College of Health Science

College of Nursing

COMMUNITY HEALTH NURSING

A Related Learning Experience

In

Concepcion Pequeña, Naga City, Camarines Sur

Pilapil Elijah Franzio F. BS NURSING II-G

Emelita T. Verdeflor, RN MAN

Clinical Instructor

Henry Callusura, RN, MAN

Clinical Program Coordinator

Stanley O. Dy, RN, MAN, PhD

Dean of College of Health Science
 CHAPTER I

INTRODUCTION

The family serves as the cornerstone of society, offering individuals

their first experiences with relationships, values, and social norms. The
dynamics within a family significantly influence each member’s identity
and shape their development from childhood into adulthood. As a small
but vital community, the family nurtures values and behaviors that
contribute to the well-being of society as a whole.

In community health nursing, the family is regarded as a key focus,

with health interventions designed not only to address individual needs
but also to promote the overall health of the family unit and, by extension,
the wider community. Community health nurses aim to empower families
by promoting wellness, preventing disease, and providing health
education. Through meaningful engagement, nurses support families in
taking control of their health and contribute to the development of
healthier, more resilient communities.

During my community health nursing duty in Camarines Sur,

specifically in Barangay Concepcion Pequeña, I conducted a health
assessment interview with the J family on September 9, 2024. Due to the
parents’ work obligations, I interviewed the eldest daughter, who provided
insights into the family’s health practices and concerns. The goal of this
case study is to assess the health status of the family members and to
formulate a nursing care plan that addresses their unique health needs.
Through customized interventions, we aim to enhance the family's
well-being and guide them toward healthier lifestyle choices.
 CHAPTER II

OBJECTIVE OF THE STUDY

OBJECTIVES

A. General Objectives

To conduct an in-depth case study of the J Family residing in Zone

4-A Spillway, Concepcion Pequeña, Naga City, with the goal of developing
a tailored intervention and nursing care plan. This plan aims to enhance
the family’s overall health, encourage healthier lifestyle practices, and
empower them to take ownership of their health, fostering long-term
self-reliance in maintaining their well-being.

SPECIFIC OBJECTIVES

1. Establish a trusting relationship with the J family to promote open

and effective communication.
2. Gather comprehensive data on the family's medical history, health
practices, and lifestyle to identify current health status, potential
risks, and future health needs.
3. Develop a detailed genogram to identify hereditary health
conditions and assess familial risk factors that may impact the
family's well-being.
4. Analyze the APGAR score to evaluate the family's functional
capacity, resilience, and ability to maintain overall health and adapt
to life changes.
5. Apply relevant nursing theories to tailor interventions that address
the family’s specific health needs and guide evidence-based nursing
care.
6. Identify and assess barriers to optimal health, including
environmental, social, and economic factors, and address these
through targeted interventions.
7. Formulate a comprehensive and prioritized nursing care plan that
addresses the family’s key health concerns, promoting wellness
through specific medical interventions, health education, and
lifestyle adjustments aimed at improving their quality of life.
 CHAPTER III

METHODOLOGY

3.1 INITIAL DATA BASE

A. FAMILY STRUCTURE AND CHARACTERISTICS

1. Members of the Household and Relationship to the Head of

the Family

Family Age Sex Civil Position Occupation Education Religion

Member Status

Berlin 39 M Married Father PHW Brgy. HighSchool Roman

Jocsin Graduate Catholic

Madelyn 39 F Married Mother Care HighSchool Roman

Jocsin Taker Graduate Catholic

Irich 18 F Single Daughte Student College Roman

Jocsin r Catholic

Carl 17 M Single Son Student Senior Roman

Jocsin HighSchool Catholic

John 16 M Single Son Student HighSchool Roman

Wayne Catholic
Jocsin

Suzethe 14 F Single Daughte Student Elementar Roman

Jocsin r y Catholic

Love 12 F Single Daughte Student Elementar Roman

Jocsin r y Catholic

2. Place of Residence of Each Family Member

Zone 4A Spillway Brgy. Concepcion Pequeña, Naga City, Camarines

Sur

3. Type of Family Structure

The type of family structure is a Nuclear Family

4. Dominant Family Members In terms of Decision Making

In terms of Decision-Making the Father is the head of the family.

 5. General Relationship of Family

In this family, the relationship is marked by mutual support and

cooperation, where each member plays an active role in
maintaining a balanced and organized home. They value teamwork,
with responsibilities shared among them to ensure that both daily
tasks and long-term goals are met. By fostering open
communication and collaboration, they create an environment
where everyone feels valued and contributes to the well-being of
the household, which strengthens their bond and helps them face
challenges together. This cooperative dynamic not only keeps the
home running smoothly but also promotes a sense of unity and
harmony among the family members.

