knowledge of preventive measures. the management given, practice ways in preventing cough and colds and maintaining clear airway such as instructing the mother to provide children increase fluid intake, take of Vitamin C, adequate rest and instructing the mother to keep her children back dry. teached the family proper coughing and deep breathing techniques.
•
Instructed the family to provide an increase fluid intake•
Instructed the family to provide an increase intake of Vitamin C, which is rich in citrus fruits and orange juice; also to provideadequate rest
•
Instructed the family to keep the back dry.•
Provided health teachings which techniques help mobilize the secretions thus keeping the airway clear. •Increased fluid intake liquefies and loosens secretions thus making it easier to expectorate so as to clear secretions from the bronchial tubes. •To boost the immune system, keep up the body resistance against harmful pathogens and for faster recuperation. •To prevent complications. • To promote healthy living. given, practice ways in preventing cough and colds and maintaining clear airway such as instructing the mother to provide children increase fluid intake, take of Vitamin C, adequate rest and instructing the mother to keep her children back dry.is to emphasize the importance of having proper personal hygiene
•
Instructed and demonstrated to the family the proper way of hand washing.•
Instructed the sick member of the family to cover the mouth when coughing and immediately sneeze out retained secretions in the nose.•
Advised the family to use herbal medicines that could alleviate the •To prevent cross contamination. •Covering your mouth when coughing and sneezing is one way to reduce the risk of spreading contamination. The purpose of immediately sneezing out retained secretions would decrease the risk of potential areas for microorganisms to be contained •Herbal medicines, such as Lagundi and Yerba Buena are advocatedillness.
•
Advised the mother to avail services/ medicine in the health center. by the Department of Health. These herbal plants have its active components which could alleviate the cough and colds. •In order to have the therapeutic treatment that shall address the problem of the family.PROBLEM # 4b: HYPERTHERMIA
1st LEVEL ASSESSMENT: Health Deficit2ND LEVEL ASSESSMENT:
Inability to provide adequate nursing care to the sick
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S> Ø O>The second child has a Inability to provide adequate nursing care to Short-term: After 4 hours of nursing interventions in 1. Established rapport with the family. 1. To gain familiarity and to establish a good working
1. Home visits.
2. Interview
method.
1. Time and
effort of the
student nurses
and the family
Short-term:
The family was
able to
temperature of 38C, flushed skin, warm to touch
>The third child also has a temperature of 38.3C, flushed skin warm to touch
the sick due to: >ignorance of facts about the nature and extent of nursing care needed >Lack of knowledge and skills in carrying out the necessary care.
one home visit, the family will be able to verbalize understanding on the health teachings given regarding the management of fever and ARI and effectively demonstrate such actions afterwards. Long-term: After 2 days of home visit, the family will be able to show compliance on the management given regarding the prevention of ARI and the absence of fever on the members of the family. 2. Made a thorough assessment of the family members with fever, cough and colds. 3. Monitored and recorded vital signs. 4. Instructed and demonstrated to the family the proper way of doing tepid-sponge bath. 5. Instructed the family to take ample rest periods and sleep. 6. Instruct the relationship with the family. 2. To determine the current status of the condition, if it is already progressing or not. 3. To have a baseline data. 4. Tepid-sponge bath is one intervention that promotes heat loss through the process of convection. 5. Activities may worsen condition. It may increase the hypermetabolic state of the body that would in turn increase the body’s core temperature. 6. To promote
3. Observation
members.
2. Participation
and
cooperation of
the family
members with
the student
nurse.
3. Pencil and
paper (for
illustration
purposes).
4. Therapeutic
Communicatio
n Skills.
5. PHN bag.
understanding
on the health
teachings
given
regarding the
management
of fever and
ARI and
effectively
demonstrate
such actions
afterwards.
Long-term:
The family was
able to show
compliance on
the
management
given
regarding the
prevention of
ARI and the
absence of
fever on the
members of
the family.
family to increase fluid intake.
7. Instruct and demonstrate to the family the proper way of doing chest tappings, back rubs and steam inhalation. 8. Instruct the family to have an increase intake of Vitamin C, which is rich in citrus fruits and orange juice. 9.Instruct the family to keep the back dry. 10. Provide health teachings on the importance of adequate hydration and loosen out secretions. 7. Steam inhalation aids in loosening retained secretions in the tracheobronchia l tree. Chest tappings and back rubs help in mobilizing secretions. 8. To increase resistance. 9. To prevent complications. 10. To promote healthy living.
having proper personal hygiene.
11. Instruct and demonstrate to the family the proper way of hand washing. 12. Instruct the sick members of the family to cover the mouth when coughing and immediately sneeze out retained secretions in the nose. 13. Instruct the family about the herbal medicines that could alleviate the illness. 11. To prevent cross contamination. 12. Covering the mouth when coughing
reduces the risk of spreading contamination. Immediately sneezing out retained secretions would decrease the risk of potential areas for microorganisms to be contained. 13. Herbal medicines, such as Lagundi is advocated by the Department of Health in alleviating such. Preparation would include:
for lagundi: boil raw fruits or leaves in 2 glasses of water for 15 minutes, until one glass of gluid is left (decoction). Chop the leaves and strain. Drink the glassful of decoction.
