Family Nursing Care Plan

FAMILY CASE ANALYSIS

Initial Data Base

Family DataFamily ChartEducational AttainmentEconomic StatusHome and EnvironmentHealth Status of the Family MemberValues Habits and Health PracticesSocial IndicesFloor Plan

    

Family Data 

 Family X is currently living in Barangay_____________, and has ____ total number of the family members. Approximately, the family is in _____ years of residency in alleged to above address. In terms of the authority, the family is (ex.Egalitaria) wherein the decision is equally distributed to each of them even the members of the family that is not yet employed. Family X is an (ex.extended) family wherein one of the siblings of Mr. and Mrs. X has a recent relation to same sex and now living together. Family X accepted him (gay partner of one of the siblings of Mr. and Mrs. X) as part of the family and one of the source of income related to his work. Family X is also considers a Live-in and Single Parent family.

 

Family ChartName Age

Sex

Civil Status

ReligionPlace

of Birth

DialectRelation to

Family HeadEmployment Occupation

Mr. M.  X 59 M S Catholic GMA Tagalog 

employed factory worker

Mrs. Z. X 58 F S Catholic GMA Tagalog live-in-partner unemployed  

A. X 50 M S Catholic GMA Tagalogbrother of Mrs. X

unemployed  

J. X 48 M S Catholic GMA Tagalogbrother of Mrs. X

employedconstruction

worker

R. X 30 M S Catholic GMA Tagalog son employedconstruction

worker

L. X 28 M S Catholic GMA Tagalog son unemployed  

K. X 12 F S Catholic GMA Tagalog granddaughter unemployed  

C.X 10 F S Catholic GMA Tagalog granddaughter unemployed  

J. X 8 M S Catholic GMA Tagalog grandson unemployed  

C 26 M S Catholic GMA Tagalogextended member

employed sales clerk

Educational AttainmentName Elementary High School College

Mr. M.  X 

Undergraduate 

Mrs. Z. X 

Undergraduate 

A. X 

Undergraduate 

J. X   Graduate  

R. X 

Undergraduate 

L. X 

Undergraduate 

K. X Grade 6    C. X Grade 4    

J. X Grade 2    

C   Graduate  

 

EXAMPLE

Economic Status

            Family’s main source of income is on the related work of each member that has a currently employed. Their monthly family income is approximately 10, 001 – 15, 000, due to unconditional wages because sometimes overtime in work may result to additional amount of salary that may lead to increase in monthly family income but in contrary some circumstances happened like sickness (may lead to absent) or end of contract then lead to decrease in monthly salary income.

            Family’s monthly expenditures are above the monthly family

income, approximately 15, 001 – 20, 000. It affects each member of the family especially Mrs. X who is the one budgeting the family monthly income and the children who is still studying. Their budget allocation is 40% to the household (basic needs), 30% for education, 15% for medicines, 10% for clothing, and 5% for recreations.

            Family felt needs; their highest priority is food, then education, financial, health needs, support system, housing, clothing, utilities, and recreation and last is spiritual needs.

EXAMPLE Home and Environment 

Family X have their own residency in an rural place with a mixed type of housing materials and have an adequate living space, lighting and ventilation enough for the family members. Their water supply is considered in Level I-point source. They owned a private excreta disposal which is in Level I-pit latrines. Electricity is their source of light. Their food and water are properly stored in a covered area. They have cell phone, and letter as their means of communication. They usually use jeepney, tricycle, motor, and bus as means of their transportation. In their social facilities, there is the availability of Barangay Hall, school, wet and dry market, day care center, basketball court as well as playground for children and chapel. There are also Barangay Health Center , Hospital, Clinic and what they call “hilot” present in their community. Accidents are present due to domestic animals that are not vaccinated such as dogs and cats in various places. Pests such as rats and mosquitoes that can cause dengue are also prevented through fumigation in their community.

EXAMPLE

Health Status of the Family Member 

Family members (excluding Mrs.. Z. X and her brother J. X) have no severe illnesses present only cough and cold for the past six months. Mrs. X has a present illness (hypertension). Their family has no health insurance and do not undergo family planning. They usually go to albularyo for consultation as their health seeking behavior but they sometimes consult to a doctor in the hospital and to the midwife in their Barangay Health Station.

EXAMPLE

Values Habits and Health Practices

          They believe in hilot, wherein they are testified that hilot is effective in curing illnesses of the family. Sometimes, they are consulting to the albularyo rather than go the nearest hospital due to their mind set of “mas makakamura kami rito”, as verbalized by Mrs. Z. X

EXAMPLE

Social Indices

Family X is not yet aware of organizations in their residence since then. As a result of it they are not aware of any organizations that can help them to have a quality healthcare.

Genogram Floor Plan

Measurement

Physical Assessment (example) Assessment

Family Member

Vital SignHeight Weight BMI Normal BMI

Actual FindingTemp. PR RR BP

Mr. M. X 36.1°C91

bpm18 cpm

140/90 mmHg

64 cm. 56 kg. 21.14

18.5-24.9 

wt. in pounds   x 703

(Ht. in inches)2

 

N

Mrs. Z. X

36.9°C81

bpm19 cpm

130/90 mmHg

61 cm. 43kg. 17.87 BN

A. X 37.2°C70

bpm16 cpm

100/70 mmHg

63 cm. 56 kg. 21.82 N

J. X 36.8°C70

bpm14 cpm

120/70 mmHg

62 cm. 57 kg. 22.57 N

L. X 36.3°C63

bpm14 cpm

120/80 mmHg

66.5 cm.

