Fncp (Final)

Name: Epifrancia Hernandez

Age: 70 years old

Sex: Female

Civil Status: Widow

Position in the family: The eldest and respected one but not the head.

Type of family: Extended

Educational Attainment: Elementary Graduate

Religion: Roman Catholic

Diet: Vegetables and Fish

Vital Sign:

BP: 140/80mmHg PR:79bpm RR:21bpm.

Family History: Father Side (+) DM ; Mother Side (+) Hypertension

Husband died 2 years ago; lung cancer.

Medical History: Unable to walk since June 2008 cause of mild stroke because of increase cholesterol, diabetes mellitus and hypertension affected her left side arm and leg. Patient stated difficulty in swallowing and also in speech. Now patient will able to speak clearly and can tolerate eating solid food with precaution. Patients stay in bed since she cannot walk and use bedside bedpan for toileting purposes. She also say they call the barangay health worker for the monitoring of her blood pressure and have a maintenance drug of Simbastatine, Trimetazine, Lemiteride, Amlodipine which she taking for almost 3 years.

Type of House:

Cocrete

Cooking Facility: Woods

Water Resources: Cavite District Water Supply (for drinking they boiled it)

Garbage disposal: Open main dump pit with presence of flies and uncovered trash can.

Health Problem

Family Nursing Problem

Goal of care Objectives of Care

Interventions EvaluationNursing

InterventionsMethod of

Nurse Family

Contact

Resources Required

Poor environmental sanitation:

Improper waste disposal

Inability to decide about taking appropriate actionsdue to failure to comprehend the nature and scope ofthe problem.

Within 4 hours of nursing interventions, the family will be able todetermine the importance of practicing proper methods on wastedisposal.

After two home visits, the family will be able to:1. identify the different ways on proper disposal of garbage such as:a. use of compost pit with cover;b. segregate the non-biodegradable and biodegradable materials;c. recycling of can-be-used garbage;d. reusing or selling of some garbage like cans, bottles and plastics.2. enumerate the proper

Provide the family informationabout the proper ways on wastedisposal such as segregation ofbiodegradable from nonbiodegradablewastes and demonstrate the methods

2. Explore with the family theadvantages and disadvantagesof the different methods ofwaste disposal

3. Emphasize the importance

Home Visit Material Resources:

Visual Aids on methods of regulating fertility

Human resources:

Time and effort of the student nurse and family

Goal met. After 2 home visits conducted with nursing interventions, thefamily was able to understand the importance o practicing the proper method ofwaste disposal

techniques on keeping the surroundings clean andthrough using proper method of waste disposal;3. define the meaning of proper garbage disposal and it’s advantages;4. recognize the possible effects of garbage burning;5. verbalize understanding about the importance of practicing proper wastedisposal

ofpracticing proper garbagedisposal with the family

4. Emphasize the importance ofpracticing proper garbagedisposal with the family

Criteria Computation Actual score Justification

o Nature of the problem

- Health threat

2/3 x 1 0.66 The problem is a health threat, because it can conducive to health and may contribute to develop health problems.

2. Modifiability of the problem

- Easily modifiable

2/2x 2 2 The problem is easily modifiable by placing proper waste disposal and perform proper waste segregation.

3. Preventive potential

3/3 x 1 1 The preventive potential highly preventive if the family recognize the importance of clean and healthy environment.

4. Salience 2/2 x 1 1 The family recognize as problem that needing urgent attention

Total Score 4.66

Health Problem

Family NursingProblem

Goal ofCare

ObjectivesOf Care

Intervention PlanNursing Intervention Method of nurse Resources Required family contact

Presence of health threat Accident

hazard (pointed/sharp objects improperly kept)

Inability to provide a home environment conducive to health maintenance due to:

Lack of knowledge of preventive measure

After a nursing intervention the family will understand the need of preventive measure in protecting from injury of sharp object.

-After a nursing intervention the family will take appropriate action to manage proper storage of sharp object out of reach of children.-Be able to learn first aid measure in case of accident sharp injury.

