University of the Cordilleras
College of Nursing
FAMILY NURSING CASE STUDY
I. INTRODUCTION
- Individual
- Family
II. INITIAL DATA BASE
A. Family Structure, Characteristics and Dynamics
1. Members of the household and relationship to the head of the family
2. Sociodbemographic data
3. Place of residence of each member
4. Type of family structure
5. Dominant family members in terms of decision making
6. General family relationship/dynamics
B. Socio-economic and cultural characteristics
1. Income and Expenses
2. Educational attainment of each family member
3. Ethnic background and religious affiliation
4. Family traditions, envents or practices affecting members health or family functioning
5. Significant others
6. Relationship of the family to the larger community
C. Home and Environment
1. Housing
2. Kind of neighboorhood
3. Social and health facilities available
4. Communication and transportation facilities available
D. Health status of each member
1. Current and past significant health condition/s or illness/es or Beliefs and practices
conducive to health and illness
2. Nutritional status
3. Developmental status
4. Risk Factor assessment indicating presence of major contributing modifiable risk factors
5. Physical assessment
6. Results of laboratory/diagnostic and other screening procedures supportive of assessment
findings
E. Values and practices on health promotion/maintenance and disease prevention
1. Immunization status
2. Health lifestyle practices-specifiy
3. Adequacy of
a. rest/sleep
b. exercise/ activities
c. Use of protective measures
d. Relaxation and other stress management activities
e. Opportunities with enhance feelings of self worth, self efficacy and sense of
connectedness to self
f. Stress management or other healthy lifestyle practices
g. Use of promotive-preventive health services
III. IDENTIFICATION OF HEALTH PROBLEMS
Health Condition and Problems Family Nursing Problems Cues/Data
Presence of Wellness condition ( these are subjective and
Health Deficit ( Nursing Practice in the Objective cues.)
Health Threat Community)
Forseeable crisis/ Presnece of Stree
Points
Malnutrition
Health Condition and Problems Family Nursing Problems Cues/Data
Health Deficit 1. Inability to recognized *Rina, three years old, weighs
the presence of 10 kgs.; looks pale, lethargic
malnutrition in a and apathetic;markedly
dependent member due underweight and
to lack of knowledge undernourished.
2. Inabiliy to decide about
taking appropriate *mother verbalized, Rina is
action due to failure to really small in bulit since since
comprehend the nature, she was a baby. She is not
magnitude and scope fond of eating too..
of the problem *Three preschool member
3. Inability to provide usually are left to the care of
adequate nursing care eight-year-old sister when
to a member suffering parents are working and other
from malnutrition due children are in schol;
to:
a. Lack of knowledge *Mother is very busy helping
about the health earn a living that she could
condition hardly see the needs of the
b. Lack of knowledge children;
on the nature and
extent of nursing *Family income is p500 a day.
care needed;
c. Inadequate
resources for care,
i.e.,responsible
family member and
financial contraints
IV. PRIORITIZATION OF HEALTH PROBLEMS
Criteria Computation Actual Score Justification
1. Nature of the Condition or problem
presented
Scale: Wellness state
Health Deficit
Health Threat
Forseeable crisis
2. Modifiability of the condition or problem
Scale: Easy Modifiable
Partially modifiable
Not modifiable
3. Preventive potential
Scale: High
Moderate
Low
4. Salience
Scale: a condition or problem, needing
immediate attention
a condition or problem not
needing immediate attention
not preceived as a problem or
condition needing change
Score:
1. Decide on a score for each of the criteria
2. Divide the score by the highest possible
score and multiply by the weight: (
Score/Highest Score) X weight
3. Sum up the scores for all criteria. The
highest score is 5, equivalent to the total
weight.
Guide for modifiability of the problem
1. Current knowledge, technology and interventions to enhance the wellness state or manage the problem
2. Resources of the family-physical, financial and manpower
3. Resources of the nurse- knowledge, skill and time
4. Resources of the community- facilities and community organization or support
Guide for preventive potential
1. Gravity or severity of the problem- the more severe the more lower preventive potential
2. Duration of the problem- the longer the problem, the poorer prognosis is
3. Current management- presence and appropriateness of intervention measures
4. Exposure of any vulnerable or high-risk group-increases the preventive potential
V. LIST OF PRIORITIZED FAMILY PROBLEM ( tabular form)
SCORE
1.
2.
3.
4.
5.
