Family Nursing Case Study

FAMILY NURSING CASE STUDY INITIAL DATABASE FAMILY STRUCTURE, CHARTACTERISTICS, AND DYNAMICS They are only 12 living in the house. Their first born Primalin Atalig is working in Bontoc. The head of the family is Mr. Fredy Atalig. They are currently residing at Barangay Bado Dangwa Tabuk City, Kalinga. The type of family is patriarchal in which the father is the head and ruler of the family. It is an extended family because the mother of Mrs. Atalig is living with them. SOCIAL-ECONOMIC AND CULTURAL CHARACTERISTICS For the income and expenses in the house it is being provided by the husband as well as their daughter who works as a babysitter while the wife manages the money. The father’s salary is not enough to support the family’s expenses as well as their education. Their ethnic background is Kalinga and their religious affiliation is NLPC (Northern Luzon Presbyterian Church. They have no tradition that affect’s one of their family’s health. In laws and relatives are the people who help them when they are in need like financial and emotional support. The family is known as law abiding and participates in Barangay activities like seminars for 4P’s and family planning HOME AND ENVIRONMENT Their house is made up pure woods. The house is simple and not too cozy. It has only one bedroom which is made of plywood and not too spacious for the family. It is not adequate for the size of the family. The neighborhood is good because they are friendly and harmonious, houses here are not far from each other. There is presence of environmental distractions like noise pollution due to many children of neighbors. The health facility of the Barangay is compose of clinic only, has a plaza with basketball court. Communication means are phones and radio, they have to go outside to ride on a jeepney like walking 5-10 minutes to reach the main road. HEALTH STATUS OF EACH FAMILY Mrs. Brigette was diagnose with congestive appendicitis and retriperitoneal hematoma probably secondary to traumatic fundal push during delivery and had an exploratory laparotomy surgery. The other members of the family are all healthy and does not have an illness. Family sometimes does not practice proper hygiene specially for the children they eat without washing their hands and does not wear any slippers whenever they play outside. Family eats 3 times a day. There is modifiable risk in the house which is the presence of stairs that may harm the children if not supervise. Risk factor is none, house is located far from the road. VALUES AND PRACTICES ON HEALTH PROMOTION / MAINTENANCE AND DISEASE PREVENTION The Family have finished their Immunization except for the infant. As for their lifestyle they are fond of eating vegetables and rarely on process foods . They have adequate sleep and rest. As for Mrs. Brigette she is not exercising because according to her it is too troublesome and she is too busy in taking care of her children. Other members of the family exercise in the form of doing household chores, and sometimes jogging. And as of relaxation they do picnic once a month. I. IDENTIFICATION OF HEALTH PROBLEMS Health Condition and Problems Inadequate Living Space Poor hygiene Unmanagebale parenthood II. A. Family Nursing Problems Inability to provide home conducive to health maintenance and personal development due to inadequate family resouces, specifically financial constraints. Inability to provide home environment conducive to health maintenance due improper hygiene. Inability to provide primary needs and care for children conducive to growth and development and health maintenance due to thier family size. PRIORITIZATION OF HEALTH PROBLEMS Inadequate Living space Criteria Computation Nature of the problem Modifiability Preventive/ potential Salience 3/3x1 1/2x2 2/3x1 1/2x1 Actual score 1 1 0.67 0.5 Poor hygiene Criteria Computation Actual score Mr./Mrs. Atalig house is not appropriate and conducive for their family size. Atalig family is considered as extended family and contains 12 member Children is not wearing any foot wear or slippers whenever going outside or playing outside Sometimes children are not doing handwashing before and after eating their meals. Mr./Mrs. Atalig can not create, maintain or regain an environment that promotes the optimum development of their children as well as supporting the education of their children Justification This is considered as a health deficit because there’s a presence of the problem The family has difficulty of providing themselves a better and conducive place to live. It is considered as moderate preventive because by increasing the living space, it will be more functionable, accessible and appropriate for their family size. They not considering this as a health problem as long as they have shelter. Total= 3.17 B. Cues/Data Justification Nature of the