Chn III - Part 2

8/7/2019 Chn III - Part 2

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Republic of the Philippines

City of Caloocan

CALOOCAN HEALTH DEPARTMENT

MANDATE

VISION

Health for all citizenry of Caloocan City by the year 2001and health in the hands

of the people by year 2020.

MISSION

To provide accessible, available, affordable, and acceptable quality basic health

care delivery system at all times through advance technology and fully equipped health

facilities manned by dedicated, competent, and well-compensated manpower.

GOAL

Harmonious partnership with LGUs, NGOs, POs, and GOs towards a common

goal of achieving a productive self-reliant and healthy citizenry.


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BASIC HEALTH SERVICES

1. Medical and Dental Services (MDS)

2. Public Health Nursing / Midwifery (PHN / M)

3. Maternal and Child Health (MCH)4. Public Health Laboratory (PHL)

5. Environmental Sanitation (ES)

6. Control of Communicable Diseases (CCD)

7. Vital Statistics and Epidemiology (VSE)

8. Health Education (HE)

THRUST HEALTH PROGRAMS

1. Control of Acute Respiratory Infection (CARI)

2. Control of Diarrheal Diseases (CDD)

3. National Tuberculosis Control Program (NTCP)

4. National Leprosy Control Program (NLCP)

5. Nutrition Program (NP)

6. Under Five Clinic Program (UFCP)

7. Expanded Program on Immunization (EPI)

8. Family Planning (FP)

OTHER THRUST PROGRAMS

1. National Cardiovascular Disease Prevention and Control Program (NCDPCP)

2. Philippine National Cancer Prevention and Control Program (PNCPCP)

3. Dengue Prevention and Control Program (DPCP)

4. National Diabetes Mellitus Control Program (NDMCP)

5. Primary Eye Care Control Program (PECCP)

6. National Voluntary Blood Service and Program (NVBSP)

7. National Rabies Control Program (NRCP)

8. HIV / AIDS Control Program (HACP)


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COMMUNITY HEALTH NURSING

Community health nursing is the nursing practice outside of the hospital. Only a

few nurses choose community health nursing because they do not like to work in the

afternoon and night shifts. Others simply enjoy the pace of work in the community.

According to the American Nurses Association, it states, Community health nursing

practice promotes and preserves the health of populations by integrating the skills and

knowledge relevant to both nursing and public health. The practice is comprehensive

and general, and is not limited to a particular age or diagnostic group; it is continual, and

is not limited to episodic careWhile community health nursing practice includes

nursing directed to individuals, families, groups, the dominant responsibility is to the

population as a whole. In other words, it is not dealing with any particular age/gender,

but the community as a whole and the individuals and families belonging to that

particular community.

Araceli Magalaya states, the focus of community health nursing are: (1) the goal

of professional practice is the promotion and preservation of the health of populations;

(2) the nature of practice is comprehensive, general, continual, and not episodic; (3) the

knowledge base comes from nursing and public health; (4) the different levels of

clientele individuals, families, and groups; and (5) the practitioners recognition of the

primacy of the population as a whole. Other factors include: (1) greater control for both

the nurse and the client in making decisions related to health care; (2) collaboration

between nurse and client are equal; (3) recognition of the impact of different factors on

health; and (4) nurses greater awareness of their clients lives and situations.

Moreover, Magalaya emphasizes, community health is a specialized field of

nursing practice. Its basic knowledge and skills are anchored on nursing theories and

important concepts from the science of public health such as: (1) emphasis on the

importance of the greatest good for the greatest number; (2) assessing health needs,

planning, implementing, and evaluating the impact of health services on population

groups; (3) priority of health-promotive and disease preventive strategies over curative


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interventions; (4) tools for measuring and analyzing community health problems; and (5)

application of principles of management and organization in the delivery of health

services to the community.

In conclusion, community health nursing can be a tough field to be in, yet a nurse

can relate to the individual or the family because he/she is able to adapt to the

standards of the community. Working in a bigger and wider field such as hospitals

where a nurse comes across individuals or families come from different places to seek

medical attention. Community health nursing targets individuals and families living in a

particular community assisting in making their environment safe and healthy.


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FAMILY HEALTH NURSING

Family health nursing is the level of community health nursing practice directed

or focused on the family as a unit of care with health as the goal and nursing as the

medium, channel, or provider of care. The three levels of clientele in community health

nursing are the individual, family, and community as a whole. Specific objectives of

family health nursing are: (1) demonstrate skill in family assessment; (2) analyze data

collected; (3) identify family nursing problems; (4) observe the different factors affecting

the health of the individual, family, and community; and (5) apply concepts with health

statistics.

