III.

FAMILY PROFILE

Head of the Family : Mr. x

Date of Birth :x
Age : 28 years old
Address :x
School Attainment :x
Religion : Iglesia ni Kristo
Citizenship : Filipino
Occupation :x
Family Income : 5000/month

Name of Wife : Mrs. x

Date of Birth :x
Age :x
Address :x
School Attainment : x)
Religion :x
Citizenship : Filipino
Occupation :x
Family Income : none
Blood Pressure : 100/70 mmHg
Temperature : 36.3 Degrees Celsius
Respiratory Rate : 20 cpm
Pulse Rate : 65 bpm
 Head of the Familyc Family Members: 6
Address: c

I. Members of the households

Family Name Relation to Head/ Sex Birth date Highest Occupation

Member Civil Status Month Year Education /Type of
Number Completed Work
1 x x F x 1980 College Level Housewife

2 x x M x 2002 Grade 1 N/A

3 x x F x 2004 Not At School Yet N/A

4 x x M x 2006 Not At N/A

School Yet
5 x x F x 1990 High school None
Graduate
 IMMUNIZATION RECORD
Immunization of Children: (Done at Bulua Health Center)

Name BCG DPT OPV HEPA B MEASLES

1.x √ √ √ √ √ √ √ √ √ √ √

2. x
√ √ √ √ √ √ √ √ √ √ √
3. x
√ √ √ √ √ √ √ √ √ √ √

4x √ √ √ √ √ √ √ √ √ √ √

5. x √ √ √ √ √ √ √ √ √ √ √

6. x √ √ √ √ √ √ √ √ √ √ √

FAMILY PLANNING USED: CONTRACEPTIVE PILLS

IV. HEALTH HISTORY

Mr. x

Mrx, the head of the family, is a soldier assigned x and goes home only
every 3 months. He started to smoke when he was 20 years old with a
minimum of 10 sticks per day and is an occasional drinker. For the
past years, he suffered minor illnesses only such as cough and fever.
According to his wife, he just takes Paracetamol 500mg 1 tab q4h and
herbal plants namely Lagundi for minor illness such as fever and
cough. As claimed by the wife, Mrx doesn’t have any heredofamilial
diseases on both paternal and maternal side.

Mrs. x

Mrsx, the wife did not complained of any health problems. She has
given Normal vaginal delivery to all her 3 children x wherein she also
had her pre-natal check ups when she was pregnant. She started to
use a family planning method after her 2nd child was born and chose
PILLS. But she claimed that she did not like taking the contraceptive
pills regularly because of its side effects such as dizziness. She said,
she would just take the pills, 1 week before her husband comes home.

x is the eldest child of the x family. Unfortunately I was not able to

assess him regularly because he is at school. But according to her
mother x is a healthy child with complete immunizations.
x

x is the 2nd child and I always meet her on each of my visit. She is a
charming child with complete immunizations also. Her mother said that
she only suffers minor illness like fever and colds and was given
medications such as Calpol , 1 tsp every 4 hours.

.x

x is the third child and has complete immunizations. Her mother said
that he has recently suffered cough and colds for 3 days so she self
medicated x with Carbocisteine, 1 tsp. 3 x a day. As I assessed x, I
noticed that there are a lot of mosquito bites on his legs. When I asked
the mother about it, she said that she has not done anything with the
problem yet.

x is the sister of Mrs. x. She stays with the x family to help and
assist her sister in rearing the children since her brother-in- law is
working away from home. She did not complain of any discomforts and
said that they don’t have any heredofamilial disease. For the past
months, she suffered minor illness only like cough and colds. When
asked what medications she took that time, she said she make used of
Lagundi leaves to cure her illness.
IMCI Assessment

MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS

Date: x
Child’s Name: x Age: 12 months Sex: M Weight: 9 kg Temp: 36.8C
ASK: What are the child’s problems? IMosquito bite Initial visit: √ Follow-up visit: _________
ASSESS (Circle all signs present)

