BSN2-A GROUP B

A typology of Nursing of Nursing Problems in Family Nursing Practice

First-Level Assessment

I. Presence of wellness condition

II. Presence of health threats

III. Presence of health deficits

IV. Presence of stress points/foreseeable crisis situation

First-Level Assessment
TYPOLOGY CUES/DATA
I. Presence of Wellness Condition stated as Potential or
Readiness - a clinical or nursing judgement
about a client in transition from a specific level
of wellness or capability to a higher level

Potential for Enhanced Capability for:

Spiritual Well- All family members are Roman Catholic. They pray the
being Holy Rosary every 6PM. They offer a prayer before
sleeping. The family regularly hear mass every Sunday
at the nearby chapel.

Parenting The family has a good relationship. There is no problem

with communication and all of them are open to each
other. Conflict is not observed between the family
members.
II. Presence of Health Threats
conditions that are conductive and to disease to
accident, or may result failure to realize
maintain wellness or health
potential
Poor Home/Environmental Condition -Inadequate living space
-Improper drainage system

The structure of the house is small and it is not enough to

accommodate the family. They live in
 an approximately 3x4 meter house made up a bamboo and
nipa located nearby the irrigation canal and ricefield
serves as the habitat of Oncomelania Quadrasii.

Sanitation -Improper garbage / refuse disposal

-Unsanitary waste disposal

Human excreta are disposed using an overhung toilet

facility and it flows directly to the irrigation canal.
Improperly disposed garbage could also be seen within the
vicinity of the home. Animal manure could be seen as
well in their backyard.

The family does not use any method of segregation and

recycling of garbage. They put their garbage in a sack
which is left untied after which they throw it to a nearby
vacant lot whenever it is full. Empty glass bottles can be
seen under the house.

Accident -Risk for fall Accident hazards are present.

The house is made up of bamboo and wood that needs to

be repaired. The flooring has holes that can increase the
risk for falls.

Poor Home -Lack of food storage facilities

Left-over foods are placed on the table and left

uncovered.
Environmental Condition -Polluted water supply

They got the water for drinking from an open dug well in
their backyard located 3 meters away from their comfort
room. No boiling nor any treatment is done prior to its
consumption. Water used for bathing, washing clothes
and dishes is also fetched from the well.

III. Presence of Health Deficits it is Mr. light diagnosed with SCHISTOMIASIS

states,regardless of whether JAPONICIUM INFECTION = this might be because of
A. Illness or undiagnosed by medical the water they drink that is from the open dug and they
diagnosed don't boil it.
practitione
r Moon light felt HIGH FEVER,FRONTAL
HEADACHE WITH RETRO – ORTBITAL PAIN
AND MYALGIA (dengue) = for it is not stated that they
are using any mosquito net
IV. Presence of Stress Points/Fo reseeable
Crisis Situations
Pregnancy • All of her deliveries were assisted by an untrained
traditional birth attendant (partera).

• She never had a prenatal check-up is because of the

scarce financial resources and that she do not know
where to go.

• Upon assessment her BP is 140/90 mmHg with slight

pedal edema; wt-53.5 kg and complained of persistent
severe headache

Parenthood  Mrs. Light is 39 years old and a mother of

five.
Additional Member  At present, Mrs. Light is on the 31st weeks AOG

Abortion  G7P5 (1-1-5-0)

Entrance at School • Mr. and Mrs. Light- elementary graduate
• Sun Light – High school graduate
Hospitalization of a Family Member  Mr. Light was hospitalized at Schistosomiasis
Research and Control Project Hospital with the chief
complaint of seizures.

Second-Level of Assessment (PANER)

I. Inability to recognize the presence of the condition or problem

II. Inability to make decisions with respect to taking appropriate health actions

III. Inability to provide adequate nursing care to the sick, disabled,dependent, or vulnerable/ at-risk
gmember of the family

IV. Inability to provide a home environment conductive to health maintenance and personal
development.

V. Failure to utilize community resources for health care

 I. Inability to recognize the presence of the condition or problem due to:
TYPOLOGIES DATA/CUES:

A. Lack of inadequate knowledge • The family doesn’t practice good hygiene and sanitation that
greatly affect their health.

• Doesn’t give importance of consulting to the barangay or a

physician about their underlying problems.

• No family or reproductive planning is practiced.

• Not aware of the services the government offers for these

kinds of sectors.

B. Denial about its existence or severity as a 1. Social stigma: They endure the pain as long as it’s still
result of fear of consequences of diagnosis of bearable. As verbalized, “Waray la ako mapakadto ha sentro
problem. kay na-iilob ko man an sakit”, ““Mag-iiban na an ina-abat ni
Moon kay nainom nah in Cortal ngan “tawa-wata” ug diri na
kinahanglan dad-on ngadto doctor.”