Rationale for the family as the unit of care are: (1) the family is considered the

natural and fundamental unity. It is an institution that involves majority of the

population; (2) the family as a group generates, prevents tolerates, and corrects health

problems within its membership; (3) the health problems of a family member are

interlocking; (4) the family is the most frequent focus of health decisions and actions in

personal care; and (5) the family is the effective and available channel for much of the

community health nursing.

Characteristics of the family as a patient include: (1) the family is more than the

sum of its individual members; (2) the family as a behaving, functioning organism is a

product of both time and place; and (3) a family, like an individual passes through a

growth cycle.

The nurses role in family care practice consists of: (1) Health monitor the nurse

is provided the opportunity to monitor more effectively concepts of illness and health

among family members; (2) Provider of care to a sick member nurse-family contact is

initiated by an illness situation in the family; (3) Coordinator of family services the

need in proper coordination of all services from health care providers for maximum

utilization of resources with minimum or no overlapping; (4) Facilitator the nurse

removes barriers to care or make services available and accessible to the family. The

nurse can facilitate utilization of an agency by making arrangements or proper referrals;


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(5) Teacher expected role of a all nurses, but often times taken for granted; and (6)

Counselor consulting and seeking advice for the most intimate and personal problem.

To conduct a nurse-family relationship, a home visit is recommended to prioritize

family problems. A home visit is a professional face to face contact made by a nurse to

the patient or the family to provide necessary health care activities and to further attain

an objective of the agency. It is made to the client or to a responsible member of the

family. The purpose of the home visit is: (1) to give nursing care to the sick, to a post-

partum mother, and a newborn with a view to teaching a responsible member of a

family to give subsequent care; (2) to find out living condition of the patient and family;

(3) to teach health practices, prevention of disease and correction of defects for better

living; (4) to detect, help prevent and report the presence of communicable disease; (5)

to establish close relationship between the health agencies and the public for the

promotion of public health; and (6) to make use of the referral system of community

services.

In conclusion, the sequence of activities in the family nursing practice include: (1)

establishing a working relation with family; (2) conduct an initial assessment; (3)

categorizes health problems into health threat, health deficit, and foreseeable crisis; (4)

determines the nature and extent of the familys performance of the health tasks on

each of the health problems; (5) determines priorities among the list of health problems;

(6) ranks health problems according to priorities; (7) decides on what problems to tackle

in the order of immediately/urgency based on priorities set; (8) defines nursing

objectives in realistic, measureable terms jointly with the family; (9) plans approach,

strategies of action (intervention), criteria and standards for evaluation; (10) implements

the plan of care; (11) evaluates the effectivity of the implemented aspects of the plan;

and (12) redefines nursing problems and reformulates objectives according to

evaluation findings.


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INITIAL DATA BASE

This was a case study conducted on the Sandoval Family. The purpose of this

study is to identify several aspects and variables affecting health and well being of the

family as a unit. Their living conditions, surrounding environment, sanitary condition,

economic status, as well as social and cultural views were taken into consideration.

I. Family Structure, Characteristics, & Dynamics

A. Family Information

Mr. Ramil Sandoval, 26, is the head of the Sandoval Family at the address 297

Camp 69 Sta. Quiteria, Caloocan City. He is the live in partner of Ms. Lita

Burgos, 25, for past 8 years. Mr. Ramil Sandoval moved into the Burgos house 8

years ago and assumed the head of the family role. They share their living

space with Ms. Burgos parents, Mr. Benjamin Burgos age 61 and Mrs. Clarita

Burgos age 60, along with her brother Mr. Edward Burgos, 19. Ms. Lita Burgos

cousins also reside in their house. The live in couple also now have a newborn

baby boy named Benjamin Sandoval, who was born on October 19, 2009.

Name Relationship Age/Sex/CivilStatus

Position EducationalAttainment

Ramil Sandoval Husband 26/M/Single HeadHigh SchoolGraduate

Lita Burgos Wife 25/F/SingleLive-inPartner

High SchoolGraduate

Benjamin Burgos Father 61/M/Married Father-in-lawElementaryGraduate

Clarita Burgos Mother 60/F/Married Mother-in-law Elementary

Benjamin Sandoval Son 1 month/M/Single Son N/A

Edward Burgos Brother 20/M/Single Brother-in-law 1st Yr College

B. Family Structure

The Sandoval family has an extended type of family structure in that not only the

Sandoval family resides in that particular house. It extends from Ms. Lita Burgos

parents, siblings, and cousins. A total of four (4) families reside in the Burgos

house.