PROBLEM # 4c: MALNUTRITION 1ST LEVEL ASSESSMENT: Health Deficit
2ND LEVEL ASSESSMENT: Inability to recognize the presence of problem due to lack of knowledge
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S>∅ O> Children’s FNRI are said to be Below Normal > Children were thin > Lack of Inability to recognize the presence of malnutrition in a dependent member due to lack of knowledge. > Inability to decide about taking appropriate action due to Short Term: After 3-4 hours of nursing interventions, the family will be able to understand the health teachings given regarding the management of malnutrition such as • Provided information about nutrition through health teachings • Discussed with the family the factors that contributed • Help the family realize the importance of proper nutrition • For family to be aware of the factors that affects and • Home visits. • Interview method. • Observation • Time and effort of the student nurses and the family members. • Participa tion and cooperation of the family members with the student Short Term: The family has understood the health teachings given regarding the management of malnutrition such as emphasizing the importance of eating nutritious
financial resources to provide nutrirional foods for the whole family > Irregular eating pattern (skipping meals) failure to comprehend the nature, magnitude and scope of the problem. Inability to provide Adequate nursing care to the members suffering from malnutrition due to: a. lack of knowledge about the health condition.
b. lack of knowledge on the nature and extent of nursing care needed. c. inadequate resources for care (e.g. responsible family members and financial emphasizing the importance of eating nutritious food like vegetables and avoid junk foods. Long Term: After five days of home visits the family will exhibit proper ways in prioritizing what food selection is appropriate to meet the necessary needs in order to achieve a desirable body weight. And to promote good nutritional habits. to inadequate nutrition. • Stressed the importance of good nutrition and how to achieve it. • Taught the mother to prepare nutritious food for family that are within their capability to produce. • Discussed to
the family the importance of proper food selection to the family • Advised them to avoid eating junk foods •Instructed the may affect their health. • To give information about malnutrition. • To provide well balance diet and to increase body resistance • to encourage the family to implement proper food selection • to prevent lessening appetite nurse. • PHN bag food like vegetables and avoids junk foods. Long Term: The family exhibited proper ways in prioritizing what food selection is appropriate to meet the necessary needs in order to achieve a desirable body weight. And to promote good nutritional habits.
mother during meals • To lessen financial expenses, thus providing more for the family
.
PROBLEM # 5: DIARRHEA
1st LEVEL ASSESSMENT: Health Deficit
2ND LEVEL ASSESSMENT: Inability to recognize the presence of the problem
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S: “nagtatae si cutfive at ang nanay ko” as verbalized by the cutma O: Cutfive: o Defecated three times o Watery stool o Yellowish in color Inability to recognize the presence of the problem due to: >inadequate knowledge about the consequenc es of the problem >inadequate financial Short-term: After 4 hours of nursing interventions in one home visit, the family will be albe to verbalize understanding on the health teachings given regarding the >made a thorough assessment of the family members with diarrhea
>vital signs taken and recorded >instructed the family to avoid solid food intake >instructed to limit >to determine the status of the condition if it is already progressing or not. >to get baseline data > to reduce intestinal workload >to prevent
Home visits
1.time and effort of the student nurses and the family members. 2.participation and cooperation of the family members with the student nurses Short-term: The family was able to the verbalize understanding on the health teachings given regarding the management of diarrhea and effectively demonstrate each actions such as how toCutla: o Defecated two times o Watery stool o Greenish in color o Moderate in quantity o Weak ness o pale resources to treat the problem management of diarrhea and effectively demonstrate each actions such as how to make oral rehydration solution.
Long term:
After 2 days
of home
visits, the
family will be
able to show
compliance
on the
management
given
regarding
the
prevention
and absence
of diarrhea
caffeine and high fiber foods, and avoid milk & fruits >instructed to increase fluid intake
>taught them how to make oral rehydration solution: 1 tbsp salt, 8 tbsp sugar, 1l of H2O >instructed the mother to handle foods properly >stressed proper handwashing promotion of diarrhea >to prevent dehydration > to overcome dehydration >to prevent diarrhea >to prevent cross-contamination 3.therapeutic communicatio n skills. make oral rehydration solution. Long-term: The family was able to show compliance on the management given regarding the prevention and absence of diarrhea
PROBLEM NO 6a: POTENTIAL FOR PARASITISM
1ST LEVEL ASSESSMENT: Health threat2ND LEVEL ASSESSMENT: Inability to take appropriate health action d/t lack of adequate knowledge
Cues Analysis Objective Interventions Rationale Method of
contact
Resources Required
Evaluation S> Ø
O> with dirty and untrimmed finger and toe nails > abnormally large abdominal girth > children is always seen walking barefooted in and out of the house > children were seen eating without even washing their hands Walking barefooted, having dirty and untrimmed finger and toenails and placing the toys towards the mouth are health threats that carries a very high risk of the developmen t of parasitism. This is due to the low salience of the family towards the occurrence of such. Short-term: After 3 hours of nursing interventions in one family visit, the family will be able to verbalize understanding on the heath teachings in preventing the potential for parasitism. Long-term: After 3 days of home visit, the family will be able to demonstrate and show compliance on the interventions to control the potential for 1. Established rapport with the family.
