Professional Documents
Culture Documents
Family Case Study
Family Case Study
In Partial Fulfillment
of the Requirements for the Degree
BACHELOR OF SCIENCE IN NURSING
Abdullah, Asniah
Afable, Jon Mikee Mae
Amano, Amirah
Chinchuntic, Joan
Largo, Ditchen
Najeeb, Marwah
Padura, Cheryl
Pandapatan, Jawaher
Paul, Kaizen Meg Alexa
Petagara, Elaisa Lyn
Sabdula, Norhaide
Sarip Mohammad Alnashry
Undag, John Arthur
Villamor, Ruffa Mae
April,2019
TABLE OF CONTENTS
PAGE
TITLE PAGE I
TABLE OF CONTENTS II
LIST OF FIGURES IV
OBJECTIVES 1
INTRODUCTION 2
GENOGRAM 11
HOME-BASED CARE 23
REFERENCES
LISTS OF TABLES
PAGE
Home-Based Care 23
LISTS OF FIGURES
PAGE
General Objectives:
At the end of one and a half – hour case presentation, the participants will be able to learn
the family health history, recognize the actual and potential problems, and their management.
Specific Objectives:
At the end of one and a half – hour case presentation, the participants will be able to:\
1. Describe Hypertension;
4. Present the Genogram, and Scale Ranking of the identified family problems;
5. Formulate a family nursing care plan for the identified family problems; and
7.
1
INTRODUCTION
The family is the smallest unit of the society and the natural fundamental core of the
community and consequently, it is considered as the primordial recipient of the nursing effort,
which is contributory to the development, and progress of the community through active
involvement and self – responsibilities of each constituent. It is composed of persons, male and
female, being molded to be as one, working hand in hand to maintain a good atmosphere among
the family members ( Pilliteri , 2015)
.Conducting a family case study is a means by which student nurse reaches and feels the
community through its basic structure the family. It is a tool in determining the health status of a
family through assessment and critical inspection. Through this health related problems are
identified, thus giving the student nurse a hint on where to act and how to intervene. It is also
means towards improving the health of the community, making them more productive. To come
up with the family case study gives a sense of fulfilment to a student nurse as she/he was given
the opportunity to share the skills, knowledge and time to alleviate and uplift the living condition
of a family.
Hypertension is generally defined as a systolic blood pressure greater than or equal to 135
mmHg and/or a diastolic blood pressure greater than or equal to 85 mmHg in individuals who do
not have diabetes. The new classification for “normal” adult blood pressure is less than 120
mmHg systolic and less than 80 mmHg diastolic. Adults with blood pressure of 120 to 139
mmHg systolic or 80-89 mmHg diastolic, considered “normal” under previous guidelines, are
now classified as prehypertensive and are in need of lifestyle changes to prevent cardiovascular
complications. Other classifications of hypertension are stage 1 hypertension which the systolic
is 140-159 mmHg and diastolic is 90-99 mmHg, and stage 2 hypertension which the systolic is
more than 160 mmHg and diastolic is more than 100 mmHg. Hypertension also called the silent
killer because people who have it are often symptom free.
2
or related disorders increases significantly. For hypertension to occur, there must be a change in
one of more factors affecting peripheral resistance or cardiac output. In addition, there must also
be a problem with the body’s control systems that monitor or regulate pressure. The tendency to
develop hypertension is inherited; however, genetic profiles alone cannot predict who will and
will not develop hypertension. In fact, researchers estimate that between individuals in 15% to
70% of cases. Many causes of hypertension have been suggested to be, increased sympathetic
nervous system activity related dysfunction of the autoimmune nervous system, increased renal
reabsorption of sodium, chloride, and water related to genetic variation in the pathways by which
the kidneys handle sodium, increased the activity of renin-angiotensin-aldosterone system,
resulting in expansion of extracellular fluid volume and increased systemic vascular resistance,
decreased vasodilation of the arterioles related to the dysfunction of the vascular resistance,
resistance to insulin action, which may be a common factor linking to hypertension, type 2 DM,
hypertriglyceridemia, obesity and glucose intolerance, activation of the innate and adaptive
components of the immune response that may contribute to renal inflammation and dysfunctions.
The purpose of this case presentation is for us to discover the process of the problem
identified, how it is being acquired, clinical manifestation which some was being experienced by
our patient and how the environment and the condition of the family relates to the problem. By
doing so, we will be able to know the appropriate nursing care for our patient as well as the
family. This study will help us student to comprehend not only the disease mentioned but also
for the commonalities and differences among other diseases.