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C. Decisions Regarding Health Care

Ms. Lita Burgos father, Mr. Benjamin Burgos, is the decision maker regarding

health care issues. Since the Sta. Quiteria Health Center is near their house, he

usually suggests the family to seek medical attention there regarding the familyswell being. The Burgos family tries to make use as much as possible of the

health centers services. At times, they self medicate themselves using herbal

medications and over the counter medicines to alleviate themselves.

D. General Family Relationship

Like many families, the Sandoval and Burgos family have the occasional

conflicts, which is usually about financial problems. They work through the

problems by talking to each other and sharing their opinions. Mr. Ramil Sandoval

works during the day while Ms. Lita Burgos stays home to take care of her

newborn. Mr. and Mrs. Burgos are at home most of the time. The household

responsibilities are shared by the family. Mrs. Clarita Burgos cooks for her family

especially when Ms. Lita Burgos is busy attending to the needs of her newborn.

However, Ms. Lita Burgos has been cooking more after giving birth to her

newborn because she could not tolerate the exposure of smoke coming from

charcoal fire during her pregnancy.

II. Socio-Economic & Culture Characteristic

INCOME

Name Occupation Place Salary

Ramil Sandoval Baker Sta. Quiteria P 3,000.00 / month

Benjamin Burgos Brgy. Tanod Sta. Quiteria P 1,500.00 / month

Total Monthly Income P4,500.00 / month


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EXPENSES

SUMMARY OF EXPENSES & INCOME

Average Daily Expenses ( 246 x 7 days ) 1,722.00

Average Weekly Expenses ( 265 x 4 weeks ) 1,060.00

Average Monthly Expenses 800.00 800.00

Average Monthly Income 4,5000.00 4,500.00

Average Monthly Expenses 3,582.00 3,582.00

EXCESS 918.00

A. Income and Expenses

Mr. Ramil Sandoval is the main source of income for the household. He is

employed at a local bakery in Sta. Quiteria. He makes P3,000/month. Mr.

Benjamin Burgos supplements the income for an additional P1,500/month by

serving as Barangay Tanod. Few weeks ago, they began to sell charcoal in front

of their house for P10/bag. Although they make some profit off the charcoal, it is

not much to rely on entirely. Due to the fact they spend on food on a daily basis,

they do not budget on how much is spent on food. The P4,500.00 is enough for

their basic needs. They spend on items or groceries as the need arises. There

is not one lone decision maker regarding money. However, they discuss the

financial issue and whoever is correct is the one to be followed. They pay their

own share in the monthly bill of electricity and water with the other three families

in the house, which help lower their expenses. They do not spend on any items

other than their basic needs. Due to excess, they put it aside for emergency

purposes, but it was spent on Ms. Burgos recent medical expenses. The excess

were also spent on the needs of the baby such as diapers and to compensate

when the need to spend more for the day arises.

Daily Expenses Weekly Expenses Monthly Expenses

2 kilos rice(P33.00)

66.002 bars of soap(P 15.00)

30.00Meralco(P 2,300.00)

500.00

2 plastic vegetable(P15.00)

30.00 2 cans of sardines(P 14. 00)

28.00 Nawasa(P 1,500.00)

300.00

1 kilo fish 90.002 sachettoothpaste(P 8.00)

16.00

4 sachet coffee(P 5.00)

20.00 1 small baby oil 28.00

1/4 kilo sugar 12.001 small babypowder

25.00

2 sachet shampoo(P 6.00)

12.001 small bottle Tiki

Tiki vitamins68.00

2 pcs. Diaper(P 8. 00)

16.00 1 small bottleCeelin vitamins

70.00

Total 246.00 Total 265.00 Total 800.00


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B. Ethnic Background

The familys religious views are of the Catholic denomination of Christianity

except for Mr. Burgos, who is a member of Iglesia Ni Christo. The rest of the

family regularly participates in praying the rosary and routinely goes to Church.

C. Role of the family in the Community

Mr. Burgos serves the community as a Barangay Tanod and the family also

participates in other religious and non religious events in the community.

III. Home and Environment Factors

A. Housing Ownership

The Burgos family has lived there all their life. The house is owned by the

Burgos family, but the lot is not theirs. They do not pay any monthly dues for the

lot as it was not expressed by Ms. Burgos when asked.

