Family Nursing Care Plan (FNCP) for Community Health Nursing (CHN) PDF

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FAMILY NURSING CARE PLANPresented to The College of NursingManila Adventist College Pasay CityIn Partial Fulfillment Of the Requirements For the Course CHNN 213 Community Health NursingSubmitted by: Alagar, Aira Yvonne Davilmar, Herold Esteban, Marianne Filomeno, John Ford Maderaje, Katherine Joy Mo...

Description

FAMILY NURSING CARE PLAN

Presented to The College of Nursing

Manila Adventist College Pasay City

In Partial Fulfillment Of the Requirements For the Course CHNN 213 Community Health Nursing

Submitted by: Alagar, Aira Yvonne Davilmar, Herold Esteban, Marianne Filomeno, John Ford Maderaje, Katherine Joy Moreno, Jesem Beth Pajardo, Maekyla Pelayo, Ma. Denielha Angel Sarmiento, Jeistha Melo

TABLE OF CONTENTS INTRODUCTION

4

SPOT MAP DESCRIPTION

5

SPOT MAP

7

COMMUNITY IN GENERAL

8

FAMILY NURSING ASSESSMENT

9

Assessment of the Family -

Family Structure

-

Education

-

Occupation

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Income

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Civil Status

Home Characteristics

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Environmental and Health Sanitation

10

-

Water Supply

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Garbage Disposal

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Toilet Facility

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Cooking Facility and Food Storage

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Domestic Animals

Lifestyle and Health Behavior

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HEALTH PROBLEM

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1. Family size beyond what family can adequately provide 2. Presence of vector breeding sites 3. Poor home and environmental condition and sanitation. 4. Presence of accident hazards

SCALE FOR RANKING HEALTH CONDITIONS AND

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PROBLEMS ACCORDING TO PRIORITIES FAMILY NURSING CARE PLAN

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SERVICES AND PROGRESS NOTES

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APPENDICES

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Appendix A: Pictures

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Appendix B: Letter of invitation

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Appendix C: Food stub and raffle stub

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Appendix D: General assembly program

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Appendix E: Certificates of Appreciation and Participation 47 Appendix F: Attendance sheet REFERENCES

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INTRODUCTION In the traditional context of human society, a family is a group of people who are either biologically related or bonded through marriage and other types of relationships. Ideally, a family is composed of a father, mother and children. Currently, there are six types of family structures and these are nuclear family, single parent family, extended family, childless family, step family, grandparent family, and dyad type of family. A family is not just a simple set of individuals engaging in their activities. It is a complex social formation organically connected with the society. Community is a group of people living or working together in the same area with common agenda, cause, interest, who collaborate by sharing ideas, information, and other resources. A family’s involvement to the community is very important. They must work together to promote health, well- being, and peace in the community. Good interactions in the community develop healthy behaviors and healthy families while problems within the area greatly affect its residents. It might affect their health, livelihood and lives. On the other side, Community Health Nursing or Public Health Nursing is the synthesis of nursing and public health practices applied to protect and improve the health of the population. It combines all the basic elements of professional clinical nursing together with the public health and community health practices. Another goal of community health nursing is to promote selfcare among individuals and families. Nurses today are playing important roles in coordinating and providing care to the community. And so, as an individual who wants to prevent illness and promote wellness, a group of community health nurses go to the community together with health professionals to identify health and nursing problems that need immediate actions. The chosen community was Barangay 186, Zone 19, Pasay City, which needed assistance for health, sanitation, and environmental improvement. It is a congested area faced with rising demands for health care, limited resources and inequalities of life and environment. Upon assessment, there were families who are facing struggles in terms of health, sanitation, and home conditions that need supervisions and help. That is why community health needs assessment has a central part to play, enabling practitioners to identify those in greatest need and to ensure that health care resources available are used to maximize health improvement. Our group selected to

