Makati Medical Center College of Nursing

SY 2015 2016

A Case History of a Family with a One Month Old Infant Living Within Inadequate
Living Space

In Partial Fulfillment of the Course

Requirement of NCM101 Related Learning Experience

Submitted To:
Maam Shangri-La Juan I
(College of Nursing)

Submitted By:
Kristoffer Villa
BSN II-A
Group I
July 29, 2015

Table of Contents
Chapter I
I) Introduction. P.3
II) Purpose P.4
III) Objectives P.5
IV) Significance of the Study.. P.6
V) Scope and Limitations. P.7
VI) Background of the Study.. P.8

Chapter II
VII) Review of Related Literature P.9 - 11

Chapter III
VIII) Client Presentation P.12

Chapter IV
IX) Bibliography P.13

Introduction

Community Health Nursing (CHN) is one of the two major fields of nursing in the
Philippines. Its a synthesis of nursing knowledge and practice and the science and
practice of public health, implemented via a systematic use of the nursing process and
other processes to promote health and prevent illness in population group. Also, CHN is
the totality of its philosophy and beliefs, principles, processes and standards. As one of
the subsystems, its influences and is influenced by the health care delivery system.
(Maglaya, 2009)
Also Community Health Nursing is a type of nursing field that combines the
primary health care and nursing practice with public health nursing. The community
nurse conducts a continuing and comprehensive practice that is supposed to prevent
the problem of the individual, cure the problem/condition of the patient that is too poor to
afford a proper hospital setting, and lastly to rehabilitate the injuries the individual has
acquired. Its Philosophy of care is based on the belief that care is directed to the
individual, the family, and the whole community contributes to the health care as a
whole.
What is a community? A community is a group of people sharing common
geographic boundaries and/or common values and interest within a specific social
system. This social system includes health system, family system, economic system,
educational system, religious system, welfare system, political system, recreational
system, legal system and communication system. (Maglaya, 2009)
What is a family? From a systems perspective, a family is defined as a collection
of people who are integrated, interacting and interdependent (Maglaya, 2009). Just like
other systems, the parts (family members) interact with each other and the action of one
affects the other members. The family has a boundary which means that other people
can recognize its members and those who are not. (Maglaya, 2009)
The family that I have used for this Case History is a nuclear family living with an
extended family arrangement. They reside in a barangay named Pio Del Pilar. The
Acua family lives in a two story house that has an unconducive environment in regards
to ventilation, space, and cleanliness. The inhabitants are the following: the
grandmother, the mother, two children, a one month old infant, and two uncles. While
the father on the other hand is working overseas in China. In addition to this, they have
some borders that rent out rooms. They also have a variety of pets such as dogs,
parrots, and cats. Furthermore, it was seen that there were some vectors identified.
Some of which were lice on the dogs and cockroaches in the home.

Purpose
The researchers motivation or intention for overseeing and managing this type of
study is to primarily determine the well-being of the 1 month old female infant. This
would also include the two siblings residing in the home. One is an eight year old male
and the other is a 10 year old female. The determination of the well-being of the infant
and children is significant to be able to pinpoint some problems that may identified that
can affect their health, growth, and development. In effect, these problems can first be
identified by the student nurse, then improved or resolved by the cooperation of the
family.
Some of the problems that was seen to be of importance was the issue of an
unconducive environment and living space of the familys home. Their house is a two
story floor with two bedrooms, one bathroom, a kitchen, and a living room. However,
there are ten people living in this cramped area.
Aside from the cramped living space, they also have an issue with vectors
running rampant. These would include dog lice and cockroaches. This would be
important because this could be a source of bacteria and sickness to the inhabitants.
For example, the family had mentioned an unrecalled skin disease that they had all
acquired including the infant. The cause of the spread of the skin disease was not
identified. This is a prime example why this type of environment will be high risk in
acquiring different diseases. It makes the infant and children extremely susceptible.
Furthermore, hampering their well-being.
The researcher will be teaching the family the proper ways to have an acceptable
living environment to raise the children. This would be to prevent any rise of disease or
vectors that will be source of contamination or infection.
In addition, this study would also allow the community know the importance of
having an adequate living space and environment for their family to thrive in.

