CEBU DOCTORS’ UNIVERSITY

COLLEGE OF NURSING

MANDAUE CITY, CEBU

1 Dr. P. V. Larrazabal Jr. Avenue, North Reclamation, 6014 Mandaue City, Cebu,Philippines Tel. No. +63 (32)
238-8746 Web: www.cebudoctorsuniversity.edu E-mail: [email protected]

Instruction: Given a hypothetical case you are to utilized the concept of Responsible
Parenthood with Family Planning.

Situation: A family residing in a slum area in Barangay Uno, Purok 2, Cebu City was interviewed
by the Student Nurse-Ben. The family is composed of seven members including the cohabitated
couple and their five children. Mr. Jose, the head of the family is also the sole earner with an
income of 400 pesos daily as a contractual garbage collector in the city. While his partner, Ms.
Mae, who currently missed her period for the past 3 weeks, looks after their children ages 11
months,2 years old, 3 years, 4 and 5 years old respectively. They are both 28 years old and
attained a secondary level of education. However, Mr. Jose is also a drunkard and verbally
abused Ms. Mae when he was drunk and threatened to hurt the kids and leave.

Learners 1-6: Identify the possible problems that can arise from the situation. Formulate a
Comprehensive Nursing Care Plan (1 problem per pair with 5 interventions) on the above
given data focusing on our concept Responsible Parenthood with Family Planning.
 Nursing Care PLan 1 : BETONIO & GALEON

Rationale
Nursing Nursing Scientific Objectives Nursing
(with
Assessment Diagnosis Basis of Care Actions
source)
I General
[Physiologic Risk for Malnutrition is Objective: I. Measures to Rationale
Risk Problem]: infection: red the primary take : for
swollen bump cause of After 2
Risk for related to immunodeficien weeks of
Infection malnutrition. cy worldwide, nurse-client 1.1 Encourage 1.1 It
with infants, relationship, patients to helps thin
children, the client’s increase fluid out
Objective adolescents, body will be intake if not secretions
Cues: and the elderly free from contraindicated. and
most affected. signs of any replace
-Increase in There is a infection. fluid loss
the size of the strong during
bump over a relationship fever. It
few days as it between Specific also
fills with pus. malnutrition and Objectives: prevents
infection and After 3 days of stasis of
infant mortality, nurse-client urine by
- Red, swollen skin because poor interaction, the promoting
around the bump. nutrition leaves client will be diluted
children able to: urine and
-Foul odor
underweight, frequent
weakened, and 1. Alleviate or emptying
- Flushed skin
vulnerable to minimize of the
infections, infection-relate bladder.
-Sweating and
primarily d
Chills
because of complications. 1.2 Routinely 1.2 These
epithelial monitor the laboratory
-Body
integrity and 2.Maintian the patient’s white values are
temperature is
inflammation . number of blood cell count, closely
38.5 °C
white blood serum protein, linked to
Malnutrition can cells within and serum the
- Facial mask
make a person normal range. albumin. patient’s
of pain.
more nutritional
susceptible to 3.Demonstrate status and
infection, and the capacity to immune
Subjective
infection also identify function.
Cues:
contributes to infection-relate
malnutrition, d symptoms.
- ”hindi ko nga alam
kung saan which causes a
nagsisimula yung vicious cycle. An 4. 1.3 Promote
impeksyon nay an inadequate Demonstrate childhood 1.3 People
eh. Basta kahit dietary intake competence in immunization with
noong bata pa sya leads to weight caring for program. incomplete
titubuan na siya ng loss, lowered infection-prone Encourage immunizati
parang pigsa” As immunity, areas. adults to obtain/ ons may
verbalized by the mucosal update not have
patient’s mother. damage, immunizations sufficient
invasion by as appropriate. acquired
- The client pathogens, and active
verbalized; impaired growth immunity.
and
“Mainit ang development in
pakiramdam ko” children. A sick
1.4 Teach the
person's 1.4
client about the
- The client is nutrition is Educating
infection,
experiencing further the patient
including its
shortness of aggravated by about the
transmission,
breath. diarrhea, illness may
complications,
malabsorption, help build
and sources of
loss of appetite, their
assistance.
diversion of confidence
nutrients for the and
immune awareness
response, and of the
urinary nitrogen critical
loss, all of nature of
which lead to adhering
nutrient losses to the
and further recommen
damage to dations.
defense
mechanisms.
These, in turn,
1.5 Encourage
cause reduced the client to wash 1.5
dietary intake. their hands, and Handwashi
In addition, then wash your ng is an
fever increases own. Use a paper efficient
both energy towel to dry your method of
and hands after preventing
micronutrient washing. illness
requirements. transmissi
on. Dry
surfaces
 are more
effective in
Source: preventing
the spread
Katona, P. of germs.
(2008, May 15).
The Interaction
between Source: R.
Nutrition and (2021,
Infection. August
Oxford 22).
Academic. Nursing
https://academi Care Plan
c.oup.com/cid/a for Risk for
rticle/46/10/158 Infection.
2/294025 NurseBuff.
https://ww
w.nursebu
ff.com/nur
sing-diagn
osis-for-inf
ection/

