template for family nursing care plan

7/28/2019 Template for Family Nursing Care Plan

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NCM 101 Lecture Notes PRELIMS Handout 2

3. place of residenceof each member whether living withthe family orelsewhere

To determineaccessibility,availability of supportfor the family, be itpsychological, financial

or other forms ofsupport for itsmembers

OIWrite complete address (contact no.,street, sitio/purok, barangay,city/municipality, province) includingpermanent landmarks, as necessary

Members live in thesame household (HH)

or may live apart butthey consider their HHas their home whereevery member goeshome at certain timesof the year

4. type of familystructure To determine specific

needs according toeach type of family

OISpecify type of structure according tosize and composition, decision makerand bread winner

1. separate rooms formales, females andcouples2. ideally, all memberslive in the same HH if

not, each memberconsiders their HH astheir home where theyalways meet othermember of the familyat appropriate times ofthe year

5. dominant familymembers in terms ofdecision making

To determine head andor dominant decisionmakers in matters ofhealth care, finances

and other majorconcerns of the family

OICheck available space on the form

Democratic

Example:Name: Place of Residence Type Of Family

StructureDecisionMaking

Rodolfo Delos Santos 45 Sta Scholastica Village Hillside Baguio City Nuclear Nelia Delos Santos 45 Sta Scholastica Village Hillside Baguio City NuclearArwen Delos Santos 501 Happy Glen Loop Baguio City Lives alone Anita Delos Santos 45 Sta Scholastica Village Hillside Baguio City Nuclear

6. general familyrelationships anddynamics

To determine thepresence or absence ofany obvious or readilyobservable conflictbetween members andthe characteristiccommunicationpatterns amongmembers and sub-

systems

OITo be described in a narrative form

1. good relationshipwith each other;smooth interactionbetween thesubsystems2. socially stable; nosibling rivalry nor childfavoritism

Example:The delos Santos family manifests strong family ties. They are all able to maintain a harmonious

relationship between and among themselves and have no problems in communicating with one another. MaamNelia especially encourages communication by allotting family time during Sundays. The children show closebonds with each other and

Types of data to begathered (INITIALFAMILY DATABASE)

Importance of Data Methods ofdata Gathering

How to fill in thedata

Expected NormalFindings

2 GreywolfRed Ms. AprilAnne D. Balanon


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B. Socio Economic and Cultural characteristic

1. income and

expenses (socioeconomic)a. occupation, placeof work and income ofeach working memberb. adequacy to meetthe basic necessitiesc. who makesdecisions aboutbudgeting

1. giving an idea

about the capabilityof the family toprovide basicnecessities2. place of work: workrelated illness andaccessibility offinancial supportsystem3. budgeting:

priorities

ROI Income per month or

year: try to makesome figure close tothe data/ averageincome if family ishesitant to disclose;approximate or actualmonthly budget forevery necessity likefood, clothing, shelter,health, education etc.

1. a family of 6 should

earn above 8 thousandpesos2. democratic decisionmaking in budgeting3. budget reflects basicnecessities as priorities

Example:Name Occupation Place of work Income Adequacy to

meet basicneeds

Budgeting

Rodolfo Delos Santos GovtEmployee

Camp Allen BaguioCity

20,000-25,000 monthly

Nelia Delos Santos Housewife n/a n/a Arwen Delos Santos Call center

agentSitel 15,000-18,000 monthly

Anita Delos Santos Student n/a n/a Alvin Delos Santos Student n/a n/a

Culturalcharacteristics2. educationattainment of each

member; grade, yearor college levelreached or completed

To determine:1. the ability tounderstand healthrelated information

2. establish level ofcommunication

ROI If graduatedemphasize the wordgraduate of whateverlevel, if not, specify

what level ofeducation had beenreached

Functionally literate

Ethnic backgroundand religiousaffiliation

To determine somepossible sources ofconflicts in valuesystems, practices,etc.

