COMMUNITY HEALTH NURSING – CASE PRESENTATION

By: BSN GROUP 2BADILLES NIQUEBLANCO RENEJANECORTEZ SASOGAMALINDA TANLIM TIPON

INTRODUCTION

“It is health that is real wealth and not pieces of gold and silver.

”

A saying that strongly correlates to Community health nursing in such a way that it focuses on the welfare of everybody.

WHAT IS CHN? Community Health Nursing is a specialized

field of nursing, public health and some phase of social assistance and function as well as part of the total public health program for the promotion of health, improvement of the conditions in the social and physical environment, rehabilitation of illness and disability according to WHO.

Its goal is to raise the level of health citizenry. The traditional function of the community

health nursing is to help other help themselves.

The practice of the community health nursing will need to remain fluid and flexible if it is to be consistent with community needs, available resources, scientific knowledge and capabilities of people being served.

WHAT IS A COMMUNITY Community is a very important target of

health care Every community has problems to be

identified Communities with poor financial and

environmental conditions in particularly, are some concerns of the nation with regards to health.

WHY WE CHOSE THIS FAMILY? We chose Panadero Family because we

had identified problems that would affect their health and give solutions for them to cope up.

By rendering health teachings and interventions, the family will be able to understand and learn about the existing and potential health problems and the family will be able to take appropriate actions to solve their problems on their own.

OBJECTIVES

GENERAL OBJECTIVES:At the end of our 4 week exposure

on Barangay Subasta, Calinan, Davao City; we, student nurses of Ateneo de Davao University, BSN 3-D group 2, will be able to apply our learnings in our community health nursing concept and will be able to provide adequate and proper nursing care.

SPECIFIC OBJECTIVES: Psychomotor:

Conduct an ocular survey to find a family suitable for the case study;

Gather demographic data and other pertinent information about the client as well as the family to support the case study;

Illustrate the family eco map;

SPECIFIC OBJECTIVES:Extrapolate to the family the health teachings

applicable to their problems;Trace the client’s genogram, family diseases

and health conditions in a diagram format with a corresponding legend;

Formulate 5 Family Nursing Care Plans for the family;

SPECIFIC OBJECTIVES: Cognitive: 

Identify observable and underlying problems within the family;

Lay down information about the background of our family case study, its purpose , why the client was chosen and how can they be an attractive and proponent of the study;

Present the initial data base of the client;Rate the family’s coping potential/capacity

based on the Family Coping Index;

SPECIFIC OBJECTIVES:List down problems noted in the family;;Prioritize problems based on the Scale for

Ranking Health Conditions and Problems According to Priorities;

Evaluate the results of our interventions if the family improved their condition;

Lay down the contributions of our Case Study to Nursing Education, Research and Practice; and

List down all references used for this particular Case Study.

SPECIFIC OBJECTIVES: Affective:

Establish rapport with the family to develop a good working relationship;

INITIAL DATA BASE

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

NAME SEX AGE CIVIL

STATUS

EDUCATIONAL

ATTAINMENTOCCUPATION RELIGION

RELATION

TO THE

FAMILY

HOMER

PANADEROMALE 28 MARRIED

1ST YR

COLLEGE

MOTOR

DRIVER

ROMAN

CATHOLI

C

HUSBAND

MARJ

PANADEROFEMALE 26 MARRIED

1ST YR

COLLEGEVENDOR

ROMAN

CATHOLI

C

WIFE

BART

PANADEROMALE 8 SINGLE GRADE2

ROMAN

CATHOLI

C

SON

MAGGIE

PANADEROFEMALE 6 SINGLE KINDER2

ROMAN

CATHOLI

C

DAUGHTER

STEWIE

PANADEROMALE 2 SINGLE

ROMAN

CATHOLI

C

SON

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS PLACE OF RESIDENCE OF EACH MEMBER

-The Panadero family is living together in one house, located at purok 1 Subasta, Calinan Davao city.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS TYPES OF FAMILY STRUCTURE

According to membership The Panadero family is a nuclear type of family

because they are living in one household and consisting of a mother, father and their children.

According to Residence The Panadero family is matrilocal since they live

in one compound with Marj’s parents and siblings.