3
FAMILY CASE STUDY IN NARRATIVE FORM
Oldest daughter, Libra , has two children, Cancer a 10 year old, born on June 29 in the
year 2010, Aquarius, a 6 year old, born on February 05 in the year 2013. They both delivered
via normal spontaneous delivery at Grospe lying-in. There was no known complications. She
started her menarche when she was 13 years old. She would usually have 28 days cycle with a
period duration of three to four days. She got pregnant at the age of 19 and was able to bear two
children According to her obstetrical record, she has G2P2T7P0A0L2M0..She decided to leave his
live in partner because of “Third Party” which was four years ago.
Mrs. Gemini husband died a year ago in the month of April because of Pancreatic
Cancer. She grew up and practiced the religion of being a Seventh Day Adventist.. Mrs.Gemini
and her daughter go hand in hand in terms of decision-making. They consult each other in terms
of planning and budgeting for their family. They also discuss matters concerning her son and
grandchildren’s school fee.
Scorpio is currently a second year college student at Medical Center College with the
course of BS Management. Cancer is grade 3 student at North Central School.
Miss Libra was a college undergraduate at Medical Center College with the course of BS
Management. She is currently working as online seller with the range income of 8,000-10,000
pesos a month. Her role in the family is a wage earner and financial provider.
Nanay Gemini was a 3rd grader at Zamboanga Elementary School. Because her mother died at
early age, she decided to stop going to school. She suffered from meningitis when she was 17
years old and was admitted for a year and 3months. She got married at the age of 22 and was
blessed with two children. She is a vendor of “chicharron” and would usually gained 600 pesos
a week.
The family’s source of income per month would range from ₱9,000-15,000. The family is
a recipient of the Pantawid Pamilyang Pilipino Program (4Ps). They would usually receive
₱3,200 every 2 months. They have been a member of this program since 2010.
4
Zodiac family has strong connection with the community . They would actively
participate in programs like Gardening, general cleaning and so on. .Mrs. Gemini would go out
in the neighborhood and talk with her friends.
Their house is made up of light constructions materials and measures approximately 12. 26
square meters of living space. They sleep on cement floor with a “banig” on a horizontal
arrangement. There are tall grasses located 4 meters away from their home and stagnant water
that makes it a breeding site of mosquitoes, rats and cockroaches. The family does have
electricity and usually pay 1000-1500 pesos per month. They have a food cover for their left
overs. The family cooks utilizing fire woods in their kitchen located inside their house. They
have an access from a water supply through a hose connected from their neighborhood. They
have a common open private water-sealed toilet located at the right side 5 meters away from
their house. They dispose their garbage by placing it in a plastic cellophane and be collected by
the garbage collector once a week. The family has refrigerator, induction cooker, television,
laptop, and cellphones.
The family believes in quack doctors before they would seek for medical consultation.
Cancer weighs kg, has a height of cm, and Cancer’s BMI as calculated is . Aquarius weighs kg,
height of . Aquarius’s BMI as calculated is All of the BMI of the two children falls under the
normal category of the KidshealthBMI chart
Mr. Gemini weighs kg and has a height of cm. He has a BMI of that falls under the
severe underweight category of the Asian BMI chart. Mr. Gemini has blood pressure is 160/100,
temperature of 36 degrees Celsius, heart rate of 65 beats per minute, respiratory rate of 25 per
minute and a pulse rate of 70 beats per minute.
Cancer and Aquarius already had a shot of BCG, Diphtheria, Tetanus and Pertussis
(DTaP) vaccine, Oral Polio Vaccine (OPV), Hepatitis-B, and Measles, Mumps and Rubella
(MMR) vaccine.
The familyhas poor hygiene as they do not take baths regularly. They have foul odor and
their nails were dirty and untrimmed. The amount of water intake per day is 2-3 glasses for the
granddchildren and 4-5 glasses of water for the adults . Mrs. Gemini is fond of drinking coffee.