ROI Ethnic background:(minority group wherean individual belongs/provincial origin)Religious affiliation(system of faith/

worship/denomination or sect)Specify the sect theclient was baptizedand or where theyactively participate forservices

1. common culture, ormay vary but a degree oftolerance andunderstanding isobservable or presentamong family members

involved2. share religious corewith full spirituality andguidance

Example:Name Educational Attainment Ethnic Background Religious

Affiliation



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NCM 101 Lecture Notes PRELIMS Handout 2Rodolfo Delos Santos College Graduate Ilocano

CatholicNelia Delos Santos College Undergraduate Pangasinense Catholic

Arwen Delos Santos College Undergraduate Ilocano-pangasinense

Born Again

Anita Delos Santos High school Graduate/ Collegestudent

Ilocano-pangasinense

Catholic

Alvin Delos Santos Elementary student Ilocano-pangasinense

Catholic

Types of data to begathered (INITIAL

FAMILY DATABASE)

Importance of Data Methods of

dataGathering

How to fill in the data Expected Normal

Findings

C. Home and Environment

1. Housing;a. adequacy of livingspace

To determine possibletransfer/ spread ofcommunicablediseases

O 1. approximate the size of living space in square meters/by the number of rooms

1. there should be enoughrooms; ideally one personper room except thecouple

b. sleepingarrangement

To determine possibletransfer/ spread ofcommunicablediseases

I 2. check or fill in applicablespace on the form

2. the house is good thatit cannot be destroyed byany natural calamityrainwater can not enter3. with good lighting andventilation4. no dirt is visible in andoutside the house

5. all things are properlyarranged6. ideally; owned

c. presence orabsence of breedingor resting sites ofinsects, rodents orother vectors

To determine possiblesources of diseases orillnesses

O Check applicable space on theform

With minimal to absenceof breeding or restingsites of insects, rodents orother vectors

d. presence orabsence of accidenthazards

To determine possiblesources of injury orhome accidents

OI Check applicable space on theform

With repairable toabsence of accidenthazards or measures hasbeen initiated

e. food storage andcooking facilities

To determine possiblesources of accidentsin the home and airpollution which may

lead to health deficits

O Check applicable space on theform

1. food storage facilitieshas/ have cover/s2. there is properventilation or exhaust



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f. water supplyg. toilet facilityh. garbage/ refusedisposali. drainage system

To determineadequacy andcleanliness becausethese can enhancethe occurrence

ROI Specify the sanitary conditionCheck applicable space on theformSpecify control measures done

1.

adequate and potablewater supply2. sanitary, owned toilet3. composting or landfillgarbage system;biodegradable segregatedfrom non bio.4. close or open type ofdrainage but nostagnation of water ispresent

2. Kind ofneighborhood

To determine somepossible sources ofconflicts, socialproblems and easytransfer ofcommunicablediseases from one HHto the other

O Check applicable space on theform; indicate brief descriptionof sanitary condition

1. less dense and arelatively clean rural areais more healthy2. less populated3. less complex andcommercialized form ofliving

3. Social and healthfacilities available

4. communication andtransportationfacilities

To determineavailability andaccessibility ofresources andcommunication forhealth care andrecreation and betterflow of informationamong its members

OI Check applicable space on theform; specify location andmanpower

Available and accessibleto all

Example:The family lives in a 3 bedroom 1 storey house approximately ________square meters. The master

bedroom is occupied by the couple, one bedroom is occupied by Alvin and the other room is where Anita stays.Arwen lives a few minutes away from the house of his parents. The hose appears to be sturdy and able towithstand natural calamities like earthquakes and typhoon. Lighting and ventilation however appears to beinadequate in some of the rooms of the household. The house is fairly clean inside, and all of their belongings arefixed and are properly arranged, but the surrounding area is unkempt. The house where the family lives is owned,but the place where Arwen their eldest son stays in is rented. He pays an approximate of ___________________ formaintenance and rent of his place. Outside the house is the presence of a notable breeding site for mosquitoes.Rodents and other vectors however are not seen to be present inside the house. Absence of accident hazards wasalso observed, especially since the house is not located near the road. Food storage and cooking facilities appearto be adequate. The family also practices proper storage of food that has not been consumed with the use ofplastic containers, and covered storage bins in the refrigerator. Their water supply is delivered every other day,and a tank for their water (approximately 20 drums) is located at the back portion of their home. The water theyutilize for drinking is boiled.Their toilet facility is water seal, and the place is kept dry and clean, and free ofodors all the time. Their garbage is collected every Thursday, and the family also practices waste segregation.They have an open compost pit beside their house where they dispose of biodegradable wastes. Their barangay isnot congested, and houses are adequately spaced from each other. The health center is approximately ___________meters from their house, their barangay hall is also __________ meters away. There appears to be no problem withcommunication or transportation in their area of residence.