2. Discussed with the family the importance of wearing foot wears in and out of the house.
3. Discussed and demonstrated the proper way of hand washing, before and after eating and after defecating. 4. Advised the family to visit the health center in order to seek proper medical attention to get medications that would disinfestate the children. 1. To gain familiarity and to establish a good working relationship with the family. 2. This practice promotes hygiene and decreases the occurrence of diseases. 3. To prevent cross contamination . 4. In order to have the therapeutic regimen that 1. Home visits. 2. Interview method. 3. Observation 1. Time and effort of the student nurses and the family members. 2. Participation and cooperation of the family members with the student nurse. 3. Pencil and paper (for illustration purposes). 4. Therapeutic Communicati on Skills. 5. PHN bag. Short-term: The family was able to verbalize understanding on the heath teachings in preventing the potential for parasitism. Long-term: The family was able to demonstrate and show compliance on the interventions to control the potential for parasitism.
More so, lack of financial resources led to the problem’s occurrence.
parasitism. shall address
the problem of the family.
PROBLEM # 6b: PRESENCE OF ACCIDENTAL HAZARDS 1ST LEVEL ASSESSMENT: Health Threat
2ND LEVEL ASSESSMENT: Inability to take appropriate health action due to failure to comprehend the scope of problem
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Expected Outcome S> ∅ O> The ceiling of the house is quite worn off > Presence of sharp rusty edges at the entrance of the house > Presence of woods for cooking are located in their kitchen area. > Facility for heating is placed in the kitchen where fire is not Inability to make decisions with respect to taking appropriate action due to: >failure to comprehend the nature, scope/magnitud e of the problem >limited financial resources Short Term: After 2-3 hours of home visits the family will be able to recognize the presence of the existing problems and identify ways in eliminating accidental hazards present inside the house. Long Term: After five days of home visits, the family will show
adherence in the teachings given as evidenced by getting rid of all the possible accident
•
Discussed to the family the presence of the accident hazards inside their home.•
Discussed and elaborate to the family all the possible consequence s that may come about from having these accident hazards in their home environment.•
Taught the family to become resourceful •To increase awareness among the members of the family. •Members realize the bad outcome of these accident hazards thus prevent possible occurrences. •This prevents the unnecessary use of their • Home visits •Interview Method • Observa tion • Time and effort of the nurse and the family members. • Participation and cooperation of the family members with the nurse. • Equipments to be used are electric tape, excess plywood, nails, hammer Short Term: The family was able to recognize the presence of the existing problems and identify ways in eliminating accidental hazards present inside the home.Long Term: The family showed adherence in the teachings given as evidenced by getting rid of all the possible accident hazards and shall develop solution to solve
controlled because of the use of woods. > Presence of pointed nails on the wall
hazards and will develop solution to solve the existing identified problem corresponding to their available resources.
and use only what physical resources they have and try to recycle them such that they may be able to utilize them in eliminating accident hazards like unused pieces of woods in correctly sealing the open and unsafe area.
•
Helped the family in placing properly the sharp and dangerous objects/materi als at a level where children cannot reach.•
Helped the family to bend the sharp edges of the limited finances and also enhances their capability in handling possible hazards and corrects them. •To reduce the risk for cuts andlacerations.
•To reduce the risk for cuts and lacerations. the existing identified problem corresponding to their available resources.
toilet door.
•
Instructed the family to move their cooking facility outside the house. •This is to prevent fire and to prevent smoke inhalation.PROBLEM #6c: LACK OF FOOD STORAGE FACILITIES 1st LEVEL ASSESSMENT: Health Threat
2ND LEVEL ASSESSMENT: Inability to recognize the presence of problem due to inadequate knowledge
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S> ∅ O:> the family has no refrigerator >they have no cabinet for food storage >leftover foods left on the table without cover Inability to recognize the presence of the problem due to: >inadequate knowledge about the consequences of the problem >inadequate financial resources to avail food storage facilities Short-term: After 2 hours of nursing intervention, the family will be able to demonstrate understanding on the importance of proper storage of food such as instructing the family members to cover their food. Long-term: After five days of home visits, the family will be able to show compliance with the health teachings
•
Established therapeutic communication with the family•
Discussed to the family the possibilities of contaminating the food if not properly stored.•
Explained the possible consequences and complication that they may acquire from contaminated food due to improper storage.•
Encourag ed covering food properly • To gain the trust and cooperation of the family•
To develop awareness to the family about the problem and intervene about it. • To increase their awareness that this could bring about complication s to their health • To prevent easy spoilage and • Home visits • Interview Method • Obser vation • Time and effort with the cooperation and participation of the family and student nurse. • Plates and plastic food covers Short-term: The family was able to demonstrate understandin g on the importance of proper storage of food such as instructing the family members to cover their food. Long-term: The family was able to show compliance with the health teachings given on proper foodgiven on proper food storage. with plates or any available and appropriate cover. contaminatio n of foods. storage.
