I.

FAMILY HEALTH PROFILE Josefina Fernandez Female Head of the Family April 6, 1945 62 years old Christian College Undergraduate Canteen Vendor Arceli Miso Male Daughter September 28, 1968 32 years old Christian College Undergraduate Barangay Counselor Faye Daphnie Miso Female Daughter August 20, 1995 12 years old Christian Highschool Student None

Name: Sex: Relation to the Head: Birth date: Age: Religion: Highest Educational Attainment: Occupation: Name: Sex: Relation to the Head: Birth date: Age: Religion: Highest Educational Attainment: Occupation: Name: Sex: Relation to the Head: Birth date: Age: Religion: Highest Educational Attainment: Occupation: II. GROWTH AND DEVELOPMENT A.

Family Member with a Health Problem Josefina Fernandez Psychosocial Theory of Developmental task Psychosocial Crisis: Generativity vs. Stagnation (40-65 years) Generativity is the concern of establishing and guiding the next generation. Socially-valued work and disciplines are expressions of generativity. Simply having or wanting children does not in and of itself achieve generativity. In relation to the case of Josefina Fernandez she successfully achieved the sense of generativity since she was able to take good care of her children. She also has a good relationship with her neighbors, she participates in the churchs activities and she is a vendor in the school canteen of their barangay. Family Members Arceli Miso Psychosocial Theory of Developmental task Psychosocial Crisis: Intimacy vs. Isolation (18-40 years) Body and ego must be masters of organ modes and of the other nuclear conflicts in order to face the fear of ego loss in situations which call for selfabandon. The avoidance of these experiences leads to openness and selfabsorptionAccording to Erik Erikson the young adult stage, Intimacy vs. Isolation, is emphasized around the ages of 19 to 34. At the start of the Intimacy vs. Isolation stage, identity vs. role confusion is coming to an end and it still lingers at the foundation of the stage (Erikson 1950). Young adults are still eager to blend

B.

their identities with friends. They want to fit in. When we arrive at stage six we should be prepared for intimacy, a close personal relationship, and isolation, the fact of being alone and separated from others. A balance between intimacy and isolation makes love possible as we must know how to be alone in order to learn to truly love. Having a balanced stage 6 will help tremendously later in the coming stages when unwelcome or unexpected isolation surfaces, for example, the death of a spouse or a loved one (Erikson, Erikson, Kivnick 1986). In connection to Arceli Miso she was able to have a family but unfortunately their relationship didnt last since they were separated. She has a daughter, which she is the one who support financially and emotionally. She didnt able to successfully fulfill this stage since their relationship with her husband didnt work. Faye Daphine Miso Psychosocial Theory of Developmental task Psychosocial Crisis: Identity vs. Role Confusion The adolescent is newly concerned with how he or she appears to others. Superego identity is the accrued confidence that the outer sameness and continuity prepared in the future are matched by the sameness and continuity of one's meaning for oneself, as evidenced in the promise of a career. The ability to settle on a school or occupational identity is pleasant. In later stages of Adolescence, the child develops a sense of sexual identity. In relation to the situation of Faye Daphnie Miso is falls under the adolescent stage. According to her mother she likes to be appreciated by other people especially with it comes to her physical appearance. She love to be in a group of people and she is always a leader if there are some group activities in school.

VII. FAMILY SERVICE AND PROGRESS RECORDS Head of the Family: Mrs. Josefina Fernandez Family Members: 3 members (currently residing) Address: Sugbongcogon, Tagoloan, CDOC Family Member Number: 2 members Names of the Family Members Name Josefina Fernandez Arceli Miso Faye Daphnie Miso Relation to Head Head of the Family Daughter Grand Daughter Sex Female Female Female Birthdate April 6, 1945 Sept. 28, 1968 August 20, 1995 Highest Education Completed College Undergraduate College Undergraduate High school Student Occupation Canteen Vendor Barangay Counselor Student Place of Work Sugbongcogon, Tagoloan, CDOC Sugbongcogon, Tagoloan, CDOC Student