They can usually consume 2 sticks of nescafee per day. Their usual viands are mixed vegetables,
daingtuyo, and ginamos. The children are fond of eating junk foods everyday like andsweet
corn, super crunch and tatto
5
GENOGRAM
Father Mother
Mimi Jan-Jan
Grandson Grandson
1 2
VI
SCALE RANKING OF HEALTH CONDITIONS/
PROBLEMS ACCORDING TO PRIORITIES
TOTAL: 4.67
VII
Salience
o a condition/ problem, needing 2
immediate attention
o a condition/ problem, not needing 1 2/2 = 1 1 1
immediate attention
o not perceived as a problem/ condition 0
needing change
TOTAL: 4.67
TOTAL: 3.3
Health Problem: Malnutrition
CRITERIA SCALE SCORE WEIGHT TOTAL
Nature of the problem/ condition presented
o wellness state 3
o health deficit 3 2/3 = 0.67 1 0.67
o health threat 2
o foreseeable crisis 1
Modifiability of the problem/ condition
o easily modifiable 2
2 1
o partially modifiable 1 ½ = 0.5
o not modifiable 0
Preventive Potential
o high 3
o moderate 2 1 1
3/3 = 1
o low 1
VIII
Salience
o a condition/ problem, needing 2
immediate attention
o a condition/ problem, not needing 1 2/2 = 1 1 1
immediate attention
o not perceived as a problem/ condition 0
needing change
TOTAL: 3.67
TOTAL: 3.34
IX
Modifiability of the problems/ condition 2
o easily modifiable 2 2
o partially modifiable 1 /2 = 1
o not modifiable
0
Preventive potential 3
o high 1 .67
o moderate 2 /3 =
o low .67
1
Salience 2
o a condition/ problem, needing
immediate attention /2 = 1
o a condition/ problem, not needing 1 1
1
immediate attention
o not perceived as a problem/
condition needing change
0
Preventive potential 3
o high 1 .67
o moderate 2 /3 =
o low .67
1
X
Salience 2
o a condition/ problem, needing
immediate attention /2 = .5
o a condition/ problem, not needing 1 .5
1
immediate attention
o not perceived as a problem/
condition needing change
0
Preventive potential 3
o high 1 .33
2
o moderate
o low 1 /3 =
.33
Salience 2
o a condition/ problem, needing
immediate attention
o a condition/ problem, not needing 1 .5
1 /2 = .5
immediate attention
o not perceived as a problem/
condition needing change
0
XI
SCORE RANKING
SCORE RANK
XII
Health problem Family Nursing Goal of care Objective of care Nursing intervention Method Resources Evaluation
problem
Poor environmetal Inability to provide After nursing Within 3 days of 1. Assess family’s H Time and effort of The family was able
sanitation as health home environment intervention, the nursing level of the student nurse to
O
threat conducive to health family will be able interventions, the understanding about and the family
1. Recognized the
maintenance and to discuss and family will be able poor environmental M
Cues: the condition and
personal understand the to. sanitation.
E verbalizes the
“Daghankaayogilag development importance of Money for
2. Emphasize the importance of
a, ipis, proper hygiene transportation
importance of a proper
ogmgalamok” 1. Cite at least 5
clean and healthy V environmental.
importance of environment..
proper sanitation I
2. The family
o Unwanted 3. Discuss with the
2. Demonstrate family the S identified the
smell of the
ways on effective importance of disadvantages of
environment. I
cleaning having proper poor environmental
drainage sytem. T sanitation.
o Presence of 4. Provide 3. The family
breeding sites teachings: performed
of mosquito o Segregating
due to stagnant o Frequent
garbage non-
water in their cleaning the
biodegradable
laundry area surroundings
from bio-
o Unsanitary o Started to
degradable
toilet segregate
o Organizing and
o Messy room biodegradabl
arranging things
e from non-
o Cleaning the
biodegradble
XIII
drainage thrice a o Organizing
week and
arranging
things
o Cleaning the
drainage
thrice a wee
XIV
Assessment Diagnosis Planning Intervention Method Resources Evaluation
Poor Hygiene of The After 2 hours -Assess the Degree -Home Visit -After the health teachings about proper
Family as related problem Nursing of awareness of the Hygiene the objectives of increasing the
-Time and effort of
due to: Intervention the community people awareness of the community is met as
the student nurse.
Family will be able with the regards to evidenced by:
to gain knowledge the existing
Untrimmed
Inability in the importance problem.
nails of good personal
To maintain a good -Enumerate 4/4 of health problems that
Foul odor hygiene.
personal hygiene will possibly cause spread of infection and
Dirty clothing
which is conductive -Discuss identified ways to maintain hygiene.
Messy hair -Soap
to health
maintenance due to -Shampoo
inadequate -They were able to demonstrate the
Objective -Towel
knowledge of teachings
importance of Within 1 hour of -Toothpaste
personal hygiene. nursing
intervention the
Family will be able
to:
-Gain
Understanding
about the
importance of
proper hygiene in
the activities of
daily living.