B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

The socio-economic and cultural characteristics of this family reflect

a modest lifestyle, shaped by their economic limitations and cultural
background. The family primarily communicates in Bikol, their native
dialect, which strengthens their connection to their local community and
cultural heritage. This common language fosters a close-knit relationship
not only within the family but also with neighbors and other members of
their barangay, where they find support and a sense of belonging. Despite
the challenges of living with a limited income, the family relies on the
resources available to them, including occasional government assistance
during times of need, ensuring that they can continue to meet their basic
requirements.

Economically, the family’s main sources of income come from the

father’s work as a Public Health Worker (PHW) in their barangay and the
mother’s role as a caretaker. Combined, their monthly earnings range
from ₱3,000 to ₱5,000, which is a significant challenge, considering the
rising costs of basic necessities. They do not have additional sources of
income, meaning their budget is stretched thin each month. Despite this,
the family has developed a clear system of prioritization for their
expenses, ensuring that their fundamental needs, such as food, water,
electricity, education, transportation, and medical expenses, are met first.
These are essential for their day-to-day survival and the well-being of
their children, especially in terms of education and healthcare.

With their limited income, the family deprioritized less essential

expenses such as telephone services, internet access, and entertainment
like Netflix subscriptions. These are considered luxuries that they manage
to live without, focusing instead on necessities. It is noteworthy that the
family does not engage in any vices such as smoking or drinking, which
could further strain their financial situation. By avoiding these
expenditures, they can allocate their limited resources to more critical
aspects of their livelihood. Despite their financial hardships, the family’s
ability to focus on priorities, live within their means, and avoid vices
demonstrates resilience and resourcefulness in managing their
socio-economic challenges.

C. Home and Environment

The family lives in a semi-concrete house made from a combination

of cement and wood, which provides them with some structural stability.
Despite the simplicity of their home, they are fortunate to own the
property, which gives them a sense of security. The house is well-divided
into functional spaces, with a living room, kitchen, bathroom, and
bedroom. The children have their own separate sleeping area, allowing for
privacy and organization within the household. However, the layout and
construction of the house do present some challenges, particularly in
terms of safety and environmental risks.

One of the major concerns in their home environment is the

frequent flooding that occurs during heavy rains and typhoons. This not
only damages the structure but also creates health risks, as stagnant
water from floods can serve as a breeding ground for mosquitoes and lead
to waterborne diseases. Additionally, the house is surrounded by hanging
and mismanaged live wires, which pose a significant accidental hazard,
especially during storms when electricity and water make for a dangerous
combination. The drainage system around their home is open and poorly
maintained, contributing to the likelihood of flooding and increasing the
risk of illnesses from water contamination and improper waste
management.

In terms of household practices, the family uses charcoal to cook

their meals every day, a common practice in areas with limited resources,
but it presents potential respiratory risks due to indoor air pollution. They
store their food in plastic containers, which helps maintain cleanliness and
organization in the kitchen. Waste disposal is managed through a garbage
collection system, but the presence of scattered trash and open drainage
nearby makes the environment vulnerable to pests and diseases. Despite
these challenges, the family has access to essential community facilities
such as a Barangay Hall, Health Center, Day Care Center, Basketball
Court, and a wet market. These resources provide them with some level of
support in terms of healthcare, education, recreation, and access to fresh
food, helping them navigate the difficulties posed by their living
conditions.

Type of Communication

Cellphone, Social Media, and Email.

Sources of Information

Television, and Internet.

D. Health Assessment of Each Family Member

In terms of health, the family has generally maintained a good state

of well-being, with their most significant past illness being a collective
bout with COVID-19. The entire family contracted the virus, but they were
quickly quarantined, which helped prevent the spread to others in the
community. Thankfully, they all recovered fully without any severe
complications, highlighting their resilience and the effectiveness of early
intervention. This experience, while challenging, brought the family closer
together and reinforced their awareness of the importance of health and
safety measures, particularly in times of widespread illness.

Currently, the only family member dealing with an ongoing health

condition is Carl, who has asthma. His asthma is managed through regular
medication, which helps control his symptoms and prevent severe attacks.
The family is vigilant about Carl’s condition, ensuring that his environment
is as free from triggers as possible, though the home’s exposure to
flooding and mismanaged wires could potentially pose a challenge to his
respiratory health. Nonetheless, Carl’s condition appears to be stable with
the care and attention he receives from his family, and they are
committed to managing his asthma to ensure his well-being.