PROBLEM # 7: FAMILY SIZE BEYOND WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE 1ST LEVEL ASSESSMENT: Health threat
2ND LEVEL ASSESSMENT: Inability to recognize the magnitude of the problem d/t inadequate knowledge
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S> O> cutdad only had a temporary or seasonal job as a farmer. >his income is not enough to support the whole members of the family (around 100 pesos per day)
>he has low educational attainment, thus it is difficult for him to find a more stable job. The problem arises due to the country’s low economic progress which has a greater impact on some families who strives hard to a better living. Another reason is that improper budgeting could lead to improper allocation of the financial resources. . Short Term: After 2 hours of Home visit the family will demonstrate understanding and realization on the effect of having inadequate financial resources to meet the needs of each in the family members. Long Term: After 3 weeks of Home visits the family members will employ the means of improving their resources they have identified. •Discussed the effects of improper budgeting of financial resources. •Advised family members to practice proper utilization of finances by avoiding purchasing of unnecessar y things. •Assisted the family members especially the mother in prioritizing the needs • To increase their awareness on the possible effects of having inadequate resources • In order to ensure proper allocation of their scarce resources in meeting the needs of the family members. • In order to avoid mismanageme nt of their already • Home visits • Interview Method • Observ ation • Time and cooperation of the family members. • Necessary teachings given to the family. Short Term: The family was able to demonstrate understanding and realization on the effect of having inadequate financial resources to meet the needs of each in the family members. Long Term: The family members were able to employ the means of improving their resources they have identified.
of the family members
inadequate resources.
PROBLEM # 8a : POOR HOUSING CONDITION: INADEQUATE VENTILATION 1ST LEVEL ASSESSMENT: Health Threat
2ND LEVL ASSESSMENT: Inability to provide a home environment conducive to health maintenance due to inadequate resources
Cues Analysis Objectives Interventions Rationale Method of
Contact Resources required Evaluation S> ∅ O>Presence of one window for the whole house. > Flow of air is inadequate because of only one window. Inability to provide a home environment conducive to health maintenance and personal development due to: >inadequate family resources especially financial constraints/ limited resources. Short Term: After 2-3 hours of nursing intervention, the family will be able to identify possible result or consequences of the existing problem. Long Term: After five days of home visits, the family will be able to show improvement in the maintenance of adequate ventilation inside their house such as •Discussed to the family the importance of good ventilation •Removed the things the blocks the passage of air coming from the window. •Instructed the family to open the windows as frequently as possible •Instructed the family •Reinforcement of knowledge increases awareness of the existing problem •To provide adequate amount of air that will flow inside the house. •To prevent any suffocation or exhaustion due to inadequate supply of oxygen •To allow adequate • Home Visits • Interview Method • Observation • Knowledge of the student nurses • Cooperation of the family members. Short Term: The family was able to identify possible result or consequences of the existing problem. Long Term: The family was able to show improvement in the maintenance of adequate ventilation inside their house such as instructing them not to
instructing them not to block the window and always tie the curtains. sees to it that the window curtains are tied •Encouraged the family whenever possible to have an additional window •Advised family members to wear loose clothing as this provides comfort ventilation inside the house. •To improve the ventilation inside the house. •Minimizes diaphoresis or over sweating thus providing comfort and feeling of freshness block the window and always tie the curtains.
PROBLEM # 8b : POOR HOUSING CONDITION: INADEQUATE LIGHTING CONDITION 1ST LEVEL ASSESSMENT: Health Threat
2ND LEVEL ASSESSMENT: Inability to provide lighting due to lack of financial resources and magnitude of problem.
Cues Analysis Objective Interventions Rationale Method of
contact Resources Required Evaluation S>∅ O>Presence of one incandescent bulb in the entire house.
> A car battery is used as their source of electricity.
> The house has only one window which the light can pass through.