Vera, M.
(2021).
Risk for
Infection
Nursing
Care Plan.
Retrieved
from
https://nur
seslabs.co
m/risk-for-i
nfection/
 NURSING CARE PLAN 2: DELFIN AND MADRAZO

Nursing Nursing Scientific Objectives of Nursing Rationale

Assessment Diagnosis Basis Care Actions (with
source)

I. [Psychologi Risk for Anxiety may General I. Measur Rationale

cal ineffective child be related to Objective: es to for:
Problem] bearing perceived After 2 weeks take:
process: due to change in of nurse-client
Risk for anxiety health status relationship, the 1.1 Encourage 1.1
ineffective and unknown client's body moderate Muscle
child Domestic etiology, will be able to exercise such strength,
bearing violence , possibly overcome as walking or flexibility,
Inconsistent evidenced by anxiety. non- weight and joint
Objective prenatal health apprehension bearing and tendon
Cues: visits; , uncertainty, activities (e.g., alignment
insufficient fear of Specific swimming, are all
-Feeling nervous all cognitive unspecified Objective: bicycling) in improved
of the time or the readiness for consequence After 3 days of accor with
majority of the time parenting; s, expressed nurse-client dance with the frequent
and not being able insufficient concerns, interaction, the client’s exercise. It
to control it knowledge of and focus on client will be physical aids in the
childbearing self. able to: condition and developme
-restlessness process; cultural nt of
apprehensive (for inadequate -Recognize and beliefs. tolerance.
example, in maternal Anxiety is a address Exercise tends
pregnancy you may nutrition; feeling of personal risk to shorten
feel constantly insufficient unease, factors. labor,
worried about your parental role worry or fear, increases likeli
baby) model; that can be - Demonstrate hood of a
insufficient mild or a healthy spontaneous
-feeling dreadful prenatal care; severe. pregnancy free vaginal
being unable to insufficient Everyone of issues that delivery, and
concentrate or support system; feels anxious may have been decreases
feeling as if your low maternal sometimes, avoided. need for
mind goes blank confidence; but some oxytocin
maternal people find it - Participate in augmentation.
-difficulty of falling powerlessness; hard to activities that
asleep maternal control their will help you 1.2 Review 1.2 Assess
psychological worries. prepare for the nutrition the need
distress; Some people birthing process requirements for gavage
substance with anxiety and baby care. and optimal feeding.
Subjective Cues: abuse; also have prenatal The
unplanned panic attacks, - Have a weight neonate
“I was doing fine pregnancy; which can be complication-fre gain to may
until it hit me like a unrealistic birth very e labor and support temporarily
ton of bricks at 28 plan; unwanted frightening. delivery. maternal- fetal require
weeks that maybe pregnancy needs. alternative
this pregnancy -Verbalize your means of
wasn't such a good comprehension obtaining
choice.” Some of the care adequate
pregnant requirements in fluids and
- The client women feel order to calories.
verbalized, “ I was distressed or support your
so anxious”. guilty about own and your 1.3 1.3
feeling baby's health. Recommend a information
-The client is anxious or consistent gives a
experiencing panic panicky when sleep and rest starting
attacks. everyone schedule (e.g., point for
expects them 1- to considering
to be happy. 2- hour ways to
But anxiety is daytime nap improve a
a mental and 8 hours of patient's
health sleep each sleep.This
condition and night) in provides
not a sign of a dark, rest to
weakness, comfortable meet
something room. metabolic
that will go needs
away on its associated
own or that with growth
you should of maternal
just ‘snap out and fetal
of’. tissues.
Reference:
1.4 Recognize 1.4
that the
patient is Acceptance
conscious of of the
his or her patient's
anxiety. feelings is
communica
ted by
acknowledg
ment of the
 patient's
feelings.