III. DESCRIPTION OF HOME AND ENVIRONMENT A. HOUSE The Fernandez family owned the house as well as the land. It was made up of woods and some areas were cemented. The house had 2 bedrooms fitted for the 3

members. They had their own toilet a composed pit type with cover. They have a small store at the front of their house and some herbal plants outside. They also have the basic appliances in the house like the refrigerator. B. WATER SUPPLY The family has a deep well as a source of water supply for their activities of daily living. The family use a communal faucet for drinking and cooking. Their drinking water doesnt under go any sterilization process. Fortunately they dont have any health compliant with regards to their drinking water. C. KITCHEN The family has a dirty kitchen at the back of their house which they used wood in order to cook their foods, they eat together, share and divided their food equally. The kitchen was made up of wood and it was connected to the house, the utensils were properly kept on a container with cover. D. WASTE DISPOSAL Regarding the familys waste disposal they have one container without cover for their garbage and dont have proper segregation of the wastes. They dispose their garbage through open dumping. They also burn their garbage outside the house. E. DOMESTIC ANIMALS The family doesnt have any domestic animals. F. COMMUNITY Barangay Sugbongcogon is like other rural area. The Zone 1 of the barangay has a small land area but it has 125 households. The area is prone for communicable disease such as dengue, malaria and etc. since there were many stagnant waters and trees along the area. Most of the people have a pastime of going to the neighbors house and had a conversation. The road of Zone 1 itself was not cemented and it becomes muddy when it rains. The health center was not far from the area which is a big advantage for the people as well as for the students.

INTRODUCTION
A family is a group of genes related in structure and in function that descended from an ancestral gene. Family denotes a group of people affiliated by consanguinity, affinity, and co-residence. The family is the primary unit of health care. The term family also includes: elderly family, disabled family, single persons, a foster care arrangement, or a kinship care arrangement. Other persons, including members temporarily absent, may be considered a part of the applicant family's household if they are living or will live regularly with the

family. It is very important in institution that performs two major functions reproduction and socialization. The structure, functions and process of the individual family unit influence and are influenced by the health status of the individuals in the family and the health of the family unit. In biological terms, a community is a group of interacting organisms sharing an environment. In human communities, intent, belief, resources, preferences, needs, risks, and a number of other conditions may be present and common, affecting the identity of the participants and their degree of cohesiveness. For us to prepare to become effective and efficient future nurses, NCM501205 required us to have a family care study to experience and appreciate how the family grows and built strong foundation and are required to give nursing interventions to our chosen patients. The objective of this study is to show how the family works as a structure and how the family deals with the environment. The Marquita Family was chosen with the knowledge that the family qualifies the criteria in choosing a family for care study and for me to become aware of the problems existing in the family and their environments as well as assisting them in improving their health status. This study is limited in the following matters; the study is made within 6 weeks visits only, within the 6 weeks its, the two sons were assessed only once, gathering of date is based on the interview, observations and documentations.

FAMILY PROFILE
FATHER: Name: Roland Pabelic Age: 47 years old Birth date: Oct. 20, 1960

Religion: Roman Catholic Address: Brgy. Sili-Sili, Pagatpat, CDO Weight: 163 pounds Height: 54 ft. Occupation: Water district worker Educational attainment: High school graduate Monthly income: P3, 000 Smoking: Not smoking Beverages: Occasional Drinker Foods usually included in the diet: Meat, fish, maluggay Usual bowel elimination: Once a day MOTHER: Name: Cristina Pabelic Age: 35 years old Birth date: June 1, 1973 Religion: Roman Catholic Address: Brgy. Sili-Sili, Pagatpat, CDO Weight: 182 pounds Height: 53 ft. Occupation: Housewife Educational attainment: High school graduate Monthly income: none Smoking: Not smoking Beverages: None Foods usually included in the diet: Meat, fish, maluggay Usual bowel elimination: Once a day ELDEST CHILD: Name: Raymond Pabelic (Fully immunized child) Age: 9 years old

