FAMILY NURSING PROCESS

Family Service and Progress Record

BRGY. CANTAGUIC, SAN JORGE, SAMAR
AS OF NOVEMBER – DECEMBER (2017)

Introduction

A family Health Care Study was conducted to the Salinas family in Purok 1 of Brgy. Cantaguic, San Jorge, Samar. The family is headed by Mr. Michael
Salinas, 23 years old, a famer. His family members are: his wife, Ailyn Baltao and son John Michael Salinas. The study consists of the following: Family Structure,
characteristics and Socio Economic Status, Home and Environment, Health Status of Each Member, Values, Practices on Health Promotion and Maintenance, and
the Nutritional and Immunization Status of Members (below 5 years old).

Initial Data Base: (First Level Assessment)

Head of the Family: __Michael Salinas___ Age: _23 years old_

Address: __Brgy. Cantaguic, San Jorge, Samar__
Occupation: _Farmer_

A. Family Structure, characteristics and Socio Economic Status:

Remarks
Family Members Birthday Occupation Date
Relation Marital Highest Educ.
Sex Entered
to Head Status Completed
Type of
No. Name Month Year Place
Work
Common Elementary
1 Ailyn Baltao Wife F August 1998 Housewife -
Law Graduate
2 John Michael Salinas Son M November 2017 S - - -
1. Religious Affiliation: _Roman Catholic_
2. Family Members: __2__
3. Types of Family Status: _Nuclear_
4. Decision Making:
a) On health matters: _Mother_
b) On matters of Expenses: _Father and Mother_
c) Education: _Mother_
d) Participation in Community Activities: _Father_
e) Others (specify): _None_
5. Significant others in the family and roles they play:
Significant Others: _None_ Role: _ None__
6. Participation of the family in the community Activities: _None_

B. Home and Environment: Date Assessed:

1. Home:
a) Ownership: _Rented__
b) Construction and Materials used: _Mixed_
c) Number of rooms used for sleeping: __1_(3 by 3 meters)__
d) Lighting facilities: _Electrical connection_
e) General sanitary condition: __Clean__
2. Drinking Water Supply:
a) Source: _Public Portability_
Water Supply: _deep well_
b) Distance from the house: _15 to 20 meters_
c) Storage: _covered container_
d) Water treatment: _Boiling_
3. Kitchen
a) Cooking facility: __Firewood__
b) Sanitary Condition: __Clean_____
c) Drainage Facility: _Open Drainage__
4. Method of refuse collection and disposal:
a) Refuse and Garbage:
Container: __Garbage Sacks___
Method of Disposal: Open dumping and burning
Sanitary Condition: __Unsanitary_____
5. Method of Excreta Disposal
a) Toilet type: _Sharing_
Distance from house: ___3-5 meters___
Sanitary Condition: ____clean____
6. Domestic Animals
Kind of Animals Number Where Kept
______None_______ ____ None_______ ______ None_____

C. Health status of Each Member, Values, Practices on Health Promotion and Maintenance:

No Name of Member Past Illness Present Illness Management Outcomes Source of Care
.
Intake of Paracetamol
1 Michael Salinas Fever, Cough and Cold None Medicine BHW
Intake of Paracetamol
Ailyn Baltao
2 Fever, Cough and Cold None Medicine BHW
John Michael Salinas
3 - - - -

D. Nutritional and Immunization Status of Members (below 5 years old)

Name Age Nutritional Status Immunization Status

Weight for Age Weight for Length/Height
Height for Weight

John Michael Salinas 10 days old Severely Severely Normal Incomplete

 Underweight Wasted

Narrative Description of the family:

A narrative report of the family Health Care Study was conducted at Brgy. Cantaguic, San Jorge, Samar. The family health load was headed by Mr. Michael
Salinas, 23 years of old, a farmer, presently residing at Zone 1 of the same barangay with an average monthly family income that ranges from 1,000 to 5,000
pesos. They are three who are utilizing the income for their daily needs. Has a nuclear type of family structure. The wife decide on health matters, education and
participation in the community activities. While, they both decide on financial matters.

The family do not have their own house. They only tenant a house where it is made of mixed materials. They only utilize a single room for sleeping with a
measure of 3 by 3 meters. They have electrical connection but they only connect from their neighbor. The source of their drinking water is deep well, wherein it is
located 15 to 20 meters away. They use covered container for their water storage and boiling as their water treatment.

The family utilizes firewood in cooking for their food and the house has an open drainage facility. The family uses garbage sacks as container for their
waste disposal, and do burning and open dumping as method of refuse disposal.

The family has no toilet, they share with the toilet of Mr. Romnick Mabubay Sr. wherein it is located 3 meters away from their house. They do not have any
animals. Their new born baby, which is 10 days old is severely underweight and severely wasted. Their new born baby is not yet fully immunized. Their house is 4
meter away from the BHS of Brgy. Cantaguic, San Jorge, Samar and 12 km away from the poblacion where the RHU is located.
Initial Data Base:

Cues/Evidence Health Problem

- Ailyn Baltao was 18 years old when she got Teenage Pregnancy
pregnant.

