CHN WEEK 5 ACTIVITY

Ivan Dan Allen

Kathleen Arceo
Lovely Sophia Arcibal
Jessie Rey Bagang
Aldrin Lumawig Berber
Kaizly Cabuso
Icha Casabar
Paolo Catama
Kristine Cruz
Sofia Bianca Dantes
Charles Rudy Dela Cruz

Situation:

Josefina Rivera is a public Health Nurse at the Rural Health Unit. She met 26-year-old Susan Yap, married, 6 months pregnant with her first child, in a Garantisadong
Pambata (outreach health services) visit at an ambulatory clinic in the barangay where the Yap family was residing.
Josefina found out that Susan never had a prenatal consultation. She also noted that Susan was underweight, with a weight of only 48kg and a height of 155 cm. When
Josefina asked her where she plans to deliver her baby, she replied that she would probably have a home delivery under the care of the local “hilot” because professional attendance
would be too expensive for them. Susan explained that she came to the ambulatory clinic upon the prodding of her husband who heard about the health workers’ visit to the
barangay. To assess the Yaps’ home situation and teach Susan health practices related to her pregnancy, Josefina asked Susan if she could make a home visit. Seemingly pleased
with Josefina’s attention, Susan agreed with Josefina on a home visit schedule, stating that she wanted to learn more from Josefina to prevent problems with her pregnancy and
delivery.
When Josefina made the home visit, she noted that Susan lived with her 32-year-old husband Mario, who was at work at the time of the visit. He was the sole breadwinner
of his family – a construction weaker earning the daily minimum wage. Susan described her husband as hardworking. They lived in a rented shack of mixed materials with a
bedroom, a bathroom and toilet, and a small multipurpose room (living and dining room and kitchen). Susan’s activities consisted mainly of household chores. Sometimes, Susan
would spend time at the homes of some friends and relatives residing in the neighborhood.
In the course of the interview, Josefina found out that Susan had inadequate knowledge about community health services, prenatal nutrition, preparation for childbirth, and
infant care. Susan said that she and her friends and relatives sometimes talk about such matters, but the information given was confusing and conflicting. Aside from palmar pallor
and underweight, other findings during physical examination were normal. When asked about her diet, Susan told Josefina that she limited her food intake because she did not
want to have a caesarian section, which may be needed if baby grew too big.
SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO PRIORITIES

PROBLEM # 1: Underweight/ malnutrition

Criteria Computation Actual Score Justification

1. Nature of the problem
3/3 x 1 1 Underweight is a Health deficit and requires more immediate attention
*Health Deficit to prevent risk on the delivery.

This problem is modifiable because there are resources available, and

2. Modifiability of the problem that solutions are visible, such as eating a well-balanced diet rich in
2/2 x 2 2
*Easily Modifiable nutritious foods which can help the client and her unborn baby achieve
the desired body weight and nutrition.

The client has been identified as being underweight, which can be

3. Preventive Potential
3/3 x 1 1 avoided by providing good health education and implementing
*Highly prevented
essential treatments.

4. Salience of the Problem

The client perceives underweight as not serious problem needing
* A condition or problem not
1/2x 1 0.5 attention because she does not want to have a cesarean section and
needing immediate attention
had a limited knowledge about prenatal nutrition.

TOTAL SCORE 4.5 Rank 1

Problem #2. Lack of knowledge on community health service, pre-natal nutrition, preparation for childbirth,
and infant care.

Criteria Computation Actual Score Justification

It poses a health threat because it might cause harm not only to the
1. Nature of the problem
2/3 x 1 0.67 mother but also the unborn, causing negative consequences due to
*Health Threat
lack of information.

This problem is modifiable because there is availability of the health

2. Modifiability of the problem
2/2 x 2 2 facilities, and the client is willing to learn on her problems in regards
*easily modifiable
with her pregnancy.

There is a high preventive potential for this problem because as a

3. Preventive Potential
3/3 x 1 1 nurse/ student nurse, we can give or teach health education to the
*Highly Prevented
family which they can use as a guide during her pregnancy.

4. Salience of the Problem The client recognizes it as a problem but not needing immediate
* A condition or problem not action due to insufficient knowledge on how to do so since the client
1/2x 1 0.5
needing immediate attention relay only her friends and relatives’ information which may make her
confused.