1.5 Allow the 1.5 Talking

patient to about
express his or anxiety-ind
her anxiety ucing
and, if situations
anxiety-provok and
ing situations worrisome
can be sensations
identified, might help
evaluate them. the patient
see the
issue more
realistically
and identify
the
variables
that are
causing the
worry.

Source:
2006.Kelly,
M. M.
Primary
care issues
for the
healthy
premature
infant.
Journal of
Pediatric
Health
Care.
Retrieved
from
https://care
plans21.rssi
ng.com/cha
n-16852400
/all_p1.html
 NURSING CARE PLAN 3: LAYESE & PARAS

Nursing Nursing Scientific Objectives of Nursing Rationale

Assessment Diagnosis Basis Care Actions (with
source)

[Psychological Deficient Family Planning General Measures to

Problem] Knowledge: is a program Objectives: increase
impaired that enables knowledge and
Deficient parenting r/t parents to After 1 week of understanding:
Knowledge insufficient deliberately nurse-client
information and responsibly interaction, the 1.1 Assess the 1.1 In order
Objective Cues: on family decide the client will be motivation and to internalize
planning number and able to: willingness of the new
spacing of their the client to knowledge
- Birth spaces children, by - Verbalize learn. acquired, the
less than 2 avoiding for the understandi client must
years apart time being, or ng of the see the need
even for an role and or purpose as
- Five indefinite importance to why they
pregnancies period, a birth. of family should apply
at the age of It is not a planning to the new
28 prognosis one’s health knowledge.
imposed on the and future - The
- Period 3 parents but an client
weeks late expression of Specific has
responsible objectives: the
- Low parenting right
self-esteem based on After 8 hours to
informed of nurse-client refuse
Subjective choices and interaction, the any
Cues: decisions of client will be educat
couples to able to: ional
- “I never achieve their service
learned about desired family 1. Verbalize s.
family size based on the
planning” their social and different 1.2 Help the 1.2 This is to
economic methods client to give the
- “I don't know capacity. of family integrate the client
anything planning information into adjustments
about her daily life. in her daily
contraceptives 2. Verbalize - Give life that will
such as birth Source: understa client result in the
control and Department Of nding of adequat desired
 IUDs” Health. (n.d.) fertility e time change in
What Is Meant awarene for behavior.
- “We did not By Family ss within integrati - New
plan out how Planning? DOH. a on. knowle
much children Retrieved monthly dge
we were September 7, period may
going to have” 2021, from create
https://doh.gov 3. Verbalize a
- “I feel as .ph/faqs/What-i benefits conflic
though I’m s-meant-by-Fa of family t
greatly lacking mily-Planning planning betwe
as a mother in en the
safely and existin
adequately g
planning out beliefs
and providing of the
for my family” client.

