CHAPTER 1

Initial Data Base for Nursing Care Practice

A. FAMILY STRUCTURE AND CHARACTERISTICS

Family Name: Marquez – Junio - Micael Family
Type of Family: Reconstituted Family
Name Relationshi Birthdate Ag Sex Civil Ethnic Religio
of p to the e Status Backgroun n
family Head of d
Member the Family
Consuel Head of April 24, 55 Femal Marrie Filipino Roman
o R. household 1966 e d Catholi
Marque c
z
Raymon Husband of June 12, 45 Male Marrie Filipino Roman
d M. the head of 1976 d Catholi
Micael household c
Maria Second August 27 Femal Single Filipino Roman
Angelica eldest 15, 1994 e Catholi
M. Junio daughter of c
the head of
household
Angelo Eldest son Septemb 23 Male Single Filipino Roman
M. Junio of the head er 29, Catholi
of 1998 c
household
Isabelo Youngest August 21 Male Single Filipino Roman
M. son of the 26, 2000 Catholi
Micael head of c
household
Maria Youngest March 2, 19 Femal single Filipino Roman
Isabela daughter of 2002 e Catholi
M. the head of c
Micael household

Analysis and Interpretation

According to John Allan Barnard (2017), family “a group of persons united by the ties
of marriage, blood, or adoption, constituting a single household and interacting with
each other in their respective social positions, usually those of spouses, parents,
children, and siblings. The family group should be distinguished from a household,
which may include boarders and roomers sharing a common residence. It should
also be differentiated from kindred (which also concerns blood lines), because
kindred may be divided into several households. Frequently the family is not
differentiated from the marriage pair, but the essence of the family group is the
parent-child relationship, which may be absent from many marriage pairs.

Marquez – Junio – Micael family is an example of a reconstituted type of family

wherein one parent or both has children from their previous marriage or relationship.
This type of family has the “step” word used by the children to address their
relationship with their new parent or sibling. Their family started with Mrs. Consuelo
Marquez having cohabitated with Mr. Angelito Junio which resulted to 3 children
which are Maria Angelicon, Maria Anngelica and Angelo Junio. After 10 years of
living together they have decided to separate leading to the relationship of Mrs.
Consuelo Marquez to Mr. Raymond Micael. They are not married but is now living
together for 25 years. They also have children together which are Isabelo and
Isabela Micael. For years Mr. Raymond Micael has stood up to be the father of the
first 3 children with him being the breadwinner before the children had work. He
supported the whole family up until now.

This shows how versatile a family can be when it comes to different situations. This
shows how a family works and it is not about the resources that surrounds the family
but the capability of the person to cope and learn to be successful together.

This family was chosen by the student nurse because their versatility when it comes
to family dynamics and they also fit the criteria that is needed. With the identification
of their diseases, the student nurse can help identify, minimize and give knowledge
about their condition that will surely help them.
B. SOCIO-ECONOMIC STATUS

Name Education Type of Place of Monthly

al work Work Income
Attainmen / (estimated
t occupatio amount)
n
Consuelo R. Marquez Highschool Self - -
Employed
Raymond M. Micael Highschool Messenger Danao and Php 25,000
Assoc.
Maria Angelicon M. Junio College Unemploy - -
ed
Maria Angelica M. Junio College Accountan Danao and Php 34,000
t Assoc.
Angelo M. Junio College Electrical Trend Php 28,000
Engineer Micro
Corp.
Isabelo M. Micael In College Student - -
Maria Isabela M. Micael In College Student - -

Monthly Income Monthly Expenses/Expenditure

House Rental – 13,000

Raymond M. Micael - Php 25,000 Food - 15,000

Maria Angelica M. Junio - Php 34,000 Electricity - 6,000

Angelo M. Junio - Php 28,000 Water - 4,000

Owns House for Rent – Php 15,000
Food Selling Sidelines – Php 20,000 Multivitamins - 1,680

Tuition Fee - 50,000 (per sem)

TOTAL: Php 127,000
Internet - 3,000

Transport Fares – 4,500

TOTAL: Php 97,180

Analysis and Interpretation
According to Philippine Statistics Authority (PSA) it is identified that the ideal income
for a family of 3 to 4 members is Php 22,000 to 45,000 to be able to afford the cost of
living here in the Philippines. This includes shelter, food, household bills and extra
expenditures (Source: Income and Expenditure | Philippine Statistics Authority (psa.gov.ph) )
Based on the collected data from the family’s monthly incoming it is evident that they
are able to afford their cost of living and still have an extra income for leisure and
such. They are not affected when it comes to the expenses of having 7 members in
the family. The data also shows that the family is able to live comfortably without
having the need to work extra or be frugal when it comes to their daily expenses.

