Question

FAMILY SANTOS

FAMILY BACKGROUND

Mr. and Mrs. Santos have been living together for 3 years without a benefit of a legal marriage. They have 4 children, 3 girls and 1 boy, 3 of them are studying and she is currently 5 months pregnant. They are currently living at Purok 8, Brgy. 16. Both Mr. & Mrs. Santos are both high school graduate. She is

a fish vendor and her husband is a “grab” driver.

She mentioned that her pregnancy is unplanned and unwanted and currently facing financial problems brought about by the school expenses of their children. They are only depending on her small income. Mrs. Santos did not submit herself for medical consult and never visited the health center for prenatal check-up due to financial constraints and unwanted pregnancy. Mrs. Santos said “I’m fine even though I was not able to go to our health center. I am okay with my condition.” ”I noticed I have been vomiting extremely for quite a while now. I almost entirely lost my appetite and I’ve lost so much weight.”

SOCIO-ECONOMIC BACKGROUND and HOME

and ENVIRONMENT

Mrs. Santos is a 29 year old, fish vendor and her husband is a “grab” driver. They have a combined daily income of Php 800.00 daily. Mrs. Santo’s mother in–law sometimes send them financial help when they are having a hard time making both ends meet. Despite the money sent as help from her mother-in-law together with the monthly income, it is still not enough for their needs. However, she makes sure that they can eat thrice a day. “For me, it’s okay if we always consume canned goods and instant noodles, most importantly, we have something to eat.” “These past few days, I couldn’t sleep properly, I am only able to sleep when it’s 12 MN because of so much things to do in our home then I’ll always wake up early to go and buy fish.”

They rent the house that they are living in. The house is made of mixed materials like bamboo and plywood. They admit that their house has an inadequate space for all of them. Furthermore, her house is prone to fire because it is made of light materials. They use charcoal for cooking in their common kitchen. The foundation of the house is not good or strong enough, since it is made of wood and bamboo and may not withstand strong winds during a typhoon. There is a big possibility that their house is damaged during a strong typhoon. There are empty cans and containers everywhere which are good breeding sites for mosquitoes and cockroaches.

HEALTH STATUS OF FAMILY MEMBER and VALUES HABITS and PRACTICES

Mrs. Santos’ parents are both still alive. Both parents are diabetic. According to Mrs. Santos, her 4 children already completed their vaccination and have kept their records well.

Mrs. Santos stated that the last pregnancy she gave birth via NSD. She did not encounter any problems. When asked if she breastfed her babies she “All of my children are not breastfed. Because there’s no milk coming out of my breats and I have so much work to do, I wasn’t able to breastfeed my children.” She has taken it for granted and did not seek medical consult or help and not even have a prenatal check – up. She has expressed her feelings of not wanting the baby but would not want to abort it either.

Mrs. Santos also narrated that when she was giving birth to their eldest child, she experienced gestational diabetes. According to her, it repeatedly happens each time that she is going to give birth to each of their children. She has been smoking ever since even if she is pregnant. “Smoking reduces my stress. But then I got pregnant, I cut my cigarettes into only 1-2 sticks per day unlike before I use all cigarettes in a pack.” “In my perspective, we do not have problems but one, and that’s our weak profit from our fish selling.”

Heat acetic and Benedict's test was performed by the Community health nurse. Heat acetic shows no changes in the urine while Benedict's test shows a change in color from blue to green. Vital signs were taken and no abnormalities were noted by the CHN.

Questions:

Make a Family Nursing Care Plan

1. Supporting Cues (Subjective & Objective cues)

2. Health condition or problem (State the most prioritized problem / Rank 1)

3. Family nursing problems

4. Goal of Care

5. Objectives of Nursing Care

6. Nursing interventions

7. Method of family nurse contacts

8. Evaluation (Outcomes & Method/tools used)

Thank you!

Answer 1

1. Subjective cues:

* Vomiting

* Loss of appetite

* Weight loss

* Inadequate sleep.

Objective cues:

* Poor environmental condition

* Mosquito breeding

* Inadequate knowledge on breastfeeding

* Smoking

* Diabetes

* Inadequate knowledge on family planning methods.

2. Health problems:

* Fluid volume deficit due to extreme vomiting.

* Altered nutritional status less than body requirements related to anorexia and diabetes.

* Risk for systemic diseases related to smoking.

3. Family nursing problem:

* Risk for infectious diseases related to mosquito breeding.

* Inadequate knowledge regarding environmental sanitation.

* Inadequate knowledge regarding health practices.

* Inadequate in meeting family needs due to big family size.

4. Goal of nursing Care:

Long term goal:

The family will be able to protect themselves from preventable diseases by maintaining good environmental sanitation and following healthy dietary practices and good health behavior.

Short term goal:

Mrs.Santos will be ale to maintain her health by practicing proper health care behavior and by seeking good medical care.

5. Objectives of nursing care:

Mrs.Santos will be able to,

- relieved and manage herself from minor disorders of pregnancy.

- balance her nutritional status.

- protect herself from complications of diabetes.

- make proper decision regarding either to continuae the pregnancy or to abort.

- maintain good health by gaining adequate knowledge on health beliefs and practices.

- the family will be able to maintain good environmental sanitation.

- the family will be able to control mosquito breeding.

- the family will be able to protect themselves from preventable diseases.

6. Nursing interventions:

* Assess for foetal development and vomiting whether mild, moderate or severe.

* Make sure for good ventilation.

* Provide clean and peaceful environment.

* Teach her to avoid peculiar smell to prevent vomiting.

* Assess for signs of hyperglycemia.

* Monitor weight.

* Teach patient how to perform home glucose monitoring.

* Instruct the client to avoid he a pads and always wear shoes when walking.

* Teach the patient to follow a diet that is low in simple sugar, low in fat and high in fiber and whole grains.

* Treat the client to treat hypoglycemia by consuming a snack or crackers.

* Encourage for small and frequent diet.

* Teach her about family planning methods and get co operation.

* Encourage her to seek medical care.

* Teach the family simple methods on how to prevent mosquito breeding site.

* Teach them to clean the the house twice a day.

* Discuss what kind of disease may acquired due to insects breeding.

* Explain them about the eradication of breeding site by spraying pesticides.

* Discuss about the consequences of smoking.

* Discuss about the consequences of big family.

* Provide teaching about importance of personal and environmental hygiene.

* Advice for adequate rest and sleep.

7. Method of family nurse contact:

Home visits

Lecture methods

8. Evaluation:

Mrs.Santos family is expected to maintain good environmental sanitation.

Mrs.Santos is expected to undergo for tubectomy.

Mrs.Santos gained adequate knowledge regarding diabetes and prevention of its complications.