CHECK FOR GENERAL DANGER SIGNS

YES__ NO
NOT ABLE TO DRINK OR BREASTFEED ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN √
VOMITS EVERYTHING
CONVULSIONS
DOES THE CHILD HAVE COUGH OR DIGFFICULT BREATHING? YES_√__ NO No
pneumonia
* For how long? _______ days * Count the breath in one minute.
COUGH
40 breaths per minute. Fast breathing?
OR COLDS
• Look for chest indrawing.
• Look for chest stridor.
DOES THE CHILD HAVE DIARRHEA? YES___ NO √
* For how long? _____ days * Look at the young infant’s general condition. Is the infant:
* Is there blood in the stool? Abnormally sleepy or difficult to awaken
Restless or irritable?
* Look for sunken eyes.
* Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds)?
Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5C or above) YES_√_NO
Decide malaria risk
* Does the child live in malaria area? LOOK AND FEEL:
* Has the child visited/travelled or * Look or feel stiff neck
stayed overnight in a malaria area in the * Look for runny nose
past 4 weeks?
If malaria risk, obtain a blood smear.
+ P1 Pv - done
THEN ASK: Look for signs of MEASLES
* For how long has the child had fever? 2 days * Generalized rash and
* If more than 7 days, has fever been present every day? * One of these; cough, runny nose, or
* Has the child had measles within the last 3 months? red eyes
If the child has measles now or within the last 3 months:
• Look for the mouth ulcers.
• If yes, are they deep and extensive?
• Look for pus draining from the eye.
• Look for clouding of the cornea.
ASSESS DENGUE HEMORRHAGIC FEVER
THEN ASK:
* Has the child had any bleeding from the nose or LOOK AND FEEL:
gums or in the vomitus or stool? * Look for the bleeding from nose or gums
* Has the child had black vomitus or black stool? * Look for skin petechiae
* Has the child had persistent abdominal pain? * Feel for cold and clammy extremities.
* Has the child had persistent vomiting? * Check capillary refill. 2 seconds.
* Perform tourniquet test if child is 6 months or
older AND has no other signs AND has fever for
more than 3 days.
DOES THE CHILD HAVE EAR PROBLEM? YES___ NO√
* Is there ear pain? * Look for pus draining from the ear
* Is there ear discharge? * Feel for tender swelling behind the ear.
If yes, for how long? _____ days
THEN CHECK FOR MALNUTRITION and ANEMIA No anemia
• Look for visible severe wasting. and not
• Look for edema of both feet. very low
• Look for palmar pallor. weight
Severe palmar pallor? Some palmar pallor?
• Determine weight for age.
Very low?
CHECK FOR CHILD’S IMMUNIZATION STATUS Circle immunization needed today. Return for
√ √ √ √ next
Immunizatio
BCG DPT1 OPV1 HEP B1
n on:
√ √ √ √
DPT2 OPV2 HEP B2 MEASLES None
√ √ √ (Date)
DPT3 OPV3 HEP B3
CHECK THE VITAMIN A SUPPLEMENT STATUS for children 6 months or older Vitamin A
Is the child six months of age or older? Yes √ No__ needed
today
Has the child received Vitamin A in the past six months? Yes__√_ No Yes
No__√_
ASSESS CHILD’S FEEDING If child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years old.
* Do you breastfeed you child? Yes___ No__√_ Feeding
Problems:
If Yes, how many times in 24 hours? __7__times. Do you breastfeed during the night? Yes___ No_√__
* Does the child take any other food or fluids? Yes___ No_√__
If Yes, what food or fluids? ___________________________________________________________
* How many times per day? _____times. What do you use to feed the child? ____________________
If very low weight for age, How large are the servings? _____________________________________
Does the child receive his/her own serving? _No- Who feeds the child and how? Mother through bottle fed
and spoons
* During the illness, has the child’s feeding changed? Yes___ No_√__
If Yes, how?
ASSESS CARE FOR DEVELOPMENT: Care and
Ask questions about how the mother cares for her child. Compare the mother’s answers to the Developme
Recommendations for Care and Development for the child’s age. nt
* How do you play with your child? Problems:
* How do you communicate with your child? Lack of time
for care on
the part of
mother due
to number
of children
to be
tended to
ASSESS OTHER PROBLEMS Insect bite
wounds

Treatments:
NO PNEUMONIA COUGH AND COLDS – Soothe the throat and relieve the cough with safe
remedy. Advised mother when to return immediately. Follow up in 5 days if not improving.
NO ANEMIA AND NOT VERY LOW WEIGHT – If the child is less than 2 years old, assess
the child’s feeding counsel the mother on feeding according to the FOOD box on the
COUNSEL THE MOTHER chart. If feeding is a problem, follow up in 5 days. Advised mother
when to return immediately.
 V.PRESENT HEALTH STATUS

EENT
[ ] impaired vision [ ] blind
[ ] pain [ ] redden [ ] drainage
[ ] gums [ ] hard of hearing [ ] deaf
[ ] burning [ ] edema [ ] lesion [x] teeth
Assess eyes, ears, nose
throat for abnormality [ ] no problem
RESP
[ ] asymmetric [ ] tachypnea
[ ] apnea [ ] rales [ ] cough [ ] barrel chest
[ ] bradypnea [ ] shallow [ ] rhonchi
[ ] sputum [ ] diminished [ ] dyspnea
[ ] orthopnea [ ] labored [ ] wheezing
[ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern,
breath sounds, comfort [ ] no problem
CARDIO VASCULAR
[ ] arrhythmia [ ] tachycardia [ ]numbness
[ ] diminished pulses [ ] edema [ ] fatigue
[ ] irregular [ ] bradycardia [ ] murmur
[ ] tingling [ ] absent pulses [ ] pain
Assess heart sounds, rate rhythm, pulse, blood
Pressure, circ., fluid retention, comfort
[ x ] no problem
GASTRO INTESTINAL TRACT
[ ] obese [ ] distention [ ] mass
[ ] dysphagia [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing
bowel sounds, comfort [x] no problem
GENITO – URINARY and GYNE
[ ] pain [ ] urine color [ ] vaginal bleeding
[ ] hematuria [ ] discharge [ ] nocturia
Assess urine frequency, control, color, odor, comfort/
Gyn-bleeding discharge [ x] no problem
NEURO
[ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure
[ ] lethargic [ ] comatose [ ] vertigo [ ] treamors
[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,
grip, gait, coordination, orientation, speech
[ x ] no problem
MUSCULOSKELETAL and SKIN:
[ ] appliance [ ] stiffness [ ] itching [ ] petechiae
[ ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity
[ ] wound [ ] rash [ ] skin color [ ] flushed
[ ] atrophy [ ] pain [ ] ecchymosis
[ ] diaphoretic [ ] moist
Assess mobility, motion gait, alignment, joint function
Skin color, texture, turgor, integrity [x ] no problem

VITAL SIGNS

1st visit (Jan. 23, 2009) PR:74 bpm RR: 20 cpm BP:100/70 mmHg T: 36.8 C
2nd visit (Jan. 30, 2009) PR:80 bpm RR: 18cpm BP: 100/70mmHg T: 37.1 C
3rd visit (Feb. 13, 2009) PR:75 bpm RR: 16 cpm BP: 90/70mmHg T: 37. 3 C
4th visit (Feb. 20, 2009) PR:68 bpm RR: 17 cpm BP:100/70mmHg T: 37 C
 x

