I. INTRODUCTION The family is the basic unit of a society.

As a universal social institution, it may be defined according to Burgess, as a group of persons united by ties of marriage, blood or adoption; constituting a single household unit, interacting and communicating with each other in their respective social rules of husband and wife, mother and father, son and daughter, and creating and maintaining a common culture. Based on his definition, the nature of family will be affected by several modifications foremost of which is the sociocultural factor. The family will inevitably be affected by the changes that occur within the society of which it is a part. Society is never static. It is constantly changing. Changes that may occur will be reflected in family life. Considering the impact of the family in molding the personality of its members, one cannot overemphasize the importance of knowing the interrelationship of family and socio-cultural forces. A family may also be two or more people who live in the same household (usually), share a common emotional bond, and perform certain interrelated tasks. Spradley (1990, p. 100). The second definition is more favorable for healthcare providers because it gives emphasis on the fact that there are different types of families. Many types of families exist, and a family will change over time as it is affected by birth, work, death, divorce and growth of each family member. A family represents a certain group in a community, and as a group, each member must have a certain role to play or complete a certain task. Majority of the roles people view as appropriate are the roles they see their parents fulfill. Each generation takes on the values and traditions of the past generation, handing down tradition and culture from one generation to the next. Some of the main tasks that essentially should be carried down or passed on from one family to the next are basically norms in society pertaining to family, which are: A family must provide food, shelter, clothing and health care for its members; prepare children to live in the community and interact with people outside the family; determine

which family needs will be met and their order of priority; open an effective means of communication between family members, establish family values and enforce common regulations for all members; apply division of labor; place members of the family into different sectors of society such as school, religious affiliations, or political groups; and maintain motivation and morale. The stability of the family is a delicate thing made up of the interplay and exchange between members. Crisis occur when change in role is necessary and the emotional balance within the family is disturbed. Illness of an individual member often creates a difficult change in role and a crisis occurs. As with the individual, the stage of development of which illness is interjected affects the nature and severity of the crisis of the family. The family as a group has the dual task of attaining its goals and meeting the needs of its individual members. Within the constraints of its social roles, each family develops its own set of values, its own patterns of behavior, or no communication between husband and wife and between parents and children are among the tasks. By fulfilling these tasks through the developmental stages, each family member must work with every other member and play his designated role. Through positive means, in effect the family structure will be healthy resulting in each members successful growth and development. As a requirement of NCM501104, we the students were required to conduct a family care study in Zone 2, Brgy. Canitoan, Cagayan de Oro City. In relation to this, we have chosen the Yamit Family for our family care study for they poses the criteria for the need of family care. Thus, education on health and health teachings regarding possible diseases at risk was emphasized. A. OBJECTIVE At the end of two (2) weeks of Community Health Exposure at Zone 2, Barangay Canitoan, we would be able to:

 Gather informations needed in formulating the family care plan Obtain the vital signs and conduct physical assessment for each member of the family for our reference and for future purposes. Analyze the data gathered during the assessment to understand further their health condition Determine the health condition and problems of the family Help the family in finding ways and solutions in treating their current health problem Identify environment problems if there is any.

B. Scope and Limitation of the Study This Family Health Care Study provides information and additional Knowledge to the family concerned. By this, we are focusing only on the Yamit Family, on its health problems, on Most importantly the prevention of illnesses, and health and also they will be thoroughly assessed and monitored on its health condition.

II. SPOT MAP

DISTRICT 2, ISLA, CANITOAN, CAGAYAN DE ORO CIT

III. FAMILY PROFILE HEAD OF THE FAMILY Name: Age: B-day: Sex: Nationality: Address: Religion: Income: Trinido Yamit 38 yrs. old May 28, 1973 male Filipino District 2, Isla Canitoan, Cagayan De Oro City Roman Catholic P5000 / month Father

Occupation: Hollow Block Maker Educational Attainment: Elementary Level Positioning in the family: Drinking: Allergies: No Allergies No hereditary of family conditions Fish, Pork, Beef, Vegetables and fruits. Beer and Tanduay Occasionally

Hereditary of family conditions: Food included in diet: Baseline Data: Blood pressure: Pulse rate: Respiratory rate: Temperature: Height: Weight:

no oppurtunity

Name: Age: B-day: Sex: Address: Religion: Income:

Myerna Yamit 32 yrs. old February 1, 1979 female District 2, Isla Canitoan, Cagayan De Oro City Roman Catholic P 2000 High School level Mother

Nationality: Filipino

Occupation: Housewife/ Manicurista Educational Attainment: Positioning in the family: Drinking: Allergies: None No hereditary of family conditions fish, pork, beef, vegetables and fruits.

water, milk, and softdrinks

Hereditary of family conditions: Food included in diet: Baseline Data: Blood pressure: Pulse rate: Respiratory rate: Temperature: Height: Weight: 5'2 110 lbs. 120/80 mmHg 65 bpm 22 cpm

36.2 C

Name: Age: B-day: Sex: Address: Religion: Income:

Benjie Yamit 16 yrs. old September 17, 1995 Male District 2, Isla Canitoan, Cagayan De Oro City Roman Catholic NONE High School Eldest Son

Nationality: Filipino

Occupation: NONE / Student Educational Attainment: Positioning in the family: Drinking: Allergies: NONE No hereditary family conditions Fish, pork, beef, vegetables and fruits

water, milk and soft drinks

Hereditary of family conditions: Food included in diet:

Baseline Data: Blood pressure: Pulse rate: Respiratory rate: Temperature: Height: Weight: no opportunity

Name: Age: B-day: Sex: Address: Religion: Income:

Sheila Mae Yamit 11 yrs old April 25, 2000 Female District 2, Isla Canitoan, Cagayan De Oro City Roman Catholic NONE Grade 6 Middle child

Nationality: Filipino

Occupation: NONE Educational Attainment: Positioning in the family: Drinking: Allergies: NONE No hereditary family conditions Fish, beef, pork, vegetables and fruits

water, milk and soft dinks

Hereditary of family conditions: Food included in diet: Baseline Data: Blood pressure: Pulse rate: Respiratory rate: Temperature: Height: Weight:

no opportunity

Name: Age: B-day: Sex: Address: Religion: Income:

Esteven Yamit 3 years old November 6, 2011 Male Zone-1 Macahambos Burgos, Brgy. Consolacion Roman Catholic NONE Not yet Youngest child

Nationality: Filipino

Occupation: NONE Educational Attainment: Positioning in the family: Drinking: Allergies: breastfeeding None No hereditary family condition Breastfeeding

Hereditary of family conditions: Food included in diet: Baseline Data: Blood pressure: Pulse rate: Respiratory rate: Temperature: Height: Weight: 61 cm 13 kgs refuse 134 bpm 50 cpm 37 C

IV. HEALTH HISTORY During our interview to them, they said that they dont have any underlying problems. In the case of the Yamit Family, they are not predisposed to any illness in both sides Mr. Trinido Yamit is 35 years of age, and is presently residing now in District 2, Isla ,Canitoan, CDO. He had 3 children with the age of 16, 11, and 3 years of age. He works as a Hollow Block Maker. No known food and drug allergy. No hospital record for him so far. Mrs. Myerna Yamit is 32 years of age, she married Mr. Trinido. She is a plain housewife and she also works as a part time manicurista and she also stays most of the time at home. She said that she is not predisposed to any illnesses. She has not been hospitalized due to any illnesses/ diseases but she is had undergone check up at X for prenatal. Mr. Benjie Yamit is 16 years of age, he was the eldest child of Mr. and Mrs. Yamit, he was delivered normally. And also no hospital record for him so far. Ms. Sheila Mae Yamit 11 years of age, she was is also delivered normally, and same as his brother, no hospital record for her so far. Mr. Esteven Yamit 3 years of age, he was is also delivered normally, and no hospital record for him so far. He completed all the

IMMUNIZATION: NAME BCG HEP-B1 HEP-B2 BENJIE FINISHED FINISHED FINISHED SHEILA MAE FINISHED FINISHED FINISHED ESTEVEN FINISHED FINISHED FINISHED

NAME HEP-B3 DPT1 DPT2 DPT3 OPV1 OPV2 OPV3 MEASLES

BENJIE FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED

SHEILA MAE FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED

ESTEVEN FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED FINISHED

For the immunization of the children, They have already completed their immunization.. The family is aware on the immunization schedule which actively being followed up and met the appropriate age of their child for compliance and prevention of unprecedented illnesses such as polio, measles, diphtheria, hepatitis and others. It is also emphasized that the mother will give immediate attention to her children health. FAMILY PLANNING On the extent of family planning and contraceptive, pills is utilized within the family. The family SMOKING In the family , they dont know how to smoke and uses it. ALLERGY They dont have any allergies experienced. HEREDOFAMILIAL CONDITIONS They dont have any heredo familial conditions in every sides of their family. They just experience common illnesses as of now, like cough, colds and fever. verbalized their awareness regarding family planning.