Criteria Computation Actual Justification
Score
1. Nature of the Condition or problem 3/3 x 1 1 It is health deficit that requires immediate management to eliminate untoward
presented consequences
2. Modifiability of the condition or problem 2/2 x 2 2 The problem is easily modifiable since the nurses resources are available; she/he can
Scale: Easy Modifiable help the family on effective budgeting of money and scheduling of time; she/he can
Partially modifiable develop the skilss of other members to achieve good nutrition proper food and
Not modifiable selection and preparation, and feeding pratices
3. Preventive potential
Scale: High 3/3 x 1 1 Susceptibility to other diseases and infections can be prevented if malnutrition is
Moderate eliminated; normal growth and development can thus be achieved
Low
4. Salience
Scale: a condition or problem, needing 0/2 x 1 0 It is not a felt problem
immediate attention
a condition or problem not
needing immediate attention
not preceived as a problem or
condition needing change
Total Score 4
VI. FNCP
HEALTH FAMILY NURSING GOAL OF OBJECTIVES OF INTERVENTION PLAN
PROBLEM PROBLEMS CARE CARE
NURSING INTERVENTIONS METHOD OF RESOURCES
NURSE FAMILY REQUIRED
CONTACT
Malnutrition 1. Inability to After Nursing After nursing 1. Discuss: Virtual Home visit Material resources:
recognized the presence intervention, intervention, the family a. The implication of the visual aids, examples
of malnutrition in a Rina’s will: signs and symptoms of of food stuffs for
dependent member due nutritional a. Avail itself of food malnutrition observed in demenstrating
to lack of knowledge state will supplements Rina and preparation of low-
2. Inabiliy to decide improve from provided by health b. The consequence of cost menus, suppies
about taking appropriate second and related malnutrition. and equipment for
action due to failure to degree agencies for pre- 2. Discuss with the family the cooking
comprehend the nature, malnutrition scholl reason for Rinas malnutrition; demonstration.
magnitude and scope of to at least malnourished inquire about and observe the
the problem first degree children; familys food selection and the Time and effort of the
3. Inability to in six months b. Be able to plan preparation and the eating Nurse and family
provide adequate time and prepare habits/practices of Rina. members
nursing care to a balanced meals 3. Discuss with the family the
member suffering from which are within course of action open to them, Expenses for
malnutrition due to: the familys budget. specifically; teaching aids and
a. Lack of c. Make Rinas weight a. explore the possibility of transportation of the
knowledge about the ncrease by at least arranging the schedule of nurse
health condition one pound per all members such that
b. Lack of month. responsible ones take
knowledge on the nature turns in seeing to the
and extent of nursing needs of younger ones
care needed; when Mrs. A is not around
c. Inadequate and;
resources for care, b. Explore with the family
i.e.,responsible fmily better ways of budgeting
member and financial family income
contraints c. Use of “contracting” as
motivational strategy to
encourage family
members to participate in
providing care to Rina
4. Develop the skills of family
members on proper food
selection and preparation
(e.g., owdered protein
concentrate such as mongo
beans, small fish and shrimps)
and feeding practices utilizing
low cost menus and food
suplement and food
supplements provided by
health agencies and
community resources
5. Guide the family in using
‘contracting’as motivitional
stragtegies
6. Make proper refferrral to
existing agencies on nutrition
so that the family can avail
itself of food supplements for
Rina.
B. EVALUATION (Sample Evaluation Plan)
Outcomes Evaluation Criteria /Indicators Evaluation Standards
Method Tool/Data Source
Goal: Improve the Weight (as nutritional status Increase of at least 1 kilogram in six weeks. Weight monitoring Weighing scale,early
nutritional status of the criterrion) childhood care and
three-year old family develoment Card for 0-6
member years
Objectives: Performance indicators/Critera:
The Famly will be able to:
1.a. identify inadequacies in
1. Provide adequate care specific nutrients generated from Correct identification of inadequacies in intake of Dietary history taking Food recall form or food
to the three-year old the baseline dietary intake of the specific macronutrients,vitamins and frequency record
member child minerals,critical to growth,bone-development and
strong immune system.
1.b. prepare meals based on Record Review Menu Plan
cycle menu plan. Accurate application of Daily Nitrition Guide
Pyramid for Filipino chirldren 1-6 years.
1.c. Feed the child based on Observation Performace evaluation
agreed upon quality and quantity Preparation of meals guided by principles such as checklist
of food nutrients preservation,increased variety and
appealing to taste.
1.d.Carry out Record Review Estimated food record
strategies/measures to adress Childs daily food intake bades on recommended Observation and performance evaluation
child’s eating idiosyncrasies and energy and nutrient intake for age group interview checklist
problems
Appropriate and effective measures based on Interview and Performance evaluation
childs age and nature/magnitude of eating/feeding Observation checklist.
problems.
VII. LIST OF REFERENCES
Nursing Practice in the Community –Araceli S. Maglaya- Fourth Edition
