Family Nursing Analysis Latest

FAMILY NURSING CARE ANALYSIS
COMMUNITY HEALTH NURSING

NCM_104B
Submitted by:
Ansagay, Mc Lein A.
Antolin, Chloe Rosette B.
Asuncion, Keziah Claire D.
Asuncion, Mary Joyce R.
Aurelio, Lyca Mae M.
Submitted to:
FEDERICO V. NAGTALON, Ed.D.

Clinical Instructor
January 2021
MARIANO MARCOS STATE UNIVERSITY
College of Health Sciences
APPROVAL SHEET
This Family Nursing Care Analysis of the Medrano Family of Brgy. #7 Garnaden, Nueva Era, Ilocos Norte prepared and submitted by
Mc Lein A. Ansagay, Chloe Rosette B. Antolin, Keziah Claire D. Asuncion, Mary Joyce R. Asuncion and Lyca Mae M. Aurelio in partial
fulfillment of the requirements in the Community Health Nursing (NCM 104b), has been presented and evaluated.
FEDERICO V. NAGTALON, M.A.N., Ed.D.

Clinical Instructor
GERLY MARK R. REDOBLE, M.A.N.

Clinical Instructor
ROSELLA A. LUCERO, R.N

Clinical Preceptor
ENGRACIA FLORDELIZA P. MIGUEL, R.N.

Clinical Preceptor
JULIE C. DAMASO, M.A.N.

Level II Coordinator
2nd Floor CAS Bldg. #16S Quiling Sur, City of Batac, Ilocos Norte
 [email protected]  +63(961)262-09-90 www.mmsu.edu.ph
ii
TERESITA ANNE O. TINIO, M.A.N.

Clinical Coordinator
ELMER A. SANTOS, M.A.N., Ed. D.

Chair, Department of Nursing
RYAN DEAN T. SUCGANG, MSHMS

OIC Dean, College of Health Sciences
iii
ACKNOWLEDGEMENT
For the successful completion of this work, the student nurses wish to express their most profound gratitude for the assistance extended
by the people who were instrumental in sharing their invaluable time, constant motivation, inspiration, and pieces of advices in the realization of
this study, particularly to the following:
TO MEDRANO FAMILY who willingly shared their time and effort for welcoming the group from the very start and were able to
cooperate well with the group, and who shared information with utmost sincerity and honesty for the success of this family nursing care plan.
TO PROF. FEDERICO V. NAGTALON, our clinical instructor, for his fatherly concern, efforts, full guidance, scholarly suggestions
and all-out support from the conceptualization to the finalization of the paper;
TO OUR OTHER MENTORS, GERLY MARK REDOBLE, ROSELLA A. LUCERO, and ENGRACIA FLORDELIZA P.
MIGUEL, for their intelligent ideas, suggestions, technical assistance and expertise that contributed for the refinement and improvement of the
paper;
TO BSN II-D, who made the process of making this paper more productive.
TO OUR PARENTS, who inspired us with their love and endless support for us to continue pursuing this output; and
Above all, to Almighty God, for His countless and bountiful blessings for through Him nothing is impossible.
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BSN II-D, Group 1-Cluster 2

TABLE OF CONTENTS
Title Page………………………………………………………………………………………………………………..…………………………….i
Approval Sheet……………………………………………………………………………………………………………………………………ii-iii
Acknowledgement……………………………………………………………………….…………………………………………………………..iv
Table of Contents………………………………………………………………………………………………………………………………….v-vi
Initial Data Base for Family Assessment
a. Family Structure, Characteristics and Dynamics……………………………………………..……………………………………………1-2
b. Socio-Economic and Cultural Characteristics…………………………………………………………………………………………….3-12
c. Home and Environment………………………………………………………...……………………………………………………….13-30
d. Health Status of Each Family Member………………………………………………………………………………………….………31-41
e. Nutritional Assessment…………………………………………………………………………………………………………….……42-59
f. Physical Assessment…………………………………………………………………………………………………………………….60-79
g. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention…………………………………….…………..80-89
Typology of Nursing Problem
v
a. First Level Assessment……………………………………………………………………………………………………….…………90-92
b. Second Level Assessment……………………………………………………………………………………………………………….93-97
c. Ranking Health Condition and Problems According to Priorities…………………………………………………………….....…….98-110
d. Family Coping Index…………………………………………………………………………………………………………...……..111-112
e. Family Nursing Care Plan……………………………………………………………………………………………………….……113-117
Instructional Design
a. Fall Preventions……………………………………………………………………………………………………………………….118-123
b. Proper Waste Disposal………………………………………………………………………………………………….…………….124-126
c. Elimination of Possible Breeding Grounds of Rodents and Insects………………………………….………………………………127-131
References…………………………………………………………………………………………………………….………………………132-136
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INITIAL DATA BASE FOR FAMILY ASSESSMENT
a. Family Structure, Characteristics and Dynamics
Table 1. Types of family, dominant family members, name, sex, age, civil status, position in the family, place and type of residence, and general family
relationships and dynamics.
Types of Dominant Name Sex Age Civil Status Position in the Place of Residence Type of General Family
Family Family Family Residenc Relationship/Dynamics
Members e
M F S M D SEP. U R Conflict between Family members
Cause Evident Not

(Specify) Evident
N-F MA Robinson Medano   Father Brgy. Garnaden, Nueva  

Era, Ilocos Norte
E-F PA Snooky Medrano   Mother Brgy. Garnaden, Nueva  
Era, Ilocos Norte
B-F SYN
COMP-F ALPC
COHAB Others
-F (Specify)
SING-P
Others
(Specify
1
The Medrano family is considered a nuclear type of family, composed of the husband, wife and their 2 children only. However,
the home is near to their extended family. Filipino customs Newlyweds usually live with the groom’s family until the first child is born
and then they move into a home of their own which is often close to the parent (Living in the Philippines, 2018).
Robinson Medrano, 36 years old and her wife, Snooky, 38 years old are equally leading the household, making the family
synergistic. This type family authority is common in the 21st century where there is clear division of labor between spouses in familial
task performance, that is, both spouses have certain areas where one had the final say (Kumagai,2015).
The place of residence of the family is located at Brgy. Garnaden, Nueva Era, Ilocos Norte which is considered as a rural
community. In many rural Filipino communities, it is subsistence living, growing and rearing what they eat and many sitios we re
composed mainly of kin. Kin ties formed the basis for most friendships and supranuclear family relationships (Dolan 1991).
Conflict between the family members is not evident and harmonious relationship is observed. It means continuous work and constant
reflection on actions that keep a healthy connection with the family as a larger unit.
2
b. Socio-Economic and Cultural Characteristics
Table 2.1. Decision maker for allocation of money, occupation, place of work, income, and other sources of income
Name of Family Decision- Occupation (Blue Collar) Occupation (White Collar Place of Work Income
maker for
Members allocation
of money
Construction farming Business Others Teacher Nurse Engr. Doctor Overseas Others Inside Outside Overseas
Worker (Specify) (Specify) (Specify) (Specify) Locality Locality
Robinson Medrano (Egg Php.

dealer) 35,000
Snooky Medrano  Php.
(Empanad 24,000
a Stand
and
Carinderi
a)
TOTAL Php.
59,000
Other Sources of
Income:
4 P’s
Relatives Abroad
Others (Specify)
TOTAL
3
Table 2.2. Summary of Monthly Income
Monthly Income Range Family Income Bracket

(Albert et.al., 2015)
Less than Php7890 per month (Poor)
Php7890 – Php15,780 (Low Income)
Php15,780 – Php31,560 (Lower Middle Income)
Php31,560 – Php78,900 (Middle Middle Income) 

Php78,900 – Php118,350 (Upper Middle Income)
Php118-350 – Php157,800 (Upper Income)
At least Php157,800 (Rich)
Incomes greatly affect how people live their daily life. Such, Robinson Medrano is an owner of egg trading business earning Php.
35,000 a month. While his wife, Snooky Medrano is also involve in business where she owns and manage Empanada Stand and Carindera
in their neighboring barangay making her to profit Php. 24,000 a month. There is also no other source of income indicated. The total
monthly income of the family is Php. 59,000 which is classified as a middle income. The key small business benefits are the financial
rewards (Alton, 2019). These benefits are wide-ranging, from having the pride of earning own money to the flexibility to put more
savings away toward goals.
4
Table 2.3. BasicNecessities
Basic Necessities (Accdg. To Adequacy to Meet Basic Needs Monthly Expenses

Maslow)
Adequate Not Adequate Actual Cost
Food  Php. 5,000
Clothing  Php.1,000
Shelter  0
Water  0
Other necessities:
Health/Illness Medication  Php. 1,000
Education  Php. 3,000
Transportation  Php. 5,000
Electric Bills  Php. 3,000
Water Bills  0
Communication  Php. 1,500
Others (Specify)
TOTAL Php. 19,500
5
Table 2.4. Monthly Expenses
Monthly Expenses Bracket Actual Monthly Expenses

>1000
1000 –2999
3000 –4999
5000 –6999
7000 –8999
9000 –10999
11000 –12999
13000 –14999
15000 - Above 
Budget allocation is one of the major challenges that every family face. The Medrano family has an adequate fund for them to
meet all their basic necessities but had difficulty in assigning their budgets according to Snooky. Their monthly expenses are; Php. 5,000
6
pesos for foods, Php. 1,000 for clothing, Php. 1,000 for health/illness medications, Php. 3,000 for education, Php. 5,000 for transportation
since it is greatly needed in their business, Php. 3,000 for electric bill, and Php. 1,500 for communication. They are not spending for
their shelter because they have their own house and water system, a well with water pump run by electricity. The total monthly expenses
of the family are Php. 19,500 which belongs to monthly expenses bracket of 15000 – Above. Rural‐urban differences associated with
food security and environmental factors suggest that the cost of living is substantially lower in rural than in urban areas (Nord, 2009).
Table 2.5. EducationalAttainment
Highest Educational Attainment (National Statistics Office, 2010 Census on Population and
Housing)
Family Members NGC EU EG HSU HSG PSUG PSG CUG CG PB NR
Robinson Medrano 
Snooky Medrano 
Princess Anjelie Medrano 
7
Sheanne Cheska Medrano 
A person’s educational attainment is considered to be the highest level (grade or degree) of education they have completed.
Robinson and Snooky are both high school graduates. Education plays a role in income however while attending college holds social and
educational merits, getting a business degree from college is far from mandatory to starting and running a successful business (Sweeney,
2019).
Princess is currently in high school level, a grade 9 student and Sheanne in elementary level, a grade 6 student. Children’s learning
is increasingly moving toward a broader vision of the 21st century learning. As children’s educations increasingly occur across a range
of settings, parents are uniquely positioned to help ensure that these settings best support their children’s specific learning needs
(Bartolome, 2017).
8
Table 2.6. Ethnicity Background and Religious Affiliation
Family ETHNICITY (Collado, Paula et al. RELIGION (Collado, Paula et al.

Members 2000) 2000)
Ilocano Tagalog Kankani Apayao Isneg Tinggian Itneg Others Roman Protesta Islam Others
(Specify Catholic nt (Specify)
) (Specify)
Robinson Medrano  /
Snooky Medrano  /
Princess Anjelie  /
Medrano
Sheanne Cheska  /
Medrano
All the family members are Ilocano. Ilocanos can be found living in the Northern Luzon. The family also share the same religion
which is Roman Catholic. The denomination of Christianity that became most embedded in Filipino culture is Catholicism, which was
introduced in the Philippines during the early colonial period by the Spanish. More specifically, 82.9% of the population identify as
Catholic (Cultural Atlas, 2017).
9
Table 2.7. Significant Others and They Play in Family’s Life
Name of Significant Other Relationship to the Family Role in the Family

Jacquelina Medrano Robinson’s Mother Taking care of children
Ruby Ralph Medrano Robinson’s Brother Worker in their business
Lita Simon Snooky’s Mother Taking care of children
Ronald Simon Snooky’s Brother Worker in their business
Helen Medrano Robinson’s Aunt For financial assistance
Esteban Medrano Robinson’s Grandfather For financial assistance
The nuclear family is the core family unit; however bonds are often tight knit among extended family members. Many Filipinos
hold the belief that each family member has several duties and responsibilities they must uphold. Observing one’s duties and
responsibilities is important in order to correctly respect others and to ensure harmony among family members (Cultural Atlas, 2017).
There are six people from their extended family or the significant others who play roles in the family. Jacquelina Medrano,
Robinson’s mother and Lita Simon, Snooky’s mother help in taking care of the children when the couple is not around. Ruby Ralph
Medrano, Robinson’s brother and Ronald Simon, Snooky’s brother are the workers of the family’s business. Lastly, Helen Medrano,
Robinson’s aunt and Esteban Medrano, Robinson’s grandfather provide financial assistance on the family for business development and
in case of emergency.
10
Table 2.8. Relationship of the Family to a Larger Community