XV
-Enumerate at least
four health
problems that will
possibly cause
spread of infection
and identify ways
to maintain proper
hygiene
XVI
Health Problem Family Nursing Objective of Care Nursing Method Resources Evaluation
Problem interventions
Malnutrition as health Inability to After 3 days of After 1 hour of 1. Emphasize the H Time and effort of The family was able to:
threat recognize the nursing nursing importance of the student nurse
presence of having healthy O 1. Recognized the
intervention the intervention the and the family
Cues: malnutrition in a weight and importance of having
family will be family will be M
dependent nutrition Money for proper nutrition and
Father BMI : 15.1 able to recognize able to:
member due to E transportation health body weight
(Severely Underweight) the importance of
lack of knowledge 1. Enumerate at
having proper 2.Discuss the 2. Chose cheap but
5th Child: BMI: 10 nutrition
least 5
consequences of healthy and nutritious
Inability to decide compications of V
(Very Severely about taking having bad foods
malnutrion
Underweight) appropriate action nutrion I 3. Plan and prepare
due to failure to 2. Plan and
3. Encourage the S balanced meals which are
comprehend the prepare balalnced
family to choose within the family’s
nature, magnitude meals which are I
cheap but health budget
and scope of the within the
problem family’s budget. foods. T
XVII
Health Problem Family Nursing Goal o Objective of Care Nursing Method Resources Evaluation
Problem Interventions
f Care
Inability to make After 3 days of After 1 hour of 1. Explain to the H Time and effort of The husband was able to
decisions when nursing nursing client how the student nurse modify his lifestyle as
Unhealthful Lifestyle as O
respect to taking intervention the intervention the important healthy and the family evidenced by:
health threat
appropriate health father will be able father will be abl life style is. M
Money for a. Minimizing drinking
Cues: action due to to understand the to:
2. Inform the E transportation coffee
addiction of essence of healthy
Father a. Recite at least 3 client for the
prohibited drugs, lifestyle b. Achieved adequate
advantages of possible threat of
o Drinking 3-5 sticks of cigarettes and having good having unhealthy
sleep and rest
alcohol. V
nescafee per day lifestyle lifestyle. c. Drinks water at least 8-
o Sleeping 3-5 hrs per I 10 glasses per day
day b. Minimize 3. Assess
drinking coffee willingness of the S
o Drinking alchohol
family I
occasionally c. Gradual
achievin adequate T
sleep and rest
4. Conduct health
teaching in the
family
a. Drinking water
at least 8-10
glasses per day
b. Sleeping at
least 8-10 hrs
XVIII
c. Limit drinking
alcoho
Health Problem Family Nursing Goal of Care Objective of Care Nursing Method Resources Evaluation
Problem Interventions
Inability to After Nursing After 1 hour of 1 The nurse will H Time and effort of After 1 hour of rendering
provide rendering proper educate the the student nurse proper nursing
Risk for injury related to intervention, O
nursing patient on how to and the family intervention the patient
right sided weakness. a home
the family will intervention the use braille call M will be free from possible
Environment Money for
patient will be light when asking injuries as evidence by
think of necessary E transportation
Conducive to action to reduce free from possible for assistance. ability to explain the
potential hazards injury. safety precautions.
heath 2 Teach the client
in to the home to keep the room V
maintenance environment clutter free at all I
and personal times.
S
development
3 Teach the client I
due to to keep any sharp
:Lack of objects from the T
knowledge on room.
dangerous
4 Asses the
construction patient ability to
materials
ambulate safely
that can cause with or without
assistive devices.
damage
5 Thoroughly
XIX
orient the patient
to environment.
6 Ask the
significant others
to always stay
with the client.
7 Instruct the
client to call for
assistance when
moving.