Overall, the family remains health-conscious and proactive,

particularly after their experience with COVID-19. Their access to
healthcare services at the local health center helps them stay informed
and manage their health needs effectively. With Carl’s asthma being the
only ongoing concern, the family works together to create a supportive
and nurturing environment that minimizes health risks and promotes
wellness for all its members.

D2. Family Health Assessment based on Functional Health Pattern

A. Health Perception health management patterns

The family maintains a positive outlook on their health, reporting no

major illnesses in the past year and believing that their overall health is
good. They place great trust in healthcare professionals, such as doctors,
nurses, and midwives, and actively follow medical advice when needed.
They are strong advocates of immunization for both children and adults,
reflecting their commitment to preventive healthcare.

Despite their limited financial resources, the family prioritizes

essential health services, regularly visiting hospitals and clinics. They also
utilize their local barangay health center for consultations and
vaccinations, making good use of available public health resources. Their
proactive health management extends to addressing potential
environmental risks in their home, ensuring that their family remains
healthy and well-prepared for any challenges.
 B. Nutritional Metabolic Pattern

In assessing the nutritional and metabolic pattern of the family, the

typical food consumption includes a balanced variety of items. The family
consumes vegetables and rice three times a day, while meat is eaten twice
daily, showing that these form the core staples of their diet. Additionally,
they eat fish and fruits once a day, indicating a moderate intake of these
nutrient-dense food groups. Processed foods, noodles, and fast food are
consumed 1-3 times per week, suggesting occasional indulgence in less
healthy options.

The family's frequency of meals aligns with a routine intake of food

at least three times a day, which may support their metabolic needs. The
family members drink more than eight glasses of water daily, contributing
to proper hydration and overall wellness. Additionally, the family
supplements their diet with vitamins, which can help address any nutrient
gaps and support their health further.

The family reports having a good appetite, with no issues related to

food discomfort, swallowing difficulties, or breastfeeding problems. They
also do not experience skin issues or dental problems, which reflects well
on their general health and hygiene. Overall, their eating habits appear
balanced, though there may be room for improvement by reducing the
intake of processed and fast foods to enhance their nutritional profile.

C. Elimination Pattern

The family's elimination pattern appears to be healthy, with no

significant issues reported regarding bowel or bladder function. According
to the assessment, there are no problems with bowel elimination or
urination, indicating that the family members do not experience difficulties
such as constipation, diarrhea, or urinary problems. This suggests that
their digestive and urinary systems are functioning normally, supporting
their overall well-being.

Moreover, there are no concerns regarding excessive perspiration or

body odor, which further reflects that the family does not suffer from
abnormal sweat patterns or related skin issues. This could be due to their
adequate hydration habits, as they consume more than eight glasses of
water daily, which helps maintain healthy skin and body function.

The absence of elimination issues, whether related to bowel,

bladder, or skin functions, signifies that the family has a well-maintained
elimination process. This is essential for maintaining health, as regular
elimination helps the body remove toxins and waste products. Their
overall pattern suggests balanced nutrition, hydration, and good personal
hygiene, all of which contribute to optimal elimination processes.
 D. Activity Exercise Pattern

The family maintains a healthy activity-exercise pattern by regularly

engaging in walking and jogging, both of which are beneficial for
cardiovascular health and overall fitness. Walking is a low-impact exercise
that is easily incorporated into daily routines, while jogging provides a
more vigorous workout, helping to improve endurance and stamina. These
activities suggest that the family prioritizes maintaining an active lifestyle,
which supports their physical health. They also report having adequate
energy and strength for daily tasks, indicating that their regular exercise
routine contributes to their overall well-being.

E. Sleep-Rest Pattern

The family’s sleep-rest pattern appears to be generally healthy, as

they report feeling rested and ready for daily activities after sleep. There
are no significant issues related to insomnia or nightmares, indicating that
the family experiences restful and uninterrupted sleep. This suggests that
they maintain good sleep hygiene and regular rest, which contributes
positively to their overall physical and mental health. With no recurring
sleep disturbances, the family is likely able to sustain energy levels
throughout the day, supporting their productivity and well-being.

F. Cognitive Perceptual Pattern

In terms of the family's cognitive-perceptual pattern, there are no

reported hearing difficulties or significant memory changes, indicating that
sensory and cognitive functions are well-maintained. However, some
family members have issues with their eyesight and are using eyeglasses
to correct vision problems. There is also no mention of any discomfort or
pain among the family members, which suggests that they are not
experiencing any sensory-related discomfort that could affect their
day-to-day functioning. Overall, the family's cognitive and perceptual
health seems to be stable, with minor vision concerns being managed
appropriately.