COMMUNITY ACTIVITIES (Davis, K.,
1997)
School Fundraising Environmental Community Religious Youth Sports/ Others
Program Program Programs projects Activities Programs Recreation (specify)
(tree planting, (food
beautification drives)
activities,
recycling)
Robinson 
Medrano
Snooky  
Medrano
Princess Anjelie   
Medrano
Sheanne Cheska  
Medrano
Snooky, PTA officer, Princess and Sheanne, students, are actively participating in school programs. The goal of positive and
productive family and community involvement is on every school improvement list (Epstein, 2016). Research suggests that this goal is
an important one to reach because families and communities contribute to children's learning, development, and school success at every
grade level.
Snooky and Robinson as residents, they are required to join community projects in their barangay. Many people feel a sense of
commitment to their barangay and are actively involved in activities to improve the quality of life there (Rolando,2014).
11
In terms of religious activities, Princess and Sheanne are involved. Major religious belief systems contain prohibitions against
substance use, promiscuity, violence, and stealing (Donahue, 1995). Youth who internalize these values are less likely to engage in risk
behaviors even when circumstances motivate them to do so
Princess is a liga player making her to embrace youth programs in their community. This program is dedicated to providing youth
with a healthy body, a healthy mind, healthy lifestyle and promote socialization among their peers.
12
c. Home and Environment
Table 3.1. Adequacy of Living Space
Provisions Adequate Inadequate

Living room 
Dining room 
Kitchen 
Bedroom 
Bathroom/Comfort room 
Balcony 
Terrace 
Storage room 
Attic 
Garage 
Backyard /
Table 3.1 shows the adequacy/inadequacy of living spaces of Medrano family in which it shows that the family has adequate
spaces for Living room, Kitchen, Bathroom/Comfort Room, and Backyard. It also shows that inadequate spaces include their Dining
room, Bedroom, Balcony, Terrace, Storage Room, Attic, and Garage.
Adequate shelter means more than a roof over one's head. It also means adequate privacy; adequate space; physical
13
accessibility; adequate security; security of tenure; structural stability and durability; adequate lighting, heating and ventilation;
adequate basic infrastructure, such as water-supply, sanitation and waste-management facilities; suitable environmental quality and
health-related factors; and adequate and accessible location with regard to work and basic facilities: all of which should be available
at an affordable cost. Adequacy should be determined together with the people concerned, bearing in mind the prospect for gradual
development. Adequacy often varies from country to country, since it depends on specific cultural, social, environmental and
economic factors. Gender-specific and age-specific factors, such as the exposure of children and women to toxic substances, should
be considered in this context (UNCHS, 2007).
Table 3.2. Sleeping Arrangement
Description Yes No
Each family member has its own bedroom 
Family members shares a room with siblings 
Parents have separate room 
A room for visitors is available 
Table 3.2 shows the sleeping arrangement of Medrano family in which it shows that the siblings a share room. It also shows
that the parents have separate rooms, and that a room for visitor is not available.
14
For children, sharing a room with a sibling can be a hugely enjoyable experience; shared secrets, giggles and midnight
feasts, but for some who may not get along so well, tensions can run high and tempers can be short in a confined space. This has
further complications when siblings have a larger age gap; bedtime and sleep can be disrupted, leading to tiredness and the
inevitable, and undesirable grumpy side effects that come with that. Privacy also becomes all the more important to children as
they age, and they may resent having to share their space with a younger sibling (Davis, 2020).
Table 3.3. Presence of Breeding or Resting Sites of Vectors of Disease Like Mosquitos, Roaches, Flies, Rodents, Etc.
Breeding Sites Mosquitos Cockroaches Flies Rodents Others
Containers   
Tires 
Barrels
Plastic drums  
Jerricans
Waste disposal    
Pest (cockroaches, mosquitoes, rats,
house fly, etc.)
Sewage/ open water reservoir  
Others (specify)
Table 3.3 shows the resting sites of vectors of disease, it also shows that majority of the vectors breed or reside in containers and
waste disposals, followed by plastic drums and open water reservoir.
15
According to housing for health, mosquitoes and flies transmit disease including trachoma, which is carried by some types
of flies and many mosquito-borne diseases. Other examples of illnesses transmitted include Ross River Fever, Barmah Forest
Disease, Dengue Fever and Murray Valley Encephalitis. Internationally, malaria is a major mosquito borne illness. Houses and yards
should be designed to reduce mosquito and fly breeding areas and areas of potential contact between mosquitoes, flies and people.
Poorly graded or blocked roof gutters, rainwater tank inlets and overflow points, pooling water from dripping taps and/or poorly
drained yard area could be breeding places for these insects.
Table 3.4. Presence of Accident Hazards
Accident Hazards Observed

Materials used in building the house
Falls (staircase, ladder, bathroom, wet floors) 
Poison (cleaning products, pesticides) 
Fire hazards (cigarette butt, candles, cooking, electric wirings)
Sharp objects (presence of knives, scissors, rakes, saws) 
Suffocation (presence of cords, strings, ropes, trash bags, electric outlets unfix) 
Table 3.4 shows the presence of accident hazards. It shows here that hazards like falls such as staircase, wet bathroom floors,
and ladders are observed. As well as poisoning which includes pesticides and cleaning products; Sharp objects with presence of
knives, scissors, rakes, etc. and Suffocation hazards.
16
The home is supposed to be where family are safe and protected but according to Stay Safe Organization (2017) ,every year
accident and emergency units deal with serious injuries and sometimes fatal accidents that occur in the home. It is not just children
and the elderly that can come to harm in the home with things like chemicals and choke hazards. Many of these accidents are
preventable and dealing with a serious accident that could have been avoided can lead to a lifetime of guilt. Making home safe is
also a process that will never be finished. That’s partly because households are always changing. Home’s safety needs will change
as your family ages, as your home ages, as you get more stuff, and even as the seasons.
Table 3.5. Food Storage and Cooking Facilities
Food Storage Observed

Dry, hanged
 Plastic containers 
 Glass containers 
 Others (specify)
Frozen
 Refrigerator 
 Freezer 
 Cooler 
 Others (specify)
Cooking Facilities
Sink 
17
Stove
 Electrical 
 Firewood/coal 
Microwave oven 
Pressure cooker
Rice cooker 
Others (specify)
Table 3.5 shows how the family stores foods and what their cooking facilities are. It shows here that the family stores food in
plastic and glass containers in their refrigerator, freezer and cooler. They cook food using stove (electrical/coal), Microwave oven,
and Rice cooker.
According to Victoria State Government (2017), food poisoning is frequently caused by bacteria from foods that have been
incorrectly stored, prepared, handled or cooked. Food contaminated with food-poisoning bacteria may look, smell and taste normal.
If food is not stored properly, the bacteria in it can multiply to dangerous levels.
Table 3.6. Water Supply
Source Observed
Ground (spring, drilled well, water pumps) 
Surface (conjunctive use, rivers, lakes, streams)
Precipitation harvesting (rooftop rainwater harvesting)
18
Ownership
Individual/private
Centralized/ public 
Potability
Chlorinated
Unchlorinated 
Table 3.6 shows the water supply of the family in which they have private water source which is ground and it is unchlorinated.
According to the Water Quality and Health Council, prior to the use of chlorinated drinking water at the turn of the century,
waterborne diseases such as cholera, typhoid fever, dysentery and hepatitis claimed thousands of lives each year. Not only does chlorination
help prevent the spread of infections such as E. coli, it also destroys bacteria, algae and mold that can grow on the walls of water storage
systems, and it removes unpleasant tastes and odors from drinking water. While chlorination is effective at sanitizing drinking water, it can
be difficult to handle without expertise and experience. The chlorination of water used for showering, laundering and swimming can dry
out the skin and hair, may cause eye irritation and can also fade fabrics.
Table 3.7. Main Source of Water Supply
Sources Observed
Surface water (lake, stream, river)
19
Ground source (well) 

Commercial
Table 3.7 shows the main water supply of the family. It shows here that the main source is ground source.
According to CDC, most of the time, groundwater is safe to use. However, groundwater sources can become contaminated
with germs, such as bacteria, viruses, and parasites, and chemicals, such as those used in fertilizers and pesticides. Contaminated
groundwater can make people sick. The presence of germs and harmful chemicals in our ground water can lead to health problems,
including diarrhea, reproductive problems, and nervous system disorders. If you have a well, you should take steps to protect it and
have the water tested annually to make sure your water is safe from harmful.
Table 3.8. Distance of the Septic Tank from the Source of Water Supply (in meters if ground
water)
Observed
>25 meters
<25 meters 
Table 3.8 shows that the distance of septic tank to the source of water supply is more than 25 meters.
Septic tanks are built underground and release wastewater slowly into the surrounding environment. For this reason, they must be
20
a set distance away from a home. In addition, they must be built at least 50 meters away from water sources. Other binding
regulations that have to be adhered to include being environmentally friendly and not polluting water sources (Wood, 2020).
Table 3.9. Toilet Facility
Type Condition Ownership

Maintained in good Unmonitored Exclusively used Shared with
condition by household another household
Water-sealed, sewer, septic tank  
Water-sealed, another depository
Closed pit
Open pit
Others (pail system, etc.)
None
Table 3.9 shows the condition and ownership of toilet facility. It shows here that the family has unmonitored water-sealed,
sewer, septic tank and it is exclusively for household. The family has and their own toilet facility, however it is unmonitored. We,
nurses should emphasize the importance of maintaining a clean toilet facility as it helps in promoting good health and hygiene.
According to McLean (2018), toilets need to be frequently sanitized. If the restrooms are not clean bacteria and germs can
quickly multiply to other parts of our homes if we are not careful. By regularly cleaning the restrooms with the right toiletries, it
means that you will get rid of bacteria and germs that cause different diseases. Bacteria and germs cause plenty of problems. The
21
bacteria and germs cause most of the diseases. Eliminating the bacteria and germs is thus a great way of preventing the spread of the
diseases. The family will express themselves better if the restrooms are adequately cleaned.
Table 3.10. Garbage/ Refuse Disposal
Garbage Disposal Observed

Liquid 
Solid waste 
Organic waste 
Hazardous 
Table 3.10 shows that the family observes proper garbage disposal of solid, liquid, organic and hazardous wastes. Observing
proper waste disposal affects the family as well as the environment for it promotes healthier surroundings. According to Rob (2015),
there’s more to proper waste disposal than keeping the environment clean. Tidy surroundings reduce health risks and hazards, resulting
in a healthier community. It also supports local recycling efforts and sustainability.
22
Table 3.11. Drainage System
Type Observed
Surface drainage system 
Sub-surface drainage system
Tube well drainage system
Main drainage system
Type
Open 
Close
Table 3.11 shows the drainage system of the family in which they have an open surface drainage system. Having a good drainage
system can prevent water accumulation that can lead to flooding by directing the water away from your home. Water that over-
accumulates in the yard may kill plants. Drainage systems also prevent the accumulation of stagnant water, which can encourage
mosquitoes to breed. Over time, stagnant water accumulated can make soil muddy, which in turn can cause soil to erode. Drainage
systems maintain balanced moisture to reduce soil erosion. (Borlongan, 2016).
Table 3.12. Animal Excreta
Waste Disposal Observed

Burned 
23
Dumped at the backyard, open 

Dumped and buried
Picked and uses as fertilizer (cow, carabao, horse, chicken, etc.)
Others (specify)
Table 3. 12 shows how the family dispose animal excreta. It shows here that the family disposes animal wastes through burning
and dumping at open backyard. Manure organic matter contributes to improved soil structure, resulting in improved water infiltration
and greater water-holding capacity leading to decreased crop water stress, soil erosion, and increased nutrient retention (Koelsch,
2019).
Table 3.13. Household Waste
Waste Disposal Observed

Burned 
Recycled/Segregated
Dumped in the specific plane and left to decompose 
Sold to junkshops
Garbage collection (barangay)
Animal feeding (left overs) 
Others (specify)
Table 3. 13 shows how the family dispose household wastes. It shows here that the family disposes household wastes through
burning, animal feeding and disposing at specific plane and leaving it to decompose. Waste poses a threat to public health and the
environment if it is not stored, collected, and disposed of properly (Yoada, 2014).
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Table 3.14. Kind of Neighborhood
Type Observed
Single dwelling
Congested 
Slum
Others (specify)
Table 3.14 shows the kind of neighborhood the family belongs. It shows here that the family belong s to a congested neighborhood
Poor quality and inadequate housing contributes to health problems such as chronic diseases and injuries, and can have harmful
effects on childhood development. Poor indoor air quality, lead paint, and other hazards often coexist in homes, placing children and
families at great risk for multiple health problems. For example, Residential crowding has been linked both with physical illness, such as
tuberculosis and respiratory infections, and with psychological distress among both adults and children. Thus, living in a congested kind
of community affects the air quality that the family breathes in. whereas the health of the family is compromised.
Table 3.15. Social and Health Facilities Available
Agencies Distance Assistance Provided

