IX.

SCHEMATIC PRESENTATION OF FAMILY HEALTH PROBLEM

FAMILY HEALTH

Socio-Cultural Factors

Biological Factors

Environmental Factors

SOCIO-CULTURAL

Economic

Political

Cultural
Family believes that herbal medicines as remedy for minor illness like cough & colds but also seek medical consultation in health center & other institution if symptoms persisted & worsen. Before seeking medical assistance they submit self to a hilot. Because they believe that illness might be due to panohut or piang.

Mother
Educational attainment: High school grad graduate graduate Shes a full time house wife with 3 children

Father

Educational attainment: high school

grad

He sells barbeque sticks: 2500php/m o

The family utilizes a democratic type of governance within their house, the father, the mother and the two elder members shares freely their ideas, judgments, and opinions in making any decision concerning matters in their family. Dong diri sa amo panimalay, tanan adunay tingog, demokratik mi diri, ipatingog ang tanan-diin kung unsa ang pinakamaayo mao ang amo ginasunod ug ginabuhat as verbalized by the mother. Each respects each others opinions and views regarding matters in their living and matters concerning Margies Harmonious relationship

The family usually eats in bare hands especially children.

Prone to diarrheal disease

Income: Php 2,500 /mo. Inadequate Family Resources

Family size beyond what family resources can adequately provide as a

Prone to mismanagement of illness. Poor personal habits/practices specifically

delay of medication as a Risk of acquiring diarrheal disease as a

Health

Health Threat

Health Threat

threat

BIOLOGICAL

Genetic

Physical

Psycho-Social

Mr. George has

familial disease of kidney problem in the maternal side.

Mrs. Beberlyn has familial disease of Cleft palate in the maternal side.

Unke pt Hair Took a bath every1-2 days A lack of personal hygiene is a breeding ground for bacterial growth.

Unclean hands Untrimme d Nails

Malnourishe
d child with severe body wasting ( Margie) Immobility

Predispose to develop Renal Failure.

Predispose to develop cleft palate that will be inherited by the next generation.

Greater risk of acquiring food borne/ diarrheal

Poor Personal Hygiene, Inadequate hand washing and unsanitary food preparation as a

Illness of cerebralpalsy

According to neighbor, parents did not seen fighting with each other Children respected their parents

Family had patience in taking good care of Margie They keep on supporting the needs of Margie though her disease is chronic.

The neighbors trusted them and they have trust with their neighbors

Risk for emotional distress as a Health Threat

Presence of illness states and disability as a

Risk of developing Renal

failure as a

Health Deficit

Health Threat

Poor personal hygiene as a

Health Threat

Health

ENVIRONMENTAL

HOME

WATER SUPPLY

TOILET FACILITIES

KITCHEN AND COOKING FACILITIES

GARBAGE DISPOSAL

The family doesnt own the house It is owned by the wifes parents. They only have one room at about 2x2 meters Clothes and other things are scattered all over the room Improper placement of dining table. Chairs placed. Presence animals are inappropriately

-Doesnt possess water supply

own

- Absence of toilet facilities. -The family do not owned a comfort room, instead, they shared toilet to their parents. -Pour flush water-sealed toilet used. -Approximately 5 meters away from the house -Filthy, stinky and presence of flies in the toilet bowl.

-Source of the familys drinking water was the faucet. -Approximately 5 meters away from their house. -Slightly rusty taste of the water. -Usage of plastic containers for water storage use for drinking.

-Most of the cooking utensils were damaged. -Kitchen wares were clean but unorganized. -Most of the time uses bare hands in eating, and washing of it was not practiced. -Usage of plastic containers for food storage. -Leftovers are sometimes left in pots or pans.

-Primarily used woods for cooking.

Doesnt possess trash bins or any container as storage for trashes. Uses open dumping and burning as method of garbage disposal.

Usages of fire woods are prone to fire hazards.

of

domesticated Poor water supply could be classified as a poor environmental condition and can put the familys health condition at risk to develop certain diseases. Diarrhea, amoeba can be manifested if not corrected on time.

Pigs, Dogs and chickens are

The overall sanitary conditions of the clients house were highly affected and are prone to develop poor home and environmental condition. Such things would also contribute to the presence of various diseases hazards within the area.

Absence of toilet facility would greatly affect the familys way of urinating and defecating. Adjustment to the distance, tidiness of the comfort room and the number of persons who used it would contribute to poor toilet conditions and at the same time prone to illnesses.