C. ENVIRONMENTAL FACTORS
POSITIVE ENVIRONMENTAL NEGATIVE
FACTORS ENVIRONMENTAL
FACTORS
Home Structure
 Made of concrete materials and
also has wooden structures on
the 2nd floor.
 It has proper ventilation and
lighting
 House with a front and backyard

Living Space
 100 sqm house with a clean and
back kitchen. Has a garage that
can fit at least 2 vans and 2
motorcycles. The house also has
a front and backyard and
composes of 2 upstairs
bedrooms. The house has 1
comfort room and a clean well for
an extra source of water.

Excreta Disposal
 Flush type
 Pail Method
 Garbage Disposal
 Their garbage is collected daily
 This may help to avoid disease
contamination, since poor
garbage disposal can attract
bugs that transmit a variety of
illnesses.
Drainage
 The rental house has a close
drainage
Source of Water
 Manila Water
 Clean Well on the backyard
Source of Power
 Meralco
Communication
 (Internet, Smartphones, Laptop)
 The family is using smartphones
and laptops that is connected to
the internet for communication.

Presence of Pest
 None
Presence of Pets and Animals
 2 shi tzu dogs inside
 5 rabbits outside

Analysis and Interpretation

The family is currently living in a well-maintained house where in there is less
exposure to contaminations, infections and diseases. Hygiene requirements are also
accessible from the outside and inside of the house which can help the family
regulate cleanliness and good hygiene. When it comes to disposal of garbage or any
form of scraps, the family immediately prepares it for the garbage collection and
does not let the attraction of any pests or insects.
Based on my observation the family is well aware of household hazards like, pests,
hoarding, faulty wirings, unkept backyards, old moldy woods and unclean waters. As
it is visible that they clean everyday and does not let the house be infected with
pests and rodents.
D. GORDON’S 11 FUNCTIONAL HEALTH PATTERNS
FUNCTIONAL HEALTH DATA
PATTERN
 The family intakes
Health perception/health multivitamins like vitamin c
management for immunity.
 Hypertensive family
members also intakes
amlodipine and saphormin.
 The family consult a doctor
if needed
 The family especially the
children has complete
immunization.
 The family completes 3
Nutrition-metabolic meals a day and also has
extra meals for merienda
and midnight snacks.
 A typical meal for the family
composes of meat, rice
vegetables and soup.
 They also drink plenty of
water and sometimes fruit
juices.
 The family has no problem
Elimination with elimination through
integumentary and urinary
system.

 The family has regular

bowel movement.
 The whole family
Activity-exercise participates in household
chores.
 Some members of the
family does exercises from
morning or night time.
 Consuelo Marquez,
Cognitive-perceptual Raymond Micael, Maria
Angelicon Junio, Maria
Angelica Junio and Angelo
Junio wears glasses for
reading and everyday use.
 The family have enough
Sleep-rest rest and 7-8 hours’ sleep a
day.
 Each family member fulfills
Role-relationship their responsibility and has
 care for the family's well-
being.
 They're all in connected
with one another.
 The children are well
bonded with their step
father.

Sexuality  Sexually Active.

 Maria Angelicon M. Junio

pregnancy history:
G–1
P–0
A–0
L–1
 The family usually
Coping-stress tolerance participates in their social
groups.
 They usually bond over
grocery and shopping in
malls.
 The children has a card
night wherein they play
card games together.
 The family identifies as a
Value-belief Roman Catholic family but
does not regularly attend
Sunday mass.
 The family considered
Self-perception / Self-concept themselves to be in a good
and healthy family.