Department of Health 3km Health care services
DSWD 3km Social protection and poverty-reduction solutions
Population Commission 3km Family Planning
Department of Education 500 m Children's services and education
PhilHealth 44 km Health insurance coverage and affordable and accessible
health care services
25
PCSO 7km Raise and provide funds for health programs, medical
assistance and services, and charities of national character.
NGO (specify)
Others (specify) Local Government Unit 3km Broad range of services in the community
Table 3.15 shows the distance of social and health facilities from the household in which Health care services (DOH) Social protection
and poverty -reduction solutions (DSWD) and Population commission and LGU are located 3km from the household, Children’s services
and education is located 500km from household, Health insurance facilities like PhilHealth are located 44 km from home, and PCSO located
7km from home. This facilities provide for the health, welfare, social, educational, spiritual, recreational, leisure and cultural needs of the
community, and play an important role in the development of vibrant neighborhoods by creating a sense of place and providing
opportunities for people to meet and interact socially (Herefordshire Council, 2015). Living in a place where social and health facilities are
accessible has a great impact on the family. It allows them to live comfortably and without worrying about resources or facilities they could
reach out to.
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Table 3.16. Communication and Transportation Facilities
Sources Availability Frequency (per week)

Radio  3 hrs
Television  6 hrs.
Cellular phones  48 hrs
Newspaper
Magazines
Social Media  48 hrs
Others (words of mouth, etc.)
Transportation Availability
Private utility Public utility
Bicycle 
Motorcycle 
Three-wheeler
Car 
Truck
Bus
Others (specify) Mitsubishi L300 
Table 3.16 shows the availability of communication resources in which the family has Radios, Television, Cellphones and Social
Media platforms as means of communication. It also shows the availability of transportation facilities that are present including bicycles,
motorcycles, car, as private utilities.
Transportation and communication are means or processes of overcoming distance. Transportation usually involves carrying or
27
moving of goods and people from place to place, while communication involves the passing of news and information from one person to
another (Ninzap, 2020). Strong, reliable communication and transportation systems play a major role in the economic development of
countries and regions. In areas where both communication networks and transportation systems are efficiently integrated, the ability to
swiftly communicate, move people, and transport goods provides a strong base for the growth of trade and hence is a crucial factor in
developing a stronger economy
Table 3.17. Participation of Community Activities
Activities Always Sometimes Never

Clean and Green 
Fiestas
 Boodle fight 
 Fun Run 
 Larong lahi 
 Liga 
 Pageant 
 Zumba  
 Others (specify)Drum and Lyre
Community assemblies 
Health Seminars/informal education 
Health mission 
Others (specify)
Table 3.17 shows the participation of the family to community activities. It shows here that the family participate sometimes in
28
community fiestas, community assemblies and Health and Education seminars. Meanwhile, the family has never attended clean and green
activities and health missions.
As nurses, we should encourage families to participate and involve in community activities to build better relationships among
themselves. According to WHO (2008) health is a fundamental human right and a social goal. The attainment of which requires a concerted
action by the health sector and all the other sectors of society. Health is also a social achievement or goal. Social goals, such as improving
the quality of life and health status, are achieved through social means, including communities and individual people accepting greater
responsibility for health and actively participating in attaining them.
Table 3.18. Recreational Activities/ Sports Activities
Activities Availability
Outdoor activities/sports activities
Watching TV 
Malling 
Listening to the radio
Picnic 
Strolling 
Reading books/newspaper
Instrumental playing
Drawing or painting
Others (specify)
The family’s form of recreational and sports activity includes watching tv, going to malls, having picnic, and strolling. We nurses
29
should emphasize that engaging in leisure and recreational activities promotes bonding and improves relationship among family
members.
According to Hutchinson (2011), Leisure activities and contexts provide a myriad of opportunities for taking better care of one’s
self, coping with and managing challenging life circumstances, affirming one’s value, (re)discovering strengths and abilities, and having
a sense of purpose and meaning in life. Moreover, because of the freedom to be self-determined in leisure and the opportunities it affords
to experience positive emotions—such as pleasure, joy, meaning, purpose—leisure may be a powerful resource for recovering from and
self-managing mental health problems and addictions.
30
D. Health Status of Each Family Member
Table 4.1. Hospitalization
Family Member Facility Diagnosis Date of Days Laboratory Remarks

Hospitalizati of Procedures (Maintenance, diet,
on Stay and Result etc.)
Robinson Medrano MMMH & MC Ulcerative colitis 06/11/2008 6 Blood Test, Stool Avoid alcohol and
Test, Colonoscopy smoking.
(Results unrecalled)
Sheanne Cheska Medrano MMMH & MC Meningitis 03/15/2009 18 Blood test, CT scan, Mild activity level
(Results unrecalled)
In the hospitalization of the family members of Family Medrano, Robinson Medrano was diagnosed with Ulcerative colitis on June
11, 2008 at Mariano Marcos Memorial Hospital and Medical Center or MMMH & MC located at Batac City, Ilocos Norte, where he stayed
there for 6 days, his laboratory procedures includes blood test to show if he have anemia or inflammation, stool test to help the doctor rule
out an infection or parasite in the colon. And also show if there’s blood in his stool, and lastly colonoscopy this procedure uses a flexible
tube containing a camera called a colonoscope, which allows your entire colon to be examined. A biopsy sample can also be taken
(Khatri,2019). Mr. Robinson Medrano cannot recall his laboratory results. His maintenance is to avoid alcohol and smoking.
Sheanne Cheska Medriano was also hospitalized at Mariano Marcos Memorial Hospital and Medical Center or MMMH & MC located
31
at Batac City, Ilocos Norte where she stayed for 18 days or 2 weeks and 4 days. Her diagnosis was meningitis and the different laboratory
procedures that she took when she was admitted was blood test wherein a blood sample is placed in a special dish to see if it grows
microorganisms, particularly bacteria and CT scan of the chest or sinuses can show infection that may be associated with meningitis (Mayo
Clinic, 2020). The results of the laboratory procedures were unrecalled. Her maintenance is to have a mild activity level meaning no
strenuous activities.
32
Table 4.2. Consultation
Family Member Facilit Reaso Always Sometimes Never

y n
Robinson Medrano Medical Center
Provincial Hospital
District Hospital
Rural Health Unit Common illnesses 
Private Hospital
Snooky Medrano Medical Center
Provincial Hospital
District Hospital
Private Hospital Hypertension 
Princess Anjelie Medrano Medical Center
Provincial Hospital
District Hospital
Rural Health Unit Common illnesses, Asthma 
Private Hospital
Sheanne Cheska Medrano Medical Center
Provincial Hospital
District Hospital
Private Hospital
On the consultation of the Medrano Family, they seek healthcare by going to their respective Rural Health Unit sometimes due to the
common illnesses like cough, colds, fever and Princess Anjelie Medrano seek medical attention because of her asthma in their Rural Health
33
Unit while Snooky Medrano goes to a private hospital to manage her hypertension. But the Family Medrano don’t go always to the different
healthcare facilities, they go there when they feel that they needed to have a check-up or the condition that they are experiencing is serious
and in need of medical attention.
Access to healthcare services is critical to good health, yet rural residents face a variety of access barriers. Ideally, residents should be
able to conveniently and confidently access services such as primary care, dental care, behavioral health, emergency care, and public health
services. Access to healthcare is important for: Overall physical, social, and mental health status, Disease prevention, Detection, diagnosis,
and treatment of illness, Quality of life, Preventable death and Life expectancy. (Healthcare Access in Rural Communities, 2019).
Table 4.3. Childhood Illnesses
Family Members Childhood

Illnesses
Chickenpox Management Measles Management Mumps Management Rubella Management
Robinson Medrano  Home  Home
remedies, remedies,
medication medication
Snooky Medrano  Home  Home
remedies, remedies,
medication medication
Princess Anjelie Medrano  Home
remedies,
medication
Sheanne Cheska Medrano  Home
34
remedies,
medication
On the childhood diseases of the Family Medrano, Robison Medrano and Snooky Medrano both have experienced chickenpox and
mumps their management was home remedies/ treatments like bed rest and drinking 8 glasses of water and medications. Princess and
Sheanne Medrano’s childhood illness is measles, their parents treated this illness by giving them medication and home remedies/ treatments
such as encouraging them to drink a lot of water, bed rest and letting them stay home to prevent the spread of the infection.
In most countries like the Philippines, communicable diseases take the top spot for the most common illnesses. With the country’s
tropical environment and prolonged rainy season, it makes it easy for diseases to spread and for people to become sick. Learning about
common childhood illnesses in the Philippines can prepare parents and have them adopt preventive measures to protect their children such
as teaching their children proper handwashing and good hygiene. (Hornillos, 2020).
Table 4.4. Surgical History
Family Members Injury Procedure Date Facility Surgeon Complications

done
Robinson Medrano Ulcerative Colitis proctocolectomy 03/17/2008 MMMH & MC unrecalled none
On the surgical history of the Family Medrano, Robinson Medrano is the only one who have undergone surgery, his injury was
ulcerative colitis and the procedure done was protoclectomy wherein the colon and rectum were surgically removed. He had his surgery
35
last March 17,2008 at Mariano Marcos Memorial Hospital and Medical Center or MMMH & MC located at Batac City, Ilocos Norte. He
can’t recall who his surgeon and there were no complication before, during and after the surgery as per verbalization.
According to Crohn’s & Colitis Foundation (2020), patients can live a long, active, and productive life with an ileostomy. In many
cases, ileostomy patients can participate in the same activities they did before the surgery, including sports, outdoor activities, swimming
and other watersports, travel, and work. It is common for patients to initially feel self-conscious about their ileostomy bag and you may
notice a change in how you feel about your body image.
Table 4.5. Injuries/Accidents
Family Type of Injury/Accident Management

Members
Snooky Medrano Bruises/Road Accident Primary health service at RHU
Princess Anjelie Medrano Dog bite Anti-rabies vaccine, suma
On the injuries or accidents of the Medrano family, Snooky Medriano was injured due to a rod accident, she also had bruises and her
bruises were treated at the primary health service at the Rural Health Unit. Princess Anjelie Medrano was bitten by a dog and she was given
ant-rabies vaccine and they went to folklore who gave them suma.
According to data released by the World Health Organization (WHO), there are 1.35M lives taken due to road accidents in 2018. And
statistics in the Philippines is recorded that 12,000 Filipinos die on the road every year. (Kim, 2020). The Philippines is among the top 10
36
countries with the highest incidence of rabies in the world, according to the Philippine Council for Health Research and Development. The
DOH estimates that about 10,000 Filipinos are treated for dog bites and 200 to 300 die from rabies every year. This is why the government
made an Act related to this, it is the Rabies Act of 2007 that mandates rabies immunization for children aged five to 14 years living in
highly endemic areas. It consists of three doses given on days 0, 7, and 21 or 28. (Elicay, 2019).
Table 4.6. OB/GYN History
Family Members Total T P A L M

number of
Pregnancies
Snooky Medrano 2 2 0 0 2 0
In the OB history of the family, Snooky Medrano is the only one who got pregnant and gave birth, her OB scoring is full term is 2
and both of them are living, she doesn’t have any premature babies, abortion and multiple pregnancies like twins, triplets and quadruplets.
About 190 babies were born per hour, or approximately 3 babies were born per minute in 2018, a decreased trend in There were a
total of 1,668,120 live births registered in the country in 2018, or around 4,570 babies born daily. This is equivalent to a crude birth rate of
15.8 or 16 births per thousand of population. (ABS-CBN News, 2020).
37
Table 4.7. Birth History
Family Members Type of Delivery Hospital Date

Robinson Medrano normal spontaneous Home Birth 04/02/1984
Snooky Medrano normal spontaneous Home Birth 02/21/1982
Princess Anjelie Medrano normal spontaneous Dona Josefa Edralin Marcos 02/05/2006
District Hospital
Sheanne Cheska Medrano normal spontaneous MMMH & MC 11/10/2008
In the birth history of the Medrano Family, Robinson Medrano was thru normal spontaneous delivery at a house in Banna, Ilocos
Norte by a “komadrona” on April 2,1984. Snooky Medrano was also born thru normal spontaneous delivery at a house in Nueva Era, Ilocos
Norte by a “komadrona” on Februaryb 21,1982. Sheanne Medrano was born thru normal spontaneous delivery at MMMH & MC located
at Batac City, Ilocos Norte on November 10, 2008. Lastly, Princess Medrano was also born thru normal spontaneous delivery at Dona
Josefa Edralin Marcos District Hospital located at Marcos, Ilocos Norte.
Childbirth always carries risks whether it happens in a hospital or not, and that is why many doctors are against home births. To
mitigate these risks, a hospital is the safest place. During a home birth, when a life-threatening complication develops, which can happen
without warning, delayed medical attention (such as the time it will take to transfer the mom from her home to a hospital) puts the lives of
the mother and the baby at high risk. Additionally, Research based on data from other countries suggests that planned home births are
associated with a higher risk of infant death and seizures, albeit rare, compared to deliveries done in hospital settings. Possible birth
complications include rupture of the uterus and postpartum hemorrhage, which can also lead to maternal death.(Perez, 2019).
38
Table 4.8. Beliefs and Practices
Belief and Practices Belief Practices
The family prepares and serves “atang” toward off sickness or illness of  
family member.
The family performs “gulgul” after burial to wash away the pain of losing someone  
and sickness and bad luck associated with the death of a family member.
The family believes that “mangkukulam” who causes illness or sickness to a  
member.
The family seeks “albularyo” whenever a member is sick/ill.  
The family seeks “agsusuma” when a member is bitten by a dog, snake,etc.  
The family seeks “manghihilot” whenever a member suffers from abdominal pain,  
sprains, fractures and musculoskeletal conditions.
The family believes in faith healres.
The family seeks “magpapaanak” who performs “suob” ritual to a mother who
just gave birth.
The family seeks “mangluluop” who specializes in diagnostic techniques, usually
referring patients after diagnosis to “albularyo”.
The family seeks “medico” who prescribes prescription medicine,
acupuncture,etc.
Others (specify)
Beliefs and Practices Yes No

The family drinks extracted oregano leaves to treat cough. 
The family uses “akot-akot” mixed with vinegar to treat mumps. 
The family member who suffers from measles wears balck and does not look in the 
mirror to
avoid spreading.
39
The family member who suffers from chickenpox wears black. 