According to Authority Egalitarian is the authority in Panadero family in

which decision lies with both couple.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS DOMINANT FAMILY MEMBER IN TERMS OF

DECISION-MAKING, ESPECIALLY IN MATTERS OF HEALTH CARE

Both Marj and Homer are responsible in making decisions with regards to health care. The two of them work hand in hand to provide the family’s health needs. Financial matters are discussed by both Marj and Homer. They help and support each other in making decisions for their family.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS GENERAL FAMILY RELATIONSHIP

The panadero family is peaceful and loving family though sometimes the family experience quarrels but they easily resolve it by talking through it.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS ACTIVITIES OF DAILY LIVING

Sleeping patternThe couple, Homer and Marj, together

with their sons and daughter, sleeps together in one room. There have been regular hours for getting up and retiring every night for the family. They usually sleep at around 8 or 9 pm and wakes up 6am In the morning because marj needs to cook and prepare her children in going to school.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

Eating Pattern

SCHEDULE FOODS WHO

PREPARES

BREAKFAST Rice, Fish/vegetables MARJ

LUNCH Rice, meat/vegetables MARJ

MERIENDA Bananacue MARJ

DINNER Rice,

fish/meat/vegetables/soup

MARJ

The family shares four meals in a day breakfast, lunch, snacks and dinner. They cook using charcoals/woods because they have no stove. Ellen usually cooks the food since she also cook viands in which she sells during lunch.

FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

Leisure time activities During free time, the family would just

watch television on their neighbor’s house since their television set is broken. And also, they sleep and clean the house during free time. If they have extra money or they need to buy something, they go to town.

SOCIO-ECONOMIC AND CULTURAL FACTORS INCOME AND EXPENSES

MEMBER

S

OCCUPATION PLACE

OF WORK

INCOME

HOMER

PANADER

O

MOTOR

DRIVER

SUBASTA P300-

P500/day

MARJ

PANADER

O

VENDOR SUBASTA P300/day

SOCIO-ECONOMIC AND CULTURAL FACTORS

The family’s income is above minimum wage (referring to Davao’s minimum wage level which is P248), having an income of 400-600 per day. It has an adequacy in meeting family’s basic need such as food and shelter. They can afford to send their children to school and able to eat at least 3-4 times a day.

SOCIO-ECONOMIC AND CULTURAL FACTORS EDUCATIONAL ATTAINMENT OF EACH

MEMBER OF THE FAMILY

Name Educational Attainment

Homer Panadero Undergraduate First yr college

Marj Panadero Undergraduate First yr college

Bart Panadero Currently on Elementary Grade

2

Maggie Panadero Currently on Kinder 2

Stewie Panadero Doesn’t go to school yet

SOCIO-ECONOMIC AND CULTURAL FACTORS ETHNIC BACKGROUND AND RELIGIOUS

AFFLIATIONS Basically, our clients are Christians. Both Homer

and Marj lived in Subasta. They don’t go to church since Homer and Marj is busy but they find time going to church during special occasions

SIGNIFICANT OTHERS Each of the family members has its own significant

roles in the family. In times of financial crises, they have their neighbors who can help them in some matters matters because most of their neighbours are their relatives,

SOCIO-ECONOMIC AND CULTURAL FACTORS RELATIONSHIP OF THE FAMILY TO THE

LARGER COMMUNITYThey are not active members in their

baranggay. Whenever there are activities in the Barangay, they do not participate because they are busy. they are friendly to their neighbours, they watch tv in their neighbours house.

ENVIRONMENTAL FACTORS HOUSING

Adequacy of living space There is inadequate living space for the entire

family. The house consists of a multifunctional room because the room serves as their bedroom, dining room, living room and kitchen. The room has a floor area of 311cm x 250cm x 300cm. They have a separate room for their comfort room which has a floor area 80cm x 100cm x 300cm. The cooking facility is separated from the house located few feet away which has a floor area of 83cm x 110cm x 300cm.

ENVIRONMENTAL FACTORSSleeping arrangement

The family altogether sleeps inside the main room. The children sleep on the floor mat while Mr. and Mrs. Panadero sleep on the bed.

Adequacy of furniture They have furniture. There is a television

set and DVD player but it is broken. They have few kitchen utensils. A dining table and wooden chairs, they have a wooden cabinet wherein they place or keep their clothes and other things.

ENVIRONMENTAL FACTORSPresence of insects and rodents

There were cobwebs noted at their ceilings. There were mosquitoes in the kitchen and their bedroom. There are also small rats and ants noted. It is highly possible for insects to get in because their windows are not screened.

