MYCP102

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LICEO DE CAGAYAN UNIVERSITYLICEO DE CAGAYAN UNIVERSITY

COLLEGE OF NURSINGCOLLEGE OF NURSING

FAMILY CARE STUDYFAMILY CARE STUDY

CARMEN, CAGAYAN DE ORO CITYCARMEN, CAGAYAN DE ORO CITY

CAGAYAN DE ORO CITYCAGAYAN DE ORO CITY

In partial fulfillment of theIn partial fulfillment of the

Requirements in RelatedRequirements in Related

Learning ExperienceLearning Experience

NCM 102NCM 102

Submitted by:Submitted by:

KRISHNA B. BALSARZAKRISHNA B. BALSARZA

GROUP 3, BSN-2AGROUP 3, BSN-2A

Submitted to:Submitted to:

Mrs. REMEDIOS S. ROLE, RN, MANMrs. REMEDIOS S. ROLE, RN, MANCLINICAL INSTRUCTORCLINICAL INSTRUCTOR

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INTRODUCTION

Community is a body of people having common rights, privileges,

or interests, or living in the same place under the same laws and regulations; a

group of people sharing common geographic boundaries and common values

and interest. Community literally means to give among each other. Community

could be defined as a group of people who share gifts which they provide to all.

The nature of community health nursing is comprehensive, directed

towards the individual, families and the community at large. The community

health nurse fulfills a unique role in the community, promoting and protecting the

health of the community, whilst using a framework of sustainability.

The objective of the study is to help the family to cope with discontinuities

in health and threats in such a way to maximize their potential for high level

wellness, as well as to promote supportive relationship between people and their

physical and social environment.

We choose the family of ______________ because their family passed

the criteria and willing to participate for the said study. This study is being

conducted in the family belong to ____________. The criteria to choose the right

family for the study are the following, the family should belong to the poverty line

with a salary not exceed 3,000-4,000/month, should have a 0-5 years old child

for the application of IMCI and the family who have several health problems or no

actual problems but lots of social problems.

Every individual has the right to receive good care. To give good care, a

nurse must plan to support familys needs, abilities, interests and preferences.

Under the law, community health nurse and families are partners in this planning

process. If clients get involved in the care planning process, it is almost certain

that they will get better care and enjoy a higher quality of life

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FAMILY PROFILE

FATHER

Name:Position in the family:

Birthday:

Sex:

Educational Attainment:

Religion:

Nationality:

MOTHER

Name : Aida Nonasco

Position in the family: Mother

Birth Date : May 3, 1965

Age : 41 Years Old

Sex: Female

Civil Status: Widow

Address : Relocation, Zone 3, Canitoan, CDO

Citizenship : Filipino

Occupation : Manicurista

Income : 600/month

Height : 52

Weight : 46 kilogramReligion : Roman Catholic

Educational Attainment : High School Level (2nd year)

Immunization: No Tetanus Toxoid received since first

pregnancy .

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SON (1)

Name: Joel Nonasco Jr.

Age: 22 years old

Birthday: June 16, 1985

Sex: Male

Educational attainment: High School Graduate

Position in the family: Eldest child

Civil status: Single

Religion: Roman Catholic

Nationality: Filipino

Occupation: Jeepney Drivers assistant Konduktor

Immunization: incomplete immunization

Income: 1200/month

SON (2)

Name: Jordan Nonasco

Age: 20 years old

Birthday: January 20, 1987

Sex: MaleEducational Attainment: First Year High School

Position in the family: 2nd child

Civil status: Single



Occupation: Jeepney Drivers assistant Konduktor

Immunization: Incomplete immunization

Income: 1000/month

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DAUGHTER (1)

Name: Jorica Nonasco

Age: 12 years old

Birthday: December 10, 1995

Sex: Female

Educational Attainment: Elementary level (Grade V)

Position in the family: 3rd Child

Civil status: Child



Occupation: None


DAUGHTER (2)

Name: Jodame Nonasco

Age: 4 years old

Birthday: March 2, 2003

Sex: Female

Educational Attainment: nonePosition in the family: Youngest Child

Civil status: Child



Occupation: None


There are only 5 members of the family living in one roof because the

father is already died. During my visit most of the time, only the mother and the 4

years old child is in the house because her two sons (Jordan and Joel) are

working as a konduktor , they usually came home late. The 12 years old child

is not available all the time because shes in the school ( Calaanan elementary

school) during my visit.