D. Health status of each family member\



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Types of data to begathered (INITIAL

FAMILY DATA BASE)

Importance of Data Methods ofdata

Gathering

How to fill inthe data

Expected NormalFindings

1.General health status including observabledevelopmental milestones(eg. General stature, fine or gross motordevelopment, dressing, developmental tasks,cognitive development NARRATIVE

2.Present health history NARRATIVE

3.Physical assessmenta.head to toe assessment TABULATEb.nutritional assessment NARRATIVE

b1. anthropometric data TABULATEb2. dietary history indicating quality and

quantity of food intake per dayb3. eating/ feeding habits and practices

NARRATIVE

4.Results of laboratory / diagnostic proceduresdone TABULATE

5.Family history NARRATIVE

6.past health history NARRATIVE

7.obstetric condition or history NARRATIVE

8.psycho-social history NARRATIVE

To determinehealthPromotive,diseasepreventive andcurativeinterventionsthat need to beinitiated orconducted

ROIPA

Fill in all databeing asked onthe form; notefor specificdetails; eg.Name ofhospital, orderand name ofchild pertainedinto: checkappropriate

spaces asindicated

1. physically and mentallystable or fit2. seldom gets sick3. eats a balanced diet,refraining from eating junkfoods4. practices Promotive andpreventive health practices

Types of data to be gathered (INITIAL FAMILY

DATA BASE)

Importance of

Data

Method

s ofdataGatheri

ng

How to fill inthe data Expected NormalFindings

E. Values and practices on health promotion/ maintenance and disease prevention

The following information is for all items in E (Values)

1. Immunization status (TABULATE:,

vaccinations given: type/name, dose,number given)

2. practice of regular check ups NARRATIVE3. practice of family planning NARRATIVE4. nutritional beliefs NARRATIVE5. Practices for rest, sleep. exercise , relaxation

and stress management NARRATIVE6. practice of vices; smoking, drinking alcohol

NARRATIVE

To determine

healthy or nonhealthylifestyle, corrector incorrectperceptions andvalues relatedto health

ROI Fill in all data

being asked onthe form; notefor specificdetails; checkappropriatespaces, asindicated

Practices Promotive and

preventive health practices

FIRST LEVEL ASSESSMENT:

NURSING PROBLEMS: DESCRIPTIONS SPECIFIC COMPONENTS:



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NCM 101 Lecture Notes PRELIMS Handout 21. PRESENCE OF

WELLNESSCONDITION

This is stated asPotential or readiness.

A. Potential for enhanced capability for

Is a nursing judgment on wellness statebased on the clients performance,current competencies, or clinical data( Observed cues)

1. Healthy lifestyle2. Health

maintenanceandmanagement

3. Parenting

4. Breastfeeding5. Spiritual well being

B. Readiness for enhanced capability for

Is a nursing judgment on wellness statebased on the clients performance,current competencies, or clinical data(Observed cues) AND the clientsVERBALIZATION of desire to achieve ahigher level of state or function inspecific areas on health promotion ormaintenance.

1. Healthy lifestyle2. Health maintenance and

management3. Parenting4. Breastfeeding5. Spiritual well being

Example:a. Potential for enhanced capability for parentingb. Potential for enhanced capability for health maintenance and managementc. Readiness for enhanced capability for breastfeeding.

2. PRESENCE OFHEALTH THREATS

These are conditionsthat are conducive todisease or accidentsThese also may be thereason for failure tomaintain wellness

A. Presence of risk factors of specificdiseases

B. Threat of cross infection from acommunicable disease case

C. Family size beyond what the family canadequately provide

D. Accident hazards 1.broken stairs2. Sharp objects on the table3. Fire hazards4. Fall hazards5. medicines kept in cabinets that

toddlers can reachE. Unhealthy nutritional habits/ feedingtechniques and practices

1. Inadequate food intake2. Faulty eating habits3. Ineffective breastfeeding4. Faulty feeding techniques

F. Stress provoking factors 1. Strained marital relationship2. Strained parent sibling

relationship3. Interpersonal conflicts between

family members

G. Poor home environment conditions 1. Inadequate living space2. Lack of food storage facilities3. Polluted water supply4. Presence of breeding or resting

sites of vectors and diseases5. Improper garbage disposal6. Poor lighting and ventilation7. Noise pollution8. Air pollution