Sex: Male Birth date: Nov. 2, 1998 Weight: 19 kilos Height: 118 cm. Grade: 3 Foods usually included in the diet: Meat, fish, maluggay Usual bowel elimination: Once a day SECOND CHILD: Name: Roland Pabelic, Jr. (Fully immunized child) Age: 8 years old Sex: Male Birth date: Dec. 20, 1999 Weight: 16 kilos Height: 115 cm. Grade: 2 Foods usually included in the diet: Meat, fish, maluggay Usual bowel elimination: Once a day THIRD CHILD: Name: Amethyst Pabelic (Fully immunized child) Age: 2 years old Sex: Female Birth date: March 3, 2006 Weight: 11 kilos Height: 83 cm. Foods usually included in the diet: Milk, fish Usual bowel elimination: Once a day

FAMILY HEALTH HISTORY

A family health history is obtained to the members of the Pabelic Family during the interview. This is a comprehensive look at the family members medical history including information such as existing diseases, previous health problems, surgical procedures, and medications that were being asked and assessed during the visit.

Mr. Roland Pabelic: Mr. Roland Pabelic, 47 years old was born through normal vaginal delivery at home assisted by a manghihilot in Baykingon, Cagayan De Oro City. He verbalized that Diabetes and hypertension was the common illness of his father and mothers side. With regards to his immunization, he had completed all the required immunizations. When he was 20 years of age, he was being admitted to the hospital and had undergone a surgery, an exploratory laparatomy procedure because of experiencing discomfort on his lower abdomen. Mr. Roland Pabelic has no known food and drug allergies but he stated that he is prone to infections and wounds.

Mrs. Cristina Pabelic: Mrs. Cristina Pabelic, 35 years old, was also born through normal vaginal delivery at home. She is the eldest among the five daughters of her parents. In her fathers side, hypertension is the common manifestation, while Diabetes is the common manifestation on her mothers side. She had completed her

immunizations that were being required. She verbalized that she experiences no disorders during her previous years except experiencing symptoms high blood pressure. She also stressed out that she often feels fatigue and restlessness due to her stressful household chores that are being routinely done. She had also no known food and drug allergies.

Raymond Pabelic: Raymond, aged 9 years old was born in Pagatpat, her mother being assisted by a manghihilot. Raymond was delivered by her mother through normal delivery on November 2, 1998. He had completed his immunization in Pagatpat Health Center, their nearest health center. His mother claimed that he was breast-fed in his infancy. Last month, Raymond experienced having a mild fever. His parents managed his condition by treating him with Paracetamol (Calpol) and preferred just letting the symptom ease at home. Her parents also expressed that Raymond experiences wounds most often because of exposure to the environment. Raymond has had no history of hospitalization; neither received blood transfusion nor had undergone any surgery. Raymond has no known allergies to any food or drugs.

Roland Pabelic, Jr.: Roland, born on the 20th of December, 1999 in Sili-sili, Pagatpat, Cagayan De Oro city, was delivered through normal delivery, her mother being assisted by a manghihilot. According to his mother, he completed all his immunizations and

has had no history of hospitalization; neither received blood transfusion nor had undergone any surgery. His mother claimed that Roland has no known allergies to any drugs or foods, and was being breastfed upon demand during his infancy.

Amethyst Pabelic: Born on the 3rd of March, 2006, Amethyst was the youngest sibling and the only daughter of Mr. and Mrs. Pabelic. She was delivered through normal delivery, also by the assistance of a manghihilot. Her mother verbalized that she completed all her immunizations as required and has had no history of hospitalization. Her mother stated that Amethyst also never experienced symptoms such as fever and diarrhea. Her mother claimed that Amethyst has no known allergies to any drugs or foods, and was being also breastfed during her infancy.