The family uses hot calamansi juice to treat cough. 
The family believes that a stye can be cured by breastmilk or by having contact with a 
child’s penis
with the stye.
The family uses aloe vera or malunggay leaves to treat wounds. 
Others (specify)
The family practice the following belief and practice: prepare and serves “atang” towards off sickness or illness of a family
members furthermore “atang” is known as a food offering that is intended to drive away evil and malevolent spirits (Dunuan, 2016). They
family believe and practice “gulgul” after a burial, “gulgul” is customarily done in the morning after the burial of a departed loved one.
The immediate family members gather together in a nearby river or seaside to perform the ritual. (Magpali,2019). The family also believes
in “mangkukulam” and they seeks an “albularyo”,“mangsusuma”and “manghihilot”.
The family Medrano belief and practice on the home remedies are only on using hot calamansi juice to treat cough and using of
aloe vera or malunggay leaves to treat wounds. They drink the calamansi juice 2 times a day (daytime and nighttime) when they have a
cough until their cough is gone while in treating their wounds they mostly use malunggay leaves, they squeeze the malunggay l eaves so
that the juice of the malunggay leaves will be out then they will apply it on the wounds.
Cultural competence is the ability of health providers and organizations to deliver health care services that meet the cultural, social,
and religious needs of patients and their families. Culturally competent care can improve patient quality and care outcomes. Strategies to
40
move health professionals and systems towards these goals include providing cultural competence training and developing policies and
procedures that decrease barriers to providing culturally competent patient care. (Swihart et al, 2020).
41
E. Nutritional Assessment
Table 5.1. Nutritional Assessment
Family Members Sex Age Height Weight Interpretation Intervention Done

Robinson Medrano M 36 161 cm 69 Overweight
Snooky Medrano F 38 157cm 62 Overweight
Princess Anjelie Medrano F 14 159cm 54 Normal
Sheanne Cheska Medrano F 11 150 cm 38 Underweight
The nutritional assessment of the Medrano family are as follows, Robinson Medrano, male, 36 years old with a height of 161 cm and
a weight of 69 kg with a BMI category of overweight. Spooky Medrano, female, 38 years old with a height of 157 cm and a weight of 62
kg with a BMI category of overweight. Their daughter Princess Angelie Medrano, female, aged 14 with a height of 159 cm and weight
of 54 kg categorized as normal, and their youngest Sheanne Cheska Medrano, female, aged 11 with a height of 150 cm and weight of 38
kg categorized as underweight.
According to Coss-Bu J. A. and Kyle U. G. (2010) on Nutritional assessment and length of hospital stay, the purpose of nutritional
assessment is to define a patient’s nutritional status, and to identify clinically relevant malnutrition as well as to monito r the
patient/client's nutritional status.
42
Table 5.2. Three-Day Diet Recall Meal
Family Members Date Breakfast Snack Lunch Snack Dinner

Robinson Medrano 10/17/20 1 fried egg 1 serving 1 cup pork 2 slices bread 1 bowl pork
1 longanisa pancit
1 cup rice 8 oz soda adobo 2 cups lauya 2 cups
banana rice
blossom
2 cups rice
10/18/20 2pcs 1 pc 1pc fried 1 bowl miki 1 pc fried tilapia
tuyo 1 ensaymada chicken 1 1 Boiled egg 1 pc jumbo
cup 8 oz soda cup monggo hotdog 2 cups
rice 2 cups rice rice
10/19/20 3 pcs pandesal 3 pcs lumpia 2 slices 3 pcs banana cue 1 cup igado
1 fried egg 1 cup ampalaya
1 cup rice letchon leaf salad 2 cups
manok rice
2 cups rice
Snooky Medrano 10/17/20 1 fried egg 1 serving 1 cup pork 1 bowl pork
1 longanisa pancit adobo 2 cups lauya 1 ½
1 cup rice 8 oz soda
1 cup coffee banana cups rice
blossom
1 ½ cups rice
10/18/20 2pcs 2 packs 1pc fried 1 bowl miki 1 pc fried tilapia
1 Boiled egg 1 pc jumbo
tuyo 1 biscuits chicken 1
cup cup monggo hotdog 1 ½
rice 1 ½ cups rice cups rice
1 cup coffee
43
10/19/20 3 pcs pandesal 2 pcs lumpia 1 slice 3 pcs banana cue 1 cup igado
1 fried egg 1 cup ampalaya
1 cup rice letchon
manok leaf salad 1 ½ cups
1 cup coffee
1 ½ kangkong rice
salad 1 cups
rice
Princess Anjelie Medrano 10/17/20 2 slices bread 1 pc jumbo 1 cup pork 20 pcs fish 1 bowl pork
1 cup milk hotdog 1 adobo 1 slice ball 8 oz lauya 1 ½
chocolate glass orange ham soda cups rice
juice 1 ½ cups rice
10/18/20 1 cup noodles 1 pack Nova 1pc fried 1 bowl miki 1 pc fried tilapia
8 oz soda 1 Boiled egg 1 pc jumbo
chicken 1
cup monggo hotdog 1 cup
1 ½ cups rice rice
1 pack 1 slice ham
Dutchmill letchon 1 ½ cups rice
manok
1 cup rice
Sheanne Cheska Medrano 10/17/20 1 longganisa 1 pc jumbo 1 cup pork 20 pcs fish 1 bowl pork
½ cup rice hotdog 1 adobo 1 cup ball 8 oz lauya 1 ½
1 cup milk
glass orange banana soda cups rice
chocolate
juice blossom
1 cup rice
1 pack
1 pack instant 1pc fried 1 bowl miki 1 pc fried tilapia
10/18/20 Piattos
pancit canton chicken 1 1 Boiled egg 1 pc jumbo
1 cup milk 8oz soda
chocolate cup monggo hotdog 1 cup
1 cup rice rice
44
1 pack 1 slice ham
Dutchmill letchon 1 cup rice
manok
1 cup rice
For the family's three day diet recall meal, structurized interview intended to capture detailed information about all foods and
beverages and possibly dietary supplements consumed by the respondent. NIH(2020)
For Robinson Medrano, for breakfast on October 17, 2020, Mr. Medrano had 1 cup of rice, 1 fried egg and 1 longganisa, for the
morning snack, he had one serving of pansit with 6 ounces of soda, for the lunch, he had 1 cup of pork adobo, 2 cups of banana blossom
with 2 cups of rice, for his afternoon snack, he had 2 slices of bread, and for his dinner, he had 1 bowl of pork Lauya and 2 cups of rice.
For his diet on October 18, 2020, for breakfast, he had 2 pieces of tutoring and a cup of rice, for his morning snack he had 1 piece of
ensymada and a 6 ounces soda. For his lunch he had, 1 piece of fried chicken, 1 cup monggo, and 2 cups of rice. For his afternoon snack,
he had 1 bowl of miki and 1 boiled egg, for his dinner he had 1 piece fried tilapia, 1 piece of hotdog (jumbo) with 2 cups of rice. For his
diet on October 19, 2020, for his breakfast, he had 3 pieces of pandesal, 1 fried egg, and 1 cup rice. For his morning snack, he had 3
pieces of lumpia, for his lunch, he had 2 slices of lechong manok and 2 cups of rice, for his afternoon snack, he had 3 pieces of banana
cue, and for his dinner, he had 1 cup of Igado, 1 cup of ampalaya leaf salad, and 2 cups of rice.
45
For Mrs. Snooky Medrano, for her meals on October 17,2020, for breakfast she had 1 fried egg, 1 longganisa, 1 cup rice, and 1
cup of coffee, for her morning meals, she had 1 serving of pancit and and a 6 ounces of soda. For her lunch, she had 1 cup of pork adobo,
2 cups of banana blossom, and 1 and a half cup rice. For her dinner, she had 1 bowl of pork Lauya and 1 and a half cup rice. For her
meals on October 18, 2020, she had 2 pieces of tutoring, 1 cup of rice and a cup of coffee, for her morning snack, she had 2 packs of
biscuits. For her lunch she had 1 piece of fried chicken, a cup of munggo, and 1 and a half cup rice. For her afternoon snack she had a
bowl of miki and a boiled egg. As for her dinner, she had 1 piece fried tilapia, 1 piece of hotdog (jumbo) with 1 and a half cup rice. For
her diet on October 19, 2020, for his breakfast, he had 3 pieces of pandesal, 1 fried egg, and 1 cup rice, as well as a cup of coffee. For
her morning snack, she had 2 pieces of lumpia, for her lunch, she had 1 slice of leeching manok, 1 and a half cup kangkong salad, and a
cup of rice. For her afternoon snack, she had 3 pieces of banana cue. For her dinner, she had had 1 cup of Igado, 1 cup of ampalaya leaf
salad, and 1 and a half cup of rice.
For Princess Anjelie Medrano's meals on October 17 of 2020,she had 2 slices of bread and a cup of chocolate milk for breakfast,
for her morning snack, she had 1 piece of hotdog(jumbo) and a glass of orange juice. For her lunch she had, 1 cup of pork adobo, 1 slice
of ham, and 1 and a half cup of rice. For her afternoon snack, she had 20 pieces of fishball, and a 6 ounces soda. For her dinner, she had
1 bowl of pork Lauya and a cup of rice. For her meals on October 18, 2020, she only had cup noodles for breakfast, for her morning
snack, she had 1 pack of Nova and a 6 ounces soda. For her lunch she had For her lunch she had 1 piece of fried chicken, a cup of munggo,
46
and 1 and a half cup rice. For her lunch, she had 1 bowl of miki with 1 boiled egg. For her dinner, she had 1 piece fried tilapia, 1 piece
of hotdog(jumbo) with 1 and a half cup rice. For her meals on October 19, 2020, she had 3 pieces of pandesal and 1 pack of dutchmill,
for her morning snack, she had 3 pieces of lumpia, as for her dinner, she had, 2 slices of leeching manok and a cup of rice. For her
afternoon snack, she had 3 pieces of banana cue. And for her dinner is 1 cup igado, 1 slice of ham, and a cup of rice.
For Sheanne Cheska Medrano, for breakfast on October 17, 2020. She ate 1 longganisa, 1/2 rice, and 1/2 milk chocolate. For her
morning snack she had 1 pc of jumbo hot dog and a 1 glass orange juice. For her lunch, she had 1 cup pork adobo, 1 cup banana blossom
and a 1 cup of rice, for her afternoon snack, she had 20 pcs of fishball and a 8 oz soda and for her dinner, she ate 1 bowl of pork lauya and
a 1 1/2 cups of rice. On her second day of diet on October 18 2020, for breakfast she had 1 pack instant pancit canton and 1 cup milk
chocolate, for her morning snack, she had 1 pack piattos and 8 oz soda. For her lunch she had, 1 pc fried chicken, 1 cup monggo and a 1
cup rice. For her afternoon snack, she had 1 bowl miki and 1 boiled egg. For her dinner, she had 1 pc fried tilapia , 1 pc jumbo hot dog
and 1 cup rice. On her third day of diet on October 19, 2020, for breakfast she had 3 pcs pandesal and 1 pack Dutch mill, for her morning
snack, she had 3 pcs of lumpia . For her lunch he had, 2 slices letchon manok and 1 cup rice. For her afternoon snack, 3 pcs banana cue.
For her dinner, she had 1 cup igado, 1 slice ham and 1 cup rice.
47
Table 5.3. Risk Factors Assessment Form (1. Robinson Medrano)
48
For Robinson Medrano his family has a history of Hypertension, Cardiovascular disease, Diabetes Mellitus, Asthma, and
Cancer. He is an ex smoker and an ex alcohol drinker. He has an active physical activity daily namely biking. For his Dietary
Fiber intake, he has inadequate intake of fruits, consisting of only one serving of fruits daily. He has adequate vegetable intake a
day consisting of 1 to 4 servings daily. His intake of High Fat/High salt foods is once a week. He is not diagnosed with diabetes
mellitus and stated feeling stressed often.
49
50
For the family member, Snooky Medrano, she has a family history of Hypertension, Cardiovascular Disease, Diabetes
Mellitus, Asthma, and cancer. She has no history of smoking or alcohol consumption. Her physical activity category is active,
for her dietary fiber intake is, for her fruit serving per day is inadequate amounting to none to only one serving of fruits,
meanwhile her vegetable servings per day for her vegetables is adequate from 1 to 4 servings each day. Her Intake of High
Fat/High salt foods such as eating fast foods, is once a week. She is not diagnosed with diabetes mellitus and is often feeling
stressed.
51
Table 5.3. Risk Factors Assessment Form (3. Princess Anjelie Medrano)
A. Non-Modifiable Risk B. Modifiable Risk Factors