The type of kitchen and cooking facilities that they have was not that good. Since most of the utensils are already old and some are damaged. Hand washing was not practiced and may contribute to unsanitary food handling.

Presence of fire hazard as a Health Threat

Absence of trash cans and inappropriate garbage disposal could contribute to poor health and environmental sanitation.

Presence of unsanitary wastes disposal as a Health

Presence of unsafe water supply as a

Health Threat
lack of concern in performing proper house management as a Health Threat Presence of various microorganisms within the toilet facility as a

Inability to perform good kitchen etiquette and proper hand washing technique as a

Threat

Health Threat

Health Threat

ENVIRONMENTAL

Drainage System

Domestic Animals

Neighborhood

Community Facilities

Absence of drainage system particularly canals and kitchens sink. Directly throw used water to the ground and sometimes placed it in an empty plastic container.

Presence of domestic animals which include 3 dogs, 3 cats and 1 pig. Animals were strayed Dungs were scattered.

Neighbors were kind and helpful.

Health and Social Facilities were readily available for the family. Nearness of the Barangay Health Center at approximately 200 meters away from their house.

The family were related to some of the neighbors.

Neighbor was approximately 5 meters

Lacking of drainage system could greatly affect the environmental sanitation of the area and ultimately predisposes to the development of breeding sites.

Roaming of animals in the area was not appropriate. Foul smell of the dungs could also affect the health condition of each member for the fact that they will be able to inhale it continuously.

Availability of neighbors at all times could be of its big essential help whenever there are circumstances that need immediate response.

A healthy group of support system as a

Readiness for Enhanced Capability

Improper placement and defecation of domestic animals as a Health

Availability of such resources in the community is of good help, for in which they will be able to seek Physician and Public Health Nurse immediately and likewise purchase available medicines and at the same time be notified of any social activities conducted within the community.

Presence of stagnant water in a container as a Health

Threat

Threat

Readily available resources of health and social facilities as a Potential

for Enhanced Capability

X.

FAMILY HEALTH PLANS

CUES

HEALTH PROBLEM

FAMILY NURSING PROBLEM Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/at risk members of the family due to: -inadequate family resources for care specifically financial constraints. -Philosophy in life which negates/hinder caring for the sick, disabled, dependent or vulnerable/at risk members.

GOAL OF CARE

OBJECTIVES OF INTERVENTION PLAN CARE NURSING INTERVENTIONS At the end of 1 hour of nursing interventions, the family will be able to: Understan d the significanc e of immediate seek of medical attention. Identify alternative ways to perform nursing care. Verbalized understan ding that not all illnesses should be treated at home or can be delayed. 1. Imparted knowledge about the significance of seeking immediate medical attention. 2. Assisted family in enhancing their choice of alternatives of care to be done to the patient in regards to their financial status. 3. Encouraged parents to utilize health center facilities and privileges to treat or alleviate illness. 4. Helped family prioritize steps to be done during common illnesses. 5. Enhanced learnings about used of herbal medications including its indication and contraindication.

EVALUATION MODE OF CONTACT RESOUR CES NEEDED Money Time Effort Goal was met. After 1 hour of nursing interventions, the family was able to : -Understand the significance of immediate seek of medical attention. -Identify alternative ways to perform nursing care. -Verbalized understanding that not all illnesses should be treated at home or can be delayed.

Subjective: Pag magsakit ipahilot namo kundi madala mag herbal mi daun usa pami mag pa check-up pag nay kwarta Objective: - presence of herbal plants outside their house -a hilot neighbor -no savings for health emergency. Unhealthy lifestyle , personal habits/practi ces specifically delay in seeking and taking medication as a health threat

At the end 2 days of home visits, the family will be able to know and appreciate the importance of seeking immediately medical attention, take alternative ways in providing nursing care to the seek members, and understand that management of illness is not merely by having herbal remedy and visiting a hilot.

Home visit

CUES

HEALTH PROBLEM

FAMILY NURSING PROBLEM Inability to make decisions with respect to taking appropriate health action due to: -inadequate proper time management

GOAL OF CARE

OBJECTI VES OF CARE At the end of each visit, the family will be able to: a. Perform household chores without complaini ng lack of time managem ent in doing such chores b.Fix some housing problem conditions .