G. Self- Perception/ Self Concept

In assessing the family's self-perception and self-concept, it is

noted that they generally have a positive view of themselves, with no
major issues regarding body image or self-esteem. Changes in their
physical appearance or body have not been reported as a significant
problem for the family members. When it comes to emotional triggers, the
spouse is identified as the person who most frequently causes stress or
irritation, which could be due to the closeness of the relationship and
shared responsibilities. Despite occasional feelings of frustration, there is
no indication of feelings of hopelessness or loss of control, and the family
seems to cope well with life's challenges.
 H. Roles and Relationship

In terms of roles and relationships, the family handles challenges

primarily through discussions, indicating strong communication and
problem-solving skills within the household. They do not have any
significant issues with their children that are difficult to manage. The
family is also active in social groups, which suggests a healthy level of
social engagement and support from the community. Additionally, they
maintain close friendships, further contributing to their social well-being.
The family feels a sense of belonging in their community, which positively
influences their relationships and emotional health.

I. Sexual/ Reproductive

N/A

J. Coping-Stress Tolerance Pattern

The family has experienced significant changes in the past year or

two, but they manage stress effectively through the support of family,
friends, and their religious community. This network of support plays a
crucial role in helping them cope with challenges. When facing stressful
situations, the family does not resort to the use of drugs or alcohol, which
suggests that they have healthy coping mechanisms in place. Overall, the
family demonstrates resilience and stress tolerance by relying on strong
relationships and positive social connections to navigate through crises.

K. Values/ Belief Pattern

Religion plays an important role in the family's values and beliefs,

as they consider their faith in God to be significant in helping them face
challenges. Their spiritual beliefs provide them with comfort and guidance
during difficult times, reinforcing their resilience. Furthermore, the family
does not currently have any major plans for the future, indicating they
may be focusing on the present and handling things as they come.
Overall, their strong religious beliefs shape their decisions and actions,
serving as a source of strength in their daily lives.
 CHAPTER IV

FAMILY BACKGROUND

A. Data Base of the respondents:

Name: Berlin Jocsin

Age: 39

Gender: Male

Address: Zone 4A Spillway Brgy. Concepcion Pequeña, Naga City,

Camarines Sur

Birthplace: Naga City, Camarines Sur

Religion: Roman Catholic

Occupation: PHW Brgy.

Civil Status: Married

Nationality: Filipino

Number of Children: 5

Educational Attainment: High School Graduate

Estimated Monthly Income: P3,000 - P5,000

Name of Spouse: Madelyn Jocsin

B. FAMILY TREE
 C. GENERAL HOUSEHOLD DATA

Total NO. of Children: 5

List of Household members:

Family Age Sex Civil Position Occupation Education Religion

Member Status

Berlin 39 M Married Father/ PHW Brgy. High Roman

Jocsin Head of School Catholic
the family Graduate

Madelyne 39 F Married Mother Caretaker High Roman

Jocsin School Catholic
Graduate

Irich 18 F Single Daughter Student College Roman

Jocsin Catholic

Carl 17 M Single Son Student Senior Roman

Lawrence High Catholic
Jocsin School

John 16 M Single Son Student High Roman

Wayne School Catholic
Jocsin

Suzethe 14 F Single Daughter Student Elem Roman

Catholic

Love 12 F Single Daughter Student Elem Roman

Marie Catholic
Jocsin

FAMILY COPING INDEX

This chapter provides an analysis of the family’s real-life behaviors

and practices, comparing them to the ideal attitudes and behaviors
typically expected within a family setting. It evaluates how the family
handles various stressors and examines their behavior for any health
concerns or negative patterns. The aim is to understand how closely the
family’s actions align with ideal expectations and to identify any areas
where their management of stressors and overall health may be lacking.
Scaling:
1- No Competence
3- Moderately Competence
5- Complete Competence
CRITERIA IDEAL ACTUAL RATING JUSTIFICATION

1.Physical The family 5 The family

Independence Is involved with members show members exhibit
the ability to complete physical full physical
move around, independence. independence.
to get out of They can move They are able to
bed to take around, take care move around
care of daily of their personal freely, manage
hygiene, hygiene, and their personal
walking, etc handle daily tasks hygiene, and
on their own carry out daily
without needing tasks without
any help. needing any
assistance.

2. Therapeutic The family follows 3 The family follows

Competence Involves all prescribed prescribed
procedures or treatments and treatments and
medications procedures, such procedures,
prescribed for as taking including taking
the treatment medication and medication and
of illness, such making lifestyle making lifestyle
as prescription changes. changes.
drugs, However, there is However, they
appliances room for could improve
dressing improvement in their adherence to
exercise, stress sticking to diet diet plans and
relief diet plans plans and exercise routines.
exercise routines.

