A Family Case Study

Presented To The Faculty of

University of St. La Salle

Bacolod City

In Partial Fulfillment

of the Requirements

for the Subject

NCM 103

Prepared By:

Paulyn Joy C. Bais

BSN3A

Submitted to:

Estela Isabel Villa

RN, MN

August 22, 2016

 TABLE OF CONTENTS

I. INTRODUCTION

II. OBJECTIVES

III. NARRATIVE REPORT

IV. RECORDS AND REPORTS

V. PROBLEMS IDENTIFIED ACCORDING TO PRIORITY

VI. FAMILY CARE PLAN

VII. CONCLUSION AND RECOMMENDATIONS

VIII. BIBLIOGRAPHY AND REFERENCES

I. INTRODUCTION
II. OBJECTIVES

Nurse-Centered Objectives

GENERAL OBJECTIVES:

AFTER TWO WEEKS OF NURSE CLIENT INTERACTION THE STUDENT

NURSE WILL BE ABLE TO:

Apply the learned knowledge in actual home setting in the community, while
demonstrating the skill for providing health care, health promotion and disease
prevention.
SPECIFIC OBJECTIVES

AFTER ONE/TWO DAYS OF NURSE CLIENT INTERACTION THE STUDENT

NURSE WILL BE ABLE TO:

Monitor the present family health status thoroughly and interpret them accordingly.

Identify at least five family health problems.

Formulate a family nursing care plan for the priority family health problem and
conduct a health teaching related to its prevention and treatment.

Client-Centered Objectives

GENERAL OBJECTIVES:

AFTER TWO WEEKS OF NURSE CLIENT INTERACTION, MY CLIENT WILL

BE ABLE TO:

Utilize the teachings and interventions being made by the student nurse regarding
the priority family health problems identified. ]
SPECIFIC OBJECTIVES

AFTER ONE/TWO DAYS OF NURSE CLIENT INTERACTION, MY CLIENT

WILL BE ABLE TO:

Assess the health status of each family member for any deviation.

Identify the problems present and prioritize the urgent one that needs immediate
attention.

Apply the appropriate intervention for the priority family health problem especially
related to its prevention and treatment.
III. NARRATIVE REPORT

A. Family structure and characteristics:

 The Villarte family residing in Purok Mabinuligon is currently composed of three
members only. The mother, who is acting as the head of the family, Milamarie is thirty five
years of age. She has two children, Jason, who is five years old and Chris John, who was
born just last July 30, 2016. The father of Jason does not live with them for they have
already separated. While the father of Chris John has a job that is situated in a far off place.
According to my client, even if they are just small in number, their resources are very
limited and their financial capacities are already stretched and maximized since only the
father is working and the mother is a plain housewife.

With the father being absent, my client usually takes the role of both mother and
father. She usually does everything from the simplest house chores to taking care of the
child with some help from her mother whose house is just adjacent to theirs. Jason does not
have a close relationship with the father since he does not see him much anymore since the
separation. And because of this, the mother is the only one who decides for the childs
well-being. With an absentee father, the Jason lacks the guidance and their foundation as a
family is affected by this. Aside from that fact however, my client and her child are very
close with each other. With my client acting as a nurturer to her child, it is evident that they
are connected by this strong emotional bond. On the other hand, Chris Johns father
usually takes time to visit his son especially during the weekends and he is the one who
provides the needs of their child.

They have been through a lot of challenges however they are still able to overcome
them. Whenever they feel down, they have a strong belief that they can always know how
to get back up. Even with a limited financial resource and an absent father, my client still
believes that she is blessed in their own ways.

B. Socio economic and cultural factors:

My client has no income of her own but states that her parents are the one who are
shouldering for their expenses. Her parents make their own money through selling their
own vegetables from their front yard at the city proper and through other means. According
to her, it is sometimes not enough to provide even just for their basic needs. The money she
gets is spent only on food and her childs education which is more demanding now that the
child is starting Grade 1. Since there was a recent addition to their family, the father of
Chris John is also the one handling the expenses for the newborn such as the diapers and
medications.