Inability to provide adequate lighting in the house. There is insufficient light inside the house because there is only 1 window open. Moreover, they have 1 incandescent light which is supplied from a car battery for the entire house which cannot supply enough light during nighttime. This reason can be traced from such as lack of financial resources and Short Term: After two hours of nursing interventions the family will be able to demonstrate comprehension on the importance of adequate lighting. Long Term: After five days of nursing interventions the family members will be able to maintain good lighting condition. • Opened the door. • Encouraged the family to remove all things which block the window and throw the things which are not needed. • Explained to the family the effect of poor lighting especially to their vision. • Explained the significance • To facilitate the passage of light. • To facilitate the passage of light. • To increase their awareness on the consequenc es of poor lighting • To let them understand the relation • Hom e Visits •Interview Method • Obse rvation • Knowledge and time of the student nurses. • Cooperation of the family members. Short Term: The family was able to demonstrate comprehension on the importance of adequate lighting. Long Term: The family members was able to maintain good lighting condition.
they can’t afford to buy a fluorescent light. This problem may also be due to the lack of knowledge about the advantage of sufficient lighting. of good lighting in relation to health and safety of health to their lighting system
FAMILY NURSING CARE PLANS
Problem No. 1: Health Deficit – Presence of Coughs and Colds
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTION RATIONALE METHOD OF FAMILY CONTACT RESOURCES REQUIRED EXPECTED OUTCOMES S - “ubo at sipon lang ang hindi naaalis sa bahay na ito” as verbalized the mother O - Aqua Inability of the family to provide nursing care to its members due to insufficient knowledge about nature SHORT TERM: -After 2 hours of home visits, Close-Up will verbalize understanding on the health teaching about measures on >assess the family’s knowledge regarding their present condition >explain to the family the effect of this problem to their health >to acquire necessary information and know where to start >to develop awareness and initiates action in >Home visits >Giving health teachings >Observation >Interview >The student nurses time knowledge and skills. >Family's cooperation. Material Resources: List of cheap SHORT TERM: After 2 hours of home visits the family shall have
verbalized understanding on the health teachings and shall have demonstrated
Fresh, Unique and Kutitap have coughs and colds during the home visits. Aqua Fresh is always experiencing colds which is clear in consistency, while Unique and Kutitap have been experiencing their colds for 3 days which is also clear in consistency. and management of the health condition or attitude towards the health of its member. how to alleviate as well to prevent this problem and will be able to demonstrate effective expectoration or clearing secretions. LONG TERM: After 2-5 days of home visit the family will
show compliance to
the health teaching given
>discuss with the family members
the nature and signs and symptoms of the problem >encourage to increase fluid intake >instruct the family regarding proper hand washing controlling this problem. >to actively understand the transmission of infection and on how to prevent its occurrence >to loosen excessive secretions >hand washing is an effective way in preventing transmission of microorganism accessible fruits rich in Vitamin >Community resources: Health Center effective expectoration or clearing of secretions. LONG TERM: After 2-5 days of
home visits the family was able
to show compliance to
the health teachings given
>instruct the family to provide
the fruit juices available in the community, like calamansi juice
>instruct the parents to visit the health center
if symptoms of cold persist
>provide adequate rest and sleep to the
children >advise the family to maintain >foods rich in vitamin C prevent further infection >this is to detect serious conditions which need immediate medical attention >to conserve energy that is needed to increase body’s resistance >to maintain and promote
personal hygiene
> instruct the family to keep
away from allergens like dust
>instruct the family to cover the mouth and
nose when coughing with clean cloth >advice the mother to keep the children in good health and prevent bacteria that causes diseases >to avoid aggravation of the disease >to prevent contamination among the family members since there is inadequacy in the living space >to provide optimal lung expansion for
Semi-fowlers position and demonstrate effective deep breathing exercise when coughing >encourage the mother to change clothes when wet and keep back
dry
>if signs and symptoms persist, encourage the mother to seek physician’s help easy expectoration and keep and maintain an open airway to breath normally > to prevent any complication and to promote comfort
>to lessen the chances of worsening or
aggravating the situation
Problem No. 2.33: Health Threat – Presence of Insects
CUES ANALYSIS OF THE OBJECTIVES NURSING INTERVENTIONS RATIONALE METHOD OF FAMILY RESOURC ES EXPECTED OUTCOME
PROBLEM CONTACT REQUIRED S - “Malamok
nga dito eh, ipis meron din. Kompleto pati alupihan” As verbalized by mother. O - Presence of mosquitoes and roaches. >Presence of junks below the house structure. > Opened plastic garbage container. >Inability to make decisions with respect to taking appropriate health action due to inadequate knowledge/ insight as to alternative courses of action opens to them. > Inability to provide a home environment , which is conducive SHORT TERM: After 2 hours of family-nurse interaction, the family will verbalize and be able to identify the diseases that these vectors might cause if not given attention. LONG TERM: After 3 days of home visit, the family will be
able to do some measures to
get rid the
>Assess the salience of the family toward the
problem in poor environmental
sanitation
>Listen the family mention the measures they are doing in controlling rodents and mosquitoes >Provide health teachings on the importance of clean environment
>Discuss with the family the diseases that these vectors might cause >To have a baseline data of the health teachings to be provided >To know which measures will be supported and encouraged
>To inspire the family to clean environment often >To provide them knowledge about the possible >Home visits >Observation Interview >Health teachings >Time and knowledge and skills of the student nurses >Cooperati on of the family SHORT TERM: After 2 hours of family-nurse interaction, the family should have identified the diseases that they possibly acquire if they don’t get
rid of these vectors. LONG TERM: After 3 days of home visit, the family was able to do some measures to
to health maintenanc e and personal developmen t due to inadequate family resources specifically financial constraints and limited physical resources. breeding place of insects. >Encourage the family to clean every corner of their house including the outside of their house >Instruct them to remove any stagnant water >Instructed the family to remove the junks surrounding their house
>Instruct the family
disease these pests may
bring
>To get rid of the breeding places where
roaches and mosquitoes love to stay
>To get rid of the breeding
site of mosquitoes
>To keep the surroundings
free from propagation site of insects.