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HEALTH HISTORY (ALL MEMBERS)

FATHER (DECEASED)

Mr Joel Nonasco Sr. was born on July 22, 1964 through normal delivery

but did not received the complete immunization. He only finished High school

level, a Roman catholic and a Filipino citizen. He passed away last April 13, 2004

at the age of 40 because of Congestive Heart Failure. As the Mrs. Aida recalled

of the incidence, Mr. Joel Nonasco had experienced fatigue but he ignored it

because he thought it was just a result of his job (jeepney driver) not until he

noticed that there is a swelling in his ankles and legs. Sometimes He

experienced shortness of breath when he is doing strenuous activities and whenlying flat in bed. He immediately rushed to the hospital and confined for 5 days

but unfortunately it was too late since the fluid already accumulated the lungs

and liver, even the doctors tried to give him medications bur still there was no

changes. Mrs. Aida said that he got his disease from his father who also died due

to heart failure.

MOTHER

Mrs. Aida Nonasco is 41 years old, born on May 3, 1965, weighs 46 kg

with a height of 52, widow and a Filipino citizen.

According to Aida, she never confined in the hospital because she had not

encountered any major health problems aside from fever, cough, cold and

fatigue. She gave birth to her four children through normal spontaneous vaginal

delivery at home assisted by the trained hilot. During her pregnancies, she never

had prenatal check-ups and she has never been injected with tetanus toxoid.

When her husband died, she works harder to support her children because at

that time her two sons have no work. Even the households are her

responsibilities including her two daughters. Since then, she always experienced

fatigue, headache, restless, back pain and sometimes difficulty of breathing. He

visit the Barangay Health Center, it was found out that she had a hypertension

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with a BP of 160/140 mmHg. She was then given with medication but she was

not able to continue it because she cant afford to buy the said medication.

According to her although it is a serious problem but she prefers to use the

money to buy for their foods instead of buying those medications. She also

mentioned that their food are always salted fish bagoong and dried fish bulad

and also she always drink coffee and soft drinks. As she said, she got this

disease from her mother because her mother is also hypertensive.

SON (1)

The eldest child of Mrs. Aida is named Joel Nonasco, 22 years old, born

on January 20, 1987, single, male, Roman Catholic and a Filipino citizen.

I was able to gathered data about Jordan only during my fourth visit

because most of the time hes not in their house because his job is a jeepney

drivers assistant (konduktor). As he mentioned, he never hospitalized before

because he just ignored his health problem such as fatigue, cough, headache

and difficulty sleeping and he did not receive a complete immunization when he

was still young. He just asked his mother on what to do about his common health

problems and sometimes their neighbors. If he experienced these symptoms, he

just took a rest and drinks some herbal plants such as kalabo. Jordan has noknown food and drug allergy and he has a regular pattern of elimination. Jordan

is a cigarette smoker, according to him he consumed 1 pack of cigarette per day.

He started smoking at the age of 18, he learned smoking from his friends. He

also mentioned that if he has a problem he asked his friend to drink alcoholic

beverages just to forget his problems financially and emotionally.

SON (2)

The second child of Mrs Aida Nonasco is named Jordan Nonasco Jr., 18

years old, male , single , born on June 16, 1985 and a Filipino citizen.

I was not able to get data from him personally because most of the time

his not around during my home visit. According to Mrs. Aida, he delivered Joel

normally at home assisted by the trained hilot in the community. According to

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her, Joel was not able to receive a complete immunization. Joel was never

confined to the hospital since he hasnt encountered any health problems. He

usually experiences cough, colds and an ordinary fever. Joel is not a smoker but

drink beverages occasionally. He has no known food and drug allergies and has

a normal pattern of elimination.

DAUGHTER (1)

The third child of Mrs. Aida named Jorica Nonasco, 12 years old, born last

December 10, 1995, Female, Roman Catholic and Filipino citizen. Jorica was

delivered through normal spontaneous delivery at home . During my visit Jorica

was always not available because shes studying at Calaanan Elementary school

(Grade V). I was able to gather data about her from his mother. According to Mrs.

Anita, jorica was not able to receive a complete immunization because shes not

particular about immunization because she doesnt know the importance of it.