INTERVENTION PLAN NURSING INTERVENTIONS MODE OF CONTACT 1. Imparted to them the importance of having a clean and organize environment 2. Assisted in identifying alternative ways in performing household chores without compromising other daily activities. 3. Suggested to make plan of activities at night for their daily activities. 4. Encouraged mother to prioritize activities. 5. Encouraged the relatives to help in doing the household chores. 6. Provided used tarpaulin to cover the holes of their roofs 7. Helped in fixing their chairs 8. Assisted family members in arranging things in their room 9. Assisted family in cleaning their surroundings 10. sources 11. canal. Drained stagnant water Assisted in making drainage Home visit

RESOUR CES NEEDED -Fare going to the familys house -Time Tarpaulin -Ropes -Nails -Hammer -Sacks -Shovel -Woods

EVALUATIO N

Subjective: bisan unsaon nako pagpaningkamot nga manglimpyo sa balay, apan kulang gyud ang oras kay atimanonon kayo ni si Margie og masakiton pa gyud, as verbalized by the mother. Objective: -no drainage system -presence of stagnant water -holes in the roof -wrecked chairs -untidy room

Lack of concern in performin g proper house managem ent as a Health Threat

At the end of 4 visits, starting from the 3rd visit, the family will be able to practice adequate proper time manageme nt and -lack of practice inadequate alternative knowledge or course insight as to actions in alternative household courses of manageme actions open to nt while not them compromisi ng their -Inaccessibility daily of appropriate activities resources for and care, improve specifically their cost housing constraints or condition. financial inaccessibility.

Short term After the 3rd visit, the house and their surrounding were cleaned and things were organized. Long term At the end of the 3rd visit, the family maintained the tidiness of their house, things were kept organize, and some housing problems were fixed.

HEALTH PROBLEM

FAMILY NURSIN G PROBLE M

GOAL OF CARE

OBJECTIVES OF CARE

INTERVENTION PLAN NURSING INTERVENTIONS MODE OF CONT ACT RESOU RCES NEEDE D

EVALUATION

Subjective: Wala man mi kaugalingong c.r sa ako man to Mama, as verbalized by the mother. Objective: -absence of own toilet facility -filthy and foul toilet bowl. -inadequate water storage inside the comfort room -damage comfort room structure.

Unsanitary toilet facility as a Health Threat

Inability to provide a home environm ent conduciv e to health maintena nce related to inadequa te knowledg e about the importan ce of toilet sanitation .

At the end of the home visits, the family will maintain sanitary toilet facility.

At the end of 1 hour of nursing interventions, the family will be able to: -Learn what toilet sanitation all about is. -Gain knowledge on the advantages of having a sanitary toilet. -Comprehend the disadvantages of having unsanitary toilet with emphasize on the common diseases that they might possible harbor. -Know the various ways to attain and maintain sanitary toilet.

1. Discussed what is toilet sanitation, including its advantages and disadvantages of not having a sanitary toilet and ways to attain and maintain it.

Home visit

Money Time Effort Water Pail

Goal was met. After 1 hour of nursing intervention the family was able to : -Learn what toilet sanitation all about is. -Gain knowledge on the advantages of having a sanitary toilet. Comprehend the disadvantages of having unsanitary toilet with emphasize on the common diseases that they might possible harbor. -Know the various ways to attain and maintain sanitary toilet.

2. Imparted the common diseases that they might harbor from unsanitary toilet. 3. Instructed to have a routine schedule in cleaning the toilet. 4. Provided with plywood to cover the toilet. 5. Provided with pail for water storage. 6. Instructed to replace water after using it.

Plywood

Vao day nghe bai nay di ban

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CUES

HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVES OF CARE

INTERVENTION PLAN NURSING INTERVENTIONS MODE OF CONTA CT RESOURCES NEEDED EVALUATION

Subjective : Gatipukon namu ug sunugon among basura, as verbalizedby the mother. Objectives: Scatter ed garbage around the house No proper segregatio n of waste Presen ce of flies in the house

Unsanitary waste disposal as a Health Threat

Inability to provide a home environme nt conducive to health maintenan ce and personal developme nt due to lack of knowledge on the importance of proper environme ntal sanitation.

After 3 home visits, the family will be able to gain knowledge on the importance of proper sanitation thus providing the family with an environment conducive for health maintenance and personal development.

At the of 1 hour and 30 minutes of nursing interventions, the family will be able to know and initiate measures that would improve their environmental sanitation/ condition such as sweeping and proper waste segregation.

1. Conducted health teaching on the importance of proper environmental sanitation and proper waste segregation 2. Assisted the family in making segregated garbage containers 3. Encouraged the family not to burn their plastics and wrappers 4. Assisted the family in cleaning the surroundings in some household chores

Do home visits

Empty sacks of rice Available bamboo sticks

Goal was met, after 1 hour and 3o minutes of appropriate nursing interventions, the family was able to segregate their waste according to its type and expressed that they have gained knowledge.