V. PRESENT HEALTH STATUS NURSING SYSTEM REVIEW CHART Name: Myerna Yamit Date: September 12, 2011 Vital signs: Pulse: 65 bpm BP: 120/80 mmHg Temp: 36.2 C Height: 52 ft Weight:. 110 lbs. INSTRUCTIONS: Place an (x) in the area of abnormality. Write comment on the space. Indicated the location of the problem in the figure using (x). EENT: [ ] impaired vision [ ] blind [ ] pain reddened [ ] drainage [ ] gums [ ] hard of hearing [ ]deaf [ ] assess eyes, ears, nose [ ] throat for abnormality [x] no problem RESPIRATION [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dysypnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, depth, pattern [x] breath sound, comfort or no problem GASTROINTESTINAL TRACT [ ] obese [ ] distention [ ] mass [ ] dysphagia [ ] rigidly [ ] pain [ ] assess abdomen, bowel habits, swallowing [x] bowel sounds, comfort o no problem GENITO-URINARY AND GYNE [ ] pain [ ] urine color [ ] vaginal bleeding [ ] hermaturia [ ] discharge [ ]noctoria [ ] assess urine freq., color, odor, comfort [ ] gyn-bleeding [ ] discharge [x] no problem NEURO [ ]paralysis [ ] stuporous [ ] unsteady [ ] seizures [ ] lethartic [ ] comatose [ ] vertigo [ ] tremors [ ] confused [ ] vision [ ] grip [ ] assess motor function, sensation, LOC, strength, [ ] grip, galt, coordination, speech, [x] no problem MUSCULOSKELETAL [ ] appliance [ ] stiffness [ ]itching [ ] petechiae [ ] hot [ ] drainage [ ]prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ]deformity [ ] atrophy [ ]pain [ ] ecchymosis [ ] diaphoretic o moist

dry and warm

dry hair not yet taken a bath

dry and warm

[ ] assess mobility, motion, galt, alignment, joint function [x] skin color, texture, turgor, integrity o no problem NURSING ASSESSMENT 2 SUBJECTIVE COMMUNICATION: [ ] Hearing loss comments: ok raman ako [ ] Visual changes ng pandungog [x] Denied Verbalized by the pt. OBJECTIVE [ ] glasses [ ] language [ ] contract lenses [ ] hearing aide R L Pupil size: 3-4 mm [ ] speech difficulties Reaction pupils equally rounded reaction to lights accommodation. Resp. [x] regular [ ] irregular Describe: respiratory rate is with in normal range and limit. R: right symmetric to the left L: left symmetric to the right Heart rhythm [x] regular [ ] iiregular Ankle edema : Carotid radial dorsal pedis femoral R: + + + + L: + + + + Comments: all pulse are palpable. [ ] dentures Full Upper [x] Lower [ ] Comments Bowel sounds Presence With in normal limit partial [] [x] [x] none with patient [] []

OXYGENATION [ ] dyspnea comments: ok raman [ ] smokling history akong gininhawaan none verbalized by the patient. [ ] cough [ ] sputum [x] denied CIRCULATION: [ ] chest pain [ ] leg pain [ ] numbness of Extremeties [x] denied

comments: wala man gasakita akong paa verbalized by the patient.

NUTRIRION: Diet []N []V comments: maayo man Characteristic pod ko magkaona, basta [ ] recent appetite in lang naa mi makaon Weight, appetite verbalized by the patient. [ ] swallowing Difficulty [x] denied ELIMINATION: Usual bowel pattern [ ] urine frequency Every morning [ ] constipation [ ] urgency Remedies [ ] dysuria NONE [ ] hematuria Date of last BM [ ] incontinence none [ ] polyuria

Bowel sounds normoactive Abdominal Distention Present [ ] yes [x] no Urine ( color, consistency Odor) yellow. Moderate and aromatic * if foley bag catheter is

[ ] diarrhea Character

[ ] foly in place [x] denied SUBJECTIVE

In place OBJECTIVE Briefly describe the patients ability to follow treatments ( diet, meds, etc.) for chronic health problems.( if present) Do not have any chronic health problems.