Jorica has no problems with regards to her health according to her mother.

DAUGHTER (2)

The youngest in the family named Jodame Nonasco, 4 years old, born on

March 2, 2003, Female, Roman Catholic and a Filipino citizen.I was able to gather data from her mother since the child was too shy to

respond to my questions. According to her mother, Jodame was not able to

receive the complete immunization for the same reason. Jodame was born

normally at home assisted by the trained hilot. According to her jodame was

never confine in the hospital. The common problem that Jodame always

complaint are stomach ache, head ache, cough, tootache and fever. She never

bring Jodame to the health center because she just gave her with some

remedies that would relieve her condition and hesitate to ask help from the health

care providers.

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ACTUAL IMPLEMENTATION

1ST Visit

My first visit with my chosen family was on January 17, 2006. I was able to

greet the family and introduced my self, what school I came from and ask them if

they will allow me to choose their family for my care study. Mrs. Aida gave me a

permission to conduct the said study and explained to her what are the purpose

and objective of the said study to establish rapport to them. I also informed them

the duration of the study which is every Wednesday, Thursday and Friday. Since

they allowed me to choose their family for the study I already gathered some

data related to the profile and common problems encountered by each member

of the family. I also took the vital signs of Mrs. Aida and her 4 years old child

since the other two members were not there.

Mrs. Aida Nonasco

Blood Pressure: 140/120 mmHg Pulse Rate: 86 beats/minute

Respiratory Rate: 21 breaths/minute temperature: 36.9C

Jodame Nonasco

Pulse Rate: 62 beats/minute temperature: 36.8C

Respiratory Rate: 19 breaths/minute

2nd Visit

The second visit with the family was on January 18, 2007. When I reached

the house I saw Mrs. Aida washing their clothes, I greet them and ask if it is okay

to disturb her for 30 minutes. She smile and said yes and I let her take a rest for

a minute and took her vital signs. Mrs. Aida always ate foods that would trigger

her condition such as salted and dried fish, and most of the time drink coffee andsoft drinks. I instructed her to avoid those foods but instead she must eat green

leafy vegetables that can be found in their backyard such as malunggay, alugbati

and camote tops. I also encouraged her to visit the health center for monitoring of

her condition. During my second visit her two sons were not there.

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Mrs. Aida Nonasco


Respiratory Rate: 22 breaths/minute temperature: 37C

Jodame Nonasco



3rd Visit

The third home visit was on January 19, 2007. I greet the family and they

welcome me in their house and have a conversation and took their vital sign. I

have observed that they have an open drainage in front of their house and have

many container and galloons for their water. The water in the containers are used

for their clothes and bathing while the water in the galloons are used for their

drinking. I instructed the family to clean their open drainage everyday and to

cover their container. Since they just throw their garbage at the back of their

house I encouraged them to burn it or have it segregated from biodegradable

and non-biodegradable. I also instructed the family to maintain the cleanliness of

their kitchen, table and their bedrooms and have it organize.

Mrs. Aida Nonasco



Jordan Nonasco

Blood Pressure: 120/80 mmHg temperature: 37.1C

Pulse Rate: 86 beats/minute Respiratory Rate: 22

breaths/minute

Jodame Nonasco



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4th Visit

My fourth visit was on January 26, 2007. I greet the family and took their

vital signs. My purpose in this visit is to inform the family about the different

health services available in the community rendered by the Department of

Health. These services are given to the people in the community for free and I

told them also how they can avail for that services. Mrs. Aida doesnt know about

it and shes happy that I gave them information about the services.

I also teach them what are those basic procedure and its purposes that

would help them to manage their health problems that are commonly experience

by the family. These procedures such as how to do tepid sponge bath properly

and the proper preparation of ORESOL for dehydration/diarrhea and the

importance of herbal plants. These procedures are very basic yet this can help to

save peoples lives.

Mrs. Aida Nonasco



Joel Nonasco

Blood Pressure: 110/90 mmHg Pulse Rate: 80 beats/minuteRespiratory Rate: 19 breaths/minute temperature: 37C

Jodame Nonasco



5th Visit

During my fifth visit last January 31, 2007 the family was not there and

their house is close. When I asked their neighbor, they told me that they went to

their relatives in Carmen.