1.3 Use media, 1.3 This is to

visual aids, consider that
pictures, people take
audiotapes, in information
video tapes to in different
have a relatable ways.
effective - This is
presentation. to
- Use allow
familiar, the
simple clients
and to take
concrete in new
informati inform
on ation
easily
becaus
e of its
related
ness
to her
daily
life.
1.4 Encourage 1.4 This is to
questions. give client
- Facilitate enlightenmen
open t to their
communi ideas and
cation. questions.
- Verbal This allows
question the client to
and receive
answer. immediate
feedback and
make
corrections
rather than
practicing the
skill wrongly.

1.5 Help client 1.5 Clients

identify can be
community involved in
resources for lifestyle and
continuing environment
information and changes. This
support is to help the
client deal
and cope
with
adjustments
in the
present and
future.
Community
resources can
also offer
financial
support.

Wayne, G. B.
(2019, March
14).
Knowledge
Deficit
Nursing Care
Plan.
 Nurseslabs.
https://nurse
slabs.com/de
ficient-knowle
dge/

World Health
Organization.
(2020, June
22). Family
planning/cont
raception
methods.
WHO.
https://www.
who.int/news
-room/fact-sh
eets/detail/fa
mily-planning
-contraceptio
n

Learners 7-10: Based on formulated problems that your group had identified, make a Health
Teaching Plan utilizing the College format, involving the three learning domains (knowledge,
attitude, skills).
 Health Teaching Plan
RIVERA, SO, VIDAL

Objectives Content Evaluation Methodology

After 1 hour of 1. These are the What is your

holistic student nurse following risks and expected evaluation
- client interaction, complications of of objective 1?
the family will be able untreated infections - The family To interact with
to: due to malnutrition will be well clients, consider
educated on education and level
1. Know the risks and Risk of Malnutrition: the risks, of literacy.
complications of ● Weight loss complications ● Do not use
untreated infections. ● Lowered , and severity complex
Immunity of untreated medical
2. Prevent and ● Mucosal infections. terms.
control the spread of damage ● Use a
infections in their ● Invasion by What is your language
home. pathogens expected evaluation that they
● Impaired of objective 2? understand
3. Identify and growth and - The family better.
perform the single development will be aware ● Use visual
most effective and in Children of the aids to
least expensive way methods in incorporate
to prevent the spread Signs of Infection: controlling and make
of infection. ● Fever the spread of an effective
● Feeling tired infection and presentation
4. Know the ● Swollen apply them in .
importance of lymph nodes their ● Demonstrat
maintaining a ● Headache household. e healthy
balanced diet. ● Nausea practices.
● Pus What is your ● Listen to the
● Pain and expected evaluation clients
5. Practice a healthy tenderness of objective 3? responses
lifestyle on site of - To ensure and interact
wound that the with them
● Delayed family is well further to
wound protected question
healing from infection and answer.
and can do so
Complications: with a budget 1. Some infections
in mind. can lead to a life
● Bacteremia - Keeping it threatening
when sustainable, condition. These
 bacteria is consistent are methods to
present in and efficient. teach the client
the blood avoid these
● Sepsis - What is your infections:
When an expected evaluation - Good
infection of objective 4? hygiene.
spreads and - The family - Avoiding an
the body will alter their environment
reacts diets to be that can
vigorously to more healthy expose the
the germs, and nutritious family to
this is what in order to illness.
happens. protect them - Introduce
● Septic shock from the clients
- is a severe infections and to a simple
form of boost their food
sepsis that immunity. pyramid to
develops as follow for a
the infection What is your stronger
progresses expected evaluation immune
and causes of objective 5? system.
the organs to - The family 2. To prevent the
shut down. will embrace spread of infection:
a healthier - Teach
2. There are simple lifestyle to clients to
things you and your improve properly
family can do to quality of life. wash their
stop the spread of hands.
infectious disease at - Avoid
home, school or in sharing
your workplace. items.
- Full
● Immunise vaccination
against for children
infectious as well as
disease - a Covid
method of vaccinations
protecting .
oneself from - Wear a face
infectious mask. face
diseases and shield.
are given to - Teach them
babies, how to
toddlers, and cough
 adults to properly in
protect them public
from diseases places.
that are both - Make the
deadly and clients
avoidable. realize the
● Wash your importance
hands - One of infection
of the most prevention.
important - Explain to
and effective the clients
strategies to that if
prevent the symptoms
transmission persist go to
of infections the nearest
and illnesses Health
● Stay at home facility
if you are immediately.
sick - to 3. Determine the
prevent the clients capabilities
infection in regards with
from financial aspects.
spreading to - Identify the
others. low cost
● Keep health care
household facilities
surfaces around the
clean - client’s area.
Regularly - identify and
cleaning research
household about an
surfaces that affordable
are substitute
frequently yet
touched will effective.
help reduce 4. give and explain
the spread of to the client a
infections. simple illustration
of the food
3. The most pyramid.
effective and least - Teach
expensive way to clients on
prevent the spread how vital a
of infection is child and an
through Proper adult to
Hand Washing receive full
because it nutrition.
eliminates bacteria - With the
causing illness from balanced
hands by rinsing diet, Proper
and rubbing the sleep goes
hands with soap hand in
and water for at hand with it.
least 20 seconds. explain to
client how a
4. A balanced diet proper sleep
gives your body the can
nutrients it needs to contribute
function correctly. to the
To get the nutrition health of a
you need, most of person.
your daily calories
should come from: 5. For a healthy
● Fresh fruits lifestyle.
● Fresh - Prepare an
vegetables illustration
● Whole grains to the client
● Legumes of a Food
● Nuts pyramid..
● Lean Proteins - Explain and
teach the
These supply client why
nutrients to the good
body for it to work hygiene is
effectively. our body necessary.
is more prone to - Explain to
disease, infection, the client
weariness, and low why
performance if you prevention
don't eat well. of infection
Malnourishment is necessary
may result in especially to
growth and the children
development and elderly.
problems, poor - Remind
academic client to
performance and balance and
frequent infections. manage
 5. Having a healthy time and
lifestyle prevents insert new
malnourishment. knowledge
The strategies to in the
avoid application
malnourishment of good
are: hygiene.
● Eat a variety
of healthy
foods
● Don’t drink
beverages
with added
sugar
● Exercising
daily