B. Construction Materials Used

The house structure is made of mixed materials. The roof is made of sheet metal

and patches of scrap metal, which is held together by plywood. The main frame

of the house is made of hollow blocks with one opening for a window and 2 doors

in the front. They hang up curtains to cover the window. The floor is cemented.

The house itself is not very well ventilated as stated, which has only one window

and it is not well lighted as well. They are connected directly to their energy

source, which is metered by Meralco. Their water is brought in by Nawasa.

C. Living Space

There is not adequate living space as they share it with 3 other families. They

spend most of their time outside.

D. Sleeping Arrangement

The family sleeps in 2 separate rooms. Mr. and Mrs. Burgos sleep in an elevated

wooden portion with a wooden floor to sleep on. Mr. Sandoval and Ms. Burgos,

the live-in couple, sleep in the room next to their parents on a wooden bed with

no foam. They also use the table in the living room as a place to sleep or nap

during the daytime.


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E. Adequacy ofFurniture and Appliances

The family claims that their appliances and furniture are adequate for their needs.

Mr. Sandoval and Ms. Burgos have an electric fan in their room. The families

also have plastic drawers to store their clothes and a few chairs and a woodenbench to do sit on. They have a television and a long wooden table for all the

families in the household to use. They use the table for eating and at times a

place to lie down on near the open window.

F. Water Source

They are supplied by NAWASA. This is their only source of water. They use it as

drinking water as well. They dont boil the water which can be a health threat to

their well being as the water can carry water borne illnesses. They have a plastic

pipe and faucet in the front which closes to where some piles of garbage can be

seen. They have a sink near the cooking area which is where they prepare the

food to be cooked. The pipe is close to the open drainage near their house which

is another cause for concern.

G. Food Storage

They cook food everyday that will be consumed that particular day. They usually

do not have leftovers. Even their sugar and other storable items they usually buy

enough as the need arises. They do not have practice storing food because the

food does not last more than a day. The food is cooked once in the day and is

left out to be eaten when a family member is hungry. The food is left outside

covered only by a plate so it could not harbor any illness if properly covered.

Flies, rodents, and other insects can contaminate the food if not properly covered

and can lead to the threat of the familys well being.

H. Cooking Facility

They cook near a wooden stairway and on an unstable surface. There is

garbage and other items scattered near the open charcoal flame. These factors

can lead to an unexpected accidental fire. The families in the household use a

clay stove to cook. The room itself is a narrow, low ventilated area. There house

does not have a roof; therefore, the smoke escapes from the top and from the

door in the front. This is not adequate enough as the room still fills the house

with smoke when cooking. Smoke cannot quickly escape fast enough from the

poorly ventilated room.


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I. Drainage Facility

The water that is used in the household runs through an open canal. This a

health threat because it can lead to the breeding of mosquitoes, flies, other

insects and rodents. These insects and rodents carry harmful illnesses that canbe transferred quickly throughout the family. Diseases, such as dengue, can

arise from these factors.

J. Toilet Facility

The four (4) families share only one (1) bathroom. They use a pail to flush down

the toilet. They try to clean it once in a while to maintain cleanliness. This can

easily be flooded due to the poor drainage system and can cause a threat to the

health of the family members.

K. Sanitary Conditions

They try to keep the house clean, but with many people going in and out this

attracts unwanted dirt and dust from other things. The outer vicinity has a

workplace for vegetables, but there is a pile of garbage a few feet from it. This

can cause contamination and cause illness if the vegetables do not get washed

and prepared properly. They use rice sacks to collect garbage, which is placed

near the cooking area, can cause wet items to seep through the sack. This can

attract rodents and insects that could lead to family acquiring communicable

diseases.

L. Neighborhood

The area can be described as a slum area. The houses are very close to each

other and poorly built. This can cause a quick spread of fires and transfer of

disease as well. The family is next to a police station and the health center,

which are a few feet away from the house. It takes about 15-20 minutes away by

jeep to travel to the main highway. The area is very busy during the day since

jeep and big trucks are usually in the area.

M. Availability of Health Care Facility

The Sta. Quiteria Health Center is very accessible and available to the family.

They often rely on the health center as their primary source for health and

wellness needs. There are also nearby pharmacies in the area.

N. Garbage Disposal

The garbage is collected weekly in the area. The family tries to fill up the

garbage sack before disposing it. Once in a while, they drop their garbage in the

garbage baskets provided by the city for use around the area.