3. Knowledge Associated with The family has a 5 The family

Of Health the specific strong demonstrates a
Condition health understanding of thorough
condition that general health understanding of
gives rise to conditions and general health
treatment, basic care needs. conditions and
such as the They are preventive
awareness of well-informed measures. They
the disease or about disease are well-versed in
the inability to prevention and disease
comprehend have a good transmission and
the grasp of what is child care,
communicabilit required for the showing a solid
y of illnesses overall grasp of these
 and the mode development of essential topics.
of their children. However, there is
transmission. This knowledge still room for
Recognizing the helps them make growth in more
general pattern informed specialized areas
of development decisions about of health
of newborn health and knowledge, which
infants and wellness and could further
basic physical ensures they can enhance their
care needs of effectively ability to manage
infants manage their complex health
family's issues effectively.
well-being.

4. Application Concerned with The family 5 The family

of Principles family action in maintains a effectively
of General relation to healthy diet, practices general
Hygiene preserving ensures they get hygiene principles.
family adequate rest, They consistently
nutrition, and follows maintain a
ensuring essential hygiene balanced diet,
adequate rest practices. They ensure they get
and relaxation are diligent about enough rest, and
for family staying actively take
members, up-to-date with preventive
accepted immunizations measures to
implementing and adhere to safeguard their
precautionary proper food health. Their
measures safety measures. commitment to
(immunization, This these practices
medical comprehensive supports their
assessment, approach overall well-being
safe supports their and helps them
homemaking in overall well-being manage their
relation to food and helps prevent health proactively.
storage and health issues.
preparation)

5. Health Primarily The family takes 5 The family

Attitudes concerned with a proactive exhibits a strong
the way the approach to and proactive
family feels healthcare by attitude towards
about health actively engaging healthcare. They
care in general, in preventive actively seek out
including services and preventive
preventive consistently services and
services, health following public diligently follow
 care and public health measures. public health
health They are guidelines. Their
measures committed to commitment to
staying ahead of staying informed
potential health and engaged in
issues by health practices
participating in reflects their
regular dedication to
screenings and maintaining their
vaccinations, and well-being and
by adhering to preventing
guidelines potential health
designed to issues.
promote overall
well-being and
prevent illness.

6. Emotional It has to do The family shows 3 The family

Competence with the strong emotional exhibits high
maturity and competence by emotional
integrity with effectively competence by
which the managing stress managing stress
members of and making effectively and
the family are well-considered fulfilling their
able to cope decisions. They responsibilities
with the usual navigate efficiently. They
stress and challenges with generally handle
problems of resilience and challenges with a
life, and to plan consistently commendable
for a happy and uphold their level of emotional
fruitful life. The cultural values. maturity.
extent to which Their ability to However, there
individuals handle difficult are occasional
recognize the situations areas where they
appropriate thoughtfully and could improve,
disciplines maintain their particularly in
enforced by cultural practices enhancing their
their own reflects their emotional
family and emotional resilience and
culture. maturity and refining their
Developing the stability. planning
responsibilities strategies to
and decisions better navigate
of the future difficulties.
individual. An
eagerness to
meet sensible
responsibilities,
to accept
fortitude
adversity, to
 consider the
needs of others
as well as one's
own.

7. Family Concerned The family 5 The family

Living about the members showcases
interpersonal maintain exceptional
or group aspect harmonious interpersonal
of family life. relationships, relationships and
Members of the providing each effectively
family get other with mutual manages
along with each support and household affairs.
other, the ways managing They engage in
in which they household collaborative
make decisions finances decision-making
that affect the efficiently. They and offer mutual
family, the consistently show support, creating
extent to which respect and a nurturing
they support affection towards environment filled
each other and one another, with respect and
do things as a which contributes affection. Their
family, the to a positive and strong familial
degree of nurturing home bond is apparent
respect and environment. in their seamless
affection, and Their ability to teamwork, as they
the way in work together address
which they and support each challenges
organize the other helps create together and
household a collaborative celebrate each
finances atmosphere other's
where everyone achievements.
feels valued and This supportive
cared for. and harmonious
dynamic reflects
their commitment
to maintaining a
positive and
cohesive family
atmosphere.

