Question

FAMILY NURSING CARE PLAN

Family Background

Client N and her family is a cohabiting family. Client N is a 25-year old female, and her partner, client JR is a 31-year old male. They have been living together for three years. She has two children, her first-born is a 6-year old boy from her previous relationship and is currently being taken care of by her parents in Manila. She gave birth to her 6-week old baby boy last August 31, 2020 whom she is taking care of now. The head of the family is client N. She is in charge of making decisions about the family.

Socio-Economic Background

Client N. is a high school graduate and is working as a massage therapist in Pasay City, and her partner is an elementary graduate and works as a street vendor near train Station. The client is currently on maternity leave from her job as a therapist. During her maternity leave, it is her partner who provides for their daily needs. She said that their income is enough to provide their family’s basic needs but she did not disclose their monthly income. They are Roman Catholic and states that they have a firm belief or faith in God, as the client verbalized "for me, God has the biggest role in our lives." They do not participate or join community activities like the city's feast or program.

PHYSICAL ENVIRONMENT

The client’s house is made of light scrap materials like plywood, big carton boxes which they decorated with wallpapers. The houses in the compound are clustered closely together with little to no space. It is a small house with no windows. It is a small space with a curtain that serves as a door near their house since the house gets too hot during the day. They do not have their own toilet and bath area; they use a common toilet and bathroom area in the compound, wherein they pay a fee of 20 pesos and 10 pesos each one bucket of water. The toilet bowl in the common bathroom does not have a flush. The sources of water in the area are deep well with a water pump and (NAWASA). They use the water from the deep well to wash their dishes and their laundry. However, the student nurse noticed that the water in the well has garbage floating in it. She also noticed several big plastic bottles without cover that scattered around the house that had rain water inside. They also leave their used dishes soaked in a basin. Their source of electricity is from the jumper cables connected to the electric posts of Meralco. The family usually buys their food from the eatery found in the area, but if they have the chance to cook, they use a small LPG single burner gas stove. The passageway to the house is filled with broken tiles which are purposely placed there because the soil beneath it is soft and muddy that the feet sink when it is stepped on. Presence of mosquitos, rats, and cockroaches were observed.

As mandated by a city ordinance about disposing garbage properly to their right place, Family N do not practice this segregation by placing their garbage into their specified categories to avoid additional health problems in the family. But among those that are found planted in cans there are lagundi, oregano, ampalaya, pito-pito and tsaang gubat located beside their house.

Family N Medical and Health History

Client N. has been complaining of having difficulty falling asleep and staying asleep that started after giving birth to her second child. Client N. and her partner has been experiencing coughs and cold for a week, and their 6-week old baby started to have colds in the morning during home visit the health provider teach them to used the available herbal plants outside their house and it is planted in a can .Proper instruction given to Client N.

Client N.'s partner has been taking Solmux 1 cap 2x a day since he started coughing and having colds per doctor's order.

Client N.'s OB score is G=2, P=2, T=2, P=0, A=0, L=2.

VITAL SIGNS are the following BP 100/80 mm/Hg Temperature 36.5c , Pulse Rate 100 beat/minutes ,

Respiration Rate 18 breaths per minutes ,

  

The client has stopped feeding her 6-week old son through breastfeeding because of her inverted nipples. She stated that her son could not suck on her breasts and has bad attachment. “I don't have time to visit the Health center for some Health counselling for my inverted nipple.”

Family Assessment Based on Functional Health Pattern

1) Health Perception - Health Management Patterns

In general, the members of the family have no chronic illnesses and they rarely get sick and if they do get sick, it is usually coughs or colds. Mostly prefer herbal remedies than medications. It is when the herbal plants do not give relief from the symptom, they seek help from the Barangay Health Station and seek medical advice from the doctor.

2) Nutritional-Metabolic Pattern

The family eats three times a day. They prefer foods cooked in the vendors and canned goods. Her parents also helped the family as verbalized by Client N once in a while, Client N has no allergies to sea foods such as shellfish, crabs, and shrimps and all the family members can enjoy eating foods that they have during meal time.

The newborn baby is not satisfied during breastfeeding because of the inverted nipple of her mother . Need more attention from Client N to give the proper breast feeding to her baby. as verbalized by the mother.

3) Elimination Pattern

Client N has no difficulties during urination and defecation. They are able to defecate once or twice a day and able to urinate 3x a day or more .

4) Activity-Exercise Pattern

CLIENT N is a working mother and a busy person so her mother helped her to watch her other child . She focuses on taking care of her child at home . Feels weak and with difficulty of sleeping after her second delivery of her child.

FAMILY HEALTH HISTORY

Family’s health history, the client N's father who is aged 52 years old has been experiencing high blood pressure that started last 2018. Apart from that, the client’s immediate family members do not have any non-communicable diseases. Client N. does not know her grandparents from her paternal side and her grandfather from her maternal side’s cause of death because they passed away before she was born.

QUESTIONS:

Make a Family Nursing Care Plan

1. Supporting cues; Objective & Subjective cues

2. Health condition or problem (State the most prioritized to least prioritized then choose the RANK 1)

3. Family nursing problems

4. Goal of care

5. Objectives of Nursing Care

6. Nursing interventions

7. Method of family contact

8. Evaluation

Answer 1

family nursing care plan:

1.

objective: on observation, client has inverted nipples

subjective: she said , i have inverted nipple and baby cant suck nipples.

nursing diagnosis: ineffective breast feeding related to inverted nipples

problem is inverted nipples

goals or objectives:

• to improve the knowledge of client on breast feeding
• to revert back nipples
• to promote breast feeding

nursing interventions:

• teach the use of breast pump
• teach the mother about holding the baby while breast feeding
• teach the mother about latching baby to breast

methods of family contact:

• home visit

evaluation:

• after a week of intervention, the client will be able to effectively breast feed

2.

objective: on observation, client look dull

subjective: she said i could not sleep at night after birth of second baby

problem: disturbed sleeping pattern

short term goal: after an hour of health eductaion, the client will improve knowledge on sleep

long term goal: after a week of intervention, the sleeping pattern will be improved

objective:

to improve the sleeping pattern

interventions:

• educate the importance of drinking warm milk before sleep
• educate to go only to bed when feel sleepy
• educate about having turns while getting up if the child cry
• educate on avoiding day time sleep

methods of family contact:

• home visit

evaluation:

• after a week of intervention, the sleeping pattern is improved

3.

objective: on observation, garbage was found not properly disposed

subjective: no subjective data

problem: poor environmental sanitation

short term goal: after an hour of health eductaion, the client will improve knowledge

long term goal: after a week of intervention, the environmental sanitation will be improved

objective:

to improve the environmental sanitation

interventions:

• educate the importance of environmental sanitation
• educate on the health problems associated with poor environment hygiene
• educate on waste segregation and sanitation

methods of family contact:

• home visit

evaluation:

• after a week of intervention, the environmental sanitation is improved