Presence of accident hazards There are large and sharp stones outside their

door. Marj verbalized “nadagma dra akong anak, naigo sa bato unya nasamad ang ulo”. the house is made of wood, the cooking area is just inches away from the house.

ENVIRONMENTAL FACTORSFood storage and cooking facilities

There is no proper food storage. They have no refrigerator; they store their fresh meats on their mother’s refrigerator. We also noticed the cooking utensils such as plates & cooking pan left unwashed in the washing area. They are using wood and charcoals for cooking.

Water supply They get their water supply in water district.

This is where they use for taking a bath, washing clothes and use for cooking. In terms of paying they pay their own water bill.

ENVIRONMENTAL FACTORSToilet facility

The toilet is privately owned and is located inside their house. It is approximately 80x210x300 cm. The toilet is not that clean. The walls of the toilet room are covered with sacks. The type of toilet is an open pit.

ENVIRONMENTAL FACTORSGarbage disposal

There is exposed garbage in plastic cellophane mixed with biodegradable and non-biodegradable. Flies and rodents are seen around the garbage plastic cellophane. There is garbage collector that makes rounds every week. The family has no proper container for their garbage wastes. They just put it in plastic cellophane where flies and rodents are present.

Drainage System The type of drainage system they have is an

open pit.

ENVIRONMENTAL FACTORS KIND OF NEIGHBORHOOD

The houses in the community are not congested. They are spaced adequately. The Panadero family lives in a peaceful community. Whenever they need something like they need to put their fresh meats in a refrigerator their neighbors would let them store their food in their refrigerator. Since some of their neighbors are their relatives, they sometimes watch TV in their relative’s house.

ENVIRONMENTAL FACTORS SOCIAL AND HEALTH FACILITIES

Health Center is present where immunizations and check-ups are rendered. Subasta also houses the Subasta Elementary School wherein almost all of the children study. The community has a basketball area and a chapel that is used by the people for recreation and official activities. There are also several sari-sari stores in the area wherein they could buy the things they need.

ENVIRONMENTAL FACTORS COMMUNICATION AND TRANSPORTATION

FACILITIES AVAILABLEThey own a motorcycle which serves as their

transportation and also to earn a living. They have their television but it is broken. They have a source of communication, they have cellphones.

HEALTH ASSESSENT OF EACH MEMBER

FAMILY MEMBER

WEIGHT HEIGHT BMI INTERPRETATION

Homer Panadero

70kg 174cm 23.10 kg/m2

NORMAL

Marj Panadero

59kg 156cm 25.8 kg/m2

NORMAL

Bart Panadero

20kg 115cm 15.15 kg/m2

UNDERWEIGHT

Maggie Panadero

20kg 110cm 16.53 kg/m2

UNDERWEIGHT

Stewie Panadero

11kg 85cm 15.28 kg/m2

UNDERWEIGHT

Classification Scale

Underweight <19 kg/m2

Normal 19-24.99 kg/m2

Overweight 25 – 29.99 kg/m2

Obese Class I

30 – 34.99 kg/m2

Obese Class II

35-39.99 kg/m2

HEALTH ASSESSENT OF EACH MEMBERFAMILY MEMBER Blood pressureHomer Panadero 120/80Marj Panadero 140/100Bart PanaderoMaggie PanaderoStewie Panadero

Mrs. Panadero has an undiagnosed hypertension. After taking her blood pressure during our home visit, her blood pressure was 140/100. She also verbalized “naa sa among lahi ang high blood. Pirminte naga taas akong dugo labi na kung kapuyon ko sa akong pagbaligya ug saging ug sud-an. Makasamot pa jud ang init ug kakapoy sa trabaho.”

HEALTH ASSESSENT OF EACH MEMBER All of their children were fully immunized.

Bart, the eldest son completed his dose of vaccine last June 2002, Maggie completed it last May 2004, and Stewie finished it last September of 2008.

HEALTH TEACHINGS They should find time to exercise. they should focus on their 3 children who

are underweight and try to check and monitor their food intake.

they should clean their toilet facility, remove cobwebs and flush the toilet after using it.

they should screen their windows to prevent entry of insects and mosquitoes.

Since they have inadequate space they should arrange their things properly to have more space and so they can move freely.

GENOGRAM

TYPOLOGY1st and 2nd level Assessment

FAMILY COPING INDEX

PRIORITIZATION OF PROBLEMS