TABLE OF COTENTS

I. Introduction

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a. Overview of the study b. Objective of the Study c. Scope and limitation of the study II. Spot Map III. Family Profile ------------------------------------------------ 2 ------------------------------------------------ 3, 4

IV. Family Health History --------------------------------------------- 5 V. Present Health Status --------------------------------------------- 6 VI. IMCI ----------------------------------------------- 7,8 VI. Home and Environment------------------------------------------- 9, 10 VIII. Family Coping Index --------------------------------------- 11, 12

IX. Schematic Presentation ------------------------------------------ 13 of the Family Health Problem X. Family Care Plan XI. Evaluation XII. Documentation ----------------------------------------- 14 -------------------------------------------------- 15 -------------------------------------------------- 16

I.

Introduction a. Overview of the Case

Family is a basic foundation of a community which is primarily well thought of as the basic element of care and the basic unit of the society. It is a factor to the development of health and nursing problems of its members. Families play a major role in transmission of religious, cultural, and social values. Moreover, it is responsible for the promotion of health, health maintenance, and prevention of diseases, the source of decision-making on health and nonhealth matters, and the bank of the most care and solid support to its members. Community health student nurses involve the patient and his/her family in the care provided in order to motivate them to assume responsibility for their care, and to be able to teach and maintain a desired level of functioning, explaining and answering the questions to clarify doubts, to maximize the clients confidence and ability to care for himself/herself, and finally to include the client as well as the family in the plan and participation of care. Thus the role of the community health nurse shifts from direct care giver to that of a teacher. I, as a nursing student of Liceo de Cagayan University, felt bless and thankful that through this profession I was given the opportunity to experience on how to conduct a family care study in where I was able to share my knowledge and learnings to those people who made my study possible. The objectives in conducting this family case study are to give nursing interventions in the problem identified and educate significant others and proper environmental sanitation that would lessen the risk for infection b. Scope and Limitation of the Study This study covers only 5 days visits to the Yanez family from November 25, December 1, 2, 9 and [Link] the study talks about the family that I had chosen, we only focus and limit it on the main problem which I identified and gave emphasis on the sanitation of Yanez family.

II. SPOT MAP A. Narrative

The point of reference is Liceo de Cagayan University. The group would have to ride a bulua jeepney going to the terminal of motor single at Bulua Cagayan de Oro City. The jeepney would follow the route to Patag, Apovel and then turn left upon reaching the place where the two roads divides. The jeepney would have to continue until it will pass Barangay of Patag and then Apovel. From Apovel, will pass again turn to left turn going to Bulua. In continuing the travel, the group would stop in the Bulua GYM, where the barangay hall and the health center located. Beside the gym is the terminal of motor single which we can have a ride going to zone 1, baikingon for the fare of 20 pesos.

III. FAMILY PROFILE

Head of the family Birnie Yanez

NO PICTURE

Age: Birthdate: Religion: Nationality: Address: Highest Educational Atainment: Occupation: Income:

46 years old April 16,1965 Roman Catholic Filipino Zone 1 baikingon Cagayan de Oro City High School level laborer 4,800 pesos

Light of the family ROSEMARIE YANEZ NO PICTURE

Age: Birthdate: Religion: Nationality: Address: Highest Educational Atainment: Occupation: Income:

39 years old November 26, 1972 Roman Catholic Filipino Zone 1 baikingon Cagayan de Oro City Elementary level Housekeeper 1,500 pesos

CHILDREN:

Eldest child in the family NO PICTURE Bernard Yanez

Age: Birthdate: Religion: Nationality: Address: Highest Educational Atainment:

18 years old July 14, 1993 Roman Catholic Filipino Zone 1, baikingon Cagayan de Oro City College level

second child in the family NO PICTURE Jomar Yanez

Age: Birthdate: Religion: Nationality: Address: Highest Educational Atainment:

17 years old December 17, 1994 Roman Catholic Filipino Zone 1, baikingon Cagayan de Oro City College level

Youngest child in the family Bernerose Yanez NO PICTURE

Age: Birthdate: Religion: Nationality: Address: Highest Educational Atainment:

3 years old January 19, 2008 Roman Catholic Filipino Zone 1, baikingon Cagayan de Oro City preschool

IV. Family Health History Name: Bernie Yanez Mr. Bernie Yanez is 46 years old; was born in barangay baikingon Cagayan de oro city Misamis Oriental on April 16, 1965 through normal spontaneous vaginal delivery at home by hilot. He works as a laborer. Mr. Bernie smokes Less than 5 sticks of cigarettes a day and drinks occasionally. He loves to eat vegetables which are the typical meal of the Yanez family. The Familys usual menu is cooked malunggay leaves, kalabasa, kangkong and other vegetables included in their menu bulad and pritong isda. He was never been hospitalized before. Has not donated any blood and has no known allergies on drugs and foods. The father side of Mr. Bernie had no familial disease of Hypertension. I was not able to assess Mr. Bernie because he is in work. Name: Rosemarie Yanez Mrs. Rosemarie Yanez is the 3rd daughter in their family. She is a 39 years old and was born in Iponan,Cagayan de Oro City through normal spontaneous vaginal delivery. She is a housewife who oversees their 3 children. She does all the houseworks from cleaning the house, washing the clothes, cooking the meals and bathing the children. She gave birth to all of her 3 children through Normal Spontaneous Vaginal Delivery (NSVD) at the Health Center. She has not been hospitalized before for any complicated diseases. She has no known food and drug allergies. She does not drink alcohol and at the same time she doesnt smoke. Children: Name: Bernard Yanez Bernard Yanez, the eldest child in the family. Bernard Yanez was born through normal spontaneous vaginal delivery at baikingon health center. He was breastfed by her mother for 1 year old of age. He had been fully immunized with BCG and Hepa-B, DPT 1,2 and 3, OPV 1,2 and 3 and Measles at Baikingon Health Center.

Name: Jomar Yanez Jomar Yanez, the second child of the family. He was born at baikingon health center through Normal Spontaneous Vaginal Delivery. He was breastfeed for only 1 year of age. He had been fully immunized with BCG and Hepa-B, DPT 1,2 and 3, OPV 1,2 and 3 and Measles. He has never been hospitalized for any diseases except for common colds, cough and fever experienced and treated only at home. He has no known allergies to foods and drugs.

Name: Bernie rose Yanez Bernie rose Yanez, the youngest child of the family and the only daughter in the family. She was born at baikingon health center through Normal Spontaneous Vaginal Delivery. She was breastfeed for only 1 year of age. She had been fully immunized with BCG and Hepa-B, DPT 1,2 and 3, OPV 1,2 and 3 and Measles. She has never been hospitalized for any diseases except for common colds, cough and fever experienced and treated only at home. She has no known allergies to foods and drugs.

V. Present Health Status a. Immunization Immunization Schedule BCG HepB1 HepB2 HepB3 DPT1 DPT2 DPT3 OPV1 OPV2 OPV3 Measles Bernar d Jomar Bernie rose

The immunization of the children of Yanez family is completed according to their age and schedule set as required. As collected, the family is aware on the immunization schedule which actively being followed up and met the appropriate age of their children for compliance and prevention of unprecedented illnesses such as polio, measles, diphtheria, hepatitis and others. Mr. Bernie, has no surgical operations from the past. At this moment of visitations, I was not able to assess him because his at work and yet I have no opportunity at all. According to his wife, he did smoke and drinks liquor occasionally. No known drug and food allergies according to the wife. Mrs. Rosemarie, a plain housewife who oversees their children. She does all the houseworks from cleaning the house, washing the clothes, cooking meals and bathing the children. According to her, she as no known allergy to drugs but she has allergy to foods like chicken, eggs, crabs and shrimps. She only eats vegetables, fish and soup which the familys mainstay meal. She does not drink alcohol and at the same time she doesnt smoke. In terms of elimination he had a normal bowel movement and five times or more as his frequency in urination. She is aware about family planning, Bernard, I was not able to assess because he is in school and yet visits are only limited. According to he mother he has no known drug and foods allergies. According to the mother, she do takes care of her childrens. Jomar, the second child of the family. According to the mother he has No food and drug allergies. I was not able to assess because Jomar is in school,according to the mother omar is healthy not only physicaly but also mentally.