EENT
[ ] impaired vision [ ] blind
[ ] pain [ ] redden [ ] drainage
[ ] gums [ ] hard of hearing [ ] deaf
[ ] burning [ ] edema [ ] lesion [x] teeth
Assess eyes, ears, nose
throat for abnormality [ ] no problem
RESP
[ ] asymmetric [ ] tachypnea
[ ] apnea [ ] rales [ x ] cough [ ] barrel chest
[ ] bradypnea [ ] shallow [ ] rhonchi
[ ] sputum [ ] diminished [ ] dyspnea
[ ] orthopnea [ ] labored [ ] wheezing
[ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern,
breath sounds, comfort [ ] no problem
CARDIO VASCULAR
[ ] arrhythmia [ ] tachycardia [ ]numbness
[ ] diminished pulses [ ] edema [ ] fatigue
[ ] irregular [ ] bradycardia [ ] murmur
[ ] tingling [ ] absent pulses [ ] pain
Assess heart sounds, rate rhythm, pulse, blood
Pressure, circ., fluid retention, comfort
[ x ] no problem
GASTRO INTESTINAL TRACT
[ ] obese [ ] distention [ ] mass
[ ] dysphagia [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing
bowel sounds, comfort [x] no problem
GENITO – URINARY and GYNE
[ ] pain [ ] urine color [ ] vaginal bleeding
[ ] hematuria [ ] discharge [ ] nocturia
Assess urine frequency, control, color, odor, comfort/
Gyn-bleeding discharge [ ] no problem
NEURO
[ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure
[ ] lethargic [ ] comatose [ ] vertigo [ ] treamors
[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,
grip, gait, coordination, orientation, speech
[ x ] no problem
MUSCULOSKELETAL and SKIN:
[ ] appliance [ ] stiffness [ ] itching [ ] petechiae
[ ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity
[ ] wound [ ] rash [ ] skin color [ ] flushed
[ ] atrophy [ ] pain [ ] ecchymosis
[ ] diaphoretic [ ] moist
Assess mobility, motion gait, alignment, joint function
Skin color, texture, turgor, integrity [ ] no problem
 VITAL SIGNS

1st visit (Jan. 23, 2009) PR:84 bpm RR: 20 cpm T: 36.5 C
2nd visit (Jan. 30, 2009) PR:80 bpm RR: 22cpm T: 37.1 C
3rd visit (Feb. 13, 2009) PR:85 bpm RR: 20 cpm T: 37. 2 C
4th visit (Feb. 20, 2009) PR:88 bpm RR: 21 cpm T: 37 C

EENT
[ ] impaired vision [ ] blind
[ ] pain [ ] redden [ ] drainage
[ ] gums [ ] hard of hearing [ ] deaf
[ ] burning [ ] edema [ ] lesion [ ] teeth
Assess eyes, ears, nose
throat for abnormality [ ] no problem
RESP
[ ] asymmetric [ ] tachypnea
[ ] apnea [ ] rales [ ] cough [ ] barrel chest
[ ] bradypnea [ ] shallow [ ] rhonchi
[ ] sputum [ ] diminished [ ] dyspnea
[ ] orthopnea [ ] labored [ ] wheezing
[ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern,
breath sounds, comfort [ ] no problem
CARDIO VASCULAR
[ ] arrhythmia [ ] tachycardia [ ]numbness
[ ] diminished pulses [ ] edema [ ] fatigue
[ ] irregular [ ] bradycardia [ ] murmur
[ ] tingling [ ] absent pulses [ ] pain
Assess heart sounds, rate rhythm, pulse, blood
Pressure, circ., fluid retention, comfort
[ ] no problem
GASTRO INTESTINAL TRACT
[ ] obese [ ] distention [ ] mass
[ ] dysphagia [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing
bowel sounds, comfort [x] no problem
GENITO – URINARY and GYNE
[ ] pain [ ] urine color [ ] vaginal bleeding
[ ] hematuria [ ] discharge [ ] nocturia
Assess urine frequency, control, color, odor, comfort/
Gyn-bleeding discharge [ ] no problem
NEURO
[ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure
[ ] lethargic [ ] comatose [ ] vertigo [ ] treamors
[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,
grip, gait, coordination, orientation, speech
[ x ] no problem
MUSCULOSKELETAL and SKIN:
[ ] appliance [ ] stiffness [ ] itching [ ] petechiae
[ ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity
[ ] wound [ ] rash [ ] skin color [ ] flushed
[ ] atrophy [ ] pain [ ] ecchymosis
[ ] diaphoretic [ ] moist
Assess mobility, motion gait, alignment, joint function
Skin color, texture, turgor, integrity [ ] no problem
 VITAL SIGNS

1st visit (Jan. 23, 2009) PR:84 bpm RR: 20 cpm T: 36.9 C
2nd visit (Jan. 30, 2009) PR:88 bpm RR: 20cpm T: 37.1 C
3rd visit (Feb. 13, 2009) PR:85 bpm RR: 22 cpm T: 37.2 C
4th visit (Feb. 20, 2009) PR:88 bpm RR: 26 cpm T: 37.3 C