8. Physical Concerned with The family’s living 3 The family lives in

Environment the home, environment is an environment
community and characterized by that is both
work significant safety unsafe and poorly
environment as concerns and maintained, which
it affects family poor significantly
health. House maintenance, impacts their
conditions such which negatively health and
as accident impacts their well-being. The
hazard health. Their conditions of their
pressure, home is of low home and
screening, quality and community
plumbing, presents present several
system, numerous serious issues,
cooking hazards that including
facilities, could pose risks hazardous living
privacy, to their conditions and
community well-being. The inadequate
level overall condition upkeep. These
(deteriorated of the living space problems create a
neighborhood, is detrimental, range of risks that
presence of reflecting a need adversely affect
social hazards, for substantial their daily lives
pests), school improvements to and overall quality
transport and ensure a safer of life. The
accessibility. and healthier combination of
environment. these factors
underscores the
urgent need for
improvements to
ensure a safer and
healthier living
environment.
9. Use of Degree of use The family 5 The family makes
Community of the family actively engages excellent use of
Facilities and awareness with various community
of the community resources to
community resources to support their
facilities support their well-being and
available for well-being and growth. They
welfare and development. regularly engage
education They utilize the with the barangay
barangay hall for hall for local
community events and
events and activities, utilize
gatherings, the health center
access the health for medical
center for medical services, and
care, and take enroll their
advantage of the children in the day
day care center care center for
for early early childhood
childhood education. In
education. addition, they
Additionally, they take full
participate in advantage of
other local various other local
services and services, which
programs that helps them access
contribute to their essential support
overall quality of and opportunities.
life. Their This proactive
involvement with engagement not
these resources only helps them
reflects a maintain their
proactive health but also
approach to ensures that their
leveraging children have
community access to quality
support for their educational
family's needs. experiences,
significantly
enhancing their
overall quality of
life.
 CHAPTER V

NURSING DIAGNOSIS

CUES OR DATA FAMILY NURSING PROBLEM

● Subjective Data: “Our Potential for Waterborne Diseases:

water pipes are rusty, which
causes us stomach pain ● The family is at risk of
when we drink the water,” as developing waterborne
expressed by a family illnesses due to the
member. consumption of
● Objective Data: The family contaminated water from
uses a communal water rusty pipes, indicating an
source, and it was observed unsafe home environment
that the pipes are rusty. that hinders health
maintenance and wellness.

● Subjective Data: “Our Risk of Respiratory Problems:

house always smells of
smoke because we often ● The family is exposed to the
burn garbage,” shared a risk of developing
family member. respiratory issues due to
● Objective Data: The inhalation of smoke from
presence of smoke from improper waste disposal.
burning garbage around the This indicates a home
house was observed, environment that is not
indicating poor air quality conducive to maintaining
inside the home. respiratory health.

● Subjective Data: “Every Risk of Injury and Waterborne

time it rains, our house gets Diseases Due to Flooding:
flooded, sometimes up to
knee-deep,” the family ● The family faces the risk of
stated. injury and exposure to
● Objective Data: The house waterborne diseases due to
is located in a flood-prone frequent flooding in their
area with inadequate home. This environment
drainage, leading to poses a threat to their
frequent flooding inside the safety and overall health.
home.
 CHAPTER VII

PRIORITIZING PROBLEMS

I. Contaminated Water Supply

CRITERIA COMPUTATION ACTUAL JUSTIFICATION

SCORE

1. Nature of the 2/2x1 0.67 This is a health

Problem threat because
the consumption
of contaminated
water can lead to
waterborne
diseases like
diarrhea.

2. Modifiability 2/2 x 2 1 This problem is

of the Problem highly modifiable
by providing
access to clean
water and
educating the
family about
proper water
treatment
methods.

3. Preventive 3/3 x 1 1 It is highly

Potential preventable
through
interventions
such as installing
water filtration
systems or using
safe water
storage practices.

4. Salience of 2/2 x 1 1 The family

the Problem recognizes this
issue as a priority
that requires
immediate action
to prevent
recurring health
issues.

TOTAL SCORE 3.67

 II. Air Pollution From Improper Waste Disposal

CRITERIA COMPUTATION ACTUAL JUSTIFICATION

SCORE

1. Nature of the 2/2x1 0.67 This is a health

Problem risk because
exposure to
smoke from
burning garbage
can cause
respiratory
problems.

2. Modifiability 1/2 x 2 0.5 It is moderately

of the Problem modifiable
through
community
education on
proper waste
management and
implementing
waste
segregation.

3. Preventive 3/3 x 1 1 Highly

Potential preventable by
promoting proper
waste disposal
techniques such
as composting
and scheduled
garbage
collection.