Bernierose , the youngest child and the only child of the family, according to the mother she has no known food and drug allergies with the, Weight 15 kg Pulse rate of 85 bpm, Respiratory rate of 23 cpm and a temperature of 37 C.

VI. IMCI: INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS MANAGEMENT OF THE SICK AGE 2 MONTHS UP TO 5 YEARS Date: July 19, 2011 Childs Name: Bernierose Age:3 years old Sex: Female Weight:15 kg. Temp: 37 C ASK: what are the childs problem? ASSESS (circle all signs present) CHECK FOR GENERAL DANGER SIGNS NOT ABLE TO DRINK OR BREASTFEED DIFFICULT VOMITS EVERYTHING CONVULSIONS ABNORMALLY SLEEPY OR TO AWAKEN No pneumonia, cough and colds No diarrhea None Initial visit: Follow-up visit:___ CLASSIFY YES_NO

DOES THE CHILD HAVE COUGH OR DIFFICULTY BREATHING? YES___NO For how long?___days Count the breaths in one minute. ____breaths per min. Fast breathing? Look for chest indrawing. Look and listen for stridor. DOES THE CHILD HAVE DIARRHEA? YES___NO For how long?___days Look at the young infants general condition. Is Is there blood in the stool? the infant Abnormally sleepy or difficult to awaken. Restless or irritable? Look for sunken eyes. Pinch skin of the abdomen. Does it go back: Very slowly (longer than 2 sec) Slowly? DOES THE CHILD HAVE FEVER?(by history/feels hot/T 37.5C or above) YES___NO Decide malaria risk Does the child live in malaria area? LOOK AND FEEL: Has the child visited/traveled or Look or feel for stiff neck Stayed overnight in a malaria area Look for runny nose In the past 4 weeks? If malaria risk, obtain a blood smear. + P1 Pv -done THEN ASK: Look for signs of MEASLES For how long has the Generalized rash and child had fever?____days One of these: cough, runny nose If more than 7 days, has fever been or red eyes. present every day? Has the child had measles within the last 3 months? 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.

No fever

 Look for clouding of the cornea. ASSES DENGUE HEMORRHAGIC FEVER THEN ASK: Has the child had any bleeding from the LOOK AND FEEL: nose or gums or in the vomitus or stool? Look for bleeding from nose or gums Has the child had black vomitus or black stool? Look for skin petechiae Has the child had persistent abdominal pain? Feel for cold and clammy Has the child had persistent vomiting? extremities. Check capillary refill____seconds. Perform tourniquet test if child is 6 months or older and has no fever for more than 3 days. DOES THE CHILD HAVE AN EAR PROBLEM? YES___NO Is there ear pain? Look for pus draining from the ear Is ther ear discharge? Feel for tender swelling behindthe YES___NO___If YES, for how long?_____days ear. 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 VIT A SUPLLEMENTATION STATUS for children 6 months or older Is the child 6 months of age or older? YES___N0___ Has the child received Vit A in the past 6 months? YES___ NO___ ASSESS CHILDS FEEDING if child has ANEMIA or VERY LOW WT. or is less than 2yrs old. Do you breast feed your child? YES___ NO___ If YES, how many times in 24 hrs? times. Do you breastfeed during the night? YES__ NO__ Does the child take any other foods or fluids? YES__ NO__ If YES, what foods or fluids? boiledwater___________________________________________ How many times per day?_6__times. What do you use to feed the child?__glass________ If very low weight for age. How large are servings? __________________________ Does the child receive his/her own serving?___ who feeds the child and how?_____ During the illness, has the childs feeding changed? YES__ NO__ If YES, how?

none

No ear infection

normal

Vit A needed today YES_NO

VII. HOME & ENVIRONMENT A. Home

The yanez family lives in a small Barangay of Zone 1 baikingon, Cagayan de Oro City. Their house is made up of wood which is located near from their other neighbors. We do observe that the family has a limited budget on extra materials from the house. The house has 3 sections: 1 used as living room and at the same time 1 for dinning room, and 1 used as a bedroom. The family has their own electricity connection and they have only TV for their appliances that would make ease their boredom for the whole day.

