9.family nursing care plan

The list of health conditions or problems ranked according to priorities:

Problem Score

1. Arthritis as a health deficit (Rheumatoid Arthritis)

4

2. Hypertension as a health deficit 4

3. Altered thought process as a health deficit

4

4. Accident hazards

4a.Improperly kept pointed and sharp objects and pesticides

3 2/3

4b. “Marupok na galba: and improperly covered well as fall hazards

3 2/3

5. Poor Environmental Sanitation

5a.Presence of breeding and resting sites of vectors of disease

3 2/3

5b.Improper/Unsanitary garbage disposal

3 2/3

5c.Improper drainage system 3 2/3

6. Unhealthy lifestyle and personal habits and practices

6a.. Eating raw meat and fish3 2/3

6b. Cigarette smoking 3 1/6

6c. Self-medication 2 2/3

HEALTH PROBLEM

FAMILY NURSING

PROBLEMS

GOAL OF CARE

OBJECTIVES OF CARE

INTERVENTION MEASURES

METHOD OF

NURSE-FAMILY

CONTACT

RESOURCES REQUIRED

1. Arthritis as a health deficit

(Rheumatoid arthritis)

Inability to provide adequate nursing care to the family member who has arthritis due to:

Lack of adequate knowledge about the disease arthritis, its nature, complications, prognosis and management.

Inadequat

After nursing intervention, Mr.Bonifacio will have a lesser attacks of arthritis w/in 5 months but complete healing is quite hard to attain because somehow the disease is hereditary.

After the nursing intervention, Mr. Bonifacio as well as other family members will :

Be knowledgeable about arthritis, son they could take appropriate action regarding the patient’s condition

Understand the benefits of proper medical consultation and the benefit of the care needed.

Perform

Educate patient as well as other family members about arthritis, its nature, complications and management.

Tell the patient that he should seek for medical consultation for proper assessment, management and prescription of medications.

Instruct the patient to discontinue self medicating himself and explain that harm self medication and take in medications as prescribed.

Advise patients to

Home Visit Material resources:

Photocopy of information about arthritis and its management including diet and medications

Time and effort of the student nurse and family members.

Financial resource: Small amount of money spent in photocopying and money spent for transportation of the student nurse.

2. Hypertensionas a health deficit

e knowledge of the nature and extent of the health care needed.

Inadequate family resources for care specifically due to financial constraints

Inability to provide adequate nursing care to the family

After nursing intervention, Mr. Bonifacio and Mrs. Leticia will have minimize or reduce rise in blood pressure in 2 months and they will be knowledgeable enough

necessary measures in the care and management of the disease. He will seek proper medical consultation and will stop taking OTC drugs or stop self medication and will take prescribed drugs as prescribed.

Control or limit taking in foods and other habits that could aggravate the attacks of arthritis.

After nursing intervention the couple will:

Have lesser times of rising blood pressure.

limit or restrict taking in meat organs, wine, salmon and sardines and gravy as well as beans and legumes, explain to him that these things could precipitate the attacks of his arthritis.

Encourage the patient to take rest during or after attacks of arthritis and tell him not to go to work anymore during these times.

Educate the patient about the benefits of having simple regular exercise and encourage him to do so.

Advise the patients to visit their RHU at least twice or thrice a month although they dint experience signs and symptoms of hypertension, for proper assessment

Home Visit

Material resources: Pamphlets about the disease and its management and money spent in printing and researching it.

.Time and effort of the student nurse

members who are hypertensive due to:

Lack of adequate knowledge about the disease hypertension, its nature, complications, prognosis and management.

Inadequate family resources- financial constraints

Lack of necessary equipments for the independent care needed such as

about the disease and the proper management or care (independent) to the patients.

Visit the RHU at least twice/ thrice a month for check-up, assessment of blood pressure or either consult a doctor for a check-up and proper prescription of medication appropriate to their condition.

Take medications as prescribed by medical practitioners

Be able to have dietary modifications by avoiding or restricting foods w/c could precipitate the rise in blood pressure

Mr. Bonifacio will stop smoking

and management

Tell the patients that if in case they are at home and they experience sings and symptoms of hypertension, they should ask the nearest person who knows to assess the blood pressure and knows independent management before going to the RHU or hospital because their residence is quite far from these health facilities.

Instruct patient to seek for medical consultations on hospital for further assessment, management and prescription of medications.

Tell the patient about the consequences and harm of taking OTC drugs or self medication and advise them to take drugs only as

and family members.

Financial resource: Expenses in researching and printing the pamphlets and for the transportation of the student nurse.