4. Salience of 2/2 x 1 1 The family

the Problem perceives this as
a significant issue
due to the
constant
exposure to
smoke and the
immediate health
risks it poses.

TOTAL SCORE 3.17

 III. Frequent Flooding

CRITERIA COMPUTATION ACTUAL JUSTIFICATION

SCORE

1. Nature of the 2/2x1 0.67 Flooding poses

Problem both safety and
health risks,
including injuries
and waterborne
diseases.

2. Modifiability 1/2 x 2 0.5 Moderately

of the Problem modifiable with
proper drainage
systems and
community
efforts to improve
flood prevention
measures.

3. Preventive 3/3 x 1 1 Preventive

Potential measures can
include
community action
for improved
infrastructure and
education on
flood
preparedness.

4. Salience of 2/2 x 1 1 The family

the Problem acknowledges the
urgency of
addressing this
issue due to the
recurrent nature
and impact on
their home.

TOTAL SCORE 3.17

 CHAPTER VIII

PLANNING AND INTERVENTION

PROBLEMS SCORE

Contaminated Water Supply 3.67

Air Pollution From Improper Waste 3.17

Disposal

Frequent Flooding 3.17

 NURSING CARE PLAN

Health Family Nursing Goal of Care Objectives of INTERVENTION PLAN

Problem Problem 2nd Level Care (Specific)
1st Level Assessment
Assessment

Contaminated Inability to recognize the After nursing After nursing Nursing Method of Resources
Water Supply danger of unsafe drinking intervention, the intervention, the Intervention Nurse-fam Required
water due to: - Lack of family will be family will be able ily Contact
knowledge on water able to prevent to: Gain
treatment methods. waterborne knowledge of
diseases by waterborne
improving water diseases, their
treatment causes, and
practices. prevention
strategies within
1. Educate the Home visits -
one month. -
family about to provide Educational
Ensure regular
water personalize materials
water treatment
treatment d education (pamphlets
methods are
methods such and monitor ,
practiced.
as boiling or family brochures,
using water adherence videos)
purifiers. to water about
2. Collaborate treatment waterborne
with local practices. diseases. -
authorities to Access to
improve the local
 water supply authorities
quality. 3. and water
Provide support treatment
in acquiring tools.
water
treatment
tools.

Health Family Nursing Goal of Care Objectives of INTERVENTION PLAN

Problem Problem 2nd Level Care (Specific)
1st Level Assessment
Assessment

Air Pollution Lack of knowledge on After nursing After nursing Nursing Method of Resources
from Improper proper waste disposal intervention, the intervention, the Interventi Nurse-fa Required
Waste methods leading to air family will be family will be able on mily
Disposal pollution. able to reduce to: - Gain Contact
respiratory knowledge about
issues caused by waste segregation
air pollution and and composting
implement within one month.
proper waste - Ensure proper
disposal waste disposal
methods. techniques are
followed within
three months.
 1. Educate Community - Educational
the family education materials
and sessions (pamphlets,
community and home videos) on
on proper visits for waste disposal.
waste personalize - Access to
disposal d guidance community
techniques on waste waste disposal
and the manageme services and
importance nt. composting
of tools.
composting.
2.
Implement
a waste
collection
system in
the
community.
3. Support
the family
in
establishing
a home
composting
system.

Health Family Nursing Goal of Care Objectives of INTERVENTION PLAN

Problem Problem 2nd Level Care (Specific)
1st Level Assessment
Assessment

Frequent Inability to protect the After nursing After nursing Nursing Method of Resources
Flooding home from flooding due intervention, the intervention, the Interventi Nurse-family Required
to: - Lack of preparation family will be family will be able on Contact
for emergencies. able to reduce to: - Gain
flood-related knowledge about
injuries and flood
improve home preparedness and
safety against prevention within
flooding. one month. -
Secure their home
1. Educate Home visits - Flood safety
and reduce the
the family and kits.
risk of flood
on flood participation - Access to
damage.
preparedn in community drainage
ess and meetings system
emergency regarding improvement
measures. flood programs.
2. Assist preparedness.
the family
in securing
their home
against
flooding by
elevating
furniture
and sealing
cracks. 3.
Collaborate
with local
authorities
to improve
community
drainage
systems.
 CHAPTER IX

Summary and Evaluation

This family case study focuses on the J family residing in Barangay

Concepcion Pequeña, Naga City, Camarines Sur. The study was conducted
to assess their health status, identify specific health concerns, and
develop a nursing care plan to address these issues. The assessment
revealed various challenges the family faces, including poor environmental
sanitation due to structural damage, risk of waterborne diseases,
unbalanced diet due to financial constraints, and sleep disturbances
caused by environmental noise. Despite these challenges, the family
shows resilience and commitment to maintaining their well-being.