2. Beliefs that doesn’t align to as of the medical practices. As

verbalized, “Labot la ha amon pamilya puro man gud normal
it paganak, salit waray kabarak-an, hereditary ngan kina-iya
han amon pamilya it panganak hin normal.”
 3. Economic/ cost complications- The family belongs to a
marginalized sector, their income can’t sustain enough for
what the whole family needs. Problems with money,
communication and transportation.

4. Physical consequences- Most of the members have underlying

complications due to lack of knowledge and access to some
services offered.
Mr. Light- Diagnosed with Schistosomiasis, enlarged abdomen,
and the skin and sclera had a yellowish color.

Ms. Light- Discomforts due to pregnancy

Moon Light- High fever, headache, pain and experienced

vomiting

C. The attitude and the beliefs as a family hinders • Due to lack of knowledge they barely recognize the severity
recognition /acceptance to the problem.. of the problem. “Diri ako andam pag-ukoy hin pagsinigarilyo
ug pag-inoom hin mga irimnon nga makahurubog kay naluya
an akon lawas kun dire ako nakaka-inom ug nakakasigarilyo.”

• They also believe that everything is okay and that the current
situation is called “tadhana”.

II. Inability to make decisions with respect to taking appropriate health actions due to:
TYPOLOGIES DATA/CUES:

1. Failure to comprehend Lack of knowledge in sanitary methods.

nature/magnitude of problem/condition

Lack of knowledge in preventive measures to avoid

Schistosomiasis
2. Low salience of the problem/condition Mr. Light stated, “Diri ako andam pag-ukoy hin
pagsinigarilyo ug pag-inoom hin mga irimnon nga
makahurubog kay naluya an akon lawas kun dire ako
nakaka-inom ug nakakasigarilyo”
3. Lack of/inadequate knowledge/insight as to alternative Mr. Light, a chainsmoker and an alcoholic drinker
courses of action open to them. have no plans on changing lifestyle.

4. Lack of/inadequate knowledge of Mrs. Light is not aware that such service (pre-natal) is
community resources for care being offered in the health center which is 5-7 km away
from their home.

Mr. Light, the head of the family verbalized, "Antes ako

nahisakob ha Schistosomiasis Hospital, diri gud kami
maaram kun mapakain".

5. Inaccessibility of appropriate resources for care, Mrs. Light never had a prenatal check-up is because of the
specifically: a. Cost constraints or economical /financial scarce financial resources
inaccessibility

Mr. Light verbalized, "...dara na gihapon ini hit

kaokupado hit trabaho ngan hit tungod hit kawarayan
ngan kapobrihan."

Misconceptions or erroneous information about As Mrs and Mr. Light verbalized, "Mag-iiban na an
proposed course(s) of action inaabat ni Moon kay nainom nah in Cortal ngan
“tawatawa" ug diri na kinahanglan dad-on ngadto doctor."

They believe in quack doctors and tambalan.

III. . Inability to provide adequate nursing care to the sick, disabled, dependent, or vulnerable/ at-risk
member of the family due to:
TYPOLOGY CUES/DATA
A. Lack of/ Inadequate knowledge about Perceived severity of experienced hypertension during
the disease/ health condition pregnancy
(as verbalized by Mrs. Light, naiilob ko man an sakit.”
She doesn’t know the danger of having high blood
pressure during pregnancy)

As verbalized by Mr Light, “waray ko ideya kun ano

ini na sakit” (Mr. Light only knows he he is diagnosed
with Schistosomiasis but he doesn’t know what is it and
how he got it)

B. Lack of/ Inadequate knowledge of the Past pregnancies assisted by untrained birth attendant
nature and extent of nursing care needed (Since all of Mrs Light’s past pregnancies came out
normal, she thinks it is okay to let an partera assist in
delivering the baby)

The need for prenatal check-ups (it became part of Mrs.

Light’s mindset that it is okay not to do check-ups since
she never had it in the previous pregnancies and her
children still came out normal)

Belief on quack doctors/ tambalan (this is due to the

influence of the barangay that the family lives in; they lack
awareness that there is a need to be checked by a
professional to have the proper treatment)

C. Lack of/ Inadequate knowledge and Drinking habits (Mrs. Light is not aware that drinking
skill in carrying out the necessary alcohol could harm the baby, and Mr. Light does not want
interventions/ treatment/ procedure/ to stop drinking despite being told by the doctor to stop)
care
Non-adherence to a healthy lifestyle (Mr. Light is
advised to stop drinking and smoking but he refuses
becauase according to him, “nanluluya
akon lawas kun diri nakakinom ngan nakakapanigarilyo”)

Lack of preventive measures during work

(Since they don’t know what Schistosomiasis is,
 they continue to not wear boots in the field, not knowing it
increases the risk to the disease)