- Ailyn Baltao, G1P0, 19 years old, delivered her Not able to utilize community resources for health care
baby in their house and handled by a trained
hilot. The baby has no essential newborn care.
The mother has no essential postpartum care.

- John Michael Salinas, 1o day old baby weighed 2 Low Birth Weight
kg and 47.8 cm, identified as severely
underweight and severely wasted.

- They don’t have their own toilet. They are Poor sanitary disposal practice
sharing with the toilet of Mr. Romnick Mabubay
Sr. which is located 3 meters away from their
house.

- Their kind of drainage system is open drainage Improper drainage system

- Garbage disposal is burning and open dumping. Improper refuse disposal

After conducting the study, the gathered data were prioritized and ranked according to the criteria and priorities of the family where each Health and
health related problem were given scores, and then the scores were summed up afterwards. The problem with the highest score ranks first and the other follows.
 After the prioritization and ranking of problems are done. The second level assessment will be followed where the health and health related problems will
be identified based on the cues gathered.
Prioritization:

1. Low Birth Weight

Criteria Computation Actual Justification

Score
Nature 3/3 x 1 1 It is a health deficit that requires immediate management
of the Problem to eliminate untoward consequence.

Modifiability 2/2 x 2 2 This is modifiable since the baby is just 10 days old. All he
of the Problem need is a proper breastfeeding and immunization to avoid
illnesses. While the mother need health education about
proper breastfeeding and she need to eat nutritious food
with a proper diet.

Preventive 2/3 x 1 0.67 This is preventable if the family member cooperate during
Potential health education and apply the contents.

Salience of the 0/2 x 1 0 The family member does not recognize this as a problem
Problem because of poor knowledge about their children
nutritional status.
Total 3.67
2. Not able to utilize community resources for health care

Criteria Computation Actual Justification

Score
Nature 1/3 x 1 0.33 This is a foreseeable crisis for the unexpected pregnancy.
of the Problem
Modifiability 2/2 x 2 2 It depends on the family. This could be easily modifiable if
of the Problem the family would cooperate with the health workers.

Preventive 1/3 x 1 0.33 This has a low preventive potential, because no matter
Potential how the pregnant mother and her family was advised that
she should gave birth in the hospital and that they do not
have to worry for the expenses they still did not follow the
advised of the midwife.
Salience of the 1/2 x 1 0.5 The family recognize this as a problem for they are
Problem financially not stable.
Total 3.16
3. Teenage Pregnancy

Criteria Computation Actual Justification

Score
Nature 1/3 x 1 0.33 This is a foreseeable crisis in terms of the mother adjusting
of the Problem with her new role and for having a newborn.
Modifiability 2/2 x 2 2 This is easily modifiable if the mother cooperate with the
of the Problem health workers. To attend health education for her to
accept and understand her new role. Also, with the help o
her family.
Preventive 3/3 x 1 1 This is highly preventable if the mother is well educated
Potential and I she will instill in her mind the things that she have
learned.
Salience of the 2/2 x 1 1 This is a serious problem. The mother will have to adjust
Problem for her baby. She is still young and may not be ready to
accept the role as a mother yet.
Total 4.33
4. Poor Sanitary Disposal Practice

Criteria Computation Actual Justification

Score
Nature 2/3 x 1 0.67 This is a health threat that is conducive to diseases.
of the Problem
Modifiability 2/2 x 2 2 This is highly modifiable. Resources are available in the
of the Problem community if the family would find ways for the
construction of compost pit.
Preventive 2/3 x 1 0.67 The spread of communicable diseases transmitted by
Potential insects and rodents can be prevented if the family
members cooperate.

Salience of the 0/2 x 1 0 The family does not recognize this problem as a serious
Problem and needing immediate attention because they are used
in burning and open dumping.

Total 3.34
5. Improper Drainage System

Criteria Computation Actual Justification

Score
Nature 2/3 x 1 0.67 This is a health threat that can be conducive to diseases.
of the Problem
Modifiability 2/2 x 2 2 Resources are available and interventions are feasible if
of the Problem the family member cooperates.

Preventive 2/3 x 1 0.67 This is preventable if the family would cooperate.

Potential
Salience of the 1/2 x 1 0.5 The family acknowledge this as a problem, they just do not
Problem have enough money to buy the needed materials like
nails.
Total 3.84
 6. Improper refuse disposal

Criteria Computation Actual Justification

Score
Nature 2/3 x 1 0.67 This is a health threat that can be conducive to diseases.
of the Problem
Modifiability 2/2 x 2 2 Resources are available and interventions are feasible if
of the Problem the family member cooperates.

Preventive 2/3 x 1 0.67 Occurrence of parasitism and other communicable

Potential diseases can be reduced or minimize/prevent breeding
places for mosquito.

Salience of the 0/2 x 1 0 The family does not acknowledge it as a problem

Problem
Total 3.34

List of problems ranked according to priorities:

 Ranked Score

1. Teenage Pregnancy 4.33

2. Improper Drainage System 3.84
3. Low Birth Weight 3.67
4. Improper refuse disposal 3.34
5. Poor Sanitary Disposal Practice 3.34
6. Home Delivery 3.16

Second Level of Assessment

Cues/Evidence Family Nursing Problem

- Ailyn Baltao, G1P1, 19 years old, gave birth in their A. Not able to utilize community resources for health care due to:
house handled by a trained hilot.
1. Financial Problem.
- She has no proper postpartum care. Her baby has no
essential new born care. 2. Distance of the Hospital.