PRESENT HEALTH HISTORY

Name: Roland Pabelic Age: 47 years old BP: 110/70 mmHg PR: 76 bpm RR: 19 cpm Temp: 38 C

EENT: [ ] impaired vision [ ] blind [ ] pain redden [ ] drainage [ ] gums [ ] hard of hearing [ ] deaf [ ] burning [ ] edema [ ] lesion teeth [ ] assess eyes ears nose [ ] throat for abnormality [x ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, pulse blood [ ] breath sounds, comfort [x ] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachycardia [ ]numbness [ ] diminished pulses [ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] mur mur [ ] tingling [ ] absent pulses [ ] pain Assess heart sounds, rate rhythm, pulse, blood Pressure, circ., fluid retention, comfort [ x] no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain [ ] assess abdomen, bowel habits, swallowing [ ] bowel sounds, comfort [ x ] no problem GENITO URINARY AND GYNE [ ] pain [ ] urine [ ] color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nucturia [ ] assess urine frequency, control, color, odor, comfort [ ] gyne bleeding [ ] discharge [ x ] no problem NEURO: [ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure [ ] lethargic [ ] comatose [ ] vertigo [ ] treamors [ ] confused [ ] vision [ ] grip

Hyperthermia

Swelling and inflammation in the right leg

[ ] assess motor, function, sensation, LOC, strength [ ] grip, gait, coordination, speech [ x ] no problem MUSCULOSKELETAL and SKIN: [ ] appliance [ ] stiffness [ ] itching [ ] petechie [ ] hot [ ] drainage [ ] prosthesis [ x ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] flushed [ ] atrophy [ x ] pain [ ] ecchymosis [ ] diaphoretic moist [ ] assess mobility, motion gait, alignment, joint function [x ] skin color, texture, turgor, integrity [ ] no problem

Name: Cristina Pabelic Age: 35 years old BP: 140/90 mmHg PR: 65 bpm RR: 21 cpm Temp: 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 [x ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, pulse blood [ ] breath sounds, comfort [x] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachycardia [ ]numbness [ ] diminished pulses [ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] mur mur [ ] tingling [ ] absent pulses [ ] pain Assess heart sounds, rate rhythm, pulse, blood Pressure, circ., fluid retention, comfort [ no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain [ ] assess abdomen, bowel habits, swallowing [ ] bowel sounds, comfort [x] no problem GENITO URINARY AND GYNE [ ] pain [ ] urine [ ] color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nucturia [ ] assess urine frequency, control, color, odor, comfort [ ] gyne bleeding [ ] discharge [x] no problem NEURO: [ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure [ ] lethargic [ ] comatose [ ] vertigo [ ] treamors

Increased blood pressure- 140/90

[ ] confused [ ] vision [ ] grip [ ] assess motor, function, sensation, LOC, strength [ ] grip, gait, coordination, speech [x] no problem MUSCULOSKELETAL and SKIN: [ ] appliance [ ] stiffness [ ] itching [ ] petechie [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic moist [ ] assess mobility, motion gait, alignment, joint function [ ] skin color, texture, turgor, integrity [x] no problem

Name: Raymond Pabelic Age: 9 years old BP: N/O PR: 92 bpm RR: 22 cpm Temp: 36.8 C

EENT: [ ] impaired vision [ ] blind [ ] pain redden [ ] drainage [ ] gums [ ] hard of hearing [ ] deaf [ ] burning [ ] edema [ ] lesion teeth [ ] assess eyes ears nose [ ] throat for abnormality [x ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, pulse blood [ ] breath sounds, comfort [ x] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachycardia [ ]numbness [ ] diminished pulses [ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] mur mur [ ] tingling [ ] absent pulses [ ] pain Assess heart sounds, rate rhythm, pulse, blood Pressure, circ., fluid retention, comfort [x] no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain [ ] assess abdomen, bowel habits, swallowing [ ] bowel sounds, comfort [ x] no problem GENITO URINARY AND GYNE