Factors
Family History Cigarette/Tobacco Alcohol drinking Physical Activity (no work) Diabetes Mellitus:
of: Smoking NValues
/ Yes / Never / Never Type of work/occupation:
Hypertension No Passive smoker Ex- alcohol Means of travel to work: Have you been diagnosed
Current smoker drinker with diabetes mellitus?
Activitiesotherthanwork:
Cardiovascular /Yes No. of Alcohol Yes /No
disease No cigarettes/day drinker: Date of Diagnosis:
/
Age started In the past month, Sedentary
Diabetes /Yes smoking how many time Active FBS:
Mellitus No No. of attempts to did you have 5
quit drinks in one Dietary Fiber Intake: Hypercholesterolemia:
Asthma / Yes Any desire to quit? occasion? Servings of fruit per NValues
No Yes No day: 0-1
Types of alcohol: Adequate elevated total
Ex smoker? / cholesterol
Frequency of intake: Inadequate
Yes Yes No elevated LDL
Cancer /day: beer Servingsofvegetableper
/ No No. of elevated triglycerides
/week: wine day: 0-1
cigarettes/day low LDL
/month: Adequate
Age started / Stress
distilled spirits Inadequate
smoking
Intake of High Fate/High Salt
No. of attempts to
foods Do you often feel stressed?
quit
/Yes No
How often do you eat fast What are the sources of your
foods (e.g. instant noodles,
52
hamburgers, French fries, stress?

fried chicken skin,etc.) and School
ihaw-ihaw?
3/week
For the client Princess Anjelie Medrano, her family history includes diagnosis of hypertension, diabetes mellitus, asthma and cancer.
They have no history of smoking and alcohol consumption. Her physical activity falls on light or sedentary, her dietary fiber intake for fruit
intake is inadequate which is 0 to only 1serving a day, her vegetable intake is inadequate which is none to only 1 serving, she goes out to eat
fast foods for at least thrice a week. She is not diagnosed with diabetes mellitus and said the she often feels stressed.
53
Table 5.3. Risk Factors Assessment Form (3. Sheanne Cheska Medrano)
54
For the client Sheanne Cheska Medrano, her family history is diagnosed with hypertension, diabetes mellitus, asthma, and cancer.
She has no history of smoking as well as drinking of alcohol. Her physical activity is light or sedentary. Her daily fiber intake includes
inadequate fruit consumption to only one fruit per day. She has adequate servings of vegetables which is 1-3 servings daily and she usually
goes out to eat fast foods for at least twice a week. She is not diagnosed with diabetes mellitus and expressed to have stress often.
55
(Robinson Medrano)
C. Anthropometric Measurement and Blood Pressure
Date Height Weight (kg) BMI Waist (in) Hip (in) W/H Ratio Nutritional Blood Hypertension
(cm) Status Pressure
<N N >N Y N
10/19/20 161 69 26.6 36 41 0.88  110/70 
D. Cancer Screening Summary:

(Specify date last service given if applicable)
ClientNota Risk:
For males Client does not have any of the risk factors
 Digital rectal exam: Affirm healthy lifestyle practices, congratulate client.
Proceed with health education on healthy lifestyle:
For females  Regular physical activity
 Clinical breast exam:  Nutrition and diet
 Acetic acid wash:  No smoking
 Pap smear:  No alcohol drinking
Client atrisk: /
 Client found to have at least one of the risk factors
 Proceed with education on lifestyle modification
Refer for screening for NCD and other diagnostic tests
The athropometric measurements of Robinson Medrano are as follows, his height is 161 centimeters, his weight is 69 centimeters, his body
mass index is 26..6 which falls to overweight category, his waist circumference is 36 inches, his hip circumference is 41 inches, and his waist
to hip ratio is 0.88. His nutritional status is over nutrition and has a blood pressure of 110/70 and is not diagnosed with hypertension. The client
showed one of the risk factors which is over nutrition, modification of lifestyle through education will proceed.
56
(Snooky Medrano)
<N N >N Y N
10/19/20 1.57 cm 62 25.15 32 38 0.84  130/80 

ClientNota Risk:
For males Client does not have any of the risk factors
Client atrisk: /
 Client found to have at least one of the risk factors
 Proceed with education on lifestyle modification
The anthropometric measurements of Snooky Medrano are as follows, her height is 157 centimeters, her weight is 62 kilograms, her body
mass index is 25.15 which falls to overweight in the body mass index range, her waist circumference is 32 inches, her waist circumference is
26 inches, and her nutritional status is over the normal range. She has a blood pressure of 130/80 and is diagnosed with hypertension. The
client has shown risk factors namely, overnutrition and hypertension, and so education for lifestyle modification will be done.
57
(Princess Anjelie Medrano)

<N N >N Y N
10/19/20 1.59 54 21.36 30 36 0.83  100/60 

Client Nota Risk: /
For males  Client does not have any of the risk factors
Client at risk:
Client found to have at least one of the risk factors
Proceed with education on lifestyle modification
The anthropometric measure of Princess Anjelie Medrano are, height 159 centimeters, weight is 54 kilograms, Body massage index is
21.36 which is considered in the normal range, waist circumference is 30 inches, hip circumference is 36 inches, her waist to hip ratio is
0.83 which is normal, her nutritional status is normal, her blood pressure is 100/60, she is not diagnosed with hypertension and the client
does not show any risk factors, these data are taken on October 10, 2020.
58
(Sheanne Cheska Medrano)
The anthropometric measurements and blood pressure of Sheanne Cheska Medrano are, her height is 148 centimeters, her weight is 38
kilograms, her body mass index is 17.34 which is considered underweight, her waist circumference is 25 inches, her hip circumference is 32, her
waist to hip ratio is 0.76 which is considered underweight, her nutritional status is underweight, and her blood pressure is 90/60 which normal for
her age range. She is not diagnosed with hypertension. The client has at least one of the risk factors which is, undernutritrion and will proceed with
modification of lifestyle through education. This data was obtained on October 10, 2020.
59
f. Physical Assessment
Date of Assessment: 10/2020
Name: Robinson Medrano
Age: 36
Date of Birth: 04/02/84
GENERAL SURVEY: MENTAL STATUS: ALLERGIES:

Height: 161 cm Weight: 69 kg  Alert Lethargic Food: X
BT: 36.5 BP: 120/80 mmHg Coma Obtunded Medication: X
HR/PR: 68bpm RR: 16 bpm Stuporous Others:
SKIN: AIRWAY: BREATHING: CARDIOPULMONARY:
 Warm  Patent Unlabored Breath sounds:
Dry Impaired Labored  Clear Wheezing Crackles
Pale Shallow Others:
Cool Deep Cardiac:
 Normal
Flushed  Regular rhythm Murmur
Diaphoretic Extra sound Strong
Jaundice Others:
60
Cyanosis PUPIL: CAPILLARY REFILL:

Birthmarks  Round 2 second/s
Lesions  Equal
Others:  Reactive to light JUGULAR NECK VEINS:
Non-reactive to light  Not visible Visible
Normal Abnormal Findings
Eyes
 Corneal light reflex- parallel alignment
of light on the cornea.
Cover eye test- the uncovered eye
remained fixed straight ahead. The
covered eye remained fixed straight
ahead after being uncovered.
Cardinal movements- smooth and
symmetrical throughout all six
directions. Eyelids and eyelashes-
properly aligned. No white sclera is
seen above or below the iris.
61
The lower and upper eyelids closes

easily and meet completely when
closed.
Eyeball- symmetrically aligned in
sockets without protruding.
Bulbar conjunctiva and sclera-
smooth, clear and moist.
Pupil and iris- round, flat, and evenly
colored. Pupil constricts in reaction to
light.
Ears
 External structures- smooth without
lesions, lumps or nodules. Color is
consistent with the color of the face.
Auricle and mastoid process-
nontender upon palpation.
Romberg test- minimal sways.
62
Nose  External Nose- color is consistent with the

rest of the face; symmetric.
Nostrils- not occluded.
Sinuses- nontender upon palpation.
Mouth, Teeth, Throat Lips- without swelling.
 Teeth and gums- 12 teeth upper part and
15 on the lower part. Gums are pink and
no lesions.
Mouth- without odor.
Soft and hard palate- pale and whitish.

Uvula- hangs in the midline.
Neck  Neck is symmetrical- The movement is
smooth. C7 is visible.
Cardiovascular  Heart rate- 68 bpm with regular rhythm.
PMI- 5th intercostal mid clavicular line.
Abdomen  Abdomen- symmetric, does not bulge
63
when client raises head. Abdominal
respiratory movement is present.
Musculoskeletal: ROM  Posture- erect and comfortable.
Gait- evenly distributed and able to stand
on heels and toes, equal on both sides.
Normal ranges as per ROM.
Leg  No pain, heat or swelling noted.
Analysis:
The Physical assessment of Mr. Robinson Medrano showed normal finding. The results were derived from thorough assessment
following the techniques of physical examination- inspection, palpation, percussion and auscultation.
64
Name: Snooky Medrano
Age: 38

Height: 157cm Weight: 62 kg  Alert Lethargic Food: X
 Warm Patent Unlabored Breath sounds:
Dry Impaired Labored Clear Wheezing Crackles
Cool Deep
Flushed Normal Cardiac:
Diaphoretic  Regular rhythm Murmur
Jaundice
Extra sound Strong
Others:
65

Lesions  Equal

Normal Abnormal Finding
Eyes  Corneal light reflex- parallel alignment of

light on the cornea.
covered eye remained fixed straight ahead
after being uncovered.
properly aligned. No white sclera is seen
above or below the iris.
66
The lower and upper eyelids closes easily

and meet completely when closed.
Eyeball- symmetrically aligned in sockets
without protruding.
light.
Ears  External structures- smooth without
67
Mouth, Teeth, Throat  Lips- without swelling.

Teeth and gums- 14 teeth upper part and
no lesions.

Musculoskeletal:ROM  Posture- erect and comfortable.

68
Analysis:
The Physical assessment of Mrs. Snooky Medrano showed no abnormalities in the physical assessment done by the nurse. The
results were derived from thorough assessment following the techniques of physical examination- inspection, palpation, percussion and
auscultation.
69
Name: Princess Anjelie Medrano
Age: 14

Cool Deep
Flushed  Normal Cardiac:
Jaundice Extra sound Strong
Others:
70

Lesions  Equal

Eyes  Corneal light reflex- parallel alignment

covered eye remained fixed straight
ahead after being uncovered.
71
The lower and upper eyelids closes

easily and meet completely when closed.
Eyeball- symmetrically aligned in
sockets without protruding.
light.
Nose  External Nose- color is consistent with
the rest of the face; symmetric.
72

Teeth and gums- 14 teeth upper part
and 14 on the lower part. Gums are
pink and no lesions.

Gait- evenly distributed and able to

stand on heels and toes, equal on both
sides.
73
Analysis:
The Physical assessment of Ms. Princess Anjelie Medrano showed normal findings. The results were derived from thorough
assessment done following the techniques of physical examination- inspection, palpation, percussion and auscultation.
74
Name: Sheanne Cheska
Medrano Age: 14

Cool Deep
Flushed  Normal Cardiac:
Jaundice Extra sound Strong
Others:
75

Lesions  Equal

Eyes  Corneal light reflex- parallel alignment

covered eye remained fixed straight ahead
after being uncovered.
76
The lower and upper eyelids closes easily

and meet completely when closed.
Eyeball- symmetrically aligned in sockets
without protruding.
light.
77

Teeth and gums- 11 teeth upper part and
no lesions.