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O. Sleeping Pattern

Each individual in the family has a specific sleep pattern. The live-in couple tries

to sleep from 10:00PM 7:00AM. However, this is usually cut short due to their

newborn. Mr. Burgos has irregular sleep patterns as he is usually up late. Heserves the barangay as a Barangay Tanod, so he is awake at night serving as a

watchman around the neighborhood. During the day, they try to take a nap to

compensate for the loss of sleep. Mrs. Clarita Burgos tries to sleep early and

wakes up around the same time the rest of the family does, which is around

7:00AM.

P. Eating patterns

The family cooks once a day, which last throughout the day. They also buy

cooked food, but they prefer to cook food for themselves. In the morning, they

buy foods such as pandesal and sometimes pancit as well. As a complement,

they drink coffee everyday for breakfast. The foods they commonly buy and

consume are vegetables and fish. They cook vegetable dishes such as pinakbet

throughout the week. When they buy fish, they usually fry it or grill it on charcoal

fire. The quality of the food is adequate, but it is in the quantity that becomes a

problem. There is usually enough to last for that particular day. Even in buying

canned items, it is only to serve for the days food needs. Ms. Lita Burgos claims

that sometimes there is not enough, so they try to make do of what is left. If

there is money, they try to buy food that is already cooked to increase the

quantity. Ms. Burgos stated that she has a soft side when it comes to salty food

and snacks. She usually adds more salt to her food to make it more to par with

her taste. None of the family seems to be overweight although Mr. and Mrs.

Burgos seem thin for their build. Ms. Burgos seems fair for her height and she

shows no signs of being overweight or underweight. They do not have a set to

time to eat and eat when they feel hungry.

Q. Leisure Time Activities

The family usually stays outside with the neighbors to pass the time. They watch

television at times as well. They try to bond with each other by going to church

and just spending time together at home. They do not spend much money on

leisure time activities. When they do spend money, it is usually on snacks. Mr.

Sandoval and his in-laws, Mr. and Mrs.Burgos, also partake in alcohol once in a

while during the week. Moreover, Mr. Burgos is a heavy smoker as he

consumes one (1) pack a day on the average.


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IV. Health and Medical History / Health Status of Each Member

A. Presence of Illness

Presently, 3 family members are experiencing illness. Both Mr. Burgos and Mrs.

Burgos are suffering from hypertension. They have consulted with the health

center and they were prescribed medicine, but refused to take them. Instead,

they try to control their hypertension through the foods they eat and take herbal

medicines. They try to eat vegetables such as garlic and take supplements such

as Taheebo. Ms. Burgos was and still is anemic. Hence, she takes ferrous

sulfate, but she forgets to take them sometimes. She also takes vitamins, but not

on a regular basis.

B. Past Illness

Besides getting the cold, cough, or influenza occasionally there is no other

presence of illness in the family. However, the transfer of communicable

diseases is fairly quick as space and ventilation is not adequate. There is no way

to keep a sick member totally isolated from the others.

IMMUNIZATION

Name Of Child Age Vaccines Complete IncompleteBenjamin Sandoval 1 month

BCGHepa B1

Given at Birth

Benjamin Sandoval 1 monthDPT / OPVHepa B2

12/04/2009

Benjamin Sandoval is 1 month old and was born on October 19, 2009. He was

delivered C-section at Valenzuela General Hospital.

V. Values, Habits, Practices on Health Promotion Maintenance & Disease

Prevention

A. Values, Beliefs, and Preventive Practices Employed by the Family

The family believes in hilot, tawas, and usog. They understand that some

vegetables, certain foods, and herbal medicines promote maintenance of health.

One of the family members expressed that the consumption of garlic reduces

hypertension. They rely on herbal medicines and supplements to help in

maintenance of health.


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B. Habits

Ms. Burgos expressed some habits she has noticed such as her fathers heavy

smoking habits. He consumes a pack of cigarettes per day on an average and

also drinks 3-4 bottles of beer a week. Mrs. Burgos and Mr. Sandoval consumealcohol occasionally. This habit of smoking can cause threats to health as the

effects of smoking are magnified in the poorly ventilated household. This can

have a great impact on the health of the family members, especially the newborn.

C. Source of health care

The familys main source of health care is the Sta. Quiteria Health Center. They

try to make use of all the services provided there. They also go to hospitals such

as Valenzuela General Hospital, where Ms. Burgos delivered her newborn.