Insect bites

[ ] pain [ ] urine [ ] color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nucturia [ ] assess urine frequency, control, color, odor, comfort [ ] gyne 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, speech [ x ] no problem MUSCULOSKELETAL and SKIN: [ ] appliance [ ] stiffness [ x] itching [ ] petechie [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic moist [ ] assess mobility, motion gait, alignment, joint function [x] skin color, texture, turgor, integrity [x] no problem

Name: Roland Pabelic, Jr. Age: 8 years old BP: N/O PR: 83 bpm RR: 19 cpm Temp: 37.2 C

EENT: [ ] impaired vision [ ] blind [ ] pain redden [ ] drainage [ ] gums [ ] hard of hearing [ ] deaf [ ] burning [ ] edema [ ] lesion teeth [ ] assess eyes ears nose [ ] throat for abnormality [x ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, pulse blood [ ] breath sounds, comfort [x] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachycardia [ ]numbness [ ] diminished pulses [ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] mur mur [ ] tingling [ ] absent pulses [ ] pain Assess heart sounds, rate rhythm, pulse, blood Pressure, circ., fluid retention, comfort [x] no problem GASTROINTESTINAL TRACT:

Insect bites

[ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain [ ] assess abdomen, bowel habits, swallowing [ ] bowel sounds, comfort [ x] no problem GENITO URINARY AND GYNE [ ] pain [ ] urine [ ] color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nucturia [ ] assess urine frequency, control, color, odor, comfort [ ] gyne 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, speech [ x ] no problem MUSCULOSKELETAL and SKIN: [ ] appliance [ ] stiffness [ x] itching [ ] petechie [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic moist [ ] assess mobility, motion gait, alignment, joint function [x] skin color, texture, turgor, integrity [ ] no problem

Name: Amethyst Pabelic Age: 2 years old BP: N/O PR: 102 bpm RR: 24 cpm Temp: 36.7 C

EENT: [ ] impaired vision [ ] blind [ ] pain redden [ ] drainage [ ] gums [ ] hard of hearing [ ] deaf [ ] burning [ ] edema [ ] lesion teeth [ ] assess eyes ears nose [ ] throat for abnormality [x ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest [ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi [ ] sputum [ ] diminished [ ] dyspnea [ ] orthopnea [ ] labored [ ] wheezing [ ] pain [ ] cyanotic [ ] assess resp. rate, rhythm, pulse blood [ ] breath sounds, comfort [x] no problem CARDIOVASCULAR: [ ] arrhythmia [ ] tachycardia [ ]numbness [ ] diminished pulses [ ] edema [ ] fatigue [ ] irregular [ ] bradycardia [ ] mur mur

Dry skin

[ ] tingling [ ] absent pulses [ ] pain Assess heart sounds, rate rhythm, pulse, blood Pressure, circ., fluid retention, comfort [x] no problem GASTROINTESTINAL TRACT: [ ] obese [ ] distention [ ] mass [ ] dyspagea [ ] rigidity [ ] pain [ ] assess abdomen, bowel habits, swallowing [ ] bowel sounds, comfort [ x] no problem GENITO URINARY AND GYNE [ ] pain [ ] urine [ ] color [ ] vaginal bleeding [ ] hematuria [ ] discharge [ ] nucturia [ ] assess urine frequency, control, color, odor, comfort [ ] gyne 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, speech [ x ] no problem MUSCULOSKELETAL and SKIN: [ ] appliance [ ] stiffness [ ] itching [ ] petechie [ ] hot [ ] drainage [ ] prosthesis [ ] swelling [ ] lesion [ ] poor turgor [ ] cool [ ] flushed [ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic moist [ ] assess mobility, motion gait, alignment, joint function [x] skin color, texture, turgor, integrity [ ] no problem

MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS -5 YRS.