BP apparatus and lack of skill in performing the care needed.

gradually

Have a regular exercise or simple work out activities

Be knowledgeable about the disease process, its possible complications so they could have the care needed accordingly

prescribed Teach the client to

avoid or restrict too much salt in the diet(too much salty foods)

Teach the client to avoid high fat and high cholesterol containing foods such as meat(fats), sinanglaw, shrimps, lobster, crabs and dairy products w/c are rich in fats and explain to them that these foods could cause rise in blood pressure in taken in excess.

Encourage them to have balanced diet that they should not totally stop taking in meat products and but they should limit specially those w/ other foods high in fats and cholesterol because anything in excess is not good as well as anything deficient is also not good.

Encourage them also

to take in fruits and vegetables such as apple, papaya, oranges, and other fruits and also green leafy vegetables.

Advise patient to increase intake of potassium rich foods such as banana, broccoli because when there is enough potassium in the body sodium w/c causes increase in BP will be low in amount.

Educate to reduce stress or avoid stressful situations because it could also trigger the rise in blood pressure.

Advise patients to have regular exercise or simple daily work outs such as walking, jogging, cycling and stretching most specially in the morning.

Instruct patients that whenever they experience signs and

3. Altered thought process

1.Inability to make decisions with respect to taking appropriate health action about the condition of Ate Imelda due to:

Failure to comprehend the nature and scope of the problem

Conflicting

After the nursing intervention, the family will take necessary measures and health actions regarding Ate Imelda’s condition within 4 months.

After the nursing intervention, the patient as well as the family will:

Seek for medical consultation or either consult a specialist

Understand the scope and nature of the condition so

symptoms of hypertension, they should take their medications as prescribed and take rest and not to go to work anymore.

Explain to the patients as well as to other family members about hypertension, its nature, complications, and independent care management, for them to know what appropriate action to take.

Let them have pamphlets or written materials that contain details about hypertension and its management and discuss it w/ the patients and also w/ other family members.

Educate the family about mental health and the and help them understand the condition of the

Home Visit

Time and effort of the student nurse and family members.

Financial resource: transportation of the student nurse.

opinions among family members on what action to take.

Fear of consequences specially social feedbacks and emotional effects of health action to the patient and also with the whole family

2. Inability to provide adequate nursing care to the patient due to inadequate family resources specifically financial

they could decide what appropriate action to take

Provide the needed care to the patient accordingly

patient.

Relate patient’s condition with someone who has the same condition, tell the family how it was diagnosed until it was managed and treated so the family could comprehend easier the benefits of health consultation.

Convince the family to seek for medical consultation and tell them the benefit of doing this is to:

o Proper diagnosis of the disease or condition so appropriate nursing care and medical management and treatment will be done

o Prevent development of the condition into a severe mental disorder

matters.

3.Failure to utilize community resources for health care due to feeling of alienation or lack of support from community.

Enumerate consequences, risk or harm to the patient, other family members and to other people if the patient’s condition is not given immediate action like the following:

o The patient could harm or hurt herself as well as other people

o The patient’s condition could develop to a severe mental disorder.

o The patient could burn their house specially that she is left alone at home cooking

o She could drink improperly kept pesticides and be wounded by improperly kept

4. Accident Hazards

4a.Improperly kept pointed and sharp objects and pesticides After nursing

intervention, within a month, the family will take necessary measures in keeping their

sharp materials

Tell the family that she shouldn’t be left alone at home, somebody should accompany her.

Educate the family about the proper care for the patient:

o Understand her as often as possible and let her feel a real familial love, care and affection.

o Do not treat her as a different individual or as an outcast but rather guide her in her daily routine.

o Don’t let her feel that she’s alone.

Instruct family not to let her play w/ children specially when no adult is watching over them,

Home Visit

Human Resources: Time and effort of the student nurse and family members.


4b. “Marupok na galba: and improperly covered well

1. Inability to recognize the presence of the problem due to lack of adequate knowledge about the harm of having an organized environment and on safety of proper storage of pointed objects and pesticides.2. Inability to provide a safe environment w/c is conducive to health maintenance and personal development due to:

Failure to

environment safe from accident and hazards from improperly kept pointed objects and pesticides

After nursing intervention, the family will:

Properly kept sharp objects and pesticides on the appropriate and intended places.

Know the consequences and possible harm of improperly kept sharp and pointed objects as well as pesticides.

she could possibly hurt them.

Tell the family that they will instruct children that they should not tease her or shout against her cause that may be the reason for her to hurt them.

Tell the family that when it is comes to their financial incapability that hinders them to seek for medical consultation, tell them that there are agencies that offer support just like this case or they should ask help to the local government.

Educate the family about the possible harm, hazard and consequences of improperly kept sharp and pointed objects as well as pesticides such as they could

Home Visit

Human Resources: Time and effort of the student nurse and family

as fall hazards

5. Poor environmental sanitation

5a.Presence of breeding and resting sites of vectors of diseases

see the benefits of an organized environment.