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6th Visit

Last February 2, 2007, I had my sixth visit with the family. I greet them and

ask why they are not available yesterday and she said they went to their relatives

to borrow some money. She said that their income is not enough to support their

needs. I gave them some instructions on how to find enough resources that could

sustain family needs. I encouraged the family to prioritize needs, to minimize

unnecessary spending and to use available resources such as vegetables

(malunggay, camote tops and alugbati) in their backyards to minimize budget for

foods. During this visit, I informed the family about the schedule of our

culminating and microteaching for them to be prepared.

Mrs. Aida Nonasco



Jodame Nonasco

Pulse Rate: 68 beats/minute temperature: 37C


7

th

VisitFebruary 08, 2007 was my 7th and last visit to the family. I informed them

that this is my last visit but we still have to see each other during the

microteaching and culminating activity. I was able to extend my gratitude to the

family for allowing me to choose their family for my case study and for being

participative. Im so happy because they said that they learned a lot from me

And they will practice all the things that they have learned. Im planning to give

something to them as a thanks giving but I decided to give it during the

culminating activity. This study has a two way process, they learned something

from me and I also learned something from them.

Mrs. Aida Nonasco



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FAMILY COPING INDEX

Area Rate Justification1. Physical

Independence ability to

move about, get of bed

and perform daily

activities.

3

The family partially provides needs to its

members.

Mother fails to give sufficient care to herself

and other members of the family

2. Therapeutic

Independence

includes procedure or

treatment prescribed

knowledge to condition

1

Prefers to use unrecognized herbal

medication to treat existing disease instead

of consulting to physician.

Listen to hearsay instead of consulting

professional medical help.

3. Knowledge of health

condition1

Knowledge deficit on the nature, signs and

symptoms, preventive and therapeutic

measures of the disease (Hypertension)4. Application of

Principles of General

hygiene

family nutrition and 6

adequate rest andrelaxation.

1

No appropriate medical treatment on her

condition. Poor hygiene, faulty eating habits,

garbage not properly thrown in right place.

(scattered at the back of their house )

Unclean kitchen and unwashed plates that

leads to the presence of flies all over their

area.

Inadequate living space, house unclean,

poor ventilation.

Incomplete immunization of the children.

5. Health attitude the

way the family feels about

heath care in general.1

Has no confidence in doctors.

Superstitious rites and belief in illnesses.

Inappropriate assumptions pertaining to

health condition.6. Emotional Competence 1 Does not give priority for immediate of her

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maturity and integrity

with which the members

of the family are able to

meet usual stresses and

problems of life and to

plan for a happy and

fruitful living .

medical condition. Shes lack of emotional

support since her husband was died.

7. Family Living

how well the family

members get along with

another in an

interpersonal relationship.

3

The family can get along with but

sometimes there are problems that they

need to talk about.

8. Physical Environment

home, community and

the work environment.

1Poor ventilation, open drainage, scattered

garbage at the back of their house,

disorganized and dirty kitchen.

9. Use of Community

Facilities

degree of the family use

and awareness ofavailable community

facilities for health

education and welfare to

physician

1

Resist health care management.

Use of unrecognized herbal medication

upon encouragement of neighbor

Legend:

5 Complete competence 3 Moderate Competence 1 No competence

HOME AND ENVIRONMENT

HOUSING

Family Nonasco recently residing at Relocation Zone 3, Canitoan Cagayan

de Oro City. There are could be considered as a squatter area because they just

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relocate for some reasons. The house is owned by the government and they

have pay 1 peso daily and there house is made of wood. They only have 1 room

used for sleeping. They used firewood as their cooking facility and located at the

inside their house. Kitchen is cluttered, usually with the presence of unwashed

dishes. Foods are placed on the dinning table, left over are not covered and not

properly kept. As to their lighting facilities they used lampara. As I have

assessed, their home is not organized and the space is inadequate for the

member of the family at the same time, rest is inadequate due to confining

space.

WATER SYSTEM

The only problem in their area is the water supply. They have poor water supply

because they still need to fetch water in a far area that is why the Nonasco family

is using clean covered tanks as a container for their drinking water. As I have

assessed, most of the people living in that area are utilizing the same water

supply as to the Nonasco family. Theyre only fortunate enough when it rain

because they will have extra water supply to be used.