EENT
[ ] impaired vision [ ] blind
[ ] pain [ ] redden [ ] drainage
[ ] gums [ ] hard of hearing [ ] deaf
[ ] burning [ ] edema [ ] lesion [x] teeth
Assess eyes, ears, nose
throat for abnormality [ ] no problem
RESP
[ ] asymmetric [ ] tachypnea
[ ] apnea [ ] rales [ x ] cough [ ] barrel chest
[ ] bradypnea [ ] shallow [ ] rhonchi
[ ] sputum [ ] diminished [ ] dyspnea
[ ] orthopnea [ ] labored [ ] wheezing
[ ] pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern,
breath sounds, comfort [ ] no problem
CARDIO VASCULAR
[ ] arrhythmia [ ] tachycardia [ ]numbness
[ ] diminished pulses [ ] edema [ ] fatigue
[ ] irregular [ ] bradycardia [ ] murmur
[ ] tingling [ ] absent pulses [ ] pain
Assess heart sounds, rate rhythm, pulse, blood
Pressure, circ., fluid retention, comfort
[ x ] no problem
GASTRO INTESTINAL TRACT
[ ] obese [ ] distention [ ] mass
[ ] dysphagia [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing
bowel sounds, comfort [x] no problem
GENITO – URINARY and GYNE
[ ] pain [ ] urine color [ ] vaginal bleeding
[ ] hematuria [ ] discharge [ ] nocturia
Assess urine frequency, control, color, odor, comfort/
Gyn-bleeding discharge [ ] no problem
NEURO
[ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure
[ ] lethargic [ ] comatose [ ] vertigo [ ] treamors
[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,
grip, gait, coordination, orientation, speech
[ x ] no problem
MUSCULOSKELETAL and SKIN:
[ ] appliance [ ] stiffness [ ] itching [ ] petechiae
[ ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity
[ ] wound [ ] rash [ ] skin color [ ] flushed
[ ] atrophy [ ] pain [ ] ecchymosis
[ ] diaphoretic [ ] moist
Assess mobility, motion gait, alignment, joint function
Skin color, texture, turgor, integrity [ ] no problem
 VITAL SIGNS

1st visit (Jan. 23, 2009) PR:94 bpm RR: 31 cpm T: 37 C

2nd visit (Jan. 30, 2009) PR:90 bpm RR: 40cpm T: 37.1 C
3rd visit (Feb. 13, 2009) PR:95 bpm RR: 30 cpm T: 37. 2 C
4th visit (Feb. 20, 2009) PR:98 bpm RR: 30 cpm T: 37.1 C

x
EENT
[ ] impaired vision [ ] blind
[ ] pain [ ] redden
throat for abnormality [ ] drainage
[ ] gums [ ] hard of hearing [ ] deaf
[ ] burning [ ] edema [ ] lesion [x] teeth
Assess eyes, ears, nose [ ] no problem
RESP
[ ] asymmetric [ ] tachypnea
[ ] apnea [ ] rales [ ] cough [ ] barrel chest
[ ] bradypnea [ ] shallow [ ] rhonchi
[ ] sputum [ ] diminished [ ] dyspnea
[ ] orthopnea [ ] labored [ ] wheezing
[ x pain [ ] cyanotic
Assess resp. rate, rhythm, depth, pattern,
breath sounds, comfort [ ] no problem
CARDIO VASCULAR
[ ] arrhythmia [ ] tachycardia [ ]numbness
[ ] diminished pulses [ ] edema [ ] fatigue
[ ] irregular [ ] bradycardia [ ] murmur
[ ] tingling [ ] absent pulses [x ] pain
Assess heart sounds, rate rhythm, pulse, blood
Pressure, circ., fluid retention, comfort
[ ] no problem
GASTRO INTESTINAL TRACT
[ ] obese [ ] distention [ ] mass
[ ] dysphagia [ ] rigidity [ ] pain
Assess abdomen, bowel habits, swallowing
bowel sounds, comfort [ ] no problem
GENITO – URINARY and GYNE
[ ] pain [ ] urine color [ ] vaginal bleeding
[ ] hematuria [ ] discharge [ ] nocturia
Assess urine frequency, control, color, odor, comfort/
Gyn-bleeding discharge [ ] no problem
NEURO
[ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure
[ ] lethargic [ ] comatose [ ] vertigo [ ] treamors
[ ] confused [ ] vision [ ] grip
Assess motor function, sensation, LOC, strength,
grip, gait, coordination, orientation, speech
[ x ] no problem
MUSCULOSKELETAL and SKIN:
[ ] appliance [ ] stiffness [ ] itching [ ] petechiae
[ ] hot [ ] drainage [ ] prosthesis [ ] swelling
[ ] lesion [ ] poor turgor [ ] cool [ ] deformity
[ ] wound [ ] rash [ ] skin color [ ] flushed
[ ] atrophy [ ] pain [ ] ecchymosis
[ ] diaphoretic [ ] moist
Assess mobility, motion gait, alignment, joint function

VITAL SIGNS

1st visit (Jan. 23, 2009) PR:74 bpm RR: 20 cpm BP: 90/70 mmHg T: 36.9 C
2nd visit (Jan. 30, 2009) PR:68 bpm RR: 22cpm BP: 100/70mmHg T: 37C
3rd visit (Feb. 13, 2009) PR:65 bpm RR: 16 cpm BP: 90/60mmHg T: 37 C
th
visit (Feb. 20, 2009) PR:68 bpm RR: 18 cpm BP:90/60mmHg T: 37.2 C

HOME AND ENVIRONMENT

 1. Housing

A. Adequacy of living space

The house of our client is primarily made up of wood with a length of 7

meters and a width of 5 meters. Not enough for a family with 6 members. A
bamboo floor was created to make it elevated especially during rainy seasons
and a wooden stair serves as their access to the house. They don t own the
house where they stay. They pay P800/ month for the house rent. The nearest
neighbor is 5 meters away and the land area is muddy and watery during rainy
seasons. There lightning facility is through x and they pay P550.00 per month for
their current bill.