VI. Health Hazards

In the case study of the Sandoval Family, the following were identified as health

threat to the Sandoval-Burgos Family.

A. Air Ventilation in the Household

This threat contributes to the quick transfer of disease not only to the family but

also the surrounding area. This is also a threat to air intake in the house when

cooking as it is polluted by the escaping smoke from the charcoal fire. There is

no place to isolate a sick member of the family. Moreover, smoking habits of Mr.

Burgos can be felt by the other family members since the air transfer is very

poor.

B. Improper Garbage Disposal

Improper garbage disposal can contribute to infestation of insects and rodents

that carry diseases, such as dengue and leptospirosis. The garbage that can be

seen near the cooking area can cause contamination of food. As a result, the

garbage can catch fire and contribute to an accidental fire.

C. Open Drainage

Open drainage can contribute to the infestation of insects and rodents. It can

also lead to the contamination of the area surrounding it and the water being

used. The water can be a breeding ground for mosquitoes that can lead to

dengue. When there is a flood from occurring calamities, these open drains can

overflow that could lead to acquiring communicable diseases.


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D. Insufficient Food Intake

Although the family consumes vegetables and fish, they do not consume enough

to fulfill their nutritive needs. They lack the quantity that they need. This can

cause health problems such as Ms. Burgos anemic concern. This problembeing brought up can help promote maintenance in Mr. and Mrs. Burgos

hypertension.


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SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TOPRIORITIES

Health Threat Due to Improper Garbage Disposal

Criteria Computation Actual Score Justification

1. Nature of theProblem

2/3 x 1 0.67 It is a health threat that needsimmediate action to reduce thepossibility of transferringcommunicable diseases that couldaffect the family.

2. Modifiability ofthe Problem

1/2 x 2 1 The problem is partially modifiablesince the family has no propereducation on the important factors

of disposing garbage properly. Anursing intervention would be todiscuss the importance ofdisposing garbage properly for thefamily to be able to practice propergarbage disposal.

3. PreventivePotential

1/3 x 1 0.33 Disposing garbage immediatelywill:

a. Reduce the transfer ofcommunicable diseasesfrom insects and rodents

that can affect all membersin the family and community.

b. Reduce the foul odor in thecommunity.

4. Salience of theProblem

1/2 x 1 0.50 The family recognizes this as aproblem that does not need animmediate attention since they arealready accustomed to what theirpractice of saving it until thegarbage collector comes to pick up

their garbage.Total Score 2.50


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Health Threat Due to Insufficient Intake of Nutritious Food



2/3 x 1 0.67 It is a health threat that needsimmediate action because it could

lead to malnutrition.2. Modifiability of

the Problem1/2 x 2 1 The problem is partially modifiable

since the family is earning anincome, yet not enough to fulfiltheir intake of food. Since thenurses resources are available,he/she can teach the familymembers achieve good nutritionand proper food selection andpreparation.

3. Preventive

Potential

2/3 x 1 0.67 Intake of proper selected and

prepared food will:a. Reduce the transfer of

communicable diseases.

b. Normal growth anddevelopment can beachieved.


1/2 x 1 0.50 The family recognizes this as aproblem that needs not animmediate attention since thefamily is contented with the food

they have selected and preparedfor that particular day.

Total Score 2.84


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Health Threat Due to Open Drainage System



2/3 x 1 0.67 It is a health threat that needsimmediate action to reduce the

possibility of transferringcommunicable diseases such asdengue.


1/2 x 2 1 The problem is partially modifiablesince the family does not haveadequate income to solve theirproblem.

3. PreventivePotential

1/3 x 1 0.33 Changing to closed drainage will:

a. Reduce the possibility ofgetting communicablediseases such as dengue

that is a deadly disease.

b. Reduce the transfer ofdisease from one familymember to another member.


0/2 x 1 0 The family recognizes this as aproblem that does not need achange since the family isaccustomed to this environment,which they have accepted.

Total Score 2.00


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Health Threat Due to Poor House Ventilation



2/3 x 1 0.67 It is a health threat that needsimmediate attention to reduce the

possibility of transferring oneillness of a family member toanother family member.


1/2 x 2 1 The problem is partially modifiablesince the family does not earn a lotto make windows and moreopenings in the house. The familycan only do so much to exchangethe indoor air with the outer air andvice versa such as opening thefront door and limited windows the

house has.3. PreventivePotential

2/3 x 1 0.67 Increasing house ventilation will:

a. Reduce the transfer ofcommunicable diseases thatcan affect all members thatlives in the household.

b. Decrease the inhalation ofair that has been exhaled byanother family member thatcould have an illness ordisease that has not beendiagnosed.