Childs name: Amethyst Pabelic CHECK FOR GENERAL DANGER SIGNS YES___NO NOT ABLE TO DRINK OR BREASTFEED ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN Date: July 21, 2008 Ag e: 5months Sex: Female CLASSIFY

VOMITS EVERYTHING CONVULSIONS DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? No For how long? __ days - Count the breaths for one minute._____ breaths per minute. Fast breathing? - Look for chest indrawing. - Look and listen for stridor. Yes__ None ___________

DOES THE CHILD HAVE DIARRHEA? No - For how long? ___days - Is there blood in the stools? - Look at the childs general condition. Abnormally sleepy or difficult to awaken? Restless or irritable? - Look for sunken eyes. - Offer the child fluid. Is the child: Not able to drink or drink poorly? Drinking eagerly, thirsty? Pinch the skin of the abdomen. Does it go back: Very slowly (longer than 2 seconds)? Slowly?

Yes___ None ____________

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? Has the child visited a malaria area in the past 4 weeks? If malaria risk, obtain a blood smear. + Pf Pv Not done Look or feel for stiff neck. For how long has the child had fever? __days If more than 7 days, has fever been present every day? Has the child had measles within the last 3 months? Look for signs of MEASLES Generalized rash and One of these: cough, runny nose. Or red eyes. . If the child has measles now or within the last 3 months: Look for mouth ulcers If yes, are they deep and extensive? Look for pus draining from the eye Look for clouding of the cornea. . Decide Dengue Risk: Yes__ N o___ If dengue risk, then ask: - Has the child had any bleeding form the nose or gums or in the vomitus or stools? - Has the child had black vomitus or black stool? - Has the child had abdominal pain? - Has the child been vomiting? - Look for bleeding from nose or gums. - Look for skin petechiae. - Feels for cold and clammy extremitites. - Check capillary refill ___seconds. - Perform tourniquet test if child is 6 months or older and Has no other signs and has fever for more than 3 days.

None ____________

Look for runny nose.

.. None ___________ .

None ____________

DOES THE CHILD HAVE AN EAR PROBLEM? No - Is there ear pain? - Is there ear discharge? If yes, for how long? ___days - Look for pus draining from the ear. - Feel for tender swelling behind the ear.

Yes___ None ____________

THEN CHECK FOR MALNUTRITION AND ANEMIA -Look for visible severe wasting. - Look for edema of both feet. - Look for palmar pallor. Severe palmar pallor? Some palmar pallor? - Determine weight for age Very Low? CHECK THE CHILDS IMMUNIZATION STATUS Circle immunization needed today BCG DPT1 OPV1 DPT2 DPT3 OPV2 OPV3 MEASLES

None ____________

Return for immunization on: Note : unrecalled (date)

next

CHECK THE VITAMIN A SUPPLEMENTA TION STATUS for children 9 months or older Is the child six months of age or older? Yes NO___ Has the child received Vitamin A in the past six months? Yes __No____ ASSESS CHILDS FEEDING if child has ANEMIA OR VERY LOW WEIGHT or less than 2 years old.

Vitamin A needed today Yes___ No

Do you breastfeed your child? Yes_ _ No_____ If Yes, how many times in 24 hours? 5 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? Rice, milk and fish How many times per day? 3 times. What do you use to feed the child? spoon fed If very low weight for age: How large are servings? Does the child receive his/her own serving? no Who feeds the child and how? Spoon fed by mother

NO FEEDING PROBLEM

During the illness, has the childs feeding changed? Yes No___ If yes, how? Decrease consumption of her share 2-3 table spoons. ASSESS OTHER PROBLEMS: No problems noted