B. Water Supply They dont have their own connection of water from the mainland, and is outside the house, so they would get their water outside from the water pump located near the main road, they would fetch water from the pump a little distance from their house. They would stack their water inside their house for they have this Gallons or container only some are covered. C .Waste Disposal We didnt noticed any trash can or compost pit around their backyard so mrs, rosemarie told me that they would just burned their garbage on any sides of their backyard which is not good for the fact that it may cause danger not only in their lives but as well as the environment.

D .Comfort Room For the toilet, it is located outside, separate from their house. It is a water sealed and but again it does not have any cover. They have common toilet with her mother in law. It means two family used in one comfort room.

E. Domestic Animals The family has pig and chickens .

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[Link] vegetables The family planted vegetable such as, malunggay, Alugbati near in their house, just outside their house. E. Community Base on my observations, though there are less waste in the whole community thus making their whole general sanitation good but we cant approve their method of disposing their garbage through burning because as we all know it could also harm our Mother Nature specifically the ozone layer that serves as our protection from the extreme heat of the sun. And we also observed only few of the households at Zone 1, baikingon have their own water supply. The health center is located far from the community itself. How we wished that the government could do something about this problem.

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VIII.

FAMILY COPING INDEX

Legend: 1 No competence 3 Moderate competence 5 Complete competence CATEGORY 1. Physical Independence SCALE 5 JUSTIFICATION The family provides partially needs to its members. The father works as a laborer to sustain the needs of his family. The mother takes care of the children and she cooks for the family. She also has extra income in doing laundry in Westfield subdivision. TheChildren received complete immunizations. Giving medications correctly but not understanding the purposes of the, symptoms to be observed. Has some general knowledge of the disease or condition, but has not grasped the underlying principles, or is only partially informed and does not know how to listen & prevent the disease. Children had adequate clothed Poor hygiene and imbalanced diet (less protein source such as meat). In terms of hygiene, the family was consciously practicing/ applying hygiene principle as part of their lifestyle. Based on the objective observation, as well as assessment gathered such as garbage disposal and absence of drainage. Accept healthcare in some degree but with reservations. Sometimes the family does not seek help of medical professionals during times of illness and prefer to self-medicate because the health center is far from there house. The family was able to maintain a reasonable degree of emotional calm face up to illness realistically and hopefully; but they were not able to discuss family problems because of the absence of the presence of the head of the family. 11

2. Therapeutic Competence

3. Knowledge of Health Condition

4. Application of Principles of 3 General Hygiene

5. Health Attitudes

6. Emotional Competence

7. Family Living

8. Physical Environment

9. Use of Community Facilities

Familys does things together and act for the good of the family as a whole and they have good interpersonal relationship but unfortunately the father does not have quality time for his family because of his work. Has open drainage and can easily bear to vectors and mosquitoes. Scattered garbage around the house. Environment areas near houses are very mud. They live near the river and danger area for floods especially this latest event of SENDONG. Family is aware of and uses of the health services offered in their barangay health center but were not able to fully avail the services.

XI. EVALUATION

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There were no difficulties encountered as to the family members attitude because they were participative and accommodating throughout the care rendered to them. Furthermore, as of other aspects was difficult to plan because it was not anticipated, such mentioned difficulty was encountered with the father of the family and her two sons because of their unavailability during the process of care. The said father leaves at 8 am and comes home at 6pm and that is why I was not able to assess and see them, I was not able take pictures because they dont have time for me to accommodated. Even though the family relies more on herbal treatment rather than medical treatment, they still go to the concerned physician that is if they experienced unusualties in there bodies lasting more than 5 days accordingly. In the client care process, several interventions were done as well as health teachings. This includes the appropriate care for the disease conditioned, information drive or further research and education which concerns of health care and health related conditions. As well as other health tips were emphasized to the concerned family, these were discussed as to anticipate the care of the individual and the family as a whole.

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Liceo de Cagayan University

In partial fulfillment of NCM501205 Related Learning Experience RLE

Submitted By: Arjay c. Rios Group A11 Submitted to: Mrs. Gemma Reambonansa RN,MAN

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