-Discuss the family -Material Resources:possible ways of Home Visit Visual Aids to teach providing proper proper precaution in storage of sharp handling sharp objects.objects.-Explain the sharp -Effort and Time of theobjects must keep student nurse and in safe site that family.cannot be reachedof children.-Caution elderly familymember that do notleave sharp object in the surrounding.-Do not let the childrento play with the sharp objective.-Emphasize the needProtective precautionWhen using sharp Objects.-Demonstrates toThe family the stepsOf first aid in the Case of sharp accident.

Accident Hazard (Sharp/pointed objects improperly kept)


1. Nature of the problem

- Health threat

2/3 x 1 0.66 The problem is a health threat, because it can be a potential for accident

2. Modifiability of the problem

- Easily modifiable

2/2x 2 2 The problem is easily modifiable by placing sharp objects in a safe place and container. Make sure that is unreachable by children.


3/3 x 1 1 The preventive potential highly preventive if the family recognize the potential accident it will cause.

4. Salience 1/2 x 1 2 The family recognize as problem but not needing urgent attention

Total Score 5.66

Name: J. M

Age: 53 years old

Date of birth: January 28, 1959

Gender: Male

Civil Status: Married

Position in the family: Head of the Family


Educational Attainment: College undergraduate (2nd year) Criminology


Vital Sign:

BP: 140/100 RR: 21 bpm

PR: 83 bpm

Medical History: (+) Hypertension

(+) Diabetes Mellitus

Laboratory Results:

(+) gallbladder polyps

creatinine

Medicines :

1. Human Insulin 18ʊ before meal (am)2. Ditiazem – 60 mg 1 tab. 2x a day3. Sodium Carbonate- 650mg 1 tab 3x a day4. Allupurinol- 100mg 1 tab after lunch5. Catapres- 150 mg 1 tab bedtime6. Follic Acid 1 capsule bedtime

Before meds:

Herbal med: - tubu-tubuhan

- guyabano

House Background:

Mr. J.M. have a 3 siblings. The eldest is 19 years old taking up tourism

at Cavite State University, the second to eldest is 18 years old taking up Engineering

at PUP and the youngest is 14 years old high school . The type of house is concrete

and has a good ventilation. They most likely eat sea foods, meats, preservative foods,

and fish. The drinking water came from alkaline water. Mr. J.M. work is piggery and

presently he has a 10 pieces of pigs.

Family Health Problem

Family Nursing Problem

Goal of Care

Objective of care

Nursing Intervention

Rationale Method of family Contact

Resources required

Evaluation

The Head of the Family has a diabetis mellitus

Ineffective Therapeutic regimen management related to:

family patterns of health care

verbalizes desire to manage the illness

failure to include treatment regimens in daily routines.

Failure to take action to reduce risk factors

After 30 minutes of nursing intervention the head of the family will be able to : Demonstrate behaviors in lifestyle necessary to maintain therapeutic regimen. - Verbalize acceptance of need to change in actions to achieve agreed- on health goals-

After nursing intervention the head of the family which is the father will be able to:Verbalize acceptance of need to desire to change actions to achieve agreed- on health goals- Participate in problem solving of factors interfering with integration of therapeutic regimen .

-Ascertain client’s understanding of condition and treatment needs

- Use therapeutic communication skills

- provide positive reinforcement for efforts

- Promotes client participation in planning and evaluating process.- assist client to develop strategies for monitoring therapeutic regimen.

-so that he can make informed decisions about managing self care.

-to assist client to problem solve solution.- to encourage continuation of desired behaviors - enhances commitment to plan, optimizing outcomes.

-Promotes early recognition of changes, allowing proactive response.

-Home Visit-Nurse/ Patient interview

Human Resources: Time and effort of both the nurse and the clients. Financial Resources: Money for the nurse’s transportation.

After nursing intervention the head of the family was able to :-Demonstrate behaviors in lifestyle necessary to maintain therapeutic regimen.