HOME AND ENVIRONMENT

Date assessed: June 21, 2008 1. Home a.) Ownership [ ] [] c.) Numbers of rooms used for sleeping: 2 d.) Lighting facilities [ ] Electricity [] Kerosene [ ] Others (specify) e.) General sanitary condition: fair sanitary condition 2. Water supply Drinking water Source [ ] Storage [ ] Private [ ] Public [ ] Distance from house: within the house none (direct from faucet or pipe) [ ] jar or can with faucet [ ] jar or galloon with faucet [ ] others (specify) 3. Kitchen a.) Cooking facility [ ] Firewood/Charcoal [ ] b.) Sanitary condition: Fair sanitary condition c.) Drainage facility [ ] Blind drainage [ ] 4. Refuge of Garbage Disposal a.) Reuse and garbage 1.) Container [ ] Covered [ ] Open [ ] Composition [ ] None [ ] 2.) Method of disposal Hog feeding [ ] Close drainage [ ] none [ ] Open drainage [] Electric stove [ ] Gas stove [ ] Owned [ ] Rented [ ] Rent-free [ ] Mixed [ ] strong b.) Construction materials used [ ] Light [ ]

Open dumping [ ] Incineration [ ] Open burning [ ] Burial in pit [ ] b.) Toilet 1.) Type [ ] None [ ] Pail system [ ] Open pit privy [ ] Closed pit privy [ ] Overhung latrine 2.) Distance from house: Inside the house 3.) Sanitary condition: Poor sanitary condition 5. Domestic animals Kind: Pig Cat Number: 1 1 Where kept: Outside the house Inside the house [ ] Antipolo system [ ] Water sealed [ ] Flush type [ ] Others (specify) Others (specify)

[ ] Bored-hole latrine

The community in general: a.) General sanitary condition: They have poor environmental sanitation b.) Housing congestion: [ ] Yes [ ] No c.) Recreational Facilities: Basketball court d.) Availability of health care facilities (Describe briefly) - Not accessible. People would have to go to the main Health Center in Pagatpat.

FAMILY COPING INDEX

AREA 1.) Physical Independence- ability to move about, get out of bed and perform activities. 2.) Therapeutic Independence- includes procedure or treatment prescribed knowledge to condition. 3.) Knowledge of health condition 1 2 RATE 4 JUSTIFICATION -The family is currently experiencing a disease that would affect morbidity. -The father provides needs to his members, and the mother is giving sufficient care to the rest of the family members. -The children had complete immunizations. -The family uses herbal medicine such as banana tree oil -The family does not perform and maintain some of the health teachings that were imparted and provided. Even with the existing health threats, the family believes they are in good condition and are not aware of the possibilities of having health problems brought about by poor environmental sanitation and 4.) Application of principles of Personal General Hygiene 2 accidental hazards. -Clean kitchen but improper storage of food leading to the existence of flies all over the area. -Garbage is not properly thrown in the right 5.) Health attitude- the 1 place. -Most of the time, the family does not seek medical advice when they experience

way the family responds about health care in general. 6.) Emotional competence- maturity and integrity with which the family members are able to meet unusual stresses and problems of life and to plan for a happy and fruitful living. 7.) Family living- how well the family members get along with one another in an interpersonal relationship. 8.) Physical Environment- Home, community and work environment. 9.) Use of the community facilitiesdegree of the family use and awareness of available community facilities for health education. 1 1 4 5

illness and discomfort and just prefer to self-medications, unless intolerable. -Does not accept health care in some degree. -Have superstitious rites and false notions on illnesses. -Prioritize immediate medical condition of the children.

-Misunderstandings in the couple cannot be avoided but still it is within tolerable level. -Parents assume their role in the family, the husband being the breadwinner and the wife doing the household chores. -The house is in poor condition, not safe.

-The family does not make use of the health care services because of its unavailability to the people. -Less aware about new ways of preventing and promoting good health. -Use of unrecognized herbal medications upon encouragement of neighbor.