>To remove a
get rid the breeding
place of insects.
to remove the hanging clothes inside the house
>Encourage the family to sleep with
a mosquito net
>Encourage the family to make use
of cheap pesticides like chalk pesticides
>Encourage the family to clean the
house and the surroundings frequently surrounding where mosquitoes love to stay >To protect them from contact or bite of insects
>To kill and control the
pests
>To prevent the breeding of
insects
Problem No. 2.33: Family Size Beyond What Family Resources Can Adequately Provide
CUES ANALYSIS OF
THE PROBLEM OBJECTIVES
NURSING INTERVENTION RATIONALE METHOD OF FAMILY CONTACT RESOURCES REQUIRED EXPECTED OUTCOMES
S - “wala man kaming naiipon” verbalized the mother O - the family is composed of eight members. the breadwinner is the father who earns an average of P400 a day for a total P12000 a month. according to National Economic Development Authority, a family must have a budget of P2,768.60 per member in a month. Inability to provide a home environment conducive to health maintenance and personal development due to inadequate family resources, specifically limited physical resources SHORT TERM: After 3 hours of nursing intervention,
the family shall recognize the existence of the problem and its
effects.
LONG TERM: After four home visits, the family will practice
proper budget allowance to meet the
needs of each member.
>assess the mother’s knowledge regarding
budgeting
>interview mother about the current family
budget
>explain the importance of proper budgeting
>encourage mother to continue utilizing family
planning
>show sample budgets appropriate for the monthly income of the
family
>give examples of
>to know other underlying cause of
the said problem
>to have a basis of the other nursing
interventions
>to let the family receive good benefits from the least of the income
>to prevent increasing the severity of the
problem
>to show the mother other alternatives >Home visit >Health teachings with demonstration >Interview >Observation >Utilized family’s available resources and sample budget meals. >Resources from the: -nurse -family -community SHORT TERM: After 3 hours of nursing intervention, the family shall have recognized the existence of the problem and its
effects.
LONG TERM: After four home visits, the family
shall have practiced proper budget allowance to meet the needs of each member.
cheap meals with high nutritional content
>advise the family to use their money wisely and buy things that are
needed
>provide the family with information regarding
different methods in earning extra money
such as recycled papers and bottles
>help the family plant backyard vegetables
such as malunggay, eggplants, etc.
>encouraged the family to prioritized their needs
>to give the mother an idea about nutritious but cheap
meals
>to have money in case of emergency
>to inform the family of the different options in order to have extra
income
>to minimize the expenses spent on
foods at the same time, these are also
from wants
>instruct the family to have a list when buying
foods
nutritious
>this will facilitate them to spend their
money wisely
>to avoid buying unnecessary stuffs
Problem No. 2.33: Poor Housing Condition – Inadequate Living Space
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTION RATIONALE METHODS OF FAMILY CONTACT RESOURCES REQUIRED EXPECTED OUTCOME S – O O – the house measurement is as follows: -length: 93 inches -width: 115 inches there are no available > Inability to make decision related to taking appropriate action to lessen the effects of the problem. > Inability to SHORT TERM: After one home
visit the family shall recognize
the problem and the risk of
having inadequate living space to their health. >assess the family’s awareness regarding the situation >explain to the family the risks of acquiring diseases due to
inadequate living space
>to know what are the appropriate interventions to
be made
>to let the family understand and identify possible illnesses/ > Home visits with Health Teachings > Home Management > Interview >Observsation >Availability of both student nurse and the
family members >Cooperation of the family > Health Teachings SHORT TERM: After one home visits the family shall have recognize the problem and the risk of having inadequate living space to
furniture since there is no place to accommodate them provide home environment conducive to health enhancement related to inadequate living space LONG TERM: After four home visits the family shall be able to practice house management that would help
them increase the living space
capacity > suggest furniture arrangement that may increase the living space capacity and remove unnecessary objects. >advise the father to do some fixing in removing stuffs
that covers the door diseases that can be acquire by an overcrowded house. > to increase the living space
in the house >to promote manpower and improve ventilation as well their health. LONG TERM: After four home visits the family was
able to practice house management that would help them increase the living space capacity
>provide the family with the
alternative solutions they can use in response to the problem >encourage the mother to maintain the cleanliness and always open the
window and door during day
time >advise the family to do all important activities at daytime
>help the family
>to promote decision-making and self
reliance
>to allow air to pass through, thus improving
ventilation
>to prevent the risk for injury
in arranging the items inside the
house >encourage frequent cleaning of the house and proper arrangement of the equipment inside >discuss the possible untoward consequences that may result from having inadequate living space such as cross-contamination of sincerity in improving the health of the family > to minimize cross contamination and spread of microorganisms
>to realize the end result of having inadequate living space to prevent spread of disease and accidents to the family
a disease from one family member to another >explain to the mother the significance of an adequate living space >to provide awareness of having adequate living space
Problem No. 3: Home Condition – Inadequate Water Supply and Facility
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTIONS RATIONALE METHOD OF FAMILY CONTACT RESOURCES OF REQUIRED EXPECTED OUTCOME S – “Yung lumalabas na tubig sa gripo pag
minsan nangangalawang.”