78
Analysis:
The Physical assessment of Ms. Sheanne Cheska Medrano showed normal findings. The results were derived from
thorough assessment done following the techniques of physical examination- inspection, palpation, percussion and auscultation.
79
g. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
Table 7.1. Immunization Status (1 y/o and below & pregnant mother)
Family Age BGG Hepa B Penta OPV IPV PCV MMR Others
Members Type Dose
Robinson 36
Medrano(no data
available)
Snooky Medrano 38
(no data available)
Princess Anjelie Medrano 14             
Sheanne Cheska Medrano 11             
Based from the table above, the family Medrano adhere to the immunization program of DOH, their two daughters completed all
the immunizations mentioned in the table- the BCG, hepaB, Penta, OPV, IPV, and MMR.
In 1976, the Expanded Program on Immunization (EPI) was established to ensure that infants/children and mothers have access to
routinel recommended infant/childhood vaccines. Six vaccine-preventable diseases were initially included in the EPI: tuberculosis,
poliomyelitis, diphtheria, tetanus, pertussis and measles. Moreover, it has a goal to reduce the morbidity and mortality among children
against the most common vaccine-preventable diseases (DOH,nd). In July 26, 2010, there was a mandate signed by former President
Benigno Aquino III, the Republic Act No. 10152 “Mandatory Infants and Children Health Immunization Act of 2011, which includes
80
basic immunization for children under 5 years old.
BCG vaccine- bacille Calmette-Guérin (BCG) vaccine has existed for 80 years and is one of the most widely used of all current vaccines,
reading >80%of neonates and infants in countries where it is part of the national childhood immunization programme (WHO). In the light
of the high degree of tuberculous infection taking place among Filipino children, BCG vaccination is justifiable as a supplementary measure
in the control of tuberculosis in the Philippines (De Santos, Dungo, Aoanan, 2016).
Hepatitis B Control- Republic Act No. 10152 has been signed. It is otherwise known as the “Mandatory Infants and Children Health
Immunization Act of 2011, which requires that all children under five years old be given basic immunization against vaccine-preventable
diseases. Specifically, this bill provides for all infants to be given the birth dose of the Hepatitis-B vaccine within 24 hours of birth. The
goal of Hepatitis B control is to reduce the chronic hepatitis B infection rate as measured by HBsAg prevalence to less than 1% in five-
year-olds born after routine vaccination started 100% Hepatitis B at birth vaccination.
Pentavalent- a combination of five vaccines-in-one that prevents diphtheria, tetanus, whooping cough, hepatitis b and haemophilus
influenza type b, all through a single dose (WHO, 2012).
OPV- Protection against poliomyelitis lasts for life after 3 doses. There is an on-going polio mass immunization in the Philippines to all
children ages 6 weeks up to 59 months old in the 10 highest risk areas for neonatal tetanus. The Philippines has been declared polio-free
since October 2000. However, the country is currently at high-risk for poliovirus transmission. For the past years, vaccination coverage for
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the third dose of the Oral Polio Vaccine (OPV) has fallen below 95%, the target required to ensure population protection against polio; the
surveillance on Acute Flaccid Paralysis has been consistently poor; and the practice of open defecation and poor sanitation have been
persisting in communities. Furthermore, the Philippines is at risk for importation of poliovirus from neighboring countries where the virus
has recently been found to have recirculated. In response, the Department of Health (DOH) identified priority areas which need to
strengthen preventive measures against polio (DOH).
IPV- produced from wild-type poliovirus strains of each serotype that have been inactivated (killed) with formalin. IPV provides serum
immunity to all three types of poliovirus, resulting in protection against paralytic poliomyelitis.
PCV- Pneumococcal Conjugate Vaccines (PCV) are indicated for the prevention of infections caused by S. pneumoniae. These infections
may either be invasive pneumococcal diseases (IPD) or noninvasive pneumococcal diseases. Currently, PCV13 in SDV preparation is
used by DOH in national immunization campaigns in selected regions of the country. (DOH, 2020).
MMR- The Department of Health, together with the Local Government Units, will conduct a nationwide measles, rubella and polio
supplemental immunization activity starting October 26 this year. In the Philippines, an estimated 2.4M children under the age of five are
susceptible for measles. Measles or tigdas is one of the most contagious diseases in the world. About 9 out of 10 people exposed to the
measles virus who are not immune will contract the disease. It can cause high-grade fever, rashes, cough, and eye infection and can lead
to complications such as pneumonia, ear infection, blindness, severe diarrhea, and swelling of the brain ( DOH, 2020).
82
Table 7.2. Smoking (Cigarette Consumption)
Family Members Age Non- Smoker Consumption Exposure to Second

Smoker Hand Smoke
Robinson Medrano 36  (ex- /
smoker)
Snooky Medrano 38 
Princess Anjelie Medrano 14 
Sheanne Cheska Medrano 11 
The family Medrano being aware of these facts do not practice cigarette smoking. However the father of the family was a former
smoker but had already quit after he was diagnosed with ulcerative colitis last 2008. Mr. Medrano also said that he was exposed to second
hand smoke as represented
Tobacco use is responsible for six million preventable deaths worldwide annually, with many of these deaths occurring
prematurely, data from World Health Organization showed. An additional 600,000 people are estimated to die from being exposed to
secondhand smoke (DOH, 2020)
83
Table 7.3. Alcohol Intake
Numberof alcoholdrinkersinthefamily: / 0 1 2 3 4 5 6 or more
Family Member Types of Alcohol Drinks Frequenc Amount of Intake Drink

y
Regula Wine Distilled spirits Monthly Weekly Daily Regula beer Wine Distilled
beer (gin,rum,vodka, spirits (gin,rum,vodka, whisky)
whisky)
once once once 330 mL 1-5wineglasses 1-5 shots

twice 2-3 times 2-3times 500 mL half bottle(375 half of bilog (175 mL )
thrice 3-4 times 4 or more 1L mL one bilog (350 mL)
4-6 times 5 or more 750 mL
once once once 330 mL 1-5wineglasses 1-5 shots

twice 2-3 times 2-3times 500 mL half bottle(375 half of bilog (175 mL )
once once once 330 mL 1-5 wine glasses 1-5 shots

twice 2-3 times 2-3times 500 mL half bottle (375 half of bilog (175 mL )


84


Table 7.4. Brushing of Teeth
Family Members Age Frequency Other Products Used Frequency of

never 1/day 2/day 3/day other (mouthwash, dental floss,etc.) products
used
Robinson Medrano 36  Mouthwash 1/day
Snooky Medrano 38  Mouthwash 1/day
Princess Anjelie Medrano 14  Mouthwash 1/day
Sheanne Cheska Medrano 11 
Based from the table, Robinson Medrano and Sheanne Cheska Medrano brushes their teeth once per day only in the evening after
meal, while Snooky Medrano and Princess Anjelie Medrano brushes their teeth two times a per day, both in the morning and in the evening
after meal. The family uses mouthwash aside from tooth brush and tooth paste. They use one product per day.
Regular toothbrushing is important for both children and adults. It helps to remove the bacteria and plaque that cause tooth decay
and gum disease. It is recommended that everybody brush their teeth twice a day – in the morning and before going to bed at night.
Brushing of teeth is one of the most common things a family do. (Better Health Channel, n.d.)
85
Table 7.5. Taking a Bath
Family Members Age Frequenc Other Products Used Frequency of

y (shampoo, conditioner, products used
never 1/day 2/day 3/day other face
scrub,etc.)
Robinson Medrano 36  Shampoo 1/day
Snooky Medrano 38  Shampoo, Hair Treatment, Kojic 1/day
Soap
Princess Anjelie Medrano 14  Shampoo, Hair Treatment 1/day
Sheanne Cheska Medrano 11  Shampoo, Hair Treatment 1/day
Analysis
Robinson Medrano and Snooky Medrano takes a bath once every day. Robinson said that he takes a bath in the late afternoon and
uses shampoo aside from soap while Mrs. Snooky said she takes a bath in the morning and uses products such as shampoo, hair treatment
and kojic soap. Princess Anjelie and Sheanne Cheska take a bath twice a day both in the morning and in the evening before going to bed
and use shampoo and hair treatment products.
86
Table 7.6. Adequacy of Rest and Sleep, Exercise, Protective Measures, Relaxation and Stress Management
Activities
Rest and Sleep Exercise Use of Protective Measures Relaxation and Stress
Management
Hrs. Adequacy Type of Frequency Duration Adequacy Use of Footwear/ Use of Protective Type Stress Effectiveness
of R M NR Activity/exercise Yes No mosquito boots in mask gears in of Mgt. Yes No
Family sleep R nets farming when manual stress
Age
Member when exposed works
sleeping when
spraying
Robinson 36 6  Biking Once every 2 2 hrs    Work -Online 

Medrano weeks gaming
-Eating
-biking
Snooky 38 6     Work -eating 
Medrano -talking
with
friends
Princess 14 8   School -eating 
Anjelie -hanging
Medrano out with
friends
-
watchin
g
movies
Sheanne 11 8  Biking 30 min  School -playing 

Cheska everyday with
Medrano friends
87
Sleep is a vital, often neglected, component of every person's overall health and well-being. Sleep is important because it enables
the body to repair and be fit and ready for another day. Getting adequate rest may also help prevent excess weight gain, heart disease,
and increased illness duration (Weatherspoon, 2019). Based from the table the family Medrano gets moderate sleep.
Regular physical activity can improve your muscle strength and boost your endurance. Exercise delivers oxygen and nutrients to
your tissues and helps your cardiovascular system work more efficiently. And when your heart and lung health improve, you have more
energy to tackle daily chores. Based from the table, Robinson and Sheanne exercise through biking. Robinson exercises once every 2
weeks for 2 hours, while Sheanne exercises every day for 30 minutes. Use of protective measures are also important in order to avoid any
accidents and acquisition of disease when doing a task. Based from the table, Robinson and Snooky uses mask when exposed when
spraying and use gears in manual works.
Stress is also a part of daily life, it can alter the mood of an individual and his or her health. The family Medrano experiences
stress from work for both of Robinson and Snooky. Robinson manages his stress through online gaming, eating and biking and according
to him, it is effective. Snooky manages her stress through eating, and talking with friends, and according to her, this is effective. Princess
and Sheanne stress over school, Princes manages her stress through eating and hanging out with friends, and according to her this is
effective. Sheanne manages her stress through playing with friends and according to her this is effective in relieving her stress.
88
Table 7.7. Preventive and Promotive Health Services
Health Services Avail Do not avail

EPI 
Maintenance (DM & HPN) 
Dietary Counseling 
Medical Check-up Every month Every year Every 2 years Every 3 years

Dental Check-up Every month Every 6 Every year Every 2 years
months
 (dental braces
of the children)
Pest control Quarterly Twice a year Every year Every 2 years

Chlorination of water /
Health promotion and disease prevention programs focus on keeping people healthy. Health promotion programs aim to engage
and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic
diseases and other morbidities.
Based from the table, family Medrano avails Expanded Program on Immunization (EPI) and taking maintenance, however they do
not avail dietary counselling health service. They do get medical check-up every year, dental check-up every month for their children who
have braces and pest control every year. The family however states that they do not avail Chlorination of water.
89
TYPOLOGY OF NURSING PROBLEM
a. First Level Assessment
PROBLEM NATURE CUES

Family health history of hypertension and Health Threat The mother is hypertensive and the first born
asthma has asthma since she was still an infant.
Accident hazards-Fall hazards Health Threat Presence of broken stairs and wet floors in
the house
Accidental hazardsPointed /sharp objects, Health Threat Knives, scissors, rakes, saws, cleaning
poisons and medicines improperly kept products, pesticides are scattered everywhere
inside the house.
Nutritional- Excessive intake in certain Health Threat The mother and father are overweight and
nutrients their second child is underweight.
Poor environmental sanitation-Inadequate Health Threat The children share a small bedroom and
living space living room and dining room are as one.
Poor environmental sanitation-Presence of Health Threat Breeding of mosquitoes, cockroaches, and
breeding places of insects and rodents flies on containers, tires, plastic drums and
open water reservoir
2nd Floor CAS Bldg. #16S Quiling Sur, City of Batac, Ilocos Norte 90
Poor environmental sanitation-Improper Health Threat Garbage are burned or dumped at the
garbage disposal backyard, open.
Poor environmental sanitation-Unsanitary Health Threat Drainage system are exposed to the surface
drainage system area.
Unsanitary food handling Health Threat Leftover foods are just covered with other
plates and sometimes there’s no cover at all.
Personal habits/practices-Selfmedication Health Threat The family self-medicate whenever they have
common illnesses.
Health history of meningitis and ulcerative Health Threat The father was diagnosed with ulcerative
colitis which may precipitate or induce the colitis way back 2008 and was operated to
occurrence of health deficit overcome the disease.
The second child experienced meningitis

when she was still 4 months old but she was
able to survive the illness.
Illness state- Health Deficit The mother is hypertensive and the first born
has asthma since she was still an infant.
Hypertension and asthma
Entrance at School Foreseeable Crisis The children have difficulty in the new
learning system since no one could help them
in answering their modules.
b. Second Level Assessment