1/2 x 1 0.50 The family recognizes this as aproblem that does not need animmediate attention since thefamily is contented with thehousehold environment that theylive in.

Total Score 2.84

THE PRIORITIZED HEALTH PROBLEMS

The list of health condition or problems ranked according to priorities is presented:

Insufficient Intake of Nutritious Food 2.84

Poor House Ventilation 2.84

Improper Garbage Disposal 2.50

Open Drainage 2.00

Given available resources, the highest ranked, Insufficient Intake of Nutritious food, willbe addressed in the family nursing care plan.


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HEALTH TEACHING

Nutrition - the process in which you consume food or nourishing liquids, digest, and

absorb them and use them for health and growth.

Five Importance of Proper Nutrition

1. Socio-economic - people with proper nutrition would equate to people with good

health which would also equate to productive people and with productive people

comes economic progress.

2. Medical - proper nutrition provides body nutritional balance which would result to

avoidance of diseases.

3. Emotional - healthy people tend to interact more pleasantly than malnourished ones.

4. Aesthetic - since proper nutrition results to balanced body requirements, people with

good and proper nutrition look more pleasing than those without.

5. Financial - with proper nutrition comes good health which then results to saving from

medical expenses.

Good nutrition can help prevent disease and promote health. There are six categories

of nutrients that the body needs to acquire from food: protein, carbohydrates, fat, fibers,

vitamins and minerals, and water.

Six Categories of Nutrients

1. Proteins

Protein supplies amino acids to build and maintain healthy body tissue. There are

20 amino acids considered essential because the body must have all of them in the

right amounts to function properly. Twelve (12) of these are manufactured in the body

but the other eight amino acids must be provided by the diet. Foods from animal source

such as milk or eggs often contain all these essential amino acids while a variety of

plant products must be taken together to provide all these necessary protein

components.

2. Fat

Fat supplies energy and transports nutrients. There are two families of fatty acids

considered essential for the body: the omega-3 and omega-6 fatty acids. Essential fattyacids are required by the body to function normally. They can be obtained from canola

oil, flaxseed oil, cold-water fish, or fish oil, all of which contain omega-3 fatty acids, and

primrose or black currant seed oil, which contains omega-6 fatty acids.


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3. Carbohydrates

Carbohydrates are the body's main source of energy and should be the major part of

total daily intake. There are two types of carbohydrates: simple carbohydrates (such as

sugar or honey) or complex carbohydrates (such as grains, beans, peas, or potatoes).

Complex carbohydrates are preferred because these foods are more nutritious yet have

fewer calories per gram compared to fat and cause fewer problems with overeating than

fat or sugar. Complex carbohydrates are also preferred over simple carbohydrates by

diabetics because they allow better blood glucose control.

4. Fiber

Fiber is the material that gives plant texture and support. Although it is primarily

made up of carbohydrates, it does not have a lot of calories and usually is not broken

down by the body for energy. Dietary fiber is found in plant foods such as fruits,

vegetables, legumes, nuts, and whole grains.

There are two types of fiber: soluble and insoluble. Insoluble fiber, as the name

implies, does not dissolve in water because it contains high amount of cellulose.

Insoluble fiber can be found in the bran of grains, the pulp of fruit and the skin of

vegetables. Soluble fiber is the type of fiber that dissolves in water. It can be found in a

variety of fruits and vegetables such as apples, oatmeal and oat bran, rye flour, and

dried beans.

Although they share some common characteristics such as being partially digested

in the stomach and intestines and have few calories, each type of fiber has its own

specific health benefits. Insoluble fiber speeds up the transit of foods through the

digestive system and adds bulk to the stools; therefore, it is the type of fiber that helps

treat constipation or diarrhea and prevents colon cancer. On the other hand, only

soluble fiber can lower blood cholesterol levels. This type of fiber works by attaching

itself to the cholesterol so that it can be eliminated from the body. This prevents

cholesterol from recirculating and being reabsorbed into the bloodstream.


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5. Vitamins and minerals

Vitamins are organic substances present in food and required by the body in a

minute amount for regulation of metabolism and maintenance of normal growth and

functioning. The B and C vitamins are water-soluble, excess amounts of which are

excreted in the urine. The A, D, E, and K vitamins are fat soluble and will be stored in

the body fat.

