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Concept: Care of Mother, Child, Family, PopulationGroups and Community
Inclusive Dates: August 30-31, September 1,6-8, 13-15 2012
Group 5BSN II-AP
Joji Castellano, RN, MANClinical Instructor
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Specific Objectives:
After 2 hours of CHN-Case Presentation, we will be able to:
impart the data gathered in the Comprehensive Family Survey.
prioritize the 5 Family Nursing Problems gained from assessment.
categorize the cues/data and Family Nursing Problems through theTypology of Nursing Problems in Family Nursing Practice which
consists of the first and second level assessment. prioritize the 5 Family Nursing Problems through ranking with the
criteria : Nature of the problem, Modifiability of the problem,Preventive Potential, Salience.
formulate the appropriate Family Nursing Care Plan for each Family
Nursing Problem. provide readings or updates about the interventions applicable to
the most prioritized Family Nursing Problem.
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The Lumambas residence is made of concrete and wood, and they are
renting. They are informal settlers. They have electric supply. Their meansof cooking , is through charcoal burning. Their source of water is MCWD.Their medical sources are midwife and doctor. Their way of garbagekeeping is through the use of garbage can and their garbage disposal iscollected by garbage truck. They have excreta disposal pour flush/pailsystem. The number of couples in the family are two, Aniceta and Severino
who is married for 40 years and Rodulfo and Rowena who is married for 12years. They have minimal knowledge about Family planning and theirsource of information are the Barangay heath workers, Student Nurses andmidwife. The type of family planning method they use mostly is pills andtheir reason for choosing the method is that it is affordable and satisfactory.The hereditary diseases common to the history of the family are
hypertension and asthma. Their usual diet are vegetables, fish and rice .Their type of family is extended. Rica Maes weight at birth is 6 lbs and herbrother Randyl is 7 lbs. In their immunization BCG (3 Doses), OPV (3Doses), DPT (3 Doses), Measles and Hepa B vaccines. The type of feedingadministered by the mother to her children during infancy is breastfeeding.
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Rank Family NursingProblem Score1st Foreseeable crisis
situations forpregnancy
4.83
2nd Malnutrition 43rd Hypertension 44th Poor environmental
Sanitation 3 2/35th Presence of Breeding
sites and insects 2 2/3
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First Level of Assessment
(Cues/Data)
Second Level of Assessment
(Family Nursing Problem)
- Family planning is not always practiced
by the couples in the family.
- Mrs. Aniceta Lumambas verbalized
Unsa diay birth space....unsa gane to?
Ah oh birth spacing diay na?...
Contraceptive? Unsa na?...
- Randyl and Rowena , whenever
engaging in sexual intercourse , only
uses condoms when they have the
money to buy.
A. Foreseeable crisis situations for
parenthood and pregnancy1. Failure to utilize community resources
for health care due to:
a. Lack of knowledge of community
resources for healthcare.
b. Failure to perceive the benefits ofhealth care/services.
2.Inability to recognize the presence of the
condition or problem due to:
a. Lack of knowledge
b. Philosophy in life which hinders
recognition.
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First Level of Assessment
(Cues/Data)
Second Level of Assessment
(Family Nursing Problem)
- Rica Mae, 11 years old weighs 39 kgs., Looks pale,
lethargenic and apathenic, markedly underweight
and undernourished.
- Grandmother verbalized Naa man gyud panagsa
masakpan na sa akong anak nga kining akong mga
apo perti kayo mukaon ng mga junkfoods imbis gulay
unta ug prutas ang angay ,sus perti jud! Mao sigurong
mukaon ni silag pag ayo wala gihapoy pagtambok.
- Two preschool members usually are left to the school
when parents are working
- Mother and father are very busy helping earn a living
that they could hardly see to the needs of the
children.
- Appetite loss of eating nutritious foods.
B. Malnutrition as a health deficit
1. Inability to recognize the presence of
malnutrition in a dependent member dueto lack of knowledge.
2. Inability to decide about taking
appropriate health action due to failure to
comprehend the nature, magnitude and
scope of the problem
3. Inability to provide adequate nursing
care to a members suffering malnutrition due
to:
a. Lack of knowledge about the health
condition
b. Lack of knowledge on the nature and the
extent of nursing care needed
c. Inadequate resources for care,
responsible family member and financial
constraints.
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First Level of Assessment
(Cues/Data)
Second Level of Assessment
(Family Nursing Problem)
- Mrs. Anecita has the following vital
signs:
T- 35.6 C
P- 76 bpm
R- 16cpm
BP- 180/100 mmHg
- Mrs. Anecita verbalized usahay
maliponko basta magdugay ug barog
nya ako rang bira-birahon akong
buhok nya ako sad pislit-pisliton
akong kamot.
- Exposed to the heat of the sun from
7am-3pm everyday while vending
vegetables.
C. Hypertension as a health deficit
1. Inability to recognize the presence of
the condition or problem due to
inadequate knowledge.
2. Inability to make decisions with
respect to taking appropriate health
action due to:
a. Failure to comprehend the nature or
magnitude of the problem or
condition
b. Fear of consequences of actions
specifically:
Economic consequences.
