I.

INTRODUCTION

Diabetes Mellitus is a syndrome of disordered metabolism, usually due to

a combination of hereditary and environmental causes, resulting in abnormally
high blood sugar levels or hyperglycemia. Blood glucose levels are controlled by
a complex interaction of multiple chemicals and hormones in the body, including
the hormone insulin made in the beta cells of the pancreas. Diabetes mellitus
refers to the group of diseases that lead to high blood glucose levels due to
defects in either insulin secretion or insulin action.
Diabetes develops due to a diminished production of insulin in type 1 or
resistance to its effects in type 2 and gestational diabetes. Both lead to
hyperglycaemia, which largely causes the acute signs of diabetes which are
excessive urine production, resulting compensatory thirst and increased fluid
intake, blurred vision, unexplained weight loss, lethargy, and changes in energy
metabolism. The classical triad of diabetes symptoms is polyuria, polydipsia and
polyphagia, which are, respectively, frequent urination, increased thirst and
consequent increased fluid intake, and increased appetite
Patients may also initially present with diabetic ketoacidosis , an extreme
state of metabolic dysregulation characterized by the smell of acetone on the
patient's breath, a rapid, deep breathing known as Kussmaul breathing;,polyuria;
nausea, vomiting and abdominal pain, and any of many altered states of
consciousness or arousal. In severe DKA, coma may follow, progressing to
death. Diabetic ketoacidosis is a medical emergency and requires immediate
hospitalization.
According to the World Health Organization, at least 171 million people
worldwide suffer from diabetes, or 2.8% of the population. Its incidence is
increasing rapidly, and it is estimated that by the year 2030, this number will
almost double. Diabetes mellitus occurs throughout the world, but is more
common in the more developed countries. Diabetes mellitus prevalence
increases with age, and the numbers of older persons with diabetes are expected
to grow as the elderly population increases in number. The National Health and
Nutrition Examination Survey demonstrated that, in the population over 65 years
old, 18% to 20% have diabetes, with 40% having either diabetes or its precursor
form of impaired glucose tolerance.
Patient education, understanding, and participation is vital since the
complications of diabetes are far less common and less severe in people who
have well-controlled blood sugar levels. Wider health problems accelerate the
deleterious effects of diabetes. These include smoking, elevated cholesterol
levels, obesity, high blood pressure, and lack of regular exercise. According to a
study, women with high blood pressure have a threefold risk of developing
diabetes.

II. A. OBJECTIVE OF THE STUDY

This study was being conducted for students of NCM501202 cluster 2 to
identify the problems that is related to health, and be able to let the students
apply the different community health nursing concepts by determining the
problem and applying appropriate nursing interventions, and also be able to
educate and impart the health teachings in promoting health and prevention of
illness, do a proper follow up and monitoring of the family case, be able to do a
referral to the community health provider at the end of the rotation to intervene on
the identified problems.

B. SCOPE AND LIMITATION OF THE STUDY

This study focuses only to the health problems that are being experienced
by the household of Garcia family who are living in zone 6, Baikingon, Cagayan
de Oro City. The scope of the study includes determining the factors that is being
caused by the experienced disease. It includes monitoring health status,
implementing appropriate nursing interventions, giving health teaching that can
be beneficial in the promotion, maintenance and restoration of health among the
family members.

III. FAMILY HEALTH PROFILE : (each member of the households)

Mrs. Cerinia Garcia a 72 years old woman a Barangay Health Worker at
Baikingon. She was married to Roberto Garcia who is a farmer. She had been
diagnosed of having type 2 Diabetes last 2003 when she had her checked up
German Hospital. She had suffered complications such as hypertension, blurred
vision and hypoglycemia. According to her, she experienced seizures when she
had been stressed out throughout the day which causes her blood sugar count to
drop. She had shown us her booklet which contains the list of her blood pressure
and blood sugar count record in every check up. Her blood sugar counts were
inconsistent. On September this year, her blood sugar count was 81 mg/dl, it was
215 mg/dl on the next month and 169 mg/dl was the latest. She had given us the
sample of her medications which includes Captopril for her blood pressure,
Glibenclamide for her Diabetes and Metroformine which is a food supplement.
She was not certain if she had inherited this disease from her parents because
as she stated, Diabetes was not known to them before considering that they
were living in the remote area. As we go along with our assessment and
interview we were able to find out that she had undergone an Extra Capsular
Cataract Lens Extraction twice. The first operation was on 1994 wherein the
cataract on her right eye was removed and on 2001 wherein her left eye was
operated for the same diagnosis.
Mr. Roberto Garcia had impaired skin integrity. His skin looked dry, scaly
and ulcerated which was quiet expected due to the fact that he is a farmer. They
have been blessed with four children who had already had their families and
were living separately from them. Joy Apus, their granddaughter who was born
on April 9, 1990 is living with them. She is 18 years of age and a current 3 rd year
high school student Iponan National High school. Celestino Garcia is also living
with them. He was born on September 12, 1932 and is 76 years old. He is the
older brother of Mr.Garcia and is also a farmer. He suffered from varicose veins.