problem Modifiability Preventive/ potential 2/3x1 0.67 2/2x2 3/3x1 Salience 2 1 2/2x1 1 This considered as health threat that can contribute complication to the health status of the children. It is easily modifiable because we educate the family specially the mother to do proper hygiene for the children It is highly preventive since we educate the family about the importace of proper grooming The family need to do some action about poor hygiene of the children specially when they going to eat without washing their hands with some dirt on the finger nails because it can lead to a complication for the health of the children. Total= 4.67 C. Unmanageable parenthood Criteria Computation Nature of the problem Modifiability 1/3x1 2/2x2 Preventive/ potential 2/3x1 Salience 2/2x1 Actual score 0.33 2 0.67 1.5 Justification This problem is considered as foreseeable crisis. This is a intermediate modifiable because they can’t give enough time to take care of the children due to work of both parents and because of thier family size. it is modarate preventive because mr./mrs atalig elder children is currently working so that they can provide for themselves and help their family. The parent need to do an action to this because they can’t manage to take care and focus to their childrens need, and need a significant others to help them to have something to provide for their family. Total= 4.5 III. LIST OF PRIORITIZED FAMILY PROBLEM 1. Poor hygiene‘ 2. Unmanageable parenthood 3. Inadequate living space FNCP HEALTH PROBLEM FAMILY NURSING GOAL OF CARE SCORE 4.67 4.5 3.17 OBJECTIVES OF CARE INTERVENTION PLAN NURSING INTERVENTIONS METHOD OF RESOURCES PROBLEMS HEALTH THREAT: Poor hygiene Inability to provide home environment conducive to health maintenance due improper hygiene. NURSE FAMILY CONTACT Within 6 days nursing of interventions , the family will be able to: identify hygienic measures such as proper handwashing, trimming of the nails and its significance Within 30 minutes-2 hours of effective nursing interventions, the patient will be able to: - identify ways on how to maintain hygiene; - enumerate the health problems that will possibly cause spread of infection; 5.demonstrate interest with regards to the presented health teaching. Within 24-48 hours of effective nursing interventions, the patient include proper trimming of nails and proper handwashing technique before and after eating; - gain understanding about the importance of proper hygiene in theactivities of daily living. Dx: - Assess the degree of awareness of the family with regards to the existing health problem. - Assess the hygiene practice of each of thefamily member. - assess for the health condition of each member that is risk for infection Tx: - Teach the client how to perform handwashing correctly - Provide health teaching about the importance of good hygiene. - Reinforce the schedule for the cleaning activity w/c was made during the visit. Edx: - Discuss to the family the importance of proper hygiene in their health. - Encourage them to wash theirhands before and after eating. - Discuss the potential healthproblems that could arise of proper hygiene is not implemented and practiced Emphasize Establishing rapport through Home visit and health teaching REQUIRED Home Visits Discussion of the disease Demonstration of proper grooming and handwashing Time & Effort of student the nurses and the family members HEALTH PROBLEM FAMILY NURSING PROBLEMS GOAL OF CARE OBJECTIVES OF CARE INTERVENTION PLAN NURSING INTERVENTIONS FORESEEA BLE CRISIS: Unmanage able parenthood Inability to provide primary needs and care for children conducive to growth and development and health maintenance due to their family size. Within 6 days of nursing intervention s, The parent will be able to: Provide primary care to the children and can focus on their childrens needs. Within 30 minutes-2 hours of effective nursing inyterventions, the patient will be able to: Participate in activities to enhance parenting skills. Demonstrate parenting behaviors. Within 24-48 hours of effective nursing interventions, the patient: Verbalize realistic information and expectations of parenting role. Identify own strenghts, individual needs, methods and resources to meet them. Dx: - Ascertain motivation and expectation for change - Observe attachment behaviors, between parents and children, recognizing that may influence expected behaviors - Assess parenting skills level, intellectual, emotional and physical strengths and weaknesses Tx: - Provide information, as indicated including time management - Make time in listening to concerns of parents - Create an environment where relationship can be strengthened Edx: - Encourage expression of feelings - Educate parents regarding child growth and development addressing parental perceptions - Provide information, as indicated including