- She was not able to go to the RHU after she gave birth 3. Distance of the RHU
in their house because of far distance from the
barangay to the RHU (12km)

- Ailyn was referred to the Samar Provicial Hospital by

Mrs. Marissa Dizon RHM III during prenatal visit for
she was a teenage pregnancy G1P0 and in need of
close supervision from a doctor. Also, Samar Provincial
Hospital has a program for teenage pregnancy, they
have classes in there to help the pregnant adjust with
their new role. To learn how to take care of their self
 and their baby. Also, they offer free philhealth
registration for the teenage pregnant for free
deliveries.

- Ailyn did not go to the Samar Provicial Hospital stating

that “Waray po kami ma’am kwarta parasahe. Waray
po liwat kami uukyan ha Catbalogan.”

- From Cantaguic to San Jorge proper via motorboat is

2hrs and with a fee of 50 pesos. And from San Jorge to
Catbalogan is 1 hour and with a fee of 30 pesos. Since
it is not safe to travel in the land for pregnant women
from Cantaguic to Quezon.

- Their barangay is 35km to the Samar Provincial

Hospital in Catbalogan.

- Ailyn Baltao was 18 years old when she got pregnant. B. Teenage Pregnancy and low birth weight

- Ailyn has only one prenatal visit 1. Unexpected Pregnancy

- John Michael Salinas, 1o day old baby weighed 2 kg 2. Teenage pregnancy, one of the causes for low birth weight.
and 47.8 cm, identified as severely underweight and
severely wasted. 3. Inadequate prenatal visit

- Low birth weight of the newborn.

- Poor Sanitary Disposal Practice C. Poor Sanitary Disposal Practice, Improper Drainage System and
Improper refuse disposal are Environmental Problem.
- Ailyn state that they share with the CR of their
neighbor Mr. Romnick Mabubay Sr. 1. Poor knowledge about the importance of hygiene and sanitation
 - Ailyn state that “mabalhin pa po kami balay, didto nala 2. Ignorance of problem about the probable disease
kami magtitindug hin CR”
3. Poor knowledge about the importance of proper environmental
- Improper Drainage System sanitation.

- Improper refuse disposal

- Their method of refuse disposal is open dumping

which is conducive to diseases.

- It can also be a breeding places for rodents.

After the 1st and second level assessments were done, the formulation of the Family Nursing Care Plan follows. The health and health related problems
based on the evidences and cues will be given solutions through an organized intervention measures with the goal and objectives of care and with the help of the
resources that will help in the conduct of interventions.

Family Nursing Care Plan

Brgy. Cantaguic, San Jorge, Samar
 As of September – December 2017

Health Problem Family Nursing Problems Goal of Care Objective of Care Intervention Measures Method of Nurse- Resources Required
Family Contact Manpower Materials
Not able to utilize 1. Financial Problem. After nursing After nursing 1. Provide knowledge Home Visit Midwife Paper,
community intervention, the intervention, the with the importance of NDP’s Pen,
resources for health 2. Distance of the mother has mother will visit to complete prenatal visit BHW Notes for
care Hospital. postpartum check- the BHS/RHU with and the risk of not home visit
up and the child is her baby for: having a complete health
3. Distance of the RHU immunized of prenatal visit. education
hepatitis B and 1. Postpartum
BCG. check-up 2. Provide knowledge
with the importance of
2. Immunization giving birth in health
based facility especially
for her and her baby.

3. Provide knowledge for

the importance of
postpartum check-up
and complete
immunization of the
baby.
Teenage Pregnancy 1.Unexpected Pregnancy After nursing After nursing 1. Provide knowledge Home Visit Midwife Paper,
and low birth weight intervention, the intervention: about the importance of NDP’s Pen,
2. Teenage pregnancy, child weight will breastfeeding. The BHW Notes for
one of the causes for low improve and the 1. The mother will proper way of home visit
birth weight. mother will use a be properly breastfeeding. health
family planning educated about education
3. Inadequate prenatal method. proper 2. Provide knowledge
visit breastfeeding of about family planning
 the baby and the and the proper spacing.
importance of
breastfeeding.

2. The mother will

be educated about
family planning
and proper
spacing.
Poor Environmental 1. Poor knowledge about After nursing After nursing 1. Discuss with the Home Visit Midwife Paper,
Sanitation the importance of intervention, the intervention, the family the importance of NDP’s Pen,
hygiene and sanitation family will be able family will be able proper environmental BHW Notes for
to know the to know how to sanitation. home visit
2. Ignorance of problem importance of practice living with 2. Discuss the probable health
about the probable proper a proper diseases/illnesses they education
disease environmental environmental can get if they do not
sanitation. sanitation. practice proper
3. Poor knowledge about environmental
the importance of sanitation.
proper environmental 3. Emphasize the
sanitation. importance of personal
hygiene.