XX
HEALTH FAMILY NURSING GOAL OF OBJECTIVE NURSING METHOD RESOURCES EVALUATION
PROBLEM PROBLEM CARE S OF CARE INTERVENTIONS OF REQUIRED
FAMILY
CONTACT
Body Inability to recognize After nursing After nursing > assess the family home visit >visual aids and low cost Partially met after the
weakness as the presence of health intervention intervention level of materials needed for nursing intervention
a health problem due to: the family will the family will understanding demonstration the client will
threat make be able to: regarding the health verbalized
>time and effort on the
necessary problem. understanding of
part of the student nurse
a. lack of or inadequate measures to disease process and
> discuss with the and family.
knowledge. properly a. have treatment regimen
family the nature
manage, adequate
signs and symptoms
control, and knowledge a
and complication that
Cues: >inability to make lessen the risk good proper
might arise due to
decision with respect factors of nutrition that
vital signs hypertension.
taking appropriate hypertension reduce
taken: hypertension > discuss with the
health actions due to:
BP: and prevent the family/client the risk
- failure to comprehend occurrence of factors of
160/100mm
the nature/ magnitude relative hypertension.
Hg
of the problem complications
-lack of adequate in the future.
knowledge as to b. Be able to
alternative courses of determine the
action open to them risk factor that
XXI
contribute
hypertension
such as family
history, age.
Health Problem Family Nursing Goal of Care Objective of Care Nursing Method Resources Evaluation
Problem Interventions
Risk for fire hazard as Inability to After 3 days of Afte one hour of H Time and effort of The family was able to:
health threat provide home nursing nursing the student nurse
1.. Demonstrate to O - To recite at least 3 ways
environment interventions, the interventions the and the family
Cues: the family the for preventive measues
conducive to family will have family will be M
ways on how to Money for
o Light construction health an awareness to able to: - Have self awareness
prevent fire E transportation
materials maintenance and prevent fire
a. Cite at least 3 accidents within
o Presence of small personal ways in family’s available
children 2 and 3 development due preventing fire resources. V
to:
years old
o Kitchen inside the b. Have self I
awareness
house 2. Educate the S
family some
preventive I
measures: T
- Keeping their
candle in the
XXII
safest place
during no
electricity
- Instruct the
children to stay
away and avoid
playing the lamp,
matchsticks etc.
Health Problem Family Nursing Goal of Care Objective of Care Nursing Method Resources Evaluation
Problem Interventions
Inability to After Nursing After 1 hour of 1. H Time and effort The family was able to:
provide nursing interventions Provideinformation of the student
Risk for Fall hazard as intervention, O a. Identified the
nurse and the
health threat a home :1.) The familywill of safety need importance of a safe
the family will M family
Environment know theimportance environment that free
Cues: think of necessary of or injury
E Money for from accidents or injury
o Unguarded stairs Conducive to action to reduce asafeenvironmentfree prevention transportation
potential hazards fromhazards b. Having self awareness
o 145 cm length, has 57 heath andmotivation to
for safety
cm in width, 27 cm in to the home andaccident. prevent. V
maintenance environment c. Encourage to put side
spacing for every I
steps and personal rails on their stairs
2.) The familywill be S
development awareand
2. Encourage the
XXIII
due to knowledgeable of family to put side I
thehazards in their rails on their stairs
:Lack of
home includingits
knowledge on 3. Instruct the
dangerous preventivemeasures
family to be
construction careful on stepping
materials the stairs
Health Problem Family Nursing Goal of Care Objective of Care Nursing Method Resources Evaluation
Problem Interventions
Financial Problem as After 3 days of After one hour of Asses level of H Time and effort of After2 days of nursing
Foreseeable Crisis community visit community visit awareness the student nurse intervention the couple
Inability to decide O
the family will be the family will be and the family enacted appropriate action
about taking
able to decide able to : M to address the problem.
appropriate Money for
Cues: about the
actions due to 1. Choose ways E transportation
appropriate
o Estimated income failure to actions to solve
saving foods
₱6000-9,000 for a comprehend the the problem.
nature and scope 2. Asses overall
month V
general condition
o 8 members of the of the problem I
health threats
family
XXIV
o Not able to meet because of S
daily needs financial problem.
I
3. Discuss some
alternative ways
that they can do to
solve their
problem(i.e.
budgeting, saving)
XXV
HEALTH TEACHING PLAN
OBJECTIVES
After 1-2 students-client interaction, the client will be able to;
1. Enumerate the different healthy food for a preschool child;
2. Identify the multiple methods in improving environmental sanitation and
3. Compare the advantage and disadvantage of proper hygiene.
RESOURCES
1.Time and effort of the student nurse and family
2. Visual Aids
HYPERTENSION
- LOSE WEIGHT
If overweight. Maintain body mass index of
18.5-24.9 kg/m2. For every 10 kg of weight
loss. BP drops by approximately 5-20mmHg.
26
pressure, especially when combined with
weight loss.
Handwashing
27
REFERENCES
28