MGT. OF HEALTH & ILLNESS: [ ] Alcohol [x] denied ( amount, frequency) dili man ko gainumverbalized by the patient [ ] SBE last Pap Smear:did not have pap smear LMP: forgotten SKIN INTEGRITY: [x] dry [ ] itching [ ] other [ ] denied comments: dry lang ako paminaw sa ko panit kay ilabe na wala pa ko naligo verbalized by the patient.

[x] dry [ ] cold [ ] pale [ ] flushed [x] warm [ ] moist [ ] cyanotic rashes, ulcers, decubitis( describe size, locartion, drainage) No rashes, ucers, decubitis present. [ ] LOC and orientation: patient is conscious and oriented to live, space, person, and participates when asked. [ ] gait [x] walker [ ] care [ ] other [ ] steady [ ] unsteady Sensory and motor losses in face or extremities No sensory and motor losses in face or extremeties [ ] ROM limitations: she has no problem regarding ROM [ ] facial grimaces [ ] guarding [ ] other signs of pain: No other signs of pain observed. [ ] side rail release form signed (60 + years) Not applicable. Observed non- verbal behavior: Smiling to us as we go on to our interview. Person ( phone number): Dont have any mobile or phone no.

ACTIVITY/ SAFETY: [ ] convulsion comments: makalihok [ ] dizziness lihok man ko sa mga [ ] limited motion buluhaton sa balay dili Of joins man ko mag lisud. [ ] ambulate verbalized by the patient. [ ] bathe self [ ] other [x] denied COMFORT/ SLEEP/ AWAKE: [ ] pain comments: makatulog ( location) frequency man ko ug tarung Remedies verbalized by the pt. [ ] nocturia [ ] sleep difficulties [x] denied COPING: Occupation:housewife Members of households:5 Most supportive person: Trinido Yamit

NURSING SYSTEM REVIEW CHART Name: Date: September 12, 2011 Vital signs: Pulse: 134 bpm BP: refused Temp:36C Height:61 cm Weight: 13 kg INSTRUCTIONS: Place an (x) in the area of abnormality. Write comment on the space. Indicated the location of the problem in the figure using (x). EENT: [ ] impaired vision [ ] blind [ ] pain reddened [ ] drainage [ ] gums [ ] hard of hearing [ ]deaf [ ] throat for abnormality [X] no problem RESPIRATION [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [x] cough [ ] bradypnea [ ] shallow [ ] rhonch [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, depth, pattern [ ] breath sound, comfort or no problem GASTROINTESTINAL TRACT [ ] obese [ ] distention [ ] mass [ ] dysphagia [ ] rigidly [ ] pain [ ] assess abdomen, bowel habits, swallowing [X] bowel sounds, comfort o no problem GENITO-URINARY AND GYNE [ ] pain [ ] urine color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ]nocturia [ ] assess urine freq., color, odor, comfort [ ] gyn-bleeding [ ] discharge [X] no problem NEURO [ ]paralysis [ ] stuporous [ ] unsteady [ ] seizures [ ] lethartic [ ] comatose [ ] vertigo [ ] tremors [ ] confused [ ] vision [ ] grip [ ] assess motor function, sensation, LOC, strength, [ ] grip, galt, coordination, speech, [X] no problem MUSCULOSKELETAL [ ] appliance [ ] stiffness [ ]itching [ ] petechiae [ ] hot [ ] drainage [ ]prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ]deformity [ ] atrophy [ ]pain [ ] ecchymosis [ ] diaphoretic o moist [ ] assess mobility, motion, gait, alignment, joint function [x] skin color, texture, turgor, integrity o no problem

dry skin warm

VI. NURSING CARE PLAN Name of Patient: Myerna Yamit

CUES
S> dry lang ako paminaw sa ko panit kay wala pa pud ko naligo as verbalized by the pt. O> the pt. manifested the ff. Dry skin Observed scratching

NURSING DX
Risk for Impaired skin integrity r/t dry skin

OBJECTIVES
After 1 hour of nursing intervention, The client and the SO shall have verbalized understanding of individual factors that contribute to possibility of skin integrity impairment and takes steps to correct the situation.