time management METHOD OF NURSE FAMILY CONTACT RESOURCES REQUIRED Home visit Interview Health teaching Time and effort of the student nurse and the full participation of the mother. HEALTH PROBLEM HEALTH THREAT: Inadequate living space FAMILY NURSING PROBLEM Inability to provide home environment which is conducive for health maintenance and personal development due to inadequate family resources specifically financial constraints GOAL OF CARE After the nursing intervention the family will develop ways on how to minimize the problem as evidenced by discarding unnecessary things to maximize space. OBJECTIVES OF CARE After nursing intervention the family should be able: a.) Identify risk factors that contribute to the congestion in the area such as unused things. b.) Demonstrate techniques to promote good environment condition such as proper arrangement of appliances c.) Verbalize understanding about the importance of having adequate living space NURSING INTERVENTIONS 1. Suggest ways on how to maximize the available living space by rearrangement of appliances or discarding things that are unnecesary .2. Advise the family to separate things they don’t use anymore. 3. Inform the family regarding the easy transmission of disease due to inadequate space. 4. Explain to the family possible effects of having inadequate living space. 5. Explain to the family advantages of having adequate living space. RESOURCES NEEDE Time and effort of both the nurse and the family. -Knowledge of the student nurse about the inadequate living space -Participation and cooperation of the family METHODS OF OF NURSE FAMILY CONTACT Home visit RESOURCES REQUIRED Material Resources: Visual Aids. Human Resources: Time and effort for the both part of the studentnurse and the family. OUTCOME HEALTH THREAT GOAL: - perform hygienic measures such as proper handwashing, trimming of the nails and its significance OBJECTIVES: the patient will be able to: 1.include proper trimming of nails and proper handwashing technique before and after eating; 2.gain understanding about the importance of proper hygiene in theactivities of daily living; 3.identify ways on how to maintain hygiene; 4. enumerate the health problems that will possibly cause spread of infection; 5.demonstrate interest with regards to the presented health teaching VI . EVALUATION EVAL. CRITERIA The goal is fully met if the family: - to identify the importance of handwashing and proper grooming. EVAL. STANDARDS The goal is partially met if the family: - demonstrate hygienic measures such as proper handwashing, trimming of the nails and its significance METHODS TOOL/ DATA SOURCES Establishing rapport through Home Visits Home visit and health teaching Discussion of the disease Demonstration of proper grooming and handwashing Time & Effort of the student nurses and the family members OUTCOME FORESEEABLE CRISIS GOAL: - provide primary care to the children and can focus on their children needs. OBJECTIVES: the patient will be able to: 1. Verbalize realistic information and expectations of parenting role. 2. Identify own strengths, individual needs,and methods and resources to meet them. 3. Participate inactivities to enhance parenting skills. 4.Demonstrateimproved parenting behaviors. EVAL. CRITERIA The goal is fully met if the family: - always giving the enough quality time, attention and care for the children needs to their growth and development. EVAL. STANDARDS The goal is partially met if the family: - Verbalized the willingness to participate in activities about parenting skills enhancement and verbalize that being a parent is tough but is worth the struggle. METHODS Establishing rapport through Home visit and health teaching TOOL/ DATA SOURCES Home Visits Discussion about parenting Time & Effort of the student nurses and the family members OUTCOME HEALTH THREATS GOAL: - the family will develop ways on how to minimize the problem as evidenced by discarding unnecessary things to maximize space. OBJECTIVES: the patient will be able to: 1. Identify risk factors that contribute to the congestion in the area such as unused things. 2. Demonstrate techniques to promote good environment condition such as proper arrangement of appliances 3. Verbalize understanding about the importance of having adequate living space EVAL. CRITERIA The goal is fully met if the family: - Make appropriate measures to develop ways on reducing the problem by disposing of unused things and proper arrangement of furniture EVAL. STANDARDS The goal is partially met if the family: - Demonstrate techniques to promote a conducive environment condition such as disposing of unused things and arrangement of furniture. METHODS Establishing rapport through Home visit and health teaching TOOL/ DATA SOURCES Home Visits Discussion about parenting Time & Effort of the student nurses and the family members