Milamarie Villarte is only a graduate of high school which is most likely why her job
prospects are not that good compared with the others. Jason is currently enrolled as a grade
1 student at the local elementary school. And Chris John is still not of school age.

My client does not usually go to church often. However, when they do, they go to the
local Catholic Church near their community. They observe some of the traditions of the
Catholic Church and they also practice the festivals and participate in the different
activities the Church has.
 The current partner of my client is the one who provides for the needs of the child,
while my client is the one who spends time and lives together with the children. Providing
them with their home, food, and whatever needs her child might have.

Today, my client has now become more aware with regards to the community
activities compared to when we just started going to the community. She has become a lot
more active in the different community activities and she is very participative in joining
them. She is also very much close with her other neighbors who is also her relatives.

C. Environmental Factors:

Having a clean surrounding will ensure that the presence of disease from a dirty
environment will be minimal or even absent. My clients house is adjacent to her parents
and it is very advantageous because my client would just usually share their homes
together and it provides more adequate living space. She does not have a lot of furniture in
her own house and when they would sleep they would just usually stay with my clients
parents because they have a bigger space. They have a refrigerator in which they would
store their food and they make use of charcoal for their cooking. My client disposes their
trash through the burning method which is now discouraged for the several effects it can
have to the environment. The presence of pests in the surroundings of my client is
eliminated through their house pets such as cats. A water pump is located within the house
of my client and they would get their water from there. It is for the use of the community
however, we are not sure if the source of water is still sanitary and safe for drinking after
all the years it has been built there. They have their own pour flush toilet which is
unfortunately not kept under sanitary conditions.

My client usually has a clean and organized house. However, since they have a pig in
their front yard, the smell can sometimes be disturbing to others around the neighborhood.
My clients house is only built from light materials and this can prove to be a hazard in
cases of fire.

When it comes to the community facilities such as social health facilities, my client
and her family usually avails of the free programs implemented by their city health unit.
My client also told me that they are assured that they get easy access to the health care
because of the convenience and the proper implementation of the different free medical
check-ups and medicines.

Since the partner of my client is well away from the place where they are living, they
usually communicate through texting. My client and her family has a very harmonious
relationship with their other neighbors. My client has their own TV and radio for their own
leisure and entertainment as well as their method to get updates about the recent
happenings. In case there is a need to go out from their purok, my client usually takes a
tricycle since it is very accessible to their area.
 D. Health assessment of each member:

My client is very vigilant once any member of the family becomes sick. They have
some herbal plants in their garden thats available for use if any of the family members
acquire common ailments such as the flu, cough, diarrhea, and etc. However once the
condition worsens or when the herbal plants do not seem to be taking effect as they should,
they give their rural health unit a visit since its very near their community and its also
free.

They practice good habits such as eating healthy and nutritious foods, specifically
vegetables, since it is practical for them and they also believe that it is excellent in the
prevention of disease. In addition to this, my client also claims to do exercises, such as
walking, that may have helped her in staying healthy and fit.

E. Values Placed on Prevention of Disease

Jason was fully immunized at birth and he still receives from time to time vaccines
from the rural health unit once there is a free or sponsored immunization available. Chris
John is currently receiving his full immunization. My own client was even fully
immunized at birth which goes to show that they put a big value on the prevention of
disease.

One issue I have discovered when I visited the family recently was that there was a
pusong negro beside their source of drinking water. Even with the consistent reminder that
it will result to health problems sooner rather than later, there was no action from my
client. After they have realized the bad effects it will have to their health, they were aware
and scared but still they didnt act on anything to prevent it.