Minerals are vital to our existence because they are the building blocks that make up

muscles, tissues, and bones. They also are important components of many life-

supporting systems, such as hormones, oxygen transport, and enzyme systems. There

are two kinds of minerals: the major (or macro) minerals and the trace minerals. Major

minerals are the minerals that the body needs in large amount. The following minerals

are classified as major: calcium, phosphorus, magnesium, sodium, potassium, sulfur,

and chloride. They are needed to build muscles, blood, nerve cells, teeth, and bones.

They are also essential electrolytes that the body requires to regulate blood volume and

acid-base balance.

Unlike the major minerals, trace minerals are needed only in tiny amounts. Even

though they can be found in the body in exceedingly small amounts, they are also very

important to the human body. These minerals participate in most chemical reactions in

the body. They are also needed to manufacture important hormones. The following are

classified as trace minerals: iron, zinc, iodine, copper, manganese, fluoride, chromium,

selenium, molybdenum, and boron.

Many vitamins (such as vitamins A, C, and E) and minerals (such as zinc, copper,

selenium, or manganese) act as antioxidants. They protect the body against the

damaging effects of free radicals. They scavenge or mop up these highly reactive

radicals and change them into inactive, less harmful compounds. In so doing, these

essential nutrients help prevent cancer and many other degenerative diseases, such as

premature aging, heart disease, autoimmune diseases, arthritis, cataracts, Alzheimer's

disease, and diabetes mellitus.

6. Water

Water helps to regulate body temperature, transports nutrients to cells, and rids the

body of waste materials.


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The Food Guide Pyramid gives you a picture of what a person should eat every day.

To get all the nutrients and calories you need to stay healthy, eat this delicious variety of

foods.

The Grain Group is located at the bottom of the pyramid. You need six to elevenservings grain per day. The Grain group gives you carbohydrates, which are a good

source of energy, as well as vitamins, minerals and fibers.

The Fruit Group and Vegetable Group make up the second row in the pyramid. You

need two to four servings of fruit a day. You need three to five servings of vegetables

per day.

The Fruit Group gives you vitamins A and C as well as potassium. Fruit also has fiber,

which helps move food through your stomach and intestines. Fiber can also help to

reduce the risk of diseases like colon cancer.

The Vegetable Group gives you vitamins A and C, and minerals like iron and

magnesium. Vegetables also provide antioxidants, which are chemicals that help to

protect cells from damage and reduce the risk of cancer and heart disease.

The Dairy Group and Meat Group are on the third level of the pyramid. You need two

to three servings of each group per day.

The Meat Group includes meat, poultry, and fish that give you protein and many

vitamins and minerals.

The Dairy Group includes milk, yogurt, and cheese. These are all excellent sources of

calcium, vitamin D and other vitamins, proteins and minerals. Calcium and Vitamin D

help build strong bones and prevent bone diseases.

At the top of the pyramid is the Fat Group which includes fats oils and sweets. These

should be eaten in small amounts.


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Health Risk related to Insufficient Intake of Nutritious Food

Malnutrition disparity between the amount of food and other nutrients that the body

needs and the amount that it is receiving. This imbalance is most frequently associated

with under nutrition, the primary focus of this article, but it may also be due to over

nutrition.

Kwashiorkoris a condition resulting from inadequate

protein intake. Early symptoms include fatigue, irritability,

and lethargy. As protein deprivation continues, one sees

growth failure, loss of muscle mass, generalized swelling

(edema), and decreased immunity. A large, protuberant

belly is common.

Marasmus - severe malnutritution in children caused by a diet

lacking in calories as well as protein. Marasmus may also be

caused by disease and parasitic infection.

Obesity - is a medical condition in which

excess body fat has accumulated to the

extent that it may have an adverse effect on

health, leading to reduced life expectancy

and/or increased health problems. It

happens when a person eats more food than

they need.


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HOME VISIT ACTIVITIES

Dates Activities

November 26, 2009 (1:00PM 5:00PM)y Initial home visit to the Sandoval Family

y Partial completion of initial data base

November 27, 2009 (8:00AM 12:00PM)y 2nd home visit to the Sandoval Family

y Continued completing initial data base

December 3, 2009 (8:00AM 12:00PM) y Completion initial data base

December 4, 2009 (8:00AM 12:00PM)

y Final home visit to the Sandoval family

y Health Teaching about nutritious food


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PHOTO GALLERY


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Date post:	08-Apr-2018
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Chn III - Part 2

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