Lack of knowledge about preventive measures of accidents and harm

Inability to provide a safe environment w/c is conducive to health maintenance and personal development due to:

Failure to see the

After nursing intervention, within 1 ½ month, the family will take necessary measures in keeping their environment safe from accident and fall hazards.

After the nursing intervention, the family will decide the appropriate or needed

After nursing intervention, the family will:

Be aware of the harm of their “marupok na galba” and improperly covered well

Replace their “galba or sim” and provide an appropriate cover to the well.

Utilize or recycle existing materials w/c are still safe to

cause accidents, wounds when they step on the improperly kept knives, scythe and nails that could cause tetanus w/c is so dangerous and poison not only to the family but also to other people.

Tell them that considering Ate Imelda’s condition, she could possibly drink the pesticides and poison her that may possibly cause her death.

Teach the family to store pesticides on a closed area; if possible it will be locked or unknown to Ate Imelda and unreachable by children because sometimes their grandchildren visit them.

Teach the family that they should properly keep sharp and pointed objects such as knives, scythe,

Home Visit

members.




benefits of an organized environment.

Lack of knowledge about preventive measures of accidents and harm

Inability to provide a home environment which is conducive to health maintenance and personal development due to: Failure to

see benefits of proper sanitation and a clean environment.

Inadequate

actions to eliminate the breeding and resting sites of vector of diseases within 2 months.

use in solving this problem to save money

After the nursing intervention, the family will: Know the

benefits of cleaning the environment and eradicating the breeding and resting sites of vector diseases.

Can enumerate the various ways on how to eradicate the breeding and resting areas of vector of diseases such as rodents, mosquitoes and flies.

a. Select the appropriate method to be use in avoiding the harmful effects of

nails and others also in cabinets or containers.

Educate the family that having these prone to fall hazards areas or materials win their environment is really a health threat to them especially to their safety.

Encourage them to replace or fix the “galda or sim” as soon as human and material resources are available to prevent accidents.

Tell the family that although their well is covered, it is not well fixed, tell them that they should cover it w/ woods properly nailed and secured w/in the opening of the well.

5b.Improper garbage disposal

knowledge of the importance of sanitation

Inadequate knowledge of preventive measures.

After the nursing intervention, the family will decide on the appropriate or needed plan and actions to be able to improve their sanitation and will be able to dispose their

rodents, mosquitoes and flies. Educate the family

about the benefits of having a clean environment free from numerous breeding and resting sites of vectors of diseases.

Tell the family that resting and breeding sites of mosquitoes, flies and rodents are present w/in their environment that may bring different diseases to the family such as malaria, dengue, diarrheal diseases, thyphoid fever and etc.

Tell or help the family locate breeding or resting sites of mosquitoes, rodents and flies for them to know or help them target to clean these areas.

Tell or help the family to remove galloons, open containers, drums and old basins where rain water (stagnant water) will

Home Visit



5c.Improper drainage system

1. Inability to recognize presence of problem due to lack of knowledge about the risky effects of having an improper garbage disposal2.Inability to provide a home environment which is conducive to health maintenance and personal development due to: Failure to

see benefits of garbage disposal

Inadequate

garbage properly within 2 months.

After nursing intervention, the family will take

After the nursing intervention, the family will : Be

knowledgeable about the different methods of ways disposal w/c are safe and proper and able to select what method they will use.

Be able to know the harmful effects of improper garbage disposal.

be contained and could be possibly breeding sites of mosquitoes and if there is no stagnant water rodents could also breed w/in those areas. Instruct also the family to burn or place old “dayami” in the compost fit that could be used as organic fertilizer so not for mosquitoes and rodents to stay there.

Tell the family that the manure of their animals should be dried under the heat of the sun to be used as an organic fertilizer instead of being dup in one area on the front side of their house, still moist and wet that causes flies to be numerous w/in their environment.

Educate the family that they should clean their surroundings always and do all of the measures sited above to eradicate

Home Visit



6. Unhealthy lifestyle and personal habits and practices

6a. Eating raw meat and fish

knowledge of the importance proper waste disposal

1. Inability to recognize presence of problem due to insufficient knowledge about the dangerous effects of having an improper drainage system.

2. Inability to provide a home environment

necessary measures to have a proper and sanitary drainage system within 2 months.

After the nursing intervention, the family will: Able to plan the

appropriate drainage for them to be use;

Have an appropriate and safe drainage system

Be able to recognize the harmful effects of improper drainage system.

vectors of different diseases and to reduce occurrence different diseases.

Teach the family not to burn their garbage especially plastics and educate them that doing this so may cause air pollution and may possibly contribute global warning w/c is dangerous to our health.

Tell the family that they should dig a pit that will serve as their dumping site of garbage

Instruct the family to situate their dumping site on an area quite far from their house.