INTERVENTIONS
>Establish rapport >Monitor VS. >Note age and sex >Assess mood, abilities, and personal styles. >Provide health teachings regarding the importance of maintaining an intact and moist skin. >Teach the pt. to give the client a balance, and nutritious food especially foods rich in Iron and vitamin C

RATIONALE
>To gain the client >To obtain data for comparison. >to evaluate degree/source of risk inherent in the individual situation. >to evaluate pt.s attitude which may contribute to skin breakdown. >To increase the pt knowledge thus, prevention of skin breakdown is realized and taken into consideration by the pt. > To improve clients

EVALUATION
The client shall have verbalized understanding of individual factors that contribute to possibility of skin integrity impairment and takes steps to correct the situation.

SUBJECTIVE

Self-care deficits related to decrease self-motivation.

At the end of 30 minutes, patient will be able to motivate self and improve personal hygiene.

>Assist patient in bathing, combing and doing mouth care. >Encourage patient to do self-care activities in daily living. >Support client in making health-related decisions and pursuit of self-care practices that promote health >

>For proper grooming. To enhance patients hygiene. >To improved patients hygiene. >to foster self-esteem and support positive self-concept.

After 30 minutes, patient was able to improved hygiene as evidenced by patient was able to take a bath and performed self -care activities.

Name of Patient: Esteven Yamit

Risk for infection related to weak immune system secondary to malnutrition

At the end of 2 visits, patient will be able to free from infection

>Encourage to have proper hygiene. >Encourage patients mother to cut the nails of the patient. >Clean the sleepers and other things used by the children. >Vitamins supplement

>To improve patients grooming/hygiene. >Microorganism could lodge into the nails, which can cause infection. >To prevent accumulation of microorganism. >To boost immune system.

After 2 visits, patient was able to be free from any infections.

>Encourage patients mother to be aware of the DOH Program which is deworming

>To remove parasites in the body.

Name of Patient: Esteven Yamit

Child Children of Mr. & Mrs Yamit was not present during the interview except to their youngest child Esteven
S> wla pa na siya maligo mao cguro gapangatol as verbalized by the mother of the pt. O> the pt. manifested the ff. Dry skin Observed scratching Risk for Impaired skin integrity r/t dry skin After 1 hr of nursing intervention, The client and the SO shall have verbalized understanding of individual factors that contribute to possibility of skin integrity impairment and takes steps to correct the situation. >Establish rapport >Monitor VS. >Note age and sex >Assess mood, abilities, and personal styles. >Provide health teachings regarding the importance of maintaining an intact and moist skin. >Teach the pt. to give the client a balance, and nutritious food especially foods rich in Iron and vitamin C >To gain the client >To obtain data for comparison. >to evaluate degree/source of risk inherent in the individual situation. >to evaluate pt.s attitude which may contribute to skin breakdown. >To increase the pt knowledge thus, prevention of skin breakdown is realized and taken into consideration by the pt. > To improve clients The client shall have verbalized understanding of individual factors that contribute to possibility of skin integrity impairment and takes steps to correct the situation.

VII: LABORATORY RESULTS

VIII. HOME AND ENVIRONMENT HOME

A. General sanitary condition: B. Ownership: ( ) owned ( ) rented ( ) rent free C. construction materials used: ( ) light ( ) mixed ( ) strong D. numbers of rooms used for sleeping: 2 E. lighting facilities: ( ) electricity ( ) kerosene ( ) others F. general sanitary condition: unsanitary WATER SUPPLY

A. Drinking water Source : ( ) private ( ) public Distance from the house: Storage: ( ) none, direct from the faucet ( ) container with cover

( ) container without cover ( ) others KITCHEN:

A. cooking facility: ( ) electric stove ( ) gas stove ( ) firewood/charcoal DRAINAGE: drainage facility: ( ) none () open drainage ( ) blind/ close drainage WASTE DISPOSAL: A. Garbage disposal 1. Container : ( ) covered ( ) open ( ) none 2. Method of disposal: ( ) opening dumping ( ) open burning ( ) compost pit

B. Toilet 1. type ( ) pit privy ( ) flush type ( ) pail system ( ) antipolo system

( ) water- sealed

( ) none

DOMESTIC ANIMALS: KIND COW 2 NUMBER PLACE KEPT Tied at the coconut trees

VIII. Family Coping Index This indicator is designed to rate the abilities of each members of the household, including the mother, father and the children in their performance inside and outside the house. This is not intended to rate the problems existing within the family, rather, rate the family for their coping capacities and for their actual competencies. Family is not seen as a factor that affects health but a patient that manifesting ability in coping problem.