ACTUAL IMPLEMENTATION
1st Visit: June 21, 2008 During our 1st exposure to the community, I was able to set up my goal as to establish rapport to the people in the Sili-Sili community. As a second-timer in this area, I was able to locate those families I have known before when have our past exposure in this area. Since we were required to scout for a family for our Family Care Study, I was able to find my way into the residence of Mr. and Mrs. Pabelic, where they welcome me warmly after introducing myself to them. To gain their trust, I offered them to assess their blood pressure and to assess their present health status. Unfortunately, their two sons were not around. However, I was able to gather information about them. I also identified a serious health problem of Mr. Pabelic. He has this inflammation at his right leg where I suspect as an infection. He was having a fever that day, so I took his temperature and found that his temperature is 38 degrees Celsius. I advised him to seek medical advice seen he is complaining of difficulty in walking. But, he was anxious because he has doubts in medicine. Still, I continued to advice him to do so, for further assessment of his condition. 2nd Visit: June 28, 2008

The second day of visit was not a lucky day for me because the whole family was not around during that day because they attend something important with regards to their family. However, group activities enable me to identify some problems in the environment where the Pabelic Family interacts with. I noticed that their environmental sanitation isnt good enough to ensure a healthy living to the family.

3rd Visit July 5, 2008 The 3rd day of duty made significance. When I visit the Pabelic Family again, his wife told me that Mr. Pabelic was admitted to Cagayan De Oro Medical Center, and was diagnosed as having a Septic Arthritis. It was overwhelming on my part, because I have motivated him to go and seek for medical advice. 4th Visit: July 12, 2008 During the fourth day of visit, Mr. Pabelic was already home from confinement. I was glad because he was given medications by his physician and his condition is better. I gave him health teachings about adequate rest, and avoidance of eating sea foods. I also advised him to follow treatment regimen and to dress his joints with aseptic dressings when needed. 5th Visit: July 19, 2008 My fifth visit was good enough because I was able to assess the Pabelic children for the first time and identified that they are having mild skin problems. Mrs. Pabelic told me that Roland and Raymond are having insect bites on their skin. I provided them health teachings on how to prevent insect bites.

6th day: July 26, 2008 During my second visit I continue to assess their entire environment. I interviewed about the kind of toilet they have, their water supply, and if they have domestic animals at home. Concerning the resources they were using, I also asked this to recognize if this can be something that can contribute to health problems. I also took this opportunity in asking the client about the kind of food that they eat and how they cooked these. During my first visit, I only asked the superficial data thats why I asked it this time. I also learned that the Pabelic couple are not using contraceptives as a means of family planning.

EVALUATION
At the end of 6 days of interaction and observation of the Pabelic Family, I was able to obtain necessary information, such as the family background and history, and the family health condition which facilitated in the plan of care that was rendered to the family. Interventions that are community-based were given to treat the health deficit and health threat to the family. The family was able to learn some health teachings regarding nutrition and how to maintain it. With the informations given, the family was able to obtain the importance of health promotion and illness prevention. Environmental factior is also one of the features that contributed to the problems of the family. The proper hygiene was greatly stressed. Somehow, the family was able to learn about it and tried to make some ways on how to meet these health teachings that is very vital to life

SPOT MAP

To locate reach Sili-Sili community, the point of origin starts in Liceo de Cagayan University, Carmen, Cagayan De Oro, proceeding to Lourdes College where jeepneys going To Pagatpat are available un taking a person to a designated area. One will pay a regular fare of P20.00- P25.00 in going to Pagatpat. The trip will last at approximately 30 minutes. As you travel to Pagatpat, you will pass J.R. Borja Street, Galam Pharmacy, passing to Zayas. Upon reaching Pagatpat, the important landmarks to remember that can be elapsed are the Church of Jehova, the main health center of Pagatpat, and Pagatpat Elementary School. One should stop in Pagatpat Elementary School and seek for a sikad to drop you at Sili-Sili at a fare of P5.00. Sili-Sili Day Care Center near the Basketball court is the prominent landmark that could be seen upon reaching the area. The health center is just beside the Day Care Center, about 10 meters away from the Day Care Center. The Health Ceneter is the point of origin in going to the Pabelic Family, rough estimation of 120 meters away from the health center.