Objectives

The following objectives are listed below:

1) Problems that led to the development of the Health problem

Inadequate living space for 1 month old infant

Risk for sickness due to unsanitary living space
Vectors running rampant around the familys living space
Pets have foreign contaminants
The lighting in the household is dim

Lately they have been healthy in the family household but in their past history the
mom said they all acquired a disease that has left marks on their skin when it
went away.
2) Interrelationship of the variables that led to the development of the Health problems
and Family Nursing problems:

The interrelationship of the inadequate living space is where the beginning of

the problems will start to manifest along with the house not being able to have
proper airway circulation. Because of this the household has been inadequate
to live due to a lot of the familys things are just being put onto anywhere and
or is stacked together in one spot of the house until it starts to grow. Thus the
vectors has made this there home due to the family just leaving the things
they own unattended. And also for the fact that they own animals that are
also unclean since they are harboring foreign contaminants such as lices,
and ticks.

3) For the familys problem the appropriate nursing interventions would be to help them
have the proper health environment for the children to thrive in. Such as

House management and cleanliness ( to rid of the unnecessary objects in the

household)
Proper airway ventilation (Windows must be open so air from the outside will
be able to get inside the house and replace the stale air)
Pet management (To inform them about the health care of having pets and
also the benefits of taking the pet to a veterinarian)

4) The familys response was positive. They have quite an understanding of the problem
and will respond to it as soon as they can. As well as too take care of the unnecessary
objects in the household.

Significance of the Study

The conduct of this study can contribute to the following individuals and
community:
First and foremost would be the inhabitants of the home. They would benefit from
this study because it will shed light to the problems that were seen in their home.
Through this, they may all be more aware of what is conducive and unconducive for
them to live in. In addition, the family may initiate problem solving and implementation to
resolve the identified problems. And they may also be encouraged in partaking in an
initiative in improving their lifestyles, health conditions, and well-being.
In the case of the Acua familys problem is important because with poor house
conditions predisposes them to a large variety of health conditions. These may include
respiratory infections, difficulty of breathing or asthma, lead poisoning, injuries, and
even an impairment of ones mental health status.
Next, the infant and children may benefit from this study by allowing their
caretakers to recognize and expand their knowledge on the infants and childrens
necessities such as health issues. Since they are at a stage where many aspects are
crucial for them to grow up, it can provide significance to their health status, growth, and
development.
Another entity that can contribute to this study could be the community. They may
further improve and develop their programs and laws that help and focus the families
necessities to thrive in a healthy environment.

Scope and Limitations

In this section states the scope or boundaries of the study. The scope of this
study is the family with a one month old infant living within inadequate living space. It
will be limited to the nuclear family living with an extended family household
arrangement.
The researcher will conduct this study in the Barangay named Pio Del Pilar which
is located in Makati City. The data was obtained on the following dates: July 6-8, 13-15,
20-22, and the 27th. The time frame of this study was from the start of CHN duty (July
6th) at the Barangay to the 27th of July.
The data sources that were used originated from the family members. Also the
interview done had open and closed ended questions to further give knowledge about
their living situation to the researcher.
The limitations that were beyond the researchers control was the familys lack of
memory on some particular information. For some of the questions in the interview, they
were not all answered thoroughly because they were unable to recall it. Another thing
that was out of the researchers control was the familys educational standing. In
consequent, sometimes they would not know the rationale or may be confused or even
have a different perception on some aspects. Due to the mentioned limitations,
restrictions must be placed on the study.
Some weakness or shortcomings that were noted in the study were the following:
It involved the researchers lack of proper time management. This was due to the
fact that he must accomplish prior responsibilities of the other patients at the health
clinic before he may visit his given family. The lack of time management could be a
result of an influx of demands at the barangays health clinic which could be many
patients needing attention to the paper works that must be accomplished.
Another issue that posed to be a potential barrier was the researchers
insufficient Tagalog. This may lead to some misinterpretations and difficulty in
communicating and understanding on both parties.
Lastly, another weakness could be the time constraint again, but on the part of
the researchers assigned partner. For him to fulfill his duties, he must wait upon his
partner to finish her responsibilities first.