54 kg. 18.88 N

B. X 36.2°C 74bp

m15 cpm

110/70 mmHg

61 cm. 56kg. 17.87 BN

K. X 36.1°C79

bpm18 cpm   57 cm. 46 kg. 21.90 N

C. X 37.2°C75

bpm17 cpm   53 cm. 30 kg. 16.52 BN

J. X 36.8°C84

bpm17 cpm   54 cm. 43 kg. 22.81 N

C 36.3°C71

bpm16 cpm

120/85 mmHg

60.5 cm.

61 kg. 25.77 AN

 

Mr. M. X Mrs. Z. X A. X J. X L. X B. X K. X C. X J. X C

Assessment Normal Finding/s Actual Finding/s Justification  HEADEYES EARSNOSE NECK  MOUTH SKIN 

   

 

  

  

         

 

 THORAX AND LUNGS

   

 MUSCULOSKELETAL

  

   

 NEUROLOGIC

      

 BREAST AND AXILLA

     

 

 CARDIOVASCULAR

    

 

 ABDOMEN

    

  

Past and Medical History (example)

 

         Family X has a history of hypertension wherein it is presently manifested to Mrs. Z. X She is not taking any medication due to financial instability. According to her, it is much better to prioritize taking at least 3 times a day of food than to take any medication for her condition. Some of the family members’ chief complaints are cough and cold, this is the main concern of the family due to intermittent condition of the said complaints. The children are not fully-immunized, so they are prone to any kind of sickness or illness secondary to financial instability that cannot provide a budget for consultation or check-up to a doctor to the nearest hospital. Additionally, they even not consult to the Barangay Health Station even though they are aware for free consultation or check-up. They much believe to the hilot or albularyo.

Gordon’s Functional Health Pattern

          

1. HEALTH PERCEPTION AND HEALTH MANAGEMENT PATTERN  2. NUTRITIONAL AND METABOLIC PATTERN

 3. ELIMINATION PATTERN  4. ACTIVITY EXERCISE PATTERN

 5. SLEEP – REST PATTERN  6. COGNITIVE PERCEPTION PATTERN  7. SELF PERCEPTION AND CONCEPT 8. ROLE – RELATIONSHIP  9. SEXUALITY AND REPRODUCTIVE  10. COPING –STRESS TOLERANCE  11. VALUE BELIEF   

Family Coping IndexFamily: Family X  Address:                       Health Department:  

Family Coping Index

Point Scale Assessed ProblemsJustification Statement

 

 Physical Independence

 1    2     3     4     5

 

 Therapeutic Competence

 1    2     3     4     5

  

 Knowledge of Health Condition

 1    2     3     4     5

   

 

 Application of Principles of General Hygiene

 1    2     3     4     5

  

 

 

 Health Attitudes

 1    2     3     4     5

   

  

 Emotional Competence

 1    2     3     4     5

    

 Family Living

1    2     3     4     5   

 

Comments:  

Nurse’s Signature  

Cues and Data (example)  

Cues/Data Family Nursing Problem Subjective:“Malimit na masakit ang batok ko,” as verbalized by the patient. Objective: T – 36.7˚CP – 78 bpmR – 16 cpmB/P – 150/90 mmHg 

-         facial grimace-         guarding

  1. Inability to recognize the presence of the condition or problem due to: §lack of knowledge§denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specially:

-         economic implication-         emotional concerns-         psychological concern

  2. Inability to make decisions with respect to taking appropriate health action due to: §low salience of the problem/condition§inadequate knowledge of community resources for care

 

Listing of Potential Health Problem

Family Name                            :           Family XName of Family Heads :           Mr. M. XAddress                                   :                                                                    

List of Health Problems                                        Nature of Problem  Hypertension                                                     Health Deficit /

Health Threat Inadequate Ventilation                                       Health Threat Inadequate Living Space                                                Health Threat Presence of resting sites of Vectors of Diseases  Health Threat Alcohol Drinking                                                            Health Threat Smoking                                                                        Health

Threat Loss of Job                                                                Foreseeable

Crisis

SCORINGHypertension

Criteria Computation Actual Score Justification

1. Nature of the Problem3/3 x 1 1

It is a Health deficit.

2. Modifiability of the problem

1/2 x 2 1

The resources and interventions needed to solve the problem are slightly available to the family

3. Preventive Potential

2/3 x 1 2/3

The possibility of complication of the condition may prevent in maintaining the blood pressure low by taking the patient’s medication regularly and by using alternative like bawang.

4. Salience of the Problem 0/2 x1 0

The family does not recognize it as a problem

Total Score 2 2/3

Scoring

 Hype

rtension 

Ranking

Priority Problem Score

1 Presence of Resting Site of Mosquito

3 1/3

2 Inadequate Ventilation 3 1/6

3 Inadequate Living Space 3 1/6

4 Smoking 3

5 Loss of Job 3

6 Alcohol Drinking 3

7 Hypertension 2 2/3

  

Family Nursing Care PlanHealth problem Family Nursing

ProblemsGoal of Care Objectives of

CareIntervention Plan

 Inadequate Living Space as Health treat

 1.       Inability to provide a home environment conducive to health maintenance and personal development due to:

•Inadequate family resources specifically: financial constrains and limited physical resources.•Lack of skill in carrying out measures to improve home environment..

 After the nursing interventions, the family will decide on appropriate actions in improving home environment.

 After nursing interventions, the family: 1.will understand the risks/ disadvantages of having inadequate living space.2.can state possible actions in improving their home environment3.will identify available resources that could help them.4.will choose the most appropriate actions for the improvement of their home.

Nursing Interventions

Method of Nurse –Family

Contact

Resources required

 1.       Discuss with the family the risks of having inadequate living space.2.       Discuss with the family on actions preventing possible effects of inadequacy of living space.3.       Encourage the family to use resources available within their vicinity in improving their living space.

 Home Visit

 Human Resources: the availability and effort of the nurse and the family