LEGEND: [ 5 ] Complete Competence [ 3 ] Moderate Competence [ 1 ] No competence

AREA PHYSICAL INDEPENDENCE ability to move out, get up from bed and perform daily activities.

RATE 5

JUSTIFICATION All of the members of the family can perform their activities of daily living like fixing their bed as soon as waking up early in the morning. The father provides the basic needs to sustain the needs of the family while the Mother takes care some household chores.

THERAPEUTIC INDEPENDENCE includes procedure or treatment prescribed knowledge to condition. 3

The family is capable of treating minor kinds of illnesses conditions. regarding and They their health have health threatening knowledge

KNOWLEDGE IN HEALTH includes health condition 3 (concerned with the particular health condition that is the occasion of care) APPLICATION OF PRINCIPLES includes of general hygiene, family nutrition relaxation. HEALTH ATTITUDE the way the family feels about health care in general. EMOTIONAL COMPETENCE maturity and integrity with which the members of the family are able to meet usual stresses and problems of life and to plan for a happy and fruitful living. FAMILY LIVING how well the family member gets along with another in an interpersonal relationship. PHYSICAL ENVIRONMENT home, community and the work 1 3 3 3 and adequate rest and 3

status. The Mother knows when a member of the household is sick. She knows the signs and symptoms of the common diseases that a family may have. The family members know how to conduct and observe proper hygiene. The mother and sometimes the daughter prepare foods such as greenleafy vegetables and meat. The family views health care as the capability to promote health. The family was able to handle and manage the problems that came into their lives. They were able to cope up with stress and other problems in the environment and in the family. The members of the family get along with each other very well. They help each other to achieve common goals. Theres no problem occurring regarding their interpersonal relationship. The family belongs in a community with non cooperative neighbourhood. They

environment USE OF COMMUNITY degree of the family use and 3 awareness of available community facilities for health education and welfare to physician.

are not helping with each other. The family is aware of the health programs that the barangay health center is rendering to the people in the community.

Subjective: Medyo hugaw gyud ang among palibot as verbalized by the mother/wife Objective: House surrounded by murky and stagnant water Flooding often occurs during rainy seasons Presence of flies and mosquitoes Flying the house.

IX. FAMILYEnvironm PLAN to CARE Inability

ental sanitation as health threat maintain sanitary environment due to environmental condition such as flooding of water in these areas. Inability to control insects and vermin due to lack of knowledge on importance of eradicating them.

After nursing intervention, the family will be able to recognize the importance of keeping environment clean and sanitary and appreciate the effects.

After nursing intervention, the family will be able to: identify causes or root of problem regarding environmental sanitation Will be able to keep and maintain a sanitary environment conducive for Health. will be able to eradicate or minimize presence of insects and vermin on surroundings especially in the house.

1. Discussed with the family the importance of keeping environment clean and sanitary. 2. Explained to the family that keeping environment conducive for health helps in the disease prevention. 3. Encouraged / advised to screen windows and doors to prevent / avoid insects such as mosquitoes and flies to enter the house and advised to kill roaches and other insects. 4. Encouraged to properly segregate and dispose garbage according to kind, and practice it religiously for health promotion and disease preventive measures. 5. Made the family aware of the risks and effects of not keeping environment sanitary.

Home Visit

Material resources: Visual aids Time and effort aids and transportation of the student nurse. Expenses for teaching aids

After the nursing intervention, the family was able to: 1. Practiced of keeping environment or surroundings clean and sanitary. 2. eradicates / control of insects, vermins, and rodents (if any).

Subjective : Gamay raman ang Kita sa akong bana verbalized by the mother

Low family income as foreseea ble cirisis.