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study the families to describe ways how these local people identify the existing problems arising in their family and confidently solve those problems in their own through the help and guidance of community health nurses. Implementations of good health and promotion of clean and safe environment conducive to health problems are the primary goal of this act. To attain that, the level II nursing students with their clinical instructors must provide health actions and interventions effectively. Planning is vital tool used to achieve goals which is to provide health care for the important client -- family. The main purpose of this study is to determine the existing health and environmental problems of the selected family of Barangay 186, zone 19, Pasay City, Philippines and to carry out nursing interventions or solutions for the problems identified. Specifically, this study will strive to meet the following specific objectives: assess the health condition of the family and its relationship to the community, identify the actual and potential health problems of the selected family according to priorities, determine the health practices of the family, and provide nursing interventions and nursing care plan for the family including the health teachings and tips to increase knowledge and awareness of the community. This study will use the survey, interview and descriptive methods of elaborating the information gathered. For the family assessment, service and progress record, the primary instrument in gathering data regarding this matter was the interview sheet. Limitations of the study limited also the community-based resources about health problems and conditions. This study only focuses on the Tugade Family and does not include other families in the community. Student nurses will use purposive sampling procedure and it will decrease the generalizability of results. Therefore this study will not be generalizing the family health conditions of all residences of the community.

SPOT MAPPING DESCRIPTION Barangay 186 – Zone 19 is one of the barangays in Pasay. The barangay has a total land area of 2.88 hectares. There are 1,340 households and has a total population of more than 5,093. The male population has a total number of 2,531 while the female population is 2,562. The total voting population is 2,645. The number of households with an average size of 5 members is 707.

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Its North barangay boundary is barangay 156 Tripa De Gallina; south boundary is Saint Augustine Street; east boundary is from Saint Claire; its west boundary is Aurora Boulevard. The barangay office is located in 2313 Saint Joan Street Maricaban. The landmark that can help people to find the barangay is the Dona Nena Health Center. Another landmark is the Pasay Central Post Office. Majority of the houses inside this barangay are made of concrete materials and the rest are wood type and some are mixed materials of concrete and wood. There are 300 houses in the surveyed area. The climate in Maricaban ranges from hot to rainy season. The barangay has light and electrical posts which can be found in all parts of the barangay. For security, the barangay has closed-circuit television (CCTV) cameras. They have sports and recreational facilities like covered court and physical fitness located at the 3rd floor of their gymnasium. There are also 2 available basketball courts near the post office. One is covered and the other is not. However, the open court functions now as a parking lot and place to dry rice grains. The most popular livelihood this barangay has is selling coconuts. The barangay has establishments of 18 sari-sari stores, 3 carinderia, and 1 bakery. Their mode of transportation is mostly tricycles and motorcycles. Golden-Pistons motor shop, Tramo Radiator shop, Basco Lolita Z Motorcycle Spare Parts, and JOEM Marketing are shops that sell motorcycle and car parts or accessories. These shops can be found along Aurora Boulevard. A truck site is also present near the Maricaban creek. The barangay also has a fire hydrant where firefighters or the people in the community can get water supply when fire happens. Water meters and water tanks are also present within the barangay. The barangay also has a bridge with guardrails along the Maricaban creek.