B. Sleeping Arrangement

The house was divided into three areas, one bedroom, a living room and a
kitchen. When the husband is around, the sister-in- law together with the two
eldest children sleeps in the living room so that the couple and the youngest
child sleeps in the bedroom. They don’t use any mosquito net as a protective
measure against mosquito bites and their windows are unscreened.

C. Presence of breeding or resting sites of vectors of diseases

The surrounding of the house is dirty, there are flies flying around because
there is no proper maintenance of cleanliness. The untrimmed plants and trees
could serve as the breeding place of mosquitoes.
If you take a look inside the house, things are not properly arranged and
cleaned which could also serve as breeding places for cockroaches and rats.

D. Presence of accident hazards

 The house is totally made up of wood that is prone to fire. It is 1 ft elevated
from the ground to protect it during rainy seasons. But the wooden floor is not
that strong to support the weight of the whole family and the wooden stairs that
serves as the access to the house is hazardous for the children.

E. Food storage and cooking facilities

Their kitchen is outside the house and their cooking area is made up of
wood. They utilize firewood, which is stored at the side of the cooking area, for
their cooking needs. The kitchen is dirty because proper maintenance is not
observed.
They have a refrigerator which serves as their storage area for their left
over foods. But the unwashed plates on their dishwashing sink is not good for it
harbors growth of microorganisms.

F. Water Supply

Their source of water supply for drinking is the faucet supplied by

NAWASA and they pay P200 a month for their water bill. They also get the water
for household chores on the same faucet.

G. Toilet facility

The family has a water sealed toilet located inside the house. It is well
maintained by the mother but the toilet door is just covered by a cloth in which it
doe not allow privacy for anyone who will use the toilet.

H. Garbage disposal
 Their means of garbage disposal is by placing it on a large plastic bag so
it will be gathered until it is full then a garbage collection at Zone 5 is done every
Wednesday. But the children are not trained on proper waste disposal and would
just throw their garbage anywhere.

I. Drainage system

The family has no drainage system .

2. Kind of neighborhood

x is a very peaceful place especially during weekdays when the children

are in school. The air is not polluted and the land area is wet and muddy during
rainy days and dusty during sunny days. The community people were very warm
and participative. Mostly, their source of income is through farming and working
in government agencies.
Some houses are closely built to each other that is why it’s not a surprise
that the community people were really bonded to each other and by just
mentioning the family name, we could already have an idea where to find them
since they were aware of the location.

3. Social and Health facilities

In the area, they have their recreational facility which is a basketball court
located x. There, we can also find the Barangay hall and the health center which
is offering an immunization and consultation every Tuesday and Pre–natal
check-ups during Thursdays. Significant community activities are also being held
in there.
 The community people gather every Friday at 2pm for their weekly Zonal
meeting at xesidence xl spearheaded by the zone leader and the division leader.
They also have a church where they can attend mass during Sundays at Zone 2.
The children go to school x.

4. Communication and Transportation Facilities available

The family owns a television and a radio in their house where they could
listen to and be updated of the latest news about available health services and
other health issues. They could ride a motorela or a sikad with a fare of P5.00 if
they would go somewhere around Igpit and ride a jeepney with a P15.00 fare if
they will go to the city proper.

VII. FAMILY COPING INDEX

The objective of this indicator is to present a benchmark for approximating

the nursing needs of a particular family, thus Family Coping Index. It is the
coping capacity and not the underlying problem that is being rated, and it is
designed to record family rather than individual coping capacity. In public health
nursing, the family cannot be seen only as a factor that affects health; rather, the
family is the patient.

Legendary:
5 - Complete Competence
3 - Moderate Competence
1 - No Competence
Area Rate Justification
1. Physical
Independence The husband is busy of his work as a soldier and
- the ability to move 3 barely comes home. So the wife mostly attends to
about, get out of bed the needs of their children’s needs. 1 out of their 3
and perform activities children were already able to perform their daily
routines.
2. Therapeutic
Independence
- Includes all of the
procedures or
treatment prescribed
for the care of illness.
3. Knowledge of Health
Condition
- Concerned with the
particular health
condition
4. Application of
Principles of General
Hygiene
5. Health Attitudes
- Refers to the family
regarding their health
care in general
including preventive
measures and care of
illness.
6. Emotional
Competence
- Maturity & integrity
which the members of
the family are able to
meet unusual stresses
and problems of life,
plan for a happy and
fruitful living
7. Family Living
- family does things
together, each member
acts for the good of the
family as a whole
8. Physical Environment
- Home, community
and working
The mother said that, whenever one of the
3 members of her family got sick they sometimes
visit the health center to have check up & ask for
their medication, because they have limited
financial resources and time.
5 The family has some general knowledge of the
disease condition such that caring of its member
with common colds and was able to grasped the
underlying principles of proper caring such as
proper hygiene and right food to eat.
The family is rated 3 because the children has
3 adequate clothing, in good grooming and hygiene,
adequate and balanced diet (less on protein source
such as meat). Their garbage is properly thrown in
right place but the children are not trained about
waste segregation. hey have unwashed dishes that
can lead to presence of flies over the area. They
have inadequate living space for children to sleep
and play. There is no drainage system in their area
The family accepts health care in some degree but
3 with reservation. The mother seeks prenatal care
during her previous pregnancy. The family does
not seek help of the medical professionals during
time of illness and prefer to self medicate. Mrs.
Bautista not taking the pills regularly is a problem
for she might get pregnant again.
The family is considered to be in the low class level
3 but despite of that they’re still hoping and trying to
uplift their condition to live their life with love and
security.
.
5 The father has a stable job and is doing his best to
provide the needs of her children. Although the
family has misunderstanding but it was then
tolerated and settled. As a whole, the family was
able to get along with each other and show respect
and affection with each other though sometimes
children have misunderstandings and tantrums.
They have inadequate living space, adequate
3 personal belongings and utensils. They have
 environment. cluttered and dirty kitchen. They have food storage
facilities but they have unwashed dishes in their
kitchen. As to their methods of storing water, they
just put it in a jars and gallons less likely
unsanitary, and without sterilizing the water for
drinking consumption. There is presence of
untrimmed plant and trees in the surrounding area
of their house and could be breeding ground for
mosquitoes.