The nursing care plan was developed in response to the prioritized

problems identified during the assessment. For each issue, specific
interventions, goals, and actions were planned and implemented to
support the family's health and improve their living conditions. The
interventions ranged from educating the family on safe water practices
and nutritious meal planning to collaborating with local authorities for
structural repairs and community noise control. These efforts aimed to
empower the family to take control of their health and environment.

Evaluation of the nursing care plan showed positive outcomes, such

as reduced risk of waterborne diseases and improved access to nutritious
food. However, challenges remain, particularly in addressing structural
issues and community-wide problems like noise pollution and waste
management. The family's active participation in community programs
and their willingness to implement recommended changes contributed
significantly to the progress made. Moving forward, continued
collaboration with local agencies and ongoing health education will be
essential in sustaining these improvements and enhancing the family's
quality of life.

Overall, the case study highlights the importance of a

comprehensive, family-centered approach in community health nursing.
By addressing both individual and environmental factors, nurses can help
families overcome challenges and promote long-term health and wellness.

Recommendations

As a 2nd-year nursing student and future nurse, I would

recommend several steps to further support the J family's health and
well-being, based on the findings of this case study:

● Strengthen Community Partnerships: Collaborate more closely

with local government units and community organizations to
 address the structural and environmental challenges faced by
families like the J family. Programs focused on improving drainage
systems and waste management could greatly reduce the risks of
flooding and air pollution, enhancing the safety and health of the
community.

● Enhance Health Education: Conduct regular health education

sessions not only for the J family but also for the entire community
on topics like proper nutrition, safe water practices, and preventive
health measures. Engaging families in these sessions will empower
them with the knowledge and skills needed to manage their health
more effectively and sustainably.

● Develop Sustainable Solutions: Encourage and support the

family in maintaining their home garden and exploring other
sustainable practices, such as rainwater harvesting and composting.
These initiatives not only provide direct benefits like improved
nutrition and reduced waste but also promote self-reliance and
resilience in managing their resources.

● Advocate for Improved Access to Health Services: Work with

local health authorities to ensure that families have better access to
health services, such as regular medical check-ups, vaccinations,
and treatment for chronic conditions like asthma. Improved access
to these services would help families manage their health
proactively and prevent complications.

● Implement Mental Health Support Programs: Given the

stressors identified, such as environmental noise and financial
constraints, it's important to integrate mental health support into
community health programs. Organize workshops on stress
management and coping strategies, and provide referrals to mental
health services when needed, to support the emotional well-being
of families.
 REFLECTIVE JOURNAL

Our first day of community duty was both exciting and challenging.
We were assigned to help the barangay distribute relief goods to families
in Zone 4A Spillway. There were many families waiting for help, so we had
to work efficiently as a team to ensure that everyone received the
assistance they needed. It was a physically tiring day, but the feeling of
being able to provide support to families made it worth it. Seeing how
grateful they were reminded me of why I chose to pursue nursing to serve
and help others in any way I can.

On the second day, our Clinical Instructor (C.I.) gave each of us a

task to interview and assess a family's overall well-being and
environmental status. I was assigned to a household where I began by
making small talk to make them feel comfortable before starting the
formal assessment. Through the interview, I learned about their daily
challenges and how their environment affected their health. This
experience taught me the importance of building rapport with patients and
being sensitive to their situation. It made me realize how crucial
communication is in nursing, especially when gathering information to
assess their needs.

By the third day, we had identified the main health problems that
the families were facing. As a group, we worked together to create a
simple health teaching plan to address these issues and raise awareness.
The aim was to provide the families with basic knowledge and tips to
improve their health. Preparing for this session was a good opportunity to
practice health education, which is an important skill for nurses. It also
allowed me to reflect on how we, as future nurses, can empower
communities through education.

When we arrived in the community for our last day, we conducted

our health teaching session. It was a simple yet meaningful activity where
we discussed topics like hygiene, proper nutrition, and basic first aid. I
was happy to see that the families were engaged and participated in the
discussion. It felt rewarding to share knowledge and see how receptive
they were. The experience made me appreciate the role of nurses in
promoting health not just in hospitals, but also within communities.

As a gesture of gratitude, we gave the families a small token of

some relief goods to show our appreciation for their time and cooperation.
This experience has given me a deeper understanding of the role of
community nurses. It’s not just about providing medical care, but also
about educating, advocating, and making a real difference in people’s
lives. It was an eye-opening experience, and I feel more motivated to
continue learning and improving as a nursing student.