1. Nature of the problem- Health deficit

3/3 x 1 1 The problem is a health deficit, because there are instances of failure in health maintenance

2. Modifiability of the problem- Easily

modifiable

2/2x 2 2 Current knowledge, interventions and resources are available to solve the problem


2/3 x 1 0.66 The preventive potential is moderate; resources can be utilized to maintain health and prevent further complications

4. Salience 2/2 x 1 2 The family recognized the problem as serious and it needs immediate attention

Total Score 5.66

General Data

Patients Name: P.I

Address: Baranggay Lumipa

Age: 76

Sex: Male


Occupation: Barbeque stick maker

Chief complaint:Hypertension

Family Assessment

Name Relation Age Sex Occupation Educational Attainment

I.I Wife 72 F Barbeque stick maker

High school undergraduate

J.I Son 53 M Labor High school graduate

D.I Son 47 M Construction worker

High school graduate

E.I Son 43 M Construction worker


A.I Son 40 M Construction worker


J.I Daughter 36 F Pabrika (electronics)


Heredo

Maternal: (+) hypertension

(+) arthritis

Inability to provide adequate nursing care to the family


5. Nature of the problem- Health deficit

3/3 x 1 1 It is a health deficit that needs proper management to avoid outward consequences in the future.

6. Modifiability of the problem- Easily

modifiable

2/2x 2 2 The problem can be easily modified, the resources needed of the family for managing the condition can be provided by the health center.


2/3 x 1 0.66 Since the condition is already present to the family member, it is to avoid it from worsening.

8. Salience ½ x 1 0.5 Family recognized it as a problem but doesn’t need immediate attention

Total Score 4.16

FAMILY HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION EVALUATION

NURSING INTERVENTION

RATIONALE METHOD OF FAMILY CONTACT

RESOURCES REQUIRED

Arthritis as a health defecit

(rheumatoid arthritis)

Inability to provide adequate nursing care to the family member who has arthritis due to:

Lack of adequate knowledge about the disease, complications, prognosis and management

After nursing intervention the client will have a lesser attack of arthritis within 4 months

After the nursing intervention the client as well as the family member will:

Be knowledgeable about the disease and have an appropriate action with regards to the condition

Educate patient as well as other family member about the complications and management

Tell the patient to seek for medical consultation.

It could help them understand more the nature of the disease and how it can be prevented.

For proper assessment, management and prescription.

Home visit Photocopy of information about arthritis and its management including medications and diet

Time and effort of the student nurse and family members.

Goals are met.

The client and family members understand the need of proper medical consultation for proper treatment of arthritis.

Name: A.I

Age: 76 years old

Sex: Female


Position in the family: The eldest and respected one but not the head.


Educational Attainment: High School Graduate


Diet: Vegetables, Fish, Meat, Chicken

Vital Signs:

BP:130/80 PR:76bpm RR:19bpm.

Medical History: She stated that last November 2012, she slipped and fell on her left wrist which caused it to be broken. She has not seen any doctors regarding her left broken wrist. Instead, she is putting efficascent oil on the broken wrist and wrapping it with a cloth. Her wrist has edema. She cannot move her left wrist at times because of the pain. She thinks that it will get well on its own. After this incident, she is unable to do chores around the house and cannot carry heavy objects.

Criteria Computation Actual Score Justification

1. Nature of the Problem

- Health Deficit

3/3 x 1 1

It is a health Deficit. Because of the condition of the accident which was caused by the fall, the patient is limited on the daily activity being done every day. The patient cannot be able to lift heavy objects which can cause more damage to the injury.

2.Modifiability of the Problem

2/2 x 2 2

If the patient was able to be seen by the doctors, the condition of the patient will be able to be improved by the treatments being done.

3. Preventive Potential 3/3 x 1 1

The condition can be improved if the patient was able to have a general check up. Because of the idea that it will get well on it own. The patient was not able to get a checkup. But with her condition, the patient is limited on her daily activities, not allowed to carry heavy objects and stress.