IV. RECORDS AND REPORTS

Home Visit Records

ARAS

Health Teaching Plan

V. PROBLEMS IDENTIFIED ACCORDING TO PRIORITY

FAMILY SIZE BEYOND WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE

CRITERIA COMPUTATION ACTUAL

SCORE
1. NATURE OF HEALTH PROBLEM 2/3 X 1 2/3
HEALTH THREAT

2. MODIFIABILITY OF PROBLEM
1/2 X 2 1
PARTIALLY MODIFIABLE

3. PREVENTIVE POTENTIAL 3/3 X 1 1

HIGH

4. SALIENCE
2/2 X 1 1
A SERIOUS PROBLEM ,
IMMEDIATE ATTENTION

TOTAL 3 2/3
 ACCIDENT HAZARDS (FIRE HAZARDS)

CRITERIA

1. NATURE OF HEALTH 2/3 X 1 2/3

PROBLEM

HEALTH THREAT

2. MODIFIABILITY OF X2 1
PROBLEM

PARTIALLY MODIFIABLE

3. PREVENTIVE POTENTIAL 2/3 X 1 2/3

MODERATE

4. SALIENCE
0/2 X 1 0
NOT A FELT
NEED/PROBLEM

TOTAL 2.33

PRIORITIZE PROBLEM: FAMILY SIZE BEYOND WHAT RESOURCES CAN

ADEQUATELY PROVIDE

CRITERIA COMPUTA ACTUAL JUSTIFICATION

TION SCORE
INADEQUATE FAMILY
1. NATURE OF RESOURCES CAN BE A
2/3 X 1 = 1 2/3
HEALTH THREAT TO THE HEALTH
PROBLEM ESPECIALLY REGARDING
NUTRITION.
HEALTH
THREAT

2. MODIFIABILITY IT IS ONLY MODIFIABLE IF

1/2 X 2 = 1 1
OF PROBLEM STEPS WILL BE TAKEN TO
PREVENT THE FAMILY SIZE
PARTIALLY FROM GROWING.
MODIFIABLE
FAMILY SIZE CAN BE
3. PREVENTIVE 3/3 X 1 = 1 1 PREVENTED FROM
POTENTIAL
GROWING THROUGH
HIGH FAMILY PLANNING.

4. SALIENCE 2/2 X 1 = 1 1 IF THE FAMILY SIZE WILL

A SERIOUS CONTINUE TO GROW,
PROBLEM, THERE WILL BE SHORTAGE
IMMEDIATE FINANCIALLY AND THEY
ATTENTION WONT BE ABLE TO SEND
THEIR CHILDREN TO
SCHOOL.
TOTAL = 3 2/3

3 2/3

VI. FAMILY CARE PLAN

DAT HEALTH FAMILY GOALS OF OBJECTIVES NURSING I

A/ CUES PROBLEM NURSING CARE OF CARE
PROBLEM

SUBJECTIVE Family size Inability to After two After one day Instruct the m
beyond provide a weeks of of nursing son not to p
what family home nursing intervention , of dirty and
resources environment intervention, the child will : the attack of
can which is my client
adequately conducive to will be able 1. Minimi State to the
provide health to recognize ze compliance
OBJECTIVE
maintenance the different playing risk if not ta
HEALTH and personal ways in dirty
THREAT development places
due to which
inadequate can
family cause
resources attack
(financial) of
asthma

2. Compl
y with
the
prescri
bed
medici
ne with
the help
of the
mother.
VII. CONCLUSION AND RECOMMENDATIONS

To be a part and having a closer relationship between me and my client is so

beneficial to the study. Having the opportunity to interact with my client is the best way of
obtaining cues to help identify and prioritize health problems and eventually solve health
threatening and deficit conditions and prevents possible future acquisition of more
diseases.

As to the family involved in the study, family members (especially parents) should
further take note of the following:

Children must be monitored when they do something because failure to do so

may lead to existence of health problems

Balanced diet must be observed.

Parents should be responsible enough to monitor their youngest child

especially in exposing in some allergic area that may cause the attack of asthma

Parents should monitor the regular vitamins of their children.

Considering the environmental factors (especially housing and the

environment outside the house) poor environmental sanitation can hardly be prevented but
strict practice of good personal hygiene by washing hands before and after eating , taking
bath, keeping oneself away from dirty places or making the environment always clean may
reduce or minimize the occurrence of health problems. So parents should not just take it for
granted.

VIII. BIBLIOGRAPHY AND REFERENCES