HEALTH HISTORY
Consuelo R. Marquez
Family Health History
Maternal: Hypertension
Paternal: Hypertension
Past Medical History: None
Present Medical Status: Healthy

Raymond M. Micael
Family Health History
 Maternal: None
Paternal: None
Past Medical History: None
Present Medical Status: Liver disease

Maria Angelica M. Junio

Family Health History
Maternal: Hypertension
Paternal: Hypertension
Past Medical History: None
Present Medical Status: Hypertension

Angelo M. Junio
Family Health History
Maternal: Hypertension
Paternal: Hypertension
Past Medical History: None
Present Medical Status: Hypertension

Isabelo M. Micael
Family Health History
Maternal: Hypertension
Paternal: None
Past Medical History: None
Present Medical Status: Healthy

Maria Isabela M. Micael

Family Health History
Maternal: Hypertension
Paternal: None
 Past Medical History: None
Present Medical Status: Healthy

Analysis and Interpretations

According to Janice I. Hooper (1996) “Gordon's functional health patterns provide a
holistic model for assessment of the family because assessment data are classified
under 11 headings: health perception and health management, nutritional-metabolic,
elimination, activity and exercise, sleep and rest, cognition and perception, self-
perception and self-concept, roles and relationships, sexuality and reproduction,
coping and stress tolerance, and values and beliefs.”
Based on the information provided, the family has a mainly normal pattern, indicating
that they can function well. They also have physical activities that can contribute to
their healthy lifestyle. They are also able to intake a complete meal with proper
nutrition that is needed to be healthy and avoid complications. They are also capable
of intaking maintenance medicines, multivitamins and other health related
supplements.

E. VALUES, HABITS, PRACTICES IN HEALTH PROMOTION, MAINTENANCE

AND DISEASE PREVENTION
IMMUNIZATION
NAME VACCINE
Consuelo R. Marquez
Complete
Raymond M. Micael
Complete
Maria Angelicon M. Junio
Complete
Maria Angelica M. Junio
Complete
Angelo M. Junio
Complete
Isabelo M. Micael
Complete

MEDICATION AND SUPPLEMENTS

NAME AGE CONDITION MEDICATION
Consuelo R. Marquez 55 Healthy Multi Vitamins
Raymond M. Micael 45 Healthy Multivitamins
Multivitamins
Maria Angelicon M. Junio 27 Hypertension Amlodipine
Saphormin
 Amlodipine
Maria Angelica M. Junio 23 Hypertension Saphormin
Multivitamins
Angelo M. Junio 21 Healthy Multivitamins
Isabelo M. Micael 19 Healthy Multivitamins

Analysis and Interpretation

The family usually have 3 meals a day or more. Since the mother of the household
prepares all the meals, she usually chooses foods that are usually savory but still
healthy as she is aware of their health conditions. Their favorite pastime on their
days off is bonding over card games or grocery shopping. They also do exercises
daily to avoid and lessen the chance of having a hypertension attack.
It is critical to have a comprehensive vaccination since it reduces the impact of a
disease on the body. Having a healthy lifestyle may help reduce chances of getting
the disease. Furthermore, careful administration and upkeep may reduce the
consequences of such situations on family functioning.

CHAPTER II
A. FIRST LEVEL ASSESSMENT
IDENTIFYING HEALTH THREATS, HEALTH DEFICITS, AND FORSEEABLE
CRISIS
HEALTH DEFICIT - a gap between actual and achievable health status
HEALTH DEFICIT JUSTIFICATION
High blood pressure
Hypertension (hypertension) is a common
condition in which the long-term
force of the blood against your
artery walls is high enough that it
may eventually cause health
problems, such as heart disease.
This could affect their daily lives
as it is possible to trigger an attack
when it comes to sudden rise of
emotions, physical chores and
eating habits.

HEALTH THREAT - conditions that promote disease or injury and prevent people
from realizing health potential.
HEALTH THREATS JUSTIFICATION
Everyday can be a different day
Physical Stress but when it turns stressful, it can
cause your blood to rise and can
 result to hypertension attack.
As hypertension can be triggered
to the sudden rise of emotions. As
we are faced with different
Sudden Rise of Emotions situations everyday it is possible to
get an attack spontaneously
without being aware of the cause.
Not knowing how to control our
stress can cause an attack.

FORSEEABLE CRISIS - anticipated periods of unusual demand on the individual or

family in terms of adjustment
FORSEEABLE CRISIS JUSTIFICATION
As all of the children that are
Knowledge Deficit affected by the disease are
dependent on their mother when it
comes to eating habits. They
should also learn how to manage
their illness as their mother is
aging and not for long won’t be
able to do everything for them.