9. Use of Community
Facilities The family is aware of the availability of the
- degree of the family use 5 community facilities. They are also aware of the
and awareness of free medications and immunizations that they could
available community avail and are making use of it.
facilities for health
education and welfare
to physician
 VIII. SCHEMATIC PRESENTATION OF THE FAMILY HEALTH PROBLEM

ENVIRONMENTAL

Home and Sanitation Toilet Garbage Drainage

Condition Disposal System

1. House is made up Functional Toilet; water sealed Waste segregation No drainage

of wood and light not practiced system observed
materials.
2. Inadequate living
space Make use of placing Water from washing of
1. Comfort room not utensils and clothes
3. Stairs without the garbage in one
completely covered with drains down the ground
banisters plastic bag and open
the use of a cloth to serve
4. Windows not dumping .
as the door.
screened
Stagnant water under
their house
1. Presence of vectors
for diseases such as
mosquitoes and flies
Breeding ground and
1.) Accident hazards as a Health Threat haven for mosquitoes
2.) Poor home/environment condition as a Health Threat
3.) Accident hazards as a Heath Threat
3.) Entry point of vectors as a Health Threat

1.) Privacy issues as a Foreseeable Crisis. Poor home/ environmental

sanitation as a Health
Threat
 BIOLOGICAL

Physical Genetic

None
Mr. Bautista smokes All the children Some
about 10 sticks/ day have mosquito members of
and drinks alcoholic bites on legs. the family had
beverages the following:
occasionally.

Mother does not take pills

regularly because of the side
The 3rd child has a cough effects
Mosquito bites as a
and colds
Health Deficit

Unhealthy lifestyle
and personal habits/ Failure to thrive/develop
practices as a according to normal rate as a Unhealthy lifestyle and
Health Threat Health Deficit personal
habits/practices as a
Health Threat
 SOCIAL

Economic Political Cultural

Poor
Governance None
FATHER MOTHER

Soldier Low Budget given

Housewife by DOH
Lesser Allocation

P5000/month and no
other sources of income
Lesser Lesser
supply for access to
Non-use of protective free health
measures medical services
supplies

Unhealthy lifestyle and

personal habits/practices 1.) No adequate knowledge
as a Health Threat on family planning as a
Health Threat
 IX. FAMILY CARE PLAN

INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF
CUES NURSING MODE OF RESOURCES EVALUATION
PROBLEM PROBLEM CARE CARE
INTERVENTIONS CONTACT NEEDED
Subjective: - Encourage the sick Home Visit Materials After nursing
“ Gi sip on ug COUGH AND Inability to decide about After nursing After nursing members as well as to resources; visual intervention, the
gi ubo si Jhon COLDS as a taking appropriate actions intervention, intervention, the the mother to increase aids on disease family was able
Ivan 3 na ka due to failure to comprehend the family will family will be able to their fluid intake transmission to take
adlaw karun” Health Deficit the nature, magnitude and be able to take • Know the appropriate
as verbalized scope of the problem appropriate following -Discuss with t he family Human action to manage
by Mrs. action to interventions for to use alternative Resources: Time health condition
Bautista Inability to provide adequate manage health cough and colds medicine such as lagundi and effort of both to the sick
nursing care to the sick condition to the and kalamansi for cough the nurse and the member
Objective: member of the family due to: sick member family.
• Lack of knowledge -Encourage the sick
Jhon about the health members about deep Financial
Ivan:RR- condition breathing exercise Resources;
40cpm Money for the
-Encourage the family nurse
• Inadequate
approach in the nearest transportation
Presence of resources for care health center if symptoms
rales sound specifically financial will worsen.
as resources
auscultated