4. Salience of the Problem

2/2 x 1 1

The condition needs to be seen in order to improve the well being of the patient. If the patient has a limited immobility, he/see may not be able to do as much things as before. However, if the patient was able to have a check-up and improve the condition then, the patient will be able to continue the daily activities

Total Score 5

Family Health

Problem

FamilyNursing Problem

Goal of CareObjectiveOf Care

NursingIntervention Rationale

Method ofFamilyContact

ResourcesRequired Evaluation

Presence of Health Deficits

*Broken Wrist (left):

Inability to make decisions with respect to taking appropriate health action due to :

Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner

After Nursing intervention, the family will take necessary action to have the condition check by a medical practitioner.

After 1 hour of home visit the following:

1)The family will ensure that the condition of the patient should be checked immediately

2)The family will know the importance of having medical check-ups

1)Provide knowledge about the important for medical check-up

2)Discuss the type of health resources provided in the community

1)It can increase the awareness about how important it is to have a check up

2)It can mobilize the community to utilize the health resources

Home visit 1) Time and effort of both student, public health nurses and client’s family.

Goals partiallyMet

The broken wrist of the client may cause future health problems if unseen.

Name: Myrna, Ampila

Age: 80 years old

Sex: Female

Civil Status: married

Position in the family: The eldest in the family,

No. of family members: 4

Type of family: nuclear

Educational Attainment: 3rd year high school

Religion: Catholic

Diet: rice, chicken, fish and vegetables

Vital Sign:

BP:150/80 PR:72bpm RR:16bpm. Temperature:36.4

Family History: Father Side (+) DM Mother Side (+) Hypertension

Medical History: Myrna has history of stroke in 2006, has vision problems and cannot speak since patient had a stroke, patient has hypertension and drinks amlodipine once a day for high BP. Patient is unable to clean their house due to disabilities and the children of the patient do not have regular schedule of cleaning the house.

Type of House: concrete and wood

Cooking Facility: LPG

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

1. Nature of the problem-health threat

2/3 x 1 0.67 The problem is a health threat because a dirty

environment/ surroundings may cause communicable diseases

2. Modifiability of the problem-easily modifiable

2/2 x 2 2 The problem is easily modifiable because the family can easily maintain a clean environment by regular cleaning of their house

3. Preventive potential-high

3/3 x 1 1 The problem is highly preventable if the family members comply with the instructed cleaning schedule of their house

4. Salience of the problem-a condition or problem not needing immediate attention

2/2 x 1 1 The problem does not need immediate attention since the family cleans their house but not on a regular basis.

TOTAL SCORE 4.67

POOR ENVIRONMENTAL SANITATION

Family Health

Problem

FamilyNursing Problem

Goal of CareObjectiveOf Care

NursingIntervention Rationale

Method ofFamilyContact

ResourcesRequired Evaluation

-poor environmental sanitation as a health threat

-dirty walls and sleeping areas, presence of many flies and bugs, and dusty walls and furniture, pieces of garbage, dried leaves and other trash around the house.

Inability to provide a home environment conducive to heath maintenance and personal development due to: Lack of knowledge of the importance of hygiene and sanitation

After 30 minutes Nursing intervention, the family will be able to effectively promote and maintain an environment with good sanitation.

After 30 minutes of home visit the ff:1.) The family will be able to demonstrate effective cleaning of the different parts of their house and their environment

1.Reinforce a cleaning schedule that should be done at least once a day

2. Emphasize the importance of a clean and healthy environment.

3. Discuss the techniques and methods used in cleaning and sanitizing

-The family should follow a cleaning schedule to promote and maintain a clean environment-knowing the importance of a clean and healthy environment will motivate the family to clean-so that family will be able to properly clean the different parts of their house and environment.

Home visit Time and effort of the student and the family.

. Goals are met. The family was able to demonstrate effective cleaning of the different parts of their house and their environment.a

Documents

Fncp (Final)