B. SECOND LEVEL ASSESSMENT

CUES DATA FAMILY NURSING PROBLEMS
Hypertension as health deficit:
Client stated that she is
experiencing sudden pain when Inability to focus on daily activities
stressed. due to sudden attack of
hypertension.

CHAPTER III
SCALES FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING
TO PRIORITIES

HEALTH PROBLEMS SCORE

1. Hypertension 4

Hypertension
 Criteria Computation Actual Justification
Score

Nature of the 3 The problem is a health deficit and

problem requires more immediate
— x 1 1 intervention.

Modifiability of the 1 The resources and interventions

problem needed to solve the problems are
— x 2 1 available to the family but the current
knowledge is not sufficient.
2

Preventative 3 Hypertension can properly be

Potential maintained upon intake of current
— x 1 1 prescribed antihypertensive
maintenance medication.
3

Salience of the 2 The family perceived hypertension

Problem as a serious problem and is ensuring
— x 1 1 the regular intake of antihypertensive
maintenance medication.
2

Total Score 4

CHAPTER IV
FAMILY NURSING CARE PLAN

I. Hypertension
Health Family Goal of Objectives Intervention Method Resource
Proble Nursing of s of s
Care Measures
ms Nurse
Problems Care Required
Family
Contac
t

Hyperte Inability to After the After 1. Assess the family's Home Material
nsion make nursing nursing level of understanding of Visit Resource
as a decisions interventi interventio the current health and s:
health on on, the n, the problem. Clinic
-Visual
deficit appropriate family family: Visit
Aids,
health must be
- will be materials
actions due given the 2. Conduct health
able to and low-
to a lack of necessar teaching in regards with:
determine cost
adequate y
their level a. Discuss the family supplies
knowledge informati
of risk factors for needed
or on to
understan hypertension in for
understandi deal with
ding of further depth. demonstr
ng about hyperten
hypertensi b. Discuss how they ation on
the sion and
on. will visit the methods
numerous how to
regulatin
options regularly organization's
g
available to manage health center to
- to make hyperten
them. their see a physician for
them sion.
health a regular checkup.
status in aware that
terms of they
providing should 3. Provide comfort Human
detailed visit a measures (back and Resource
informati specific neck massage, the s:
on to physician elevation of head). -Time
both the in their
Decreases discomfort and effort
patient health
and may reduce on the
and the center or
sympathetic stimulation. part of
family. hospital on
the nurse
a regular
and the
basis for
4. Instruct in relaxation family
further
informatio techniques, guided
n about imagery, distractions.
the Financial
Can reduce stressful Resource
condition. stimuli, produce a s:
calming effect, thereby
 reducing BP. Money
for the
nurse
5. Monitor response to transport
medications to control ation
blood pressure.

CHAPTER V
FAMILY NURSING CARE PLAN

Summary
In creating this FNCP or Family nursing care plan, we have chosen a family that is
reachable and fits the criteria we have set. We asked the family question that are
necessary in formulating an FNCP. With this the family participated well and
informed us of everything we need to know regarding their health status and
household condition. Upon the finishing of every detail we have concluded that the
family is at risk for hypertension as it is a dominant disease in the maternal side of
the family. We also have created an NCP that will help the family identify, minimize
and be knowledgeable regarding their health condition.
Conclusion
In conclusion the student nurses determined that some members of the family has a
condition that is dominant in the maternal side. We have also identified the possible
health risks that can trigger their condition. With this an NCP was created for the
family.
Recommendations
We the student nurses recommend the family to continue their healthy lifestyle and if
possible, explore more and have interest in researching their disease for them to
have a wider knowledge about the said disease. Being able to identify and have a
broad knowledge can help them in handling their conditions but still live and eat
normal.

ANNEXES

Expenses
With the family’s monthly income, it is clear that they are able to afford their lifestyle
and at the same time still have and extra for their leisure and emergency funds. With
the family having 3 members employed with high salaries and joined with their
investments which are house rentals and food selling sidelines by the mother, they
are able to have a large sum of money enough for a 7-member family. The family
has a total income of Php 127,000 monthly and only have Php 97,180 of expenses
and this excludes the tuition fee for monthly counting as it is stated by the family that
the provided amount of tuition fee is per semester.

Tools Used
Visual Aids for better understanding
Handouts for assessment guide