O – There is no faucet inside the
bathroom. The pipes are old and
Inability of the family to solve the existing problem. This is because the family’s income is not SHORT TERM: After 2 – 3 hours of home visit the
family will recognize the importance of water storage and the > Assess the family’s understanding regarding the situation > Encourage the family to boil their
drinking water
>To gather the necessary information & to know where to start intervening > To kill the water borne molecules and >Home visits >Observations ->Health Teachings >Time effort with participation of the family and student nurse. >Health Teachings. SHORT TERM: After 2 hours of nursing interventions, the family shall have verbalized understanding the
rusty. The only source of water present is found behind the house which is shared by 3 families. adequate to install their own water supply, they have to walk to fetch or go outside their house to get water. proper way of acquiring safe and steady water supply at home. LONG TERM: After 2-5 days of home visit, the family will
show compliance to the health teachings given. >Explain to the family the effect of this problem in their health >Explain to the family the possible water borne diseases
that they can acquire from the
problem
>Suggest technique that may help prevent the occurrence of borne illness like boiling of water before drinking and use of filters
microorganisms >To develop awareness and initiate action in controlling this problem
>To let the family know the
risk they are into if the problem is not given proper attention >To decrease the risk of contracting diseases caused by dirty and unsafe drinking water importance of water storage and practice proper way of acquiring safe and steady water supply at home. LONG TERM: After 2 -5 days of home visits, the family shall have complied with the health teachings given.
>Encourage the family to store their water in a clean container with cover >Encourage the family to secure more containers and fill it with
water
>Suggest to make their pitcher pump
>To have an adequate supply of clean
water
>To lessen the time of going to
their house to fetch water
>To have free and available
water supply
Problem No. 4.33: Condition – Lack of Food Storage Facilities
CUES ANALYSIS OF THE
PROBLEM OBJECTIVES NURSING INTERVENTION RATIONALE METHOD OF FAMILY CONTACT RESOURCES REQUIRED EXPECTED OUTCOMES S - ”Yung mga natitirang ulam
Inability to make decisions with respect to taking appropriate health action due to failure to comprehend
SHORT TERM: After 2 hours of nursing interventions the >Discuss the significance of having a food storage facility
>To be aware of its effect on the daily living of the
family >Home visit >Health teachings with demonstration >Participation and cooperation of the family SHORT TERM: After 2 hours of home visit the family
linalagay naming sa party box” as verbalized by the mother O - Presence of detergent powder and bans on the food storage facility. Some leftovers are not properly covered.
the nature/magnitude of the problem/condition and low
salience of the problem/condition. Inability to provide a home
environment conducive to health maintenance and personal development due
to inadequate family resources limited financial
resources.
family will verbalize understanding of
the appropriate storage facilities and its significance and the proper way of preparing and
handling food.
LONG TERM: After 2-6 home visits the family will
be able to demonstrate compliance to the health teachings given by correct arrangement of food on the storage
facility and the proper way of preparing and handling food.
>Discuss correct placement of food within the storage
facility
>Encourage frequent cleaning of the storage facility
>Assist in cleaning the storage facility
>Site examples of good storage facility
>Suggest alternatives that the family can
utilize
>To prevent cross-contamination of
food
>To prevent cockroach egg or
other vectors to nest within the storage facility
>To show sincerity of the nurses in
alleviating this problem
>Offer affordable alternatives
>To let the family decide which alternative to use
>To let the family
>Interview >Observation >Knowledge and skills of the student nurses >Health teachings verbalized understanding of the appropriate storage facilities and its significance and the
proper way of preparing and handling food.
LONG TERM: After 2-5 days of
home visits the family shall have
demonstrated compliance to the health teachings given by correct arrangement of food on the storage facility and the proper way of preparing and handling food.
>Identify options for financial assistance
>Assist family to develop a plan for maintaining a clean, healthful environment
take the initial step in avoiding all the
risk
>To create or maintain a safe, growth-promoting
environment
Problem No. 4.33: Poor Home Condition – Poor Lighting
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTIONS RATIONALE METHOD OF FAMILY CONTACT RESOURCES OF REQUIRED EXPECTED OUTCOME S – O O - >upon entering, a person can’t read properly >windows are obstructed which means there is blocking in the Knowledge deficit r/t lack of knowledge on the importance of proper lighting to prevent poor living standards SHORT TERM: After 2-3 days of home visits, the family will
be able to verbalize importance of proper lighting.