REFERENCES

Habboush, Y. (2021, July 23). Infection Control - StatPearls - NCBI Bookshelf. National

Center for Biotechnology Information. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK519017/

Schulman, J. (2019). Signs of bacterial infection: Cuts, burns and in the body. Healthline.

Retrieved from https://www.healthline.com/health/signs-of-infection

Anderson, L. (2021). Complications of infection. Retrieved from

https://www.drugs.com/cg/complications-of-infection.html

Katona, P. & Katona-Apte, J. (2008). The interaction between nutrition and infection.

Infectious Diseases Society of America. Retrieved from

https://academic.oup.com/cid/article/46/10/1582/294025
Ministry of Health (2021). Prevent the spread of infectious disease. Retrieved from

https://www.health.govt.nz/your-health/healthy-living/environmental-health/infectious

-disease-prevention-and-control/prevent-spread-infectious-disease

Vera, M. (2021). Risk for Infection Nursing Care Plan. Retrieved from

https://nurseslabs.com/risk-for-infection/

Habboush, Y., Yarrarapu, S. & Guzman, N. (2021). Infection control. StatPearls Publishing

LLC. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519017/

Buttler, N. (2020). Balanced diet. Healthline. Retrieved from

https://www.healthline.com/health/balanced-diet

Castaneda, R. (2019). How to avoid malnutrition. US News. Retrieved from

https://health.usnews.com/health-care/patient-advice/articles/how-to-avoid-malnutriti

on

Deficient Knowledge – Nursing Diagnosis & Care Plan. (2021). Retrieved 7 September 2021,

from https://nurseslabs.com/deficient-knowledge/