Non-
productive
cough noted
 INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES
CUES NURSING MODE OF RESOURCES EVALUATION
PROBLEM PROBLEM CARE OF CARE
INTERVENTIONS CONTACT NEEDED
Subjective: MOSQUITO Inability to After nursing After nursing 1. Involve all the children in Home Visit Materials After nursing
BITES as a provide adequate intervention, intervention, discussing about the nature of resources: intervention,
‘’ Daghan HEALTH nursing care to the mosquito the family will mosquito, the disease it can visual aids and the family was
lage ug DEFICIT the children with bites of the know and be cause and the proper care low cost able to know
pinaakan mosquito bites children will able to apply needed
supplies to and apply
sa lamok due to: heal in one therapeutic manage/treat therapeutic
ilang tiil’” as 2. Discuss with the family
month. measures, possible ways of providing scabies measures,
verbalized
• Lack of including skin adequate prevention of Human including skin
by he care, to Resources: care, to
knowledge mosquito bites utilizing less
mother manage Time and effort manage
about the expensive drugs and supplies
condition adequately the of both the adequately the
Objective: mosquito bites 3. Demonstrate to the mother nurse and the mosquito bites
• Inadequate
knowledge of on the children. and other member of the family family. of the children.
Presence the preparation of Akapulko Financial
the nature
of mosquito Ointment and its application to Resources;
and extent of
bites on the affected skin
Money for the
nursing care
both lower nurse
needed 4. Emphasize the importance
extremities transportation
• Inadequate of proper sanitation and
family cleanliness and teaching
resources for aids
care 5. Explore with the family
specifically possible ways to implement
responsible measures to eliminate the
family breeding place of mosquitoes.
member and
financial
resources
 INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF EVALUATIO
CUES NURSING MODE OF RESOURCES
PROBLEM PROBLEM CARE CARE N
INTERVENTIONS CONTACT NEEDED
Subjective ABSENCE OF Inability to provide a After After nursing 1. Encourage the Home Visit Materials After nursing
: DRAINAGE home environment nursing interventions, family to make resources; intervention,
“Wala man as a HEALTH conducive to health intervention, the family will drainage. visual aids on the family
mi kanal THREAT maintenance and the family have drainage Transmission was able to
2. Discuss to the
diri” as personal development will have a of their own and of Diseases. have a proper
family members the
verbalized due to: drainage of appreciate the Human drainage
importance of having
by the • Lack of knowledge of their own in presence of drainage. Resources: system.
mother. the importance of 2 weeks drainage in their Time and
having a drainage time house. effort of both
3. Stress that the the nurse and
and proper sanitation
Objective: following diseases that the family.
could be acquired Financial
Inability to recognize the
-no from having no Resources;
absence of drainage as drainage:
drainage a HEALTH THREAT Money for the
system a.) Diarrhea nurse
due to ignorance of the b.) Malaria
-presence possible diseases transportation
c.) Scabies
of stagnant acquired from it.
water 4.) Discuss the
complications of the
aforementioned
diseases and stressed
that Prevention is
better than Cure
 INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF
CUES NURSING MODE OF RESOURCES EVALUATION
PROBLEM PROBLEM CARE CARE
INTERVENTIONS CONTACT NEEDED
Subjective:: IMPROPER Inability to provide a After nursing After nursing 1. Discuss to the family Home Visit Materials After nursing
“Ga tipokon GARBAGE home environment intervention, intervention, the the benefits that they resources: intervention,
lang namo DISPOSAL as conducive to health the family family will: could get out of having area and the family was
ang a HEALTH maintenance and will be able a compost pit. materials for able to
THREAT
basura”as personal development to segregate • Understand the compost pit segregate
2. Teach the family
verbalized due to: their the members the proper
making such their garbage.
by the • Lack of adequate garbage. importance of way of segregation of as shovel,
mother. knowledge on the proper garbage. crowbar, etc
importance of proper garbage Human
disposal. 3. Discuss with the Resources:
sanitation
Objectives: • Segregate family the diseases that Time and effort
-presence their garbage they could get for of both the
Inability to recognize
of into having improper nurse and the
improper garbage garbage disposal.
scattered disposal as a HEALTH biodegradabl family.
garbage THREAT due to e and non Financial
- open ignorance of the possible biodegradabl Resources;
dumping of diseases acquired from e. Money for the
garbage it. nurse
disposal transportation
noted
 INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF
CUES NURSING MODE OF RESOURCES EVALUATION
PROBLEM PROBLEM CARE CARE
INTERVENTIONS CONTACT NEEDED
Subjective: ACCIDENT Inability to recognize After nursing After nursing 1 Encourage the family Home Visit Materials After nursing
“Medyo HAZARD as a the presence of the intervention, intervention, the to earn money for the resources: intervention,
gabok na HEALTH condition or problem the family family will: repair of stairs and materials the family was
THREAT unsafe floor
gyud ni due to inadequate will take the • Generate a needed for able to take
amo balay knowledge necessary budget for carpentry such the necessary
2.Dicuss with the family
gi butang Inability to provide action to repair of the benefits of
as hammer, action to
butangan home environment improve stairs and improving tier home iron nails, etc improve home
ra gani ni conducive to health home unsafe floor. environment Human environment
namo ug ali maintenance ad environment • Learn the Resources: so as to
para dili personal development so as to benefits of 3.Stress out to the Time and effort prevent
mahulog due to : prevent improving family that prevention of both the accident
ang bata” • Inadequate family accident their home is better than cure nurse and the
as resources environment family
verbalized 4.Encourage Mrs. Financial
specifically Free from
by the Bautista to encourage Resources:
financial resources accident hazard her husband to repair
mother • Mr. Bautista Money for the
the stairs and unsafe
will take nurse
• Lack of knowledge floor
Objectives: action to transportation
Presence of preventive
address this
of unsafe measures.
problem
stairs and
floor
 INTERVENTION PLAN
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF
CUES NURSING MODE OF RESOURCES EVALUATION
PROBLEM PROBLEM CARE CARE
INTERVENTIONS CONTACT NEEDED
Subjective: POOR HOME Inability to provide a After nursing After nursing 1. Encourage the Home Visit Materials After nursing
‘’Daghan ENVIRONMENT: home environment that intervention, intervention, the resources: interventions,
daghan pud PRESENCE OF family will be able: family about
lamok labi na BREEDING are conducive to health the family visual aids the family was
ug gabii as maintenance and will be able • Identify importance of clean Human able to
SITES OF
verbalized by INSECTS, personal development to improve and possible Resources: improve their
the mother RODENTS AND breeding environment.
due to: sanitary Time and effort sanitary
VECTORS as a sites of
Objective:
• lack of condition to 2. Discuss the health of both the environment
HEALTH
-Presence of THREAT knowledge about eliminate risk insects, nurse and the to avoid health
problems that may
importance of for vector rodents and family problems
stagnant
borne vectors. result due to Financial specifically on
water good sanitation
diseases Resources: vector borne
• Demonstra
unsanitary
-House Money for the diseases
• lack of skills in
surrounded te ways of environment nurse
by banana carrying out eliminate transportation
trees and measures to 3.Demonstrate to
other plants breeding
improve sanitary sites of the family about
condition vectors. methods in
• Take eliminating the
measures in
breeding sites
maintaining
the sanitary .
surroundings
X. ACTUAL IMPLIMENTATION