Inability to make decisions with respect to taking appropriate health action and inability to decide which action to take from among a

At the end of nursing interventions the family will find enough resources that could sustain family health needs.

At the end of nursing interventions the family will be able to identify ways to utilize family income wisely and earn money for

1. Discussed to the family the importance of finding additional ways to earn money. 2. Explained to the family to learn to prioritize needs

Home visit

Material resources: Visual aids, examples of food stuffs for demonstrating preparation of low-cost menus, for cooking demonstrations.

At the end of nursing interventions, the family was able to identify some ways to utilize their income and was able to understand

X. SCHEMATIC PRESENTATION OF THE FAMILY CARE PROBLEM

XI. ACTUAL IMPLEMENTATION ACTUAL IMPLEMENTATION Day 1 Orientation Phase On the very first day of duty in the community, we need to find our own patient and at the same time choosing our family care study patient that will be visited and assessed. Basically, we have to follow on the criteria given to us that will qualify a family to be our respective patients. If we are to base on the problems the family has, the community has less problems that concerns on health related areas since more of the identified dilemmas were environmentally traces. Despite of this fact, we patiently took the time in finding our patients that can be of help to us and we can be a help to them as well as a change agent or an educator in their humiliating health conditions. So, as we have tried to move on and grabbed

some learning that skilfully enhances our knowledge in close contact to people and showing them of how to be a people to people, we were able to select the family based on their needs. Through this manner, prioritization is being practiced and sharpened. As finally decided, We able to choose the patient that bests seek our support in their living. Most likely, the need to establish rapport and gauging their interest and participation is our main goal at this moment of time. Determination of their effort to participate and sincerest approval to our presence is also a great deal to be cleared and promoted throughout the entire visit that we are to take with them. As we begin this contact with them, we initiatively took the step to have personal contact; we visit them in their households and take some part of their time. We took the step in taking their data, which in this way, collection of data is performing the procedures that will be more sharpened as the more we do it. DAY 2 Working Phase In our 2nd day we do the pahina with the help of some of the community members in District 2, Isla, Canitoan, even though some community members were not cooperative during the pahina somehow all senses were being improved to find flaws and comprehend the application of learned theories in actual setting by doing health teachings and giving guidelines to be followed by them. This task took us responsible to what we could bring to the family in so many ways we can as student nurses. This activity is believed to take a closer connection to the family that applications of needed activities require thorough study to prevent errors and faulty nursing practices. The building of trust may be noticed in time towards the end of the actual performances. In response to their short responses, we believe that this has captured and enlightened their function as a human of their own. Helping them enrich their lives calls a sense of responsibility and accountability to their selves.

Everyone wish to help our family clients, addressing their needs and giving them care to what they wish. It is our chance to share our knowledge through giving health teachings and imparting information for their own benefits. Most likely, our tasks as student nurses are primarily focused on the basic areas to be implanted to them in action and words. This may be appreciated once the taught knowledge will be applied and inhibited. We gladly thank our patients in giving their time and may they be able to find their position in life as a person.

XII. REFERRAL AND FOLLOW UP The family was advice and encourage to have a regular check up to the Barangay Clinic, health center or Hospital. This is to determine if some members of the family is sick and to easily prevent diseases. And they should also follow the advices or instructions that was given by the health provider.

XIII.EVALUATION Although some short comings were not thoroughly anticipated during the care of the family as well as referral was not very successful due to the unavailability of the family members to be referred. Still we were able to care to the concerned family. There were no difficulties encountered as to the family members attitude because they were participative and accommodating throughout the care rendered to them. Furthermore, as of other aspects was difficult to plan because it was not anticipated, such mentioned difficulty was encountered with the father of the family because of his unavailability during the process of care. We give them some health tips that were emphasized to the concerned family, these were discussed as to anticipate the care of the individual and the family as a whole.

XIV. BIBLIOGRAPHY Maglaya, A., & Earnshaw , R., Nursing Practice in the Community. Community Health Nursing by DOH Kozier, et al. Fundamentals of Nursing. Singapore: Pearson Education Asia Ltd.,2004 www.wikipedia.com/family www.nursingcrib.com/fcp

DOCUMENTATION:

SPOT MAPPING

INTERVIEWING OUR CLIENT

GROUP C5 =)