Background of the Study

In the community that the Acua family resides is a Barangay called Pio Del
Pilar. In this area there are services that are being provided for its residents. These
services would include the following: Health, Education, Transportation,
Communication, Leadership, Peace and Order, and Economy. Within the
aforementioned services there are allotted budgets for each sector. This is important so
the projects, events, and other necessities / resources for the services can be carried
out and be given to the people living in Pio Del Pilar.
As for the health purposes, in the barangay they have a health clinic that is
accessible to the residents. At the health clinic the people may go there for routine
checkups, obstetric checkups, consultations, administration of immunizations and/or
other medications.
Next, for educational purposes, the Barangay shows an importance in the
schooling of the children. There is an elementary and high school that the students can
attend.
In addition, the transportation that they use on a day to day basis can range from
jeepneys, tricycles, bicycles, motorcycle, or a vehicle.
Then for communication and gathering information, they use cell phones,
television for the news, and also the newspaper.
Also Pio Del Pilar has outstanding leaders that range from Budget and Finance
to Bids and Awards committee. These leaders are essential in guiding and motivating its
people to a certain goal of the Barangay. While the Public Order and Safety is
responsible for maintaining peace and harmony within the streets and homes. This area
is patrolled and monitored for the better good of its residents. Ever since Pio Del Pilar is
recognized to be a place with a lesser extent of crime in the residence of the people.
As for the economy, they have been doing well with the circulation of monetary.
There are many shops, stalls, and restaurants that are available.
Barangay Pio Del Pilar is also known with another name which would be CuliCuli. This particular name was coined because there was once an enormous rice field
where fruits and vegetables were planted and sown. Although Culi-Culi was not
classified as a horse ranch, it had more than 100 horses that were used to service
Calesa or Karitelas. This is what the travelers or visitors would use for transportation.
Culi-Culi was later renamed after the hero named General Pio Del Pilar, who lived in a
placed located at J. Victor Street corner, Jacinto Street.
My reasons as to why I chose the Acua family was because I was interested in
the one month old baby that I was assigned to. Another reason was because I also
wanted to discover the type of environment that the one month infant was exposed to.

By implementing the nursing interventions may be able to help the family with the
identified problems.
Review of Related Literature

Health Promotion
In defining the term, health promotion, there are three terms that are closely
related which is primary prevention, health protection, and illness prevention. Prevention
is defined as a means of avoiding a development of a disease. Now the levels of
prevention occurs at different stages. These is were primary, secondary, and tertiary
prevent come in. There are five steps that describe these levels: Primary prevention
emphasizes on (a) health promotion, (b) health problem protection. While secondary
prevention is targeted on (a) early health problem identification and (b) timely
interventions carried out. On the other hand, tertiary prevention is focused on the
restoration and rehabilitation of an individuals level of function.
There exist many health promotion programs that facilitate its offering such as
health promotion, definite protection, and screenings for diseases. In the community, the
local department specifically for health may also offer immunizations and other safety
measures. (Berman and Snyder, 2012)

Home Care
Within home care may include a diverse population that encompasses a range of
ages, health issues, family structures, and cultural backgrounds. Some important
dimensions would be safety and infection control.
Firstly, safety is a key component in preventing injuries. The most commonly
encountered cases would be falls, fire, poisoning, and other accidents. Although the
home health nurse cannot be expected to alter a familys living space and lifestyle, they
can encourage their concern and provide an intervention that can help improve the
living conditions of the family. Some areas to assess is the environment of the home.
This could include the following:
-

The walkways and stairways (inside and outside) whether they are uneven,
broken, of an absence of handrails.
Floors can be noted if they are uneven or slippery.
Bathrooms can be noted if there is an adequate night lighting or ease of
accessibility and cleanliness.
Kitchen can be noted if there are any repairs needed to be done.
Bedrooms if there is an adequacy of lighting, ease of access to the commode
Electrical if there are any frayed electrical cords and outlets that are
overloaded.
Communication devices are noted if they have an access in case of
emergency.
Medications if some are beyond their expiration date and method of disposal.

