FAMILY HEALTH NURSING PROCESS

Prepared By: Aida V. Garcia, MAN, RNOLFU CON - Val

STEPS

Relating - trust

Assessment

PlanningIntervention

Evaluation

Assessment

1st Level Asessment

2nd Level Assessment

1ST LEVEL

Data Collection