H. Unsanitary food handling and

preparation



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NCM 101 Lecture Notes PRELIMS Handout 2I. Unhealthy lifestyle and personal habits

and practices1. Alcohol drinking2. Cigarette

smoking3. Poor personal

hygiene4. Substance abuse

5. Inadequate rest and sleep6. Lack of adequate exercise and

physical activityJ. Inherent personal characteristics 1. Poor impulse control

K. Inadequate immunization status

Example:1. Poor home environment conditions related to lack of food storage facilities2. Stress provoking factors from strained marital relationships3. Accident hazards related to broken stairs/ house located beside the highway

3.Presence ofhealth Deficits

Manifested through:failure in healthmaintenance

A. Illness States 1. HPN2. DM3. Cholera4. Dengue

B. Failure to develop according tonormal rate and standards

C. Disability 1. Aphasia2. Temporary paralysis

3. Leg amputation

Example:1. Failure to develop according to normal rate and standards, as evidenced by inability of the child to

perform developmental tasks appropriate to his age2. Disability secondary to leg amputation from motorcycle accident

4. Presence of stresspoints/ foreseeablecrisis situations

These are anticipatedperiods of unusualdemand on theindividual or family interms of familyresources.

A. MarriageB. PregnancyC. Parenthood

D. AbortionE. DivorceF. AdolescenceG. Loss of jobH. MenopauseI. Death of family member

SECOND LEVEL OF ASSESSMENT:

Family Nursing Problem: Related Factors (due to:)

a. INABILITY TO RECOGNIZE THE PRESENCE OF THECONDITION OR PROBLEM

1. Knowledge deficit/ inadequate knowledge2. Denial about the existence of the problem

b. INABILITY TO MAKE DECISIONS WITH RESPECT TOTAKING APPROPRIATE HEALTH ACTIONS

1. Failure to comprehend the nature of the problem2. Low salience of the problem3. Feeling of confusion, helplessness, or resignation

brought about by perceived severity of thesituation.

4. Lack of alternative courses of action regarding theproblem

5. Inability to decide which course o action to take6. Conflicting opinions among family members



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NCM 101 Lecture Notes PRELIMS Handout 27. Fear of consequences8. Lack of confidence in hospital

personnel9. Misconceptions/ false beliefs

about the proposed actions to solve the problemc. INABILITY TO PROVIDE ADEQUATE NURSING CARE

TO THE SICK, DISABLED, OR VULNERABLE/ AT RISKMEMBERS OF THE FAMILY

1. Lack of adequate knowledge about the health

condition2. Lack of knowledge about the nature and extent of

the problem3. Lack of the necessary facilities and supplies needed

for the care of the sick member of the family4. Inadequate family resources for health care5. Altered role performance

d. INABILITY TO PROVIDE A HOME ENVIRONMENTCONDUCIVE TO HEALTH MAINTENANCE ANDPERSONAL DEVELOPMENT

1. Inadequate family resources2. Failure to see benefits of investments to the health

and well being of the family members

3. Inadequate knowledge about the importance ofmaintenance of good personal hygiene.

4. Lack of skill in carrying out specific interventionsneeded for the care of the sick member of thefamily

e. FAILURE TO UTILIZE COMMUINTY RESOURCES FORHEALTH CARE

1. Lack of knowledge regarding available communityresources for health care

2. Failure to perceive health benefits3. Previous unpleasant experiences with health care

personnel4. Fear of consequences of actions5. Unavailability of required health care services

Example:1. INABILITY TO PROVIDE ADEQUATE NURSING CARE TO THE SICK, DISABLED, OR VULNERABLE/ AT RISK MEMBERS OF THE

FAMILY related to Lack of knowledge about the nature and extent of the problem2. FAILURE TO UTILIZE COMMUINTY RESOURCES FOR HEALTH CARE due to Previous unpleasant experiences with health care

personnel3. INABILITY TO MAKE DECISIONS WITH RESPECT TO TAKING APPROPRIATE HEALTH ACTIONS related to Feeling of confusion,

helplessness, or resignation brought about by perceived severity of the situation.


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