If possible, educate the family to segregate their waste according to biodegradable and non- biodegradable ones and instruct them that they should place the biodegradable

Home visit.

Home visit.



6b.Cigarette smoking

which is conducive to health maintenance and personal development due to: Failure to

see benefits of garbage disposal

Inadequate knowledge of the importance proper waste disposal

Inability to recognize the presence of the problem due to lack of adequate knowledge about the harm or bad effects of

After the nursing intervention, the family will properly decide as to take healthy and nutritious foods abd be able to prepare and handle foods properly within 1 ½ month.

After the nursing intervention, Mr. Bonifacio will take alternative ways to stop smoking within 3

After the nursing intervention, the family will: Be

knowledgeable that eating raw meat and fish is not healthy

Be knowledgeable of the possible effect of their practice

Stop or avoid taking in raw meat and fish and be able to cook them

garbages like leaves, papers, weeds “dayami” and others in the compost pit and could be use as organic fertilizer while on the other hand, tell them that the non-biodegradable materials such as plastic bottles, old bottles and tin cans should be set aside f or it can be recycled or sold.

Tell the family that having an open drainage system is not proper and unsanitary and additionally it is not safe to their health

Instruct the family to not to throw left over foods on their drainage area to lessen flies and other vectors of diseases to accumulate on that area.

Encourage the patient that they should dig a hole in the ground where the tube w/c is

Material resources: Pamphlets about the smoking and its management and money spent in printing and researching it.

.Time and effort of the student nurse and family members.

Financial resource: Expenses in researching and printing the pamphlets and for the transportation of the student nurse.

eating raw meat and fish to their health

1. Inability to recognize the presence of the problem due to lack of adequate knowledge about the harmful effects of smoking.2. Inability to make decisions with respect to taking appropriate health action due to low salience of the problem.

months. properly

After the nursing intervention, Mr. Bonifacio will: Start to stop

smoking until he will get rid of it totally and perform alternative ways to help him in stopping and doing again his practice

Know the harmful effects of smoking to him as well as to his family member

connected to the lavatory will be placed so that the flow of water, other materials and fluids will be blind or sanitary.

Instruct the family to avoid or if possible to stop eating raw meat and fish.

Educate the family that by eating raw meat and fish they could possibly acquire different diseases such parasitism and diaarrheal diseases

6c. Self-medication

Teach them to prepare their foods properly by washing them well and cooking them well to kill the possible microorganisms within that food material.

Educate the patient and other family members about smoking by providing a pamphlet about smoking w/emphasizes the harmful effects of smoking to health.

Tell the patient that his practice is not only dangerous to his health but also to his family members and other people who will inhale the smoke.

Teach the patient of the alternative ways to help him stop smoking such as:

o Slowly reduce of cigarettes per day until he has stopped completely.

Home visit.



1. Inability to recognize the

After the nursing intervention, Mr.Bonifacio will stop self medicating himself and will take necessary measures as to take prescribed medications within 2 months. After the nursing

intervention, Mr.Bonifacio will: Be aware that

self medication is not safe to his health.

Seek for medical consultation for proper

o Drink plenty of water and eat fruits and vegetables. Take plenty of vitamins and minerals. Carrots, apples, singkamas, chewing gum, and candies are good munching foods to replace the feel of a cigarette in the mouth. .

o Take naps, warm baths or showers during intensive cravings to smoke.

o Tell friends and family that you have stopped smoking. This will make you feel embarrassed when they catch you smoking.

o Change activities or habits that are associated with smoking. For

presence of the problem due to lack of adequate knowledge about the possible harm or bad effects of self medication.

2. Inability to make decisions w/ respect to taking appropriate health action to take due to: Low

salience of the problem

Lack of resources in terms of financial matters

prescription of medication

Stop self medicating himself and taking OTC drugs

Take medications for his disease as prescribed

.

instance, find other ways to finish a meal without smoking. Go out for a walk, go to a place where smoking is prohibited.

o Go away or avoid places and people that will cause temptation to smoke again.

o Tell the patient that if the above ways are not yet effective, there is another way called the Nicotine Replacement Therapy (NRT) wherein a smoker who stops smoking is given small amounts of nicotine over a period of six weeks or more to reduce withdrawal signs. The

nicotine is given either as chewing gum. patch, nasal spray or cigarette-like inhaler but emphasize that before using this method the patient should consult a physician about NRT.

Educate the patient that self medication is not safe to health especially in existence of 2 or more disease conditions and emphasize to the patient that it is still be the safest to take prescribed medications.

Instruct the patient to stop self medication and to seek for medical consultation for proper prescription of medication.

Encourage them to

utilize existing resources so he could afford to have medical consultation and to finance medications that will be prescribed.

9.family nursing care plan

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