Secondly, for infection control can present to be a challenge especially if the

home care facilities are not conducive to basic aseptic requirements such as basic
running water. Hygiene poses an importance in preventing the spread of
microorganisms. These would include hand cleansing, wound cleaning, etc.
Lastly, in the home some health issues must be established. These could be
inadequacy living space, lack of cleanliness, or inadequate air circulation. One of the
most commonly experience issues however would be the familys lack of knowledge in
regards to health control and self-care. (Berman and Snyder, 2012)

Family Health
In a society, a family is a basic unit that consists of indiviuals who may or may not
be genetically related. Family health is centered on the consideration of the entire
familys health status as a whole along with each family members. The functions of the
family is to secure economic resources, defending the health by giving food and shelter.
There are different types of families in todays society. They are comprised of the
following:
-

Traditional family
Two-career family
Single-parent family
Adolescence family
Foster family
Blended family
Intragenerational family
Cohabiting family
Gay and Lesbian family
Single Adults Living Alone

On to another note, by applying a theoretical framework, helps promote the

health of the individuals and families. This will also aid in determining the familys level
of function, interaction / communication patterns, pinpoint their strengths and
weaknesses, and describe their health statuses. (Berman and Snyder, 2012)

Pest / Infection Control

There are four major categories of microorganisms that cause contamination in
humans: bacteria, viruses, fundi, and parasites. All of which could be carried by several
hundreds of species that can create problems. They can live and be transported via the
air, water, food, soil, body tissues and fluids, and inanimate objects. They could also live
on living organisms that can cause malaria, worms, and arthropods such as mites,
fleas, or ticks.
For microorganisms to be spread there are many different types of methods of
transmission:

Direct
Indirect (e.g. vehicle-borne, vector-borne)
Airborne

Furthermore, there are also factors that increase the susceptibility of infection
these would include age. The reason being because newborns and older adults
have a lowered immune system to defend against infections. The major cause of
infant mortality would be credited to infection because they still have an immature
immune system and is only protected by their mothers immunoglobulins for the
first two to three months. However, immunizations can be given to help boost
their immunity by preventing different ailments. (Berman and Snyder, 2012)

Client Presentation
In this section will be the description of the selected family client who is the one
month old female infant. MORE

Discussion of the significant individual findings of the family members currently living the
same household:

The father Jerry Yu is currently overseas at work

The mother FlorDeliza Acua is an accountant and a college graduate, but is

currently a stay at home mom.

The grandmother was a 6th grade graduate and her line of work would be a tailor

making dresses
The brother Constantino Acua owns and sells birds as a living as well as owning

a shop and also a college graduate

The other brother Benji Acua works with the brother and a college graduate
The 8 year old brother along with the 10 year sister are both going to elementary
school within the Barangay Pio Del Pilar.

Discussion that includes the prioritized Health Problems:

Inadequate living space for 1 month old infant

Risk for sickness due to unsanitary living space
Vectors running rampant around living space
Pets in household are carrying foreign contaminants
The lighting in the household is dim, may cause injuries.

The Nursing interventions given to the patients family has been met. The family have
understood the dangers of the health problems that were listed and are working to rid of
the problem as to not cause any Health issues later on.

Bibliography

Berman, A., Snyder, S. (2012) Kozier and Erbs Fundamental of Nursing Concepts,
Process and Practice. Ninth edition.
Pearson Education, Inc. New Jersey. United States.

Maglaya, Araceli S. (2009) Nursing Practice in the Community. 5th Ed.

Argonauta Corporation. Marikina City. Philippines.