HEALTH PROBLEMS NURSING PROBLEMS SUPPORTING DATE
IDENTIFIED
DATA/CUES
Family health history of Inability to make decisions The family recognize family health history 10/20/20
hypertension and asthma with respect to taking of illnesses like hypertension and asthma as
appropriate health action due not so important problem since the
to low salience of the manifestations are easily managed, as per
problem. verbalize.
Accident hazards- Fall Inability to make decisions The family wasn’t able to recognize the 10/20/20
hazards with respect to taking problem with having broken stairs and wet
appropriate health action due floors in the house, as per verbalize.
to failure to comprehend the
nature, magnitude or scope
of the problem.
Accidental hazards- Inability to make decisions The family wasn’t able to recognize the 10/20/20
Pointed /sharp objects, with respect to taking problem with having knives, scissors,
appropriate health action due rakes, saws, cleaning products, and
poisons and medicines to failure to comprehend the pesticides scattered everywhere inside the
improperly kept nature, magnitude or scope house, as per verbalize.
of the problem
Nutritional- Excessive Inability to recognize the The family did not know that their BMI are 10/20/20
intake in certain nutrients presence of the problem due above and below normal, as per verbalize.
to ignorance of facts.
Poor environmental Inability to provide a home The family has inadequate budget to expand 10/20/20
sanitation- Inadequate environment which is or renovate their house because business is
living space conducive to health their priority first, as per verbalize.
maintenance and personal
development due to
inadequate family resources,
specifically limited physical
resources- like lack of space
to construct facility.
Poor environmental Inability to provide a home The family has deficient knowledge on how 10/20/20
sanitation-Presence of environment conducive to to regulate breeding places of mosquitoes,
health maintenance and cockroaches, and flies, as per verbalize.
breeding places of insects personal development due to

and rodents lack of knowledge of
preventive measure
Poor environmental Inability to provide a home The family has deficient knowledge on 10/20/20
sanitation-Improper environment conducive to proper waste disposal, as per verbalize.
garbage disposal health maintenance and
personal development due to
inadequate knowledge of the
importance of hygiene and
sanitation
Poor environmental Inability to make decisions The family recognize their drainage system 10/20/20
sanitation-Unsanitary with respect to taking which is exposed to the surface area as
drainage system appropriate health action due unimportant problem to resolve, as per
to low salience of the verbalize
problem.
Unsanitary food handling Inability to provide a home The family has deficient knowledge on 10/20/20
environment conducive to handling food sanitation and possible risks
health maintenance and if it is not sanitized, as per verbalize.
personal development due to

inadequate knowledge of the
importance of hygiene and
sanitation
Personal habits/practices- Inability to recognize the The family did not know that selfmedication 10/20/20
Self-medication presence of the problem due can cause health risks, as per verbalize.
to ignorance of facts.
Health history of Inability to make decisions The family recognize their serious past 10/20/20
meningitis and ulcerative with respect to taking health conditions as not important anymore
colitis which may appropriate health action due because they are already fully recovered
precipitate or induce the to low salience of the with no further complications, as per
occurrence of health problem. verbalize.
deficit
Illness state- Hypertension Inability to make decisions The family recognize illnesses like 10/20/20
and asthma with respect to taking hypertension and asthma as not so important
appropriate health action due problem since the manifestations are easily
to low salience of the managed, as per verbalize.
problem.
Entrance at School Inability to provide a home The parents did not know how to help their 10/20/20
environment which is children with the new learning system, as
conducive to health per verbalize.
maintenance and personal
development due to lack of
knowledge and skill in
carrying out necessary
action.
c. Ranking Health Condition and Problems According to Priorities
Problem 1: Family health history of hypertension and asthma
COMPUTATED SCORE
CRITERIA ACTUAL SCORE WEIGHT
Nature of the 2 1 2/ 3 X1= 0.67

Problem
Modifiability of the 1 2 1/ 2 X 2 = 1
problem
Preventive potential 2 1 2/ 3X 1= 0.67
Salience 1 1 1 /2 X 1= 0.5
TOTAL 2.84
Problem 2: Accident hazards-Fall hazards
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Preventive potential 3 1 3/ 3X 1= 1
Salience 2 1 2 /2 X 1= 1
TOTAL 4.67
Problem 3: Accidental hazards-Pointed /sharp objects, poisons and medicines improperly kept
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 3.34
Problem 4: Nutritional- Excessive intake in certain nutrients
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 3.34
Problem 5: Poor environmental sanitation-Inadequate living space
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 1 1 1 /2 X 1=0.5
TOTAL 2.84
Problem 6: Poor environmental sanitation-Presence of breeding places of insects and rodents
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 4.34
Problem 7: Poor environmental sanitation-Improper garbage disposal
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 4.67
Problem 8: Poor environmental sanitation-Unsanitary drainage system
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 3.67
Problem 9: Unsanitary food handling
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 3.67
Problem 10: Personal habits/practices-Self-medication
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 1 1 1 /2 X 1= 0.5
TOTAL 4.17
Problem 11: Health history of meningitis and ulcerative colitis which may precipitate or induce the occurrence of health
deficit
COMPUTATED SCORE
Nature of the 2 1 2/ 3 X1= 0.67

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 2.34
Problem 12: Illness state-Hypertension and asthma
COMPUTATED SCORE
Nature of the 3 1 3/ 3 X1= 1

Problem
problem
Salience 2 1 2 /2 X 1= 1
TOTAL 2.33
Problem 13: Entrance at School
COMPUTATED SCORE
Nature of the 1 1 1/ 3 X1= 0.3

Problem
problem
Salience 1 1 1 /2 X 1= 0.5
TOTAL 2.46
RANKING
PROBLEMS SCORE RANK
Accident hazards-Fall hazards 4.67 1.5
Poor environmental sanitation-Improper garbage disposal 4.67 1.5
Poor environmental sanitation-Presence of breeding places of insects and 4.34 3

rodents
Personal habits/practices-Self-medication 4.17 4
Poor environmental sanitation-Unsanitary drainage system 3.67 5.5
Unsanitary food handling 3.67 5.5
Accidental hazards-Pointed /sharp objects, poisons and medicines 3.34 7.5

improperly kept
Nutritional- Excessive intake in certain nutrients 3.34 7.5
Family health history of hypertension and asthma 2.84 9.5
Poor environmental sanitation-Inadequate living space 2.84 9.5
Entrance at School 2.46 11
d. Family Coping Index
CRITERIA RATING JUSTIFICATION

1. Physical Independence 5 All family members are well and no
disabilities. They are able to move about, get
out of bed for their daily activities.
2. Therapeutic Competence 3 The family self-medicate whenever they have
common illnesses.
3. Knowledge of Health Conditions 3 The family recognize their illnesses such as
hypertension and asthma as not so important
problem since according to them,
manifestations are easily managed.
4. Application of Principle and Personal 1 The diet of the family is unbalance since the
Hygiene mother and father are overweight and their
second child is underweight. Moreover, the
mother and father only sleep for less than 6
hours because of their busy work. The family
also practice unsanitary food handling.
5. Health Attitude 5 The family accepts medical treatments,
procedures, preventive measures and public
health measures.
6. Emotional Competence 5 The family generally maintains a happy
environment and has positive outlook in life.
7. Family Living 5 The family is well grounded and close to each
other. Though the parents spend of the days
to work, they make sure they get to spend
time with their children once a week.
111
8. Physical Environment 3 There is inadequate space for the whole

family and accidental hazards are present.
However, the neighborhood or surroundings
are safe.
9. Use of community facilities 3 The family visit healthcare centers for their
health problems however due to low salience
of the condition, sometimes the family refuse
to consult and just practice self-medication.
112
e. Family Nursing Care Plan
NURSING OBJECTIVES OF PLAN OF INTERVENTION PLAN OF EVALUATION

PROBLEM NURSING CARE CRITERIA/ METHODS OR TOOLS
STANDARDS
Inability to After rendering 1-2 a. Provide information of safety After rendering 1-2 hours Home visits which includes:
make decisions hours of nursing need or injury prevention and of nursing intervention, the
with the respect intervention, the motivation to prevent. family was able to: 1. Supervision and
to taking family will be able b. Discuss about supervision for a. Verbalize evaluation if the safety
appropriate to: the young ones and understanding of issues are addressed.
health action a. Verbalize improvement of the faculty. individual risk 2. Provide educational
due to failure to understanding c. Emphasize to the family the factors that resources (e.g., home
comprehend of individual importance of solving the contribute to the safety checklist,
the nature, risk factors that problem and on maintaining possibility of falls. equipment directions for
magnitude or contribute to an environment which is b. Demonstrate proper use) for later
scope of the the possibility safety at home. Rationale: To behaviors of review and
problem as of falls. develop the family’s ability and willingness to reinforcement of
manifested by b. Demonstrate commitment to provide change lifestyle, learning.
the fall hazards behaviors of nursing care to the members reduce the factors
willingness to of the family and on taking and protect self
change actions to solve the problems from injury.
lifestyle, d. Provide suggestions about c. Modify
reduce the solving the problem and environment and
factors and preventive measures on fall enhanced safety
protect self hazards such as putting a
from injury. cover made of wood or
c. Modify plywood, having the sides of
environment the well cemented, and
putting a wooden fence
and enhanced around the well to guard the

safety hole and enhance the safety of
each family member.
Rationale: To guide the family
on how to decide or select for
appropriate actions to take
with regards to the problem
identified.
Inability to After 1-2 hours of 1. Establish a rapport After 1-2 hours of nursing Home visits which includes;
provide a home nursing interventions 2. Assess the degree of interventions the family a. Evaluation of
environment the family will be awareness of the family was able to: surroundings such as the
conducive to able to: regards to the existing a. Properly discuss inside and outside
health a. Properly problem. Rationale: to the importance of environments
maintenance discuss the identify the family’s level of garbage disposal. b. Interviewing the family
and personal importance of understanding about proper b. Enumerate
development garbage garbage disposal possible risks and
due to disposal. 3. Perform a health teaching hazards of this
inadequate b. Enumerate about proper garbage disposal problem.
knowledge of possible risks and recycling methods. c. Enumerate
the importance and hazards of Rationale: to provide the interventions and
of hygiene and this problem. family’s awareness in terms its importance.
sanitation c. Enumerate of proper garbage disposal d. Adapt to the
manifested by interventions and the effect of the improper interventions
improper and its garbage disposal to one’s
garbage importance. health and to the Mother
disposal d. Adapt to the Nature.
interventions 4. Discuss the importance of
proper waste segregation.
Rationale: to give the family

knowledge about the
importance of proper waste
segregation.
5. Discuss the potential health
problems that could arise if
proper waste disposal is not
implemented and practiced.
6. Encourage the family to
utilize resources such as
empty rice sacks as garbage
containers and making sure
that they are uncovered.
Rationale: to maximize the
family’s resources while
minimizing the cost of
purchasing garbage
containers
7. Educate about composting
their garbage as a less
harmful and more eco-
friendly garbage disposal
means
Inability to After 1-2 hours of 1. Assess the family’s level of After 1-2 hours of Home visits which includes;
provide a home rendering nursing understanding of the breeding rendering nursing a. Evaluating and
environment interventions the sites of insects and rodents. interventions the family monitoring of
conducive to family will be able Rationale: This is to help was able to; surroundings for
health to; assess the needed care and a. Understand the breeding grounds of
maintenance importance of the insects and rodents
and personal a. Understand specifications of the interventions for b. Interviewing of the

development the interventions. insect and rodent family
due to lack of importance 2. Perform health teaching prevention.
knowledge of of the about proper bottle recycling b. Enumerate
preventive interventions as well as possible water discussed
measure for insect and accumulation materials interventions.
manifested by rodent which may cause c. Able to adapt to
the presence of prevention. accumulation and stagnation discussed
breeding places b. Enumerate of water. interventions as a
of insects and discussed Rationale: This is to help the part of home
rodents interventions. family understand the need maintenance.
c. Able to adapt for recycling and preventing d. Able to verbalize
to discussed of water accumulation which confidence in
interventions may lead to breeding grounds ensuring for their
as a part of for mosquitoes and insects. better health
home 3. Discuss proper house maintenance.
maintenance. organization for materials to
d. Able to prevent possible breeding
verbalize grounds for rodents. These
confidence in include; rags on corners, pile
ensuring for of woods, and a possible
their better opening through their wall.
health Rationale: This is due to the
maintenance. fact that rodents and insects
prefers to live in damp, dark,
and corners of houses
4. Discuss potential risks and
health problems that may
arise from these animals.
Rationale: This is to help the

family of the possible health
threats that may arise due to
various insects and rodents.
5. Encourage daily cleaning and
habitual organizing to prevent
accumulation of garbage and
stagnated water as breeding
grounds.
Rationale: This serves as a
preventive measure in the
buildup of garbage, water,
and damp areas wherein
insects and rodents may live.
6. Encourage proper sanitation,
these includes;
a. Wearing gloves when
cleaning.
b. Proper handwashing after
cleaning.
c. Sanitize house with
cleaning agents.
Rationale:
This is to prevent
acquiring bacteria and
viruses after cleaning the
household.
INSTRUCTIONAL DESIGN
Title: Fall Preventions
Target Client: Medrano Family of Brgy. #7 Garnaden , Nueva Era , Ilocos Norte
Rationale: Implementation of favorable fall prevention program is a vital part of nursing care in any healthcare environment and needs a
multifaceted approach. Nurses also have a significant role in educating families about the prevention of falls beyond the care continuum.
Goal: After 1 hour of health teaching, the family will be able to identify ways to prevent fall.
Time
Learning Outcomes Content Methodology Resources Evaluation
Frame
After 1 hour of health
teaching, the family
must have:
a. Discuss about Factors that contribute to Falls. Discussion and 25 mins. Laptop Question and Answer
the different Discussion should include: Visual Aid White Screen after discussion
factors that can a. ) The individual risk factors that Digital Photos
contribute to can contribute to fall such as: such as
the possibility age, gender, ability and health
of falls. conditions. Discuss further the
implication of these individual
characteristics to the possibility of
fall.
118
b.)Environmental risk factors refer