First Visit (January 23, 2009)

A life of a nurse will be irrelevant if she will be unable to make changes on the
lives of the people that are gathered around her everyday. As I arrived at x I
immediately roam around to find a family for my care plan. There I saw Mrs. Bautista
outside their home. I hurriedly approached her and asked her some questions
basing on the criteria of the care study. I was glad to know that her family qualifies
for that certain criteria. I immediately introduced myself to the family members,
asked for their approval, stated for my purposes and duration of visit, and
established good rapport with them. Fortunately, they permitted me to conduct my
care study with her family.
I interviewed Mrsx with regards to the names, birthdays, educational
attainment, occupation, monthly income, religion, and heredo-familial diseases of the
family. I was then informed that her husband is working away from home and comes
home only every 3 months. I took their vitals signs and assessed the children who
are present since the eldest child is at school. Immediately, I saw many shortcoming
of the family which may lead to serious problems. I then instantly gave my initial
health teaching on the importance of keeping their house clean and safe. When
asked where they get the water they used for drinking, the mother answered that the
water is supplied by NAWASA and they pay a minimum bill of P200 a month. I was
able to roam around the place and saw areas that could serve as breeding places
for mosquitoes and other vectors of diseases. I taught the mother ways to minimize
and eradicate breeding places of vectors of disease by keeping their environment
clean always. I also observed that the children are having mosquito bites on both
lower extremities.

Second Visit (January 30, 2009)

On my 2nd day of assessment, I continue to gather-up important data for the
study and for my actual implementation. I also gave partial health teachings
regarding the proper care for mosquito bites. The family was able also to understand
the teachings i made with them. I have learned that Mrs. x is using contraceptive
pills as means of family planning method but I was surprised to know when she
admitted that she does not regularly take her pills because of the undesirable side
effects. She also stated that she only takes pills 1 week before her husband comes
home. I taught her about the advantages and disadvantages of noncompliance to
her contraceptive pills and she seems to understand it. I encourage her to inquire in
the Health Center about other family planning methods available and change her
family planning method.
I also observed that the youngest child is having cough and colds during my
2nd visit and he is having fast breathing. I then assessed the child and taught the
mother about the things she must do and also educate her of how to manage of
some of the child illness.

Third Visit (February 13, 2009)

On my 3rd day of visit, I have seen that proper sanitation was one of the health
problems so I imparted health teaching regarding proper sanitation. I have taught the
mother that she could segregate the waste into biodegradable and non-
biodegradable. She was also encouraged to train her children regarding proper
waste disposal while they are still young.
I also encouraged Mrs. x to encourage the repair of the wooden stairs by
paying somebody to do the labor for her. Saving a budget for the repair of the
wooden stairs was discussed so that the mother will have an idea how to solve the
problem on the hazardous stairs. Then we also stressed out that having drainage is
important to avoid diseases such as diarrhea and malaria so she was advised to let
some neighbor do the drainage for her since her husband is not around.

Fourth Visit (February 20, 2009)

The 4th visit is my last visit to my family client since time is not enough to
cover the 6 visits. This last visit will serve as my evaluation to see if my health
teachings to the family were effective. Based on my evaluation, the family is now
ready to make decisions to make appropriate actions and mobilize resources
independently for the health of the family. Though, some of my goals and plans is
still on going, I am looking forward that the family will continue what they have
started. I reviewed what we have health teach to them and stressed out the
important things for them to remember.
With the family’s cooperation during the whole community exposure, I
extended my gratitude to them by giving them some food supply for the children.
Furthermore, an evaluation was conducted in order to know if there are
improvements in their health status, and health seeking behavior
XI. EVALUATION

As part of our requirement as nursing students of Liceo de Cagayan

University, we were exposed at x
I was able to render care to the Bautista family for 4 home visits at x. During
those visitations, the family was being assessed and various problems were being
identified which needed attention in order to improve the family living condition. In
those problems I had able to identified, I was able to give nursing care based on the
knowledge that I learned from school.
After giving them the interventions, the family became knowledgeable of the
importance of ones health and the importance of having a clean safe and disease
free environment.
This experience made me realized the true essence of being a health care
provider. I was able to experience rendering care not just to this certain family but
also to the community people and its not easy. But even if this is so, I felt challenged
and I enjoyed the times when we were walking under the scorching heat of the sun.
Blending with the community people and mingling with them gave me a feeling of
satisfaction to be accepted as health care providers. I was able to touch and made
even a difference to the lives of the family I cared for and so with those people in the
community.
XII. BIBLIOGRAHPY

• Community Health Nursing Service Section, National League of Philippine

Government Nurses, Inc.,Community Health Nursing Services in the
Philippines, 9th Ed.

• Maglaya, Arceli, Nursing Practice in the Community, 4th Ed.Argonanta

Corporation, Marikina City, Philippines, 2004.

• Kozier et al, Fundamentals of Nursing, 5th Ed. Pearson Education Asia Ptc.
Ltd., Singapore, 2002.

• Lippincott et al, Manual of Nursing Practice, 7th Ed. Philippines Edition.

Gopson Papers Ltd, Noida, India, 2001.

• Integrated Management of Childhood Illness, Department of Health

• Doenges, M. E., et al., Nurses Pocket Guide: Diagnosis, Interventions, and

Rationales, 9th Edition.

• Sparks and Taylor. Nursing Diagnosis Reference Manual; 6th Edition.

Copyright 2005 by Lippincott Williams and Wilkins