IV V. CHIEF COMPLAINT & HISTORY OF PRESENT ILLNESS:

Mrs. Cerinia Garcia is a 72 year old Barangay Health Worker married to
Roberto Garcia who worked as a farmer. She is suffering from type 2 Diabetes
Mellitus. She was diagnose having Diabetes Mellitus secondary to complication
to Hypertensive, hypoglycemia, blurred vision and hypoglycemia. Currently, she
is taking medications for her hypertension and Diabetes.

VII. FAMILY SERVICE AND PROGRESS RECORDS

A. Head of the Family

Roberto Garcia

B. Family Members

Cerinia Garcia
Celestino Garcia
Joy Apus

C. Address

Zone 6, Baikingon, Cagayan de Oro City

D. Family Member

E. Names of Family Member

Cerinia Garcia

1. Relation to head

wife

2. Sex

Female

3. Age

72 years old

4. Highest education completed:

Elementary level (Grade 6)

5. Occupation

Barangay Health Worker

6. Type of work

Health Care Provider

7. Place of Work

Baikingon Health Center

8. Religion

Philippine independente

Brother

Celestino Garcia

1. Relation to head

2. Sex

Male

3. Age

76 years old

4. Highest Education completed :

Primary Level

5. Occupation

Farmer

6. Type of Work

N/A

7. Place of work

Farm in Baikingon

8. Religion

Philippine Independente

1. Relation to head

Granddaughter

2. Sex

Female

3. Age

18 years old

Joy Apus

4. Highest Education completed :

3rd year highschool

5. Occupation

None

6. Type of Work

N/A

7. Place of work

N/A

8. Religion

Philippine Independente

VIII. DESCRIPTION of HOME & ENVIRONMENT (ENVIRONMENT PROFILE)

HOUSE
The house is made of nipa and wood. It really looks like a typical
Bahay Kubo. It is mostly made up of bamboos. Mostly of the visitors are
welcomed in the terrace. It has 3 small bedrooms, a mini sala wherein
their dining table is placed. Beside their sala is their kitchen wherein you
will see gallon containers of water which indicates that they dont have a
faucet inside their house. The roof has a whole on it and is not properly
fixed. Their kitchen is a dirty kitchen type wherein they use wood for
cooking.

WATER SUPPLY
They dont have faucet inside their house. They are just getting
their water supply from the spring of the Barangay. They managed to have
their water for drinking stored in a big gallon. The water that they are using
for other things also came from the spring.

KITCHEN
Their kitchen is made up of Bamboos. It is located inside their
house beside their sala. It is a dirty kitchen type and they use fire woods in
cooking their foods.

WASTE DISPOSAL
They have made a compost pit which is situated outside their
house. It is where they throw their garbage. They dont have segregation
of their waste.

DOMESTIC ANIMALS
They have many domestic animals in their house. They seemed to
be a pet lover. They have 2 cows, 3 puppies, 8 chickens and 1 cat.

COMMUNITY
Zone 6, Barangay Baikingon is a rural area. It is 14 kilometers away
from the city. It is such a nice and a peaceful place to live in because it is
environmental friendly and away from pollution. You can see people who
have simple living. The residents are raising lots of domestic animals such
as pigs, cows, goats, chicken and even horses. It seemed that one of their
sources of income is selling barbeque sticks made of bamboo based on
the barbeque sticks that we saw which were made dry outside their
houses. You'll experience good ambiance, but unluckily the roads are not
fully cemented and it is so muddy and slippery most especially during
rainy seasons. The houses are distant from the other. The people living in
the place are all approachable, friendly and very hospitable. But
unfortunately their health center is not accessible because it only opens
every 3rd Monday of the month. The HRDP is situated in this particular
zone. Mostly of the community people are very warm hearted and they
always welcome us with a warm smile.