TOTAL SCORE 4.17 Rank 2

Problem # 3. Iron Deficiency (Palmar pallor)

Criteria Computation Actual Score Justification

1. Nature of the Problem 3/3 x 1 1 Iron deficiency is a health deficit in which may cause a major
*Health Deficit risk in one’s health not only to the mother but also to the fetus.
1/2 x 2 1 The problem is partially modifiable since she doesn’t have the
2. Modifiability of the Problem ability to recognize the presence of her condition due to
*Pazzrtialy Modifiable inadequacy of knowledge.

3. Preventive Potential 3/3 x 1 1 Further complications will be avoided if the problem will be
*Highly prevented recognized and be given careful attention.

4. Salience of the Problem 0/2 x 1 0 The family does not recognize it as a problem, and it does not
*Not perceived as a problem or seem the problem as needing immediate action due to
needing condition needing inadequate knowledge about health services and prenatal
change. care.
TOTAL SCORE 3 Rank 3
THE PRIORITIZED HEALTH PROBLEMS:
Family Nursing Diagnosis Scoring Justification Rank

Imbalanced Nutrition: Less than Body 4.5 Underweight is a medical condition that demands immediate attention to avoid harming Rank 1
Requirements related to insufficient dietary her pregnancy such as higher risk for delivery of low birth weight (LBW) infants, retarded
intake as evidence by limitation of food fetal growth, and perinatal mortality. As a fetus relies on its mother's diet to sustain its
intake nutritional needs for growth and development in the womb.

Readiness for enhanced knowledge 4.17 Lack of knowledge and false information places one's health in danger because it has Rank 2
the potential to harm not just the mother but also the unborn child.

Risk for bleeding related to iron deficiency 3 Iron deficiency is a medical problem that can be harmful to both the mother and to the Rank 3
unborn. This increases the risk of premature birth and is also associated with having a
low-birth-weight baby and postpartum depression.
 HEALTH METHODS
FAMILY
PROBLEM GOAL OF OF NURSE RESOURCES
NURSING OBJECTIVE INTERVENTIONS RATIONALE EVALUATION
IDENTIFIED CARE FAMILY REQUIRED/USED
DIAGNOSIS
ASSESSMENT CONTACT
Imbalanced Clinic-Visit
UNDERWEIGHT/ Nutrition: Less -After nursing Short Term: 1. Provide -Help the client Home Visit -Time and effort of Goals are met:
MALNUTRITION than Body interventions, information to realize the both public health
Requirements the client will -After 4-5 regarding individual importance of nurse and family. Short Term:
Subjective: related to display hours of nutritional needs and proper
insufficient behaviors and nursing ways to meet these nutrition. - The client was
The client is 6 dietary intake lifestyle intervention, needs within able to
months pregnant, as evidenced changes to the client will: financial constraints. -Low-cost resources understand the
and she limits her by limitation of recover/regain to support lifestyle health teachings
food intake to food intake. appropriate 1. able to avail changes to offered about the
prevent cesarean weight. of food recover/regain need of nutritional
delivery. supplements appropriate weight. intake and was
for pregnant able to use the
women supplements
provided by provided by the
Objective: the health 2. Discuss the -To be aware health facility. In
center. factors that of the factors addition, the client
Underweight contribute to that affect and was able to make
2. able to inadequate nutrition. may affect appropriate food
(155 lbs.) make their health. selections to
appropriate achieve the goal
food weight and
selections to improve their
achieve the overall health.
goal weight
within a -To give
specified 3. Emphasize the information
budget. importance of well- about
malnutrition.
 balanced, nutritious
intake.
Long Term:

3. Increase the -To provide -The client has

overall health well balanced demonstrated
status of the diet and to adequate
mother and 4. Teach the client to increase body methods for
the fetus. prepare nutritious resistance prioritizing which
food for the family foods are
within their capability appropriate for
to produce. meeting the basic
needs in order to
obtain a desired
Long Term: body weight.

After two -To encourage

weeks of the client to
home visit the implement
client will 5. Discuss with the proper food
exhibit proper client the necessity selection
ways in of correct food
prioritizing choices for pregnant
what food women and the
selection is benefits that
appropriate to consuming nutritious
meet the food may provide for .
necessary his or her unborn
needs in order child.
to achieve the
goal weight
and to
promote good
nutritional
habits for
pregnant
women.