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First Level of Assessment
(Cues/Data)
Second Level of Assessment
(Family Nursing Problem)
- Garbage collection initiated through
barangay garbage truck is notfollowed and complied by the family.
- Mrs. Anecita verbalized Among
mga ginagmay na basura diha ra sa
kilid-kilid ilabay labi na kanang mgachichirya nga basuranah! Akong
mga apo ana gyud.
- They clean their house only every
Sunday.
D. Poor Environmental Sanitation
1. Failure to utilize communityresources for health care due to:
a. Failure to perceive the benefits of
health care/services.
1. Inability to provided home
environment conducive to healthmaintenance and personal
development due to:
a. Inadequate knowledge of preventive
measures.
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First Level of Assessment
(Cues/Data)
Second Level of Assessment
(Family Nursing Problem)
- Water containers are uncoveredand stored water is stagnant.
- Mrs Anecita verbalized Mag
stock mi ug tubig gamit among
drum ug balde
- Mosquitoes are abundant in their
residence because of the presence
of breeding sites.
-
E. Presence of Breeding sites and
insects1. Inability to make decisions with
respect to taking appropriate
health action on the health threats
due to:
a. Failure to comprehend the natureof the problem
b. Inability to provide a home
environment conducive to health
maintenance and personal
development due to: Ignorance of preventive measures
Inadequate family resources
specifically:
^ Financial resources
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CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1. Nature of theproblem
1/3x1 0.33 It is aforeseeable
crisis.
1. Modifiability of
the problem
2/2x2 2 Resources are
available and
interventions arefeasible.
1. Preventive
Potential
3/3x1 1 Their ability to
prevent the
problem is high.
1. Salience of the
Problem
1/2x1 1/2 The problem
does not need
change.
TOTAL SCORE 4.83
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CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1. Nature of the
problem
2/3x1 1 It is a health
deficit that
requires
immediate
management to
eliminate
untoward
consequences.
1. Modifiability of
the problem
2/2x2 2 The problem is
easily modifiable.
1. Preventive
Potential
3/3x1 1 Susceptibility to
other diseases
and infectionscan be prevented
if malnutrition is
eliminated.
1. Salience of the
Problem
0/2x1 0 It is not a felt
problem.
TOTAL SCORE 4
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CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION
1. Nature of the
problem
3/3x1 1 The problem is a
health deficit and
requires more
immediate
intervention.
1. Modifiability of the
problem
2/2 2 The resources and
interventions needed
to solve the problemare available to the
family.
1. Preventive
Potential
3/3 1 The possibility of
complications can be
prevented if HPN
situations are
reduced.
1. Salience of the
Problem
0/2 0 The family does not
recognize the
existence of the
problem
TOTAL SCORE 3
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CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION1. Nature of the
problem
2/3x1 2/3 It is a health
threat.
1. Modifiability of
the problem
2/2 2 Resources are
available and
interventions are
feasible.
1. Preventive
Potential
3/3 1 Occurrence of
parasitism and
other
communicable
diseases can be
reduced
1. Salience of the
Problem
No data
available
No data
available
TOTAL SCORE 2 2/3
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CRITERIA COMPUTATION ACTUAL
SCORE
JUSTIFICATION
1. Nature of the
problem
2/3 x 1 2/3 Presence of Breeding
sites and insects is a
health threat.
1. Modifiability of
the problem
1/2 x2 1 The resources are
partially available and
interventions are
feasible.
1. Preventive
Potential
2/3x 1 1 The communicable
diseases that insects can
transfer has low rate of
prevention.
1. Salience of the
Problem
0/2 x 1 0 The family perceives it
as a problem needing no
attention.
TOTAL SCORE 2 2/3
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Intervention Plan
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Health
ProblemFamily Nursing
ProblemGoal of Care
(SMART)Nursing
Intervention
Intervention PlanNursing
InterventionsMethod of
Nurse Family
Contact
Resources
Required
Foreseeable crisis
Situations forPregnancy
Inability torecognize the
presence of thecondition or
problem due toattitude and
philosophy in lifetowards acceptingthe magnitude of
the problem
After nursingintervention the
family will beable to realizethe post threatof foreseeable
crisis situationsfor pregnancy as
well as to beable to choose
the mostapplicablemeasure to
them.
Short Term:After 2-3 hours
of Home visit andhealth teaching thefamily will be able to
identify thepresence of the
problem and wayson how to alleviate
the problem asevidenced by thediscussion of the
family.
Long Term:After 4 days
of home visit, the
family will be able tocomply anddemonstrate the
health teaching ofthe student nurses
such as to find wayson how to preventcases of pregnancy.