CUES

HEALTH PROBLE M

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVES OF INTERVENTION PLAN CARE NURSING INTERVENTIONS

EVALUATION MODE OF CONTAC T Home Visit RESOUR CES NEEDED -Fare going to the familys house -Time Goal was met, after the initial visit, the family was able to: -verbalize importance of taking a bath daily -learned practice of good hygiene on their own. -improved their physical appearance as evidenced by on the next visit the family members available had already taken a bath and had shown good physical appearance.

Subjective: Dili permi ga agas ang tubig mao nga tagsa sa duha ka adlaw ra mi makakaligo og tarong, as verbalized by the mother. Objectives: -unkept hair -body odor -empty toothpaste sachet -untrimmed nails -no owned water supply -water supply is approximately 5 meters away from home.

Poor personal hygiene as a Health Threat

Inability to make decision with respect to taking appropriate health action due to: -low salience of the problem -Inaccessibility for appropriate resources for care, specifically, physical inaccessibility of water supply and toiletries.

At the end of the 5 visits, starting the 2nd visit, the family will be able to practice and maintain good personal hygiene.

At the end of initial visit, the family will be able to: -Verbalize importance of taking a bath daily. -Learn practice of good hygiene on their own. -Improve their physical appearance.

1. Discussed the benefits of taking a bath daily. 2. Provided them with nail cutter and encouraged to trim their nails. 3. Encouraged to clean their ears once a week. 4. Instructed to brush their teeth with toothpaste or salt twice daily. 5. Advised to take a bath with antibacterial soap and shampoo. 6. Taught them to comb their hair regularly.

Tra lai em niem vui khi duoc gan ben em, tra lai em loi yeu thuong em dem, tra lai em niem tin thang nam qua ta dap xay. Gio day chi la nhung ky niem buon... http://www.freewebtown.com/gaigoisaigon/ CUES HEALTH FAMILY GOAL OF OBJECTIVES OF INTERVENTION PLAN EVALUATION PROBLEM NURSING CARE CARE NURSING INTERVENTIONS MODE RESO PROBLEM OF URCES CONT NEEDE ACT D Subjective: Kabalo man mi nga kinahanglan manghugas og kamot pero usahay diretso na lang kaon, as verbalized by the mother. Objectives: -dirty hands -untrimmed nails Absence of hand-washing practice and unsanitary food preparation as a Health Threat Inability to make decisions with respect to taking appropriate health action due to low salience of the problem At the end of 6th visit, the family will be able to practice proper handwashing before and after meals practice proper food preparation At the of 1 hour of appropriate nursing interventions, the family will be able to: Verbalize the importance of proper handwashing Verbalize the importance of proper food preparation 1. Demonstrated the proper hand washing technique. 2. Instructed to do proper hand-washing before and after meals. 3. Encouraged to use spoon and fork. 4. Instructed to wash properly their vegetables, fish and meat, and etc., before cooking. 5. Instructed to cover their food properly. 6. Instructed to trim their nails. 7. Instructed to cook their food properly. Home visit -Fare going to the familys house -Time - visual aids Goals were met. After 1 hour of appropriate nursing interventions, the family was able to: -Verbalize the importance of proper handwashing -Verbalize the importance of proper food preparation.

CUES OR DATA

NURSING DIAGNOSIS

OBJECTIVES

NURSING INTERVENTIONS

RATIONALE

EVALUATION

Ineffective feeding pattern SUBJECTIVE: mag lisod man gud ni siya ug didi tungod ani iyang condition. as verbalized by the mother

At the end of 3-4 days the client/ baby will be able to: a). gain weight appropriately. b). be free from aspiration. c). display adequate output by sufficient number of wet panty/ diapers daily.

a). instruct the mother to provide special nipples or feeding device ( e.g. soft pliable bottle with soft nipple with enlarge opening) b). teach mother to hold the child in a semi upright position; direct the formula away from the cleft and toward the side And back of the mouth c). feed the child slowly and burp frequently. d). Stimulate sucking by gently rubbing the nipple against the lower lip

a). for child unable to suck adequately to standard nipples

At the end of nursing intervention the client was able to gain weight but not enough for the criteria for operation.

b). to prevent aspiration.

c). to prevent excessive swallowing of air and regurgitation. d). to initiate feeding

OBJECTIVE: -Bilateral complete cleft palate