Resorting to herbal medication only as treatment

(when their son Moon Light got sick, the couple treated
him with tawa-tawa decoction instead of getting proper
treatment; as verbalized by them,
“diri na kinahanglan dad-un ha doctor”)

D. Inadequate family resources for care, As verbalized by Mr. Light, “dara na ini tungod hit
specifically: kawarayan ngan kapobrihan” (when asked why he
 Financial constraints cannot prioritize his sickness)

No prenatal check-ups because of scarce financial

resources according to Mrs. Light

E. Member’s preoccupation with own Father as head of the family must work to provide
concerns/ interests (“Antes ako nahisakob ha Schistosomiasis Hospital, diri
gud kami maaram kun mapakain, dara na gihapon ini hit ka
okupado hit trabaho…”)

Children in the family are mostly students (the youngest

is three years old and still needs to be taken care of)

Mother’s pregnancy (Mrs. Light is 31 weeks pregnant

and is experiencing discomforts)

F. Altered role performance, specifically: Mrs. Light is dealing with all of these at the same time:
 Role overload *pregnancy
*work
*taking care of husband
*taking care of children

IV. Inability to provide a home environment conductive to health maintenance and personal
development due to:
TYPOLOGIES DATA/CUES
A. Inadequate Family Resources 1. Financial constraints
CUE: Mr. Light - farmer with 3,000
income Mrs. Light - vegetable vendor with
1,000 income

2. Limited Physical Resources

CUE: They live in an approximately
3x4 meter house

B. Failure to see benefits of investment in home They believe that everything is okay and that the
environment improvement current situation they are in is given to them by God
and it is their destiny or as they call it - their "tadhana"

C. Lack of knowledge of importance of hygiene and Improperly disposed garbage could also be seen
sanitation. within the vacinity of the home. Animal manure could
be seen as well in their backyard.

-They do not use spoon and fork when eating.

-They got the water for drinking from an open dug

well in their backyard located 3 meters away from
their comfort room. No boiling nor any treatment is
done prior to its consumption.

D. Lack of knowledge of preventive measures. Mr. and Mrs. Light do not use boots whenever they
are in the field because they feel uncomfortable.
 -Left-over foods are placed on the table and left
uncovered.

E. Negative attitude in life which is not conducive to “Diri ako andam pag-ukoy hin pagsinigarilyo ug
health maintenance. pag-inoom hin mga irimnon nga makahurubog kay
naluya an akon lawas kun dire ako nakaka-inom ug
nakakasigarilyo.”

F. Lack of competencies in relating to each other for They also believe that everything is okay and that the
mutual growth and maturation. current situation they are in is given to them by Godd
and it is their destiny or as they call it –their
“tadhana.”

V. Failure to utilize community resources for health care due to:

TYPOLOGIES DATA/CUES:

Lack of/inadequate knowledge of community -Mrs. Light is not even aware that such service (pre-
resources for health care natal) is being offered in the health center which is 5-7
km away from their home.

-Mr light stated about Schistosomiasis that “waray ko

ideya kun ano in inga sakit ngan ngain kami madaop.”

Failure to perceive the benefits of health care/services -Mrs. Light stated “pero diri man ako Ma’am
nakakaabat hin maski ano labot la han pirme pag-ulol
han ak ulo ngan tangkugo. Waray la ako mapakadto ha
sentro ka na-iilob ko man an sakit. “

Lack of trust/confidence in the agency/personnel -They believe in quack doctors and tambalan.
Previous unpleasant experience with health worker -None

Fear of consequences of action (preventive, 1. Physical/psychological consequences

diagnostic, therapeutic, rehabilitative) specifically :

Mr. Light verbalized “ “diri ako andam pag-ukoy hin

pagsinigarilyo ug pag-inoom hin mga irimnon nga
makahurubog kay naluya an akon lawas kun dire ako
nakaka-inom ug nakakasigarilyo.”

2. Financial consequences

Mrs. Light never had a prenatal check-up is because

of the scarce financial resources.

Mr. Light stated “Antes ako nahisakob ha

Schistosomiasis Hospital, diri gud kami maaram kun
mapakain, dara na gihapon ini hit ka-okupado hit
trabaho ngan hit tungod hit kawarayan ngan
kapobrihan.”

Lack of or inadequate family resources, specifically 1. Manpower resources

-baby sitter, no other relatives or significant others
live with the family.

2. Financial resources, cost of medicines

prescribe.

- Due to lack of financial resources they prefer

quack doctors/tambalan and the use of herbal medicine
like the tawa-tawa” decoction.
Feeling of alienation to/lack of support from the -None
community, e.g. stigma due to mental illness, AIDS,
etc.

Negative attitude/ philosophy in life which hinders -They also believe that everything is okay and that the
effective/maximum utilization of community current situation they are is their destiny or as they call
resources for health care it –their “tadhana.”