>Assess the living condition of the
family
>Discuss how inadequate lighting may affect
their health especially their eyesight as well >To have a baseline data >For the family to gain knowledge so as to prevent eye Home visits Participation and cooperation of the family SHORT TERM: After 2-3 days of home visits, the family shall have verbalized the importance of proper
passage of light even at daytime
>uses incandescent bulb less than 50 watts
or 20-40 watts fluorescent bulb and eye straining. LONG TERM: After 5 days of home visits, the
family will be able to show compliance with regards to having adequate lighting in the house. as to their living standards. >suggest to make two more windows one on
the 1st floor and
2nd floor >suggest to buy a light bulb >suggest to make a small transparent roof >instruct the family to use the
space in front to straining that leads to poor living standards. > to facilitate the coming of light from the sun > to properly see all the
materials inside the house >to facilitate the entry of light >to have an adequate space to lighting. LONG TERM After 5 days of home visits, the family shall have shown compliance with regards to having adequate lighting in the house.
make hanging wire
>suggest to the father to make a
closet to make room for their clothes which are
hanged on the walls >Stress the importance of lighting in performing some activities. >Advise the family to do all important activities at day lighten up the whole house > to have a adequate light of the house >To help them realize the need for
lighting source especially at
night.
>To prevent the risk for
injury or accidents
time.
>Encourage family to remove things that block the entrance of light. >Encourage the mother to maintain the cleanliness and always open the
window and the door at daytime. >Encourage the family to add a window or a light bulb if their resources would allow. > Provide the during night. >To allow entrance of enough light to the house.
>To allow air to pass through thus it helps in ventilation. >To improve adequacy of lighting. >To promote
family with the alternative solutions they can
use in response to the problem
>Advise the father to do some fixing
and removing stuffs that cover
the door. decision-making and self-reliance. >To promote man-power and improve ventilation
Problem No. 4.33: Poor House Condition – Lack of Toilet Facility
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTION RATIONALE METHOD OF FAMILY CONTACT RESOURCES REQUIRED EXPECTED OUTCOME S - “ilang pamilya kaming gumagamit diyan, minsan kailangan naming maghintay” This condition affects the family because they are susceptible to infectious diseases SHORT TERM: After 2-3 hours of home visit the family will
be able to verbalize understanding of the importance of >explain to the family the effect
of this problem to their health. > discuss to family the importance of >to develop awareness and initiate action in controlling this problem. >to provide proper knowledge among the >Home visits >Observations >Health teachings >Interview >Cooperation of the family members. >Time and effort of the student nurse. >Health SHORT TERM: After 2 hours of nursing interventions the family shall
verbalized understanding
of the importance of
verbalized the mother O – the family is sharing their toilet with other families nearby because of lack toilet facilities. having a toilet facility and recognize the diseases that may be brought by the presence of this problem and health teachings given LONG TERM: After 2-5 days of home visit the family will
be able to demonstrate compliance to health teachings given.
having their own toilet facility.
>discuss to the family the
possible diseases they can acquire like
UTI, diarrhea, etc. >encourage them to practice proper hand washing >involve in appropriate community education programs members of the family.
>to prevent the occurrence of certain disease >to prevent cross-contamination within the members of the family. >to increase awareness of spread/prevention of communicable diseases.
teachings. having a toilet facility and recognized the diseases that may be brought by the presence of this problem and health teachings given. LONG TERM; After 2-5 days of home visits the family shall
have demonstrate compliance to health teachings given.
>identify resources available to the
family
>note age and sex (children,
young adult, elderly persons,
and men are at greater risk) >evaluate family’s response to violence in the surroundings >note socioeconomic status/availability and use of resources >to reduce/correct existing risk factors > to evaluate degrees/source of risks inherent in the family situation >may determine ability to access health for identified problem >indicator for need for information, assistance with making positive changes,
>ascertain knowledge of needs/cross-contamination prevention and motivation to prevent diarrheal diseases >encourage the users to clean and disinfect the
toilet after using
promoting safety and a sense of security >helps client to identify what is really based >to prevent cross-contamination
Problem No. 5: Lifestyle and Personal Habits/Practices: Walking Barefooted or Inadequate Footwear
CUES ANALYSIS OF THE PROBLEM OBJECTIVES NURSING INTERVENTIONS RATIONALE METHOD OF FAMILY CONTACT RESOURCES OF REQUIRED EXPECTED OUTCOME S - “marami naman kaming mga inability to recognize the SHORT TERM: After 2 hours of home visits, the
>assess family’s understanding with regards to >to know where to start and to know >home visits >interview knowledge, time and effort
of the student
SHORT TERM: After 2 hours of home visits, the