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COMMUNITY IN GENERAL Located on 2313 Saint Joan St., Maricaban Pasay lies Barangay 186. On May 1, 1990, Barangay 186 Zone 19 was born with an population of 3272. On September 1 of 1995, the population has grown 7.80%. When it reached May 1, 2000, the population has decreased by -1.07%. By August 1, 2007, the growth rate has dropped -2.28%. By May 1, 2010, the population has significantly grown 15.12% to a total of 5,786 residents and as of writing, the barangay has maintained an average of more than 5,000 in 2019. According to the 2015 Census, the age group with the highest population in Barangay 186 is 20 to 24, with 567 individuals. This barangay represents 1.2 % of the total population of Pasay. Some physical features are that it is quite clean, meaning they sweep the main road but some dog feces are still seen on the road. The climate around the barangay is rather rainy in the mornings and is tremendously hot in the afternoons. Because they are located in Metro Manila they do not have much fresh air as the different parts of the country. The barangay is led by Captain Losendo B. Garbo followed by Hon. Arnie Marlois T. Marzo SK Chairman; Cesar M. Castro Lugeon, coordinator; Alvin J. Baldemor, secretary; and Amelinda Y. Tabios treasurer. The whole barangay is composed of 2.88 hectares of land with 475 households which averages 5 members. The majority of the houses are mostly built with concrete but some are mixed. Some of the major establishments are Golden-Pistons Motor Shop, Tramo Radiator Shop, Basco Lolita Z Motorcycle Spare Parts, and JOEM Marketing. Other establishments are mineral water shops, the post office, health center, and 2 multipurpose halls. There is a a big multipurpose hall and a small one for smaller gatherings. There are many health centers around the area, but the main health center is Dona Nena Health Center located across the Pasay Central Post Office. Some of the services they offer are free syphilis tests, dental check-ups, TB tests, and HIV counselling. On an average, 100-120 people come to visit the health center daily. Their way of living is highly productive like washing their clothes, cooking, and selling different kinds of foods, etc. The foods they sell are coconuts, fruits, baked goods, ice cream, and junk foods. Their source of communication is mostly through mobile phones. Their ways of transportation are comprised of motorcycles, tricycles, jeeps, and cars. Their feast day is called Mary Comforter and it is every

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year on the 3rd Sunday of August. Otherwise, the residents around the barangay are happy and hard workers.

FAMILY NURSING ASSESSMENT Assessment of the Family Mr. JT and Ms. AP were living in a common law marriage situation for 16 years and they decided to get married on January 2020. The head of the family is JT, 39 years old and was born on June 13, 1980 at Ospital ng Maynila Medical Center. He was a high school graduate at Parañaque Multinational and currently working as a house painter in Valenzuela City. He comes home every Saturday evening. He is the only one working for the family and earns a salary of P3,000 per week. AP, 32, is the mother, who was born on April 13, 1987. She was also a high school graduate at MacArthur National High School in Leyte. She stays at home taking care of their children. The family consists of seven children. CT, first child, was born on April 23, 2004. He is 15, a Grade 8 student. The second child is JT, 14, was born on June 20, 2005. He is a Grade 8 student also. The third child is CT, 13, was born on November 20, 2006. She is a Grade 7 student. All of them attend the same school at Corazon Aquino National High School. CT, 12, was born on December 14, 2007, a Grade 5 student. CJT, 10, was born on December 25, 2008. She is a Grade 4 student. JT, 5, was born on May 1, 2014, a kindergarten student. All of them study at Maricaban Elementary School. Jefferson Tugade, 3, was born on June 25, 2016. He is not yet attending school and just stays at home with his mother. The family has a good communication where they share their opinions or problems with each other in terms of finances, marital issues and academic concerns. The parents were both making the decisions for the family and they respect each other’s perspectives.

Home Characteristics Home is a place where we can feel comfortable and safe. Keeping the surroundings con-

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ducive to health maintenance and well-being of the family is vital. But there are also situations that are inevitable and the truth is that there are still families that living and surviving under unstable conditions. The family is living in a congested community, located at 272 St. Rita, Barangay 186, Zone 19 Maricaban, District 2, Pasay City. The house is a two-storey building composed of mixed concrete and wood. It is small and messy with scattered clothes everywhere. The house also lacks proper ventilation. Unpleasant odor is also present due to poor environmental sanitation and the space is inadequate for them to live in. Outside the house, an old motorcycle and clotheslines are seen as well. At the entrance, there is a TV in front, one chair made of plastic, one wall fan on the right side to facilitate ventilation, two fluorescent lights for the kitchen, living room, and the bedroom. Stuff toys are well organized in a glass cabinet located atop the television and two DuraBoxes tower the scene where they put their clothes and other stuffs. Accidental hazards such as unstable foundation of the flooring and stairs that will be a risk for falling are present. The area is too small that the receiving area also serves as their bedroom too. The mother, together with the children, sleeps on two connecting wooden beds with foam situated near the entrance which also serves as their couch. On the head of the bed, there is a small table where small materials are placed. Blanket and foams were scattered on the bed. Other beds are located upstairs and only curtains served as the division of the kitchen and the bedroom/living room.