to hazards found in and around the
home such as uneven surfaces and
the lack of hand or grab rails.
Discuss further the implication of
these environmental factors to the
possibility of fall.
b. Identify ways Present ways to prevent falls at home. Discussion and 35 mins. Laptop Pre-test and post-test
to modify Start by discussing possible ways to Visual Aid White Screen evaluation.
environment as improve individual risk factors such Checklist and
indicated to as age, gender, ability and health pamphlets
enhance safety. condition. Discussion should include regarding ways to
ways such as: prevent falls.
1. Make an appointment with
your doctor regarding the
family’s health condition such
as eye problems, dizziness,
joint pain, shortness of breath,
or numbness in your feet and
legs. The Doctor will evaluate
or asses the eyes of the
members of the family at risk
of fall and evaluate muscle
119
strength, balance and walking

style (gait) as well.
Discuss also ways to modify

environment to create a safe home
free of fall hazards. The following
ways should be included:
1. Clean up clutter. The easiest
method for preventing falls is
to keep the home neat and
tidy. Remove all clutter, such
as stacks of old newspapers
and magazines, especially
from hallways and staircases.
2. Repair or remove tripping
hazards. Sometimes home
fixtures can contribute to
falls, which can then lead to
back pain and other injuries.
Examine every room and
hallway, looking for items
such as loose carpet, slippery
throw rugs, or wood
floorboards that stick up.
Then repair, remove, or
120
replace those items for more

effective fall prevention.
3. Install grab bars and

handrails. These safety
devices are crucial for going
up and down stairs, getting on
and off the toilet, and stepping
in and out of the bathtub
without injuring yourself.
4. Avoid wearing loose

clothing. You want to feel
comfortable at home, but
baggy clothes can sometimes
make you more likely to fall.
Opt for better-fitting and
properly hemmed clothing
that doesn’t bunch up or drag
on the ground.
5. Light it right. Inadequate

lighting is another major
hazard. To create a home
121
that’s more suitable for the

elderly, install brighter light
bulbs where needed,
particularly in stairways and
narrow hallways.
6. Wear shoes. Socks may be

comfortable, but they present
a slipping risk. Preventing
falls at home can be as simple
as wearing shoes. They can
also purchase non-slip socks
that have grips on the soles of
the feet if shoes are too
uncomfortable.
7. Make it nonslip. Bathtubs

and showers, as well as floors
in kitchens, bathrooms, and
porches, can become
extremely dangerous when
wet. Make use of non-slip
mat.
122
8. Move more carefully.

Preventing falls like this is as
easy as taking their time. All
they have to do is pause after
going from lying down to
sitting and from sitting to
standing. Also take a pause
before using the railing on
stairs, whether going up or
down.
Emphasize to the family the

importance of solving the problem
and on maintaining an environment
which is safety at home. To develop
the family’s ability and commitment
to provide nursing care to the
members of the family and on taking
actions to solve the problems
123
Title: Proper Waste Disposal

Target Client: Medrano Family of Brgy. #7 Garnaden, Nueva Era, Ilocos Norte
Rationale: With waste being properly disposed of, the family’s environment is cleaner, meaning there will be fewer health risks and hazards to
them.
Goal: After 2 hours of health teaching the family will be able to improve their knowledge about proper waste disposal and will be able apply it
in their daily living.
Learning Outcomes Content Methodology Time Resources Evaluation
Frame
After 2 hours of health
teaching family must
have:
a. Enumerate the types Types of Wastes Discussion, 15 mins Laptop, Brochure, Question and
of wastes 1. Biodegradable- capable of being Visual Aid Digital Photos Answer
decomposed
2.Non-Biodegradable- not capable of
being decomposed
 Recyclable- can be processed
and used again
 Residual- cannot be processed
and used again
 Special (Toxic, Bulky,
Electronic, and Medical)-
124
poisonous and highly

hazardous
b. Define proper waste Definition: Lecture 10 mins Laptop, Brochure, Question and
disposal Proper Waste Disposal- management Discussion, Digital Photos Answer
that includes activities and actions Visual Aid
required to manage waste from its
inception to its final disposal to
maintain cleanliness.
c. Enumerate the Proper Waste Disposal Methods Lecture 25 mins Laptop, Brochure, Question and
proper ways of waste 1. 3R’s - Reduce, Recycle, and Reuse Discussion, Digital Photos Answer
disposal wastes Visual Aid
2. Composing- burying biodegradable
wastes in a pit to make fertilizer.
3. Waste segregation- separating and
sorting waste to facilitate its disposal
and recycling.
d. Enumerate the Importance of Proper Waste Disposal Lecture 15 mins Laptop, Brochure, Question and
importance of proper to; Discussion, Digital Photos Answer
waste disposal 1.Environment Visual Aid
2.Community
3.Home
4.Individual
125
e. Enumerate the Effects of Improper Waste Disposal Lecture 15 mins Laptop, Brochure, Question and
effects of improper 1.Contamination Discussion, Digital Photos Answer
waste disposal. (Water, Land and Air) Visual Aid
2. Diseases and Infections (Blood,
Skin, Eyes, Lungs and Throat)
f. Perform the Application of Proper Waste Disposal Demonstration, 40 mins Garbage bag, PPE, Return
skills/techniques 1. 3R’s (Reduce, Recycle, and Reuse) Audio-Visual recycling materials, Demonstration
needed in proper 2. Composing Aid digging tools,
waste disposal. 3. Waste segregation Instructional
Videos Online
126
Title: Elimination of Possible Breeding Grounds of Rodents and Insects.
Target Client: Medrano Family of Brgy. #7 Garnaden, Nueva Era, Ilocos Norte.
Rationale: With the family being knowledgeable on the possible breeding grounds of both insects and rodents, they may be able to prevent any
infestation which may cause health concerns.
Goal: After 2 hours of health teaching, the family will be able to acquire skills and knowledge in the prevention of rodent and insect infestations.
Learning Outcomes Content Methodology Time Resources Evaluation

Frame
After 2 hours of health
teaching, the family
must have:
a. Enumerate the Control of insects, rats, and other pests Discussion 20 mins Brochure Question and Answer
common rodent should be the concern of every
and insects and member of the family and the
their breeding community because of their ill effects
sites. on the health and economy of the
people. Destroying their breeding
places and knowing ways to control
them can help get rid of these pest.
1. Rats and Mice
Rodents love rubbish. Where there is
litter or exposed food, it would not be
surprising if you see rats and mice
127
lurking around. They can also be

found in pipes, insulation, under
buildings, in ceilings and in trees and
gardens.
2. Bed Bugs
Like fleas, bed bugs also need blood
in order to develop. They are
transported by humans through their
luggages and beddings. These bugs
usually hide in places where people
sleep, keeping themselves hidden
from view during the day.
3. Fleas
Fleas like sandy areas. In order to
reproduce, they need blood, which
they mostly get from animals.
4. Flies
Flies are commonly found in rubbish,
open septic tanks, food scraps, dirty
benches and tables, open leach drains,
lawn clippings and animal feces.
5. Mites
Mites live and breed on furry animals
and can also be found on human hair.
128
6. Ants
Garbage cans Destroy breeding places
by spraying them with chemicals or
pouring hot water on them.
7. Mosquitoes
These insects like cold and dark
places, so they are mostly found in
areas where there is rain water
accumulation like car tires and tins,
water storage tanks, discarded
refrigerators and in septic tanks. They
can also be found around ponds and
natural bodies of water.
b. Discuss the Prevention eliminates the contact you Discussion 20 mins. Brochure Question and Answer
importance of the have with bothersome and sometimes
interventions for damaging pests. Common household
insect and rodent bugs that can pose a problem to your
prevention health include poisonous spiders and
cockroaches and rodents like mice and
rats are also known for spreading
diseases.
129
c. Discuss about Proper bottle recycling : Discussion and 20 mins. Bottles Simulation activities
proper bottle By recycling bottles it prevents demonstrations Gloves such as recycling
recycling as well stagnation of water inside it which Recycling
as possible water may lead to a possible breeding sack/bin
accumulation grounds for insects especially
materials which mosquitoes. It also helps prevent
may cause pollution.
accumulation and Materials which may cause stagnation
stagnation of of water:
water. Old tires, cans, open lid bottles,
buckets, pots, and other items.
d. Identify the Risks and Health problems due to Discussion and 20 mins. Brochure Question and Answer
potential risks and rodents and insects: video Laptop
health problems  Leptospirosis presentation of Speaker
that may arise  Lymphocytic the different
from the presence choriomeningitis (LCM) diseases which
of rodents and  Rat-Bite Fever (RBF) these animals
insects  Salmonellosis may cause.
 Tularemia
 Zika
 West Nile
 Eastern Equine Encephalitis
 Dengue
 Malaria
130
e. Demonstrate Proper sanitation: Discussion and 20 mins. Gloves Return demonstration

proper sanitation  Wearing gloves when cleaning demonstration Soap
 Proper handwashing after Water
cleaning Sink
 Sanitize the house with Disinfectants
cleaning or disinfectant agents Rags
f. Eliminate the Elimination of breeding grounds: Discussion and 20 mins. Gloves Demonstrations
possible breeding  Recycling materials such as demonstrations Soap
grounds of bottles, cans, tires, and Water
rodents and buckets. Gloves
insects  Planting plants in pots to Trash bins/sacks
prevent water stagnation.
 Declutter materials which
rodents may live in.
 Clean the house daily to
prevent accumulation of
waste.
131
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FAMILY NURSING CARE ANALYSIS

COMMUNITY HEALTH NURSING

FEDERICO V. NAGTALON, Ed.D.

FEDERICO V. NAGTALON, M.A.N., Ed.D.

GERLY MARK R. REDOBLE, M.A.N.

ROSELLA A. LUCERO, R.N

ENGRACIA FLORDELIZA P. MIGUEL, R.N.

JULIE C. DAMASO, M.A.N.

TERESITA ANNE O. TINIO, M.A.N.

ELMER A. SANTOS, M.A.N., Ed. D.

RYAN DEAN T. SUCGANG, MSHMS

this study, particularly to the following:

BSN II-D, Group 1-Cluster 2

Initial Data Base for Family Assessment

a. Family Structure, Characteristics and Dynamics……………………………………………..……………………………………………1-2

b. Socio-Economic and Cultural Characteristics…………………………………………………………………………………………….3-12

c. Home and Environment………………………………………………………...……………………………………………………….13-30

d. Health Status of Each Family Member………………………………………………………………………………………….………31-41

g. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention…………………………………….…………..80-89

Typology of Nursing Problem

a. First Level Assessment……………………………………………………………………………………………………….…………90-92

b. Second Level Assessment……………………………………………………………………………………………………………….93-97

c. Ranking Health Condition and Problems According to Priorities…………………………………………………………….....…….98-110

d. Family Coping Index…………………………………………………………………………………………………………...……..111-112

e. Family Nursing Care Plan……………………………………………………………………………………………………….……113-117

b. Proper Waste Disposal………………………………………………………………………………………………….…………….124-126

c. Elimination of Possible Breeding Grounds of Rodents and Insects………………………………….………………………………127-131

INITIAL DATA BASE FOR FAMILY ASSESSMENT

a. Family Structure, Characteristics and Dynamics

Cause Evident Not

N-F MA Robinson Medano   Father Brgy. Garnaden, Nueva  

b. Socio-Economic and Cultural Characteristics

Robinson Medrano (Egg Php.

Table 2.2. Summary of Monthly Income

Monthly Income Range Family Income Bracket

Php31,560 – Php78,900 (Middle Middle Income) 

savings away toward goals.

Table 2.3. BasicNecessities

Basic Necessities (Accdg. To Adequacy to Meet Basic Needs Monthly Expenses

Table 2.4. Monthly Expenses

Monthly Expenses Bracket Actual Monthly Expenses

Table 2.5. EducationalAttainment

Family Members NGC EU EG HSU HSG PSUG PSG CUG CG PB NR

Princess Anjelie Medrano 

Sheanne Cheska Medrano 

Table 2.6. Ethnicity Background and Religious Affiliation

Family ETHNICITY (Collado, Paula et al. RELIGION (Collado, Paula et al.

Catholic (Cultural Atlas, 2017).

Table 2.7. Significant Others and They Play in Family’s Life

Name of Significant Other Relationship to the Family Role in the Family

Table 2.8. Relationship of the Family to a Larger Community

behaviors even when circumstances motivate them to do so

c. Home and Environment

Table 3.1. Adequacy of Living Space

Provisions Adequate Inadequate

room, Bedroom, Balcony, Terrace, Storage Room, Attic, and Garage.