TOILETWhen I assessed their toilet, I have noticed that they are using the pouring

system in which they will just pour water after using the bowel. It is located

outside their house at a distance of 5 meters. It is a public CR but they dont

need to pay every time they used it.

SANITARY CONDITION

They disposed their garbage at the back of their house and they did not

practicing proper waste segregation. They also have an open drainage in front of

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their house and according to Mrs. Aida, they clean it just once a week. They dont

have a pet inside their house and they dont have any domestic animals.

KIND OF NEIGHBORHOOD

The neighborhood is composed mostly of low- income families. A few of

these families are friendly and show concern for one another especially when

there is a problem among them.

EVALUATION

The family Nonasco needs to cooperate with therapeutic changes to help

the condition of the entire family. Understanding the disease condition

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(hypertension) and the importance of proper management should be one of the

priorities the family must continually maintain and must be on guard of.

Since environmental factor is one of the problem in the family, extra

measures should be practiced like cleaning the house and its surroundings. . it is

advisable that the surrounding should be kept clean, proper waste disposal

should observed not just for the family but, as well, for the whole community.

Diet should be strictly monitored also like avoiding salted and dried fish and avoid

drinking soft drinks and coffee. It is very important for them to eat green leafy

vegetables since they can get this in there small garden.

Self discipline would help Mrs. Aida to control her blood pressure such as

diet control, medications and the importance of visiting the health centers for

monitoring of her condition.

NAME: MRS. AIDA NONASCO DATE: JANUARY 17, 2007

Vital signs:

Pulse: 105 bpm BP: 100/60 mmHg Temp: 37.6C Resp. 25cpm

INSTRUCTIONS: Place an [X] in the area of abnormality. Comment at the space provided. Indicate the location of the

problem in the figure using [X].

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EENT:[ ] pain [ ] reddened [ ] impaired vision [ ] drainage

[ ] gums [ ] hard of hearing [ ] deaf

[ ] burning [ ] edema [ ] lesion of teeth

[ ] assess eyes, ears, nose

[ ] throat for abnormality [ ] no problem

RESPIRATION

[ ] asymmetric [ ] tachypnea [ ] barrel chest

[ ] apnea [ ] rales [ ] cough

[ ] bradypnea [ ] shallow [ ] ronchi

[ ] sputum [ ] diminished [ ] dyspnea

[ ] orthopnea [ ] labored [ ] wheezing

[ ] pain [ ] cyanotic

[ ] asses resp. rate, rhythm, pulse blood

[ ] breath sounds, comfort [ ] no problem

GASTROINTESTINAL TRACT

[ ] Obese [ ] distention [ ] mass

[ ] dysphagia [ ] rigidity [ ] pain

[ ] assess abdomen, bowel habits, swallowing

[ ] bowel sounds, comfort [ ] no problem

GENITO-URINARY AND GYNE

[ ] pain [ ] Urine [ ] color [ ] vaginal bleeding

[ ] hematuria [ ] discharge [ ] nocturia

[ ] assess urine frequency, control, color, odor,

[ ] comfort, gyne bleeding [ ] discharge

[ ] no problem

NEURO

[ ] paralysis [ ] stuporous [ ] unsteady [ ] seizures

[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors

[ ] confused [ ] vision [ ] grip

[ ] assess motor, function, sensation, LOC, strength

[ ] grip, gait, coordination, speech [ ] no problem

MUSCULOSKELETAL AND SKIN

[ ] appliance [ ] stiffness [ ] itching [ ] petechiae

[ ] hot [ ] drainage [ ] prosthesis [ ] swelling

[ ] lesion [ ] poor turgor [ ] cool [ ] flushed

[ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic moist

[ ] assess mobility, motion gait, alignment, joint function

[ ] skin color, texture, turgor, integrity [ ] no problem

_______________

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NAME: JODAME NONASCO DATE: JANUARY 17, 2007

Vital signs:




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RESPIRATION



















[ ] no problem

NEURO













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______________________________

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NAME: JORDAN NONASCO DATE: JANUARY 19, 2007

Vital signs:




EENT:

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[ ] pain [ ] reddened [ ] impaired vision [ ] drainage





RESPIRATION



















[ ] no problem

NEURO













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NAME: JOEL NONASCO DATE: JANUARY 26, 2007

Vital signs:






_______________

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RESPIRATION



















[ ] no problem

NEURO













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