Assess the
general/livingcondition of the
family and aswell as their
perceivehindrances informulating
solution to theproblem.-
Present to themthe consequences
of the presentcondition-
Identifyalternatives ways
on how toincreaseknowledge on
family planningto meet the
needs of all themembers
Home VisitPlan
-Time andeffort
of thestudentnurses&
thefamily-
Participation and
cooperation of thefamily-
Skills andknowledge
of thestudentnurse
I t ti Pl
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Health
ProblemFamily Nursing
ProblemGoal of Care
(SMART)Nursing
Intervention
Intervention PlanNursing
InterventionsMethod of
Nurse Family
Contact
Resources
Required
using contraceptivesand practicing birth
spacing- Present to the motherand father the availablecontraceptive methodsavailable provided by thecommunity.-Educate the
advantages and
disadvantages of thevarious contraceptivespresented.-Present thevarious risks broughtabout by proper birthspacing.-Emphasize
the risks presented bythe inability to provide
for the needs of thefamily members.
Intervention Plan
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HealthProblem
Family NursingProblem
Goal of Care(SMART)
NursingIntervention
Intervention Plan
NursingInterventions
Method ofNurse Family
Contact
Resources
Required
Hypertensionas healthdeficit
Inability of thepatient to continue
taking hermedication as
prescribed due to:a.) Always keeping
self busy.b.) Unable to
remind herself for
taking duemedication.
c.) Inadequateknowledge on
preventivemeasures.
d.) Inability ofpatient to visitRHU/clinic for
regular check-up.
>After effectivenursing
interventions,the patient will
be able toremind herselfin taking of hermedication and
also the
importance ofhaving regularcheck-up.>Thepatient will able
to impart herknowledge to
her familymembers the
things that willbe discussed
regardingpreventive
measures byhealthcareprovider.
After effectivenursing
interventions, thepatient will able
to:a.) Educate herfamily measures
about theimportance of
regular check-up.b.) Explain
importance ofproper diet orfood intake.
c.) Enumerate thediseases that
might develop ifhypertension isnot prevented
earlier.d.) Educate
patient on theDos and Dontsof hypertension
Re-iterate otherpeople who aresmokers and aswell as alcoholdrinkers to atleast limitconsumptionof liquors or tostop it together
with smoking.Encourage themto considerlifestylemodification fortheir benefits.Teach them onhow to takeblood pressureon their own.Educate themthe proper wayof taking goodcare of theirhealth and food
intake
Establishing rapport
(Good eye-to-eye
contact).Home visit.
Healthteachingsregarding
hypertension
BPapparatus.Medication .Visual
aid fordiscussio
n
Intervention Plan
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HealthProblem
Family NursingProblem
Goal of Care(SMART)
NursingIntervention
Intervention PlanNursing
InterventionsMethodof NurseFamilyContact
ResourcesRequired
A. POORENVIRONMEN
TALSANITATION:ImproperGarbageDisposal
1. Inability to decideabout taking
appropriate actionsdue to failure tocomprehend the
nature and scope ofthe problem
Withinproper nursi
nginterventions, the familywill be able
todetermine
theimportanceof practicingproper methods on waste
disposal
Short Term: Afterone Home visit and
health teaching thefamily will be able to
demonstratecompliance with the
health teachingsgiven as evidenced by
the cooperationof the family.
Long Term: After 4-5days of home visit,
the family willpractice and
maintain a goodenvironmental
sanitation
-Assess the familys
environmentalsanitation- Assessthe levelof understanding ofthe family regardingto the problem-Educate the familythe effects ofimproper garbagedisposal suchoccurrence ofdiseases- Discusshow garbage couldcause illnesses.>Explore with the
family theadvantages anddisadvantages of thedifferent methodsof waste disposal
HomeVisit Plan
Time andeffort
of thestudentnurses&
thefamily-
Participation and
cooperation of thefamily-
Skills andknowledge of thestudentnurse
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Emergency Contraception (EC): A Safe and Effective Way to Prevent UnplannedPregnancy
04.01.06 - It is estimated that over three million American women have unplannedpregnancies each year, and over half of these end in abortion. Emergencycontraception (EC), sometimes called the "morning-after pill," is an effective methodof preventing unwanted pregnancy.1
EC is Safe and Effective to UseEC prevents pregnancy via a course of hormonal contraceptive pills taken in one- or
two-dose regimens. EC is most effective if the first dose is taken within 24 hours afterunprotected sex; however, it can be effective up to 5 days after intercourse. If theregimen is started within 24 hours, EC can be 95% effective.
EC is well tolerated by most women, including those who have had trouble usingoral contraceptives regularly. Reported side effects are generally mild, includingheadache, nausea and stomach discomfort, and vary with the brand used.
Because EC can be used at all stages of a woman's menstrual cycle, its mode of actionvaries. After intercourse, EC may prevent pregnancy by preventing ovulation, blockingfertilization or possibly preventing implantation of a fertilized egg.
Link:
http://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancy
http://reproductiverights.org/en/our-issues/contraception/emergency-contraceptionhttp://reproductiverights.org/en/our-issues/contraception/emergency-contraceptionhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/document/emergency-contraception-ec-a-safe-and-effective-way-to-prevent-unplanned-pregnancyhttp://reproductiverights.org/en/our-issues/contraception/emergency-contraceptionhttp://reproductiverights.org/en/our-issues/contraception/emergency-contraception7/29/2019 CASE PRE (CHN)
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Maglaya, Araceli. (2004) Nursing Practice in the Community : fourth
edition. Philippines : Argonauta Corporation. Pages 66-73 & 89.
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