Environmental and Health Sanitation Environmental sanitation means the art and science of applying sanitary to improve the environmental conditions and to control the spreading of diseases caused by bacteria and other factors. It provides protection of the health and protects the welfare of the public. Pollution of the environment such as water and earth pollution is observed. A lot of holes on the ground is evident of the canalization that was poorly done in the streets. Attention was focused on the houses and its vicinity. Aside from being congested with each other, the space inside the house is also not enough for nine members of the family and the

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dog that they have. Gas stove is used to cook food and whenever there is leftover food they just cover it on the table. Large plates are sometimes utilized to achieve so. Beside the kitchen is the toilet which is pour flush. The drinking water is purified water. Every Thursday the garbage collector collects the garbage of the houses, but before that the family needs to segregate their waste. They have open canals and pipes for drainage. Every week also the barangay has clean-up drive programs to promote sanitation for the community.

Lifestyle and Behavior The family’s lifestyle is quite normal based on the interview. They do not smoke cigarettes and drink alcohol. They get at least 6 hours of sleep daily which is inadequate because they need at least 8 hours especially since they have 7 small children. From what has been observed, the mother is fairly timid and does not really have control over her children. The children were wild and loud. As reported by the mother, they are practicing family planning and get their supplies from Sheidy Perminder Lying-In. They are using a modern method of intrauterine contraceptive device (IUD). According to the interview they are satisfied with the family planning that they use. When it comes to talking to their children, they do talk to them regarding their sexuality. As of now, the mother is a housewife and the husband is the only one who works, providing and support the family, while the children (except for the youngest) are all in school.

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PROBLEM SHEET HEALTH PROBLEM

NURSING PROBLEM

SUPPORTING DATA CUES

DATE IDENTIFIED RESOLVED

1. Family size beyond Inability to make decision Subjective: “Ang trabaho po ng asawa ko ay what family can ade- with respect to taking ap- painter. Siya lang po ang nagtatrabaho sa quately provide propriate health actions amin.” the mother verbalized. due to lack of knowledge as to alternative courses of action open to them

Objective • Family has 7 kids

12

• Scanty food on the table • Minimal income of father

21 Nov 2019

Not resolved

2. Presence of vector Inability to recognize the Subjective: “Madalas po talagang malamok breeding sites presence of the condition dito, lalo na sa tapat ng bahay.” mother verbalor problem due to lack of ized. or inadequate knowledge Objective • Presence of breeding grounds of mosquitoes in the environment within the house vicinity 13

• Presence of nearby creek

21 Nov

Not re-

2019

solved

3. Poor home and envi- Inability to provide a Subjective: “Maliit lang po kasi ang bahay namronmental condition home environment con- ing. Hindi sapat para sa’ming lahat.” the mothand sanitation. ducive to health mainte- er verbalized. • I n a d e q u a te living space • Poor lighting and ventilation.

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• Presence of air pollution

nance and personal development due to limited Objective financial resources • The home is small enough for the family’s number • Window not enough for proper ventilation • Narrow door entrance can hardly fit people • Poor lighting • Humidity inside the house • Poor ventilation

Not 21 Nov 2019

resolved

4. Presence of accident Inability to provide a Subjective: “Nadulas na po sila d’yan dahil hazards as evidenced home environment con- makitid.” the mother verbalized. by: ducive to health mainte• Narrow stairs • Fall hazards • Fire hazards

nance and personal development due to limited Objective: financial resources • Presence of pointed objects and narrow staircase

21 Nov 2019

• Absence of stair handrail • Weak structure of stair (made of old 15

wood) • Octopus wiring

Not resolved

SCALE FOR RANKING HEALTH CONDITION AND PROBLEMS ACCORDING TO PRIORITIES Family size beyond from what family can adequately provide CRITERIA COMPUSCORE

1. Nature of the

TATION 2/3 x 1

2/3

Problem

JUSTIFICATION

An increase size of family can be a threat to the existing

2. Modifiability

2/2 x 2

2

family health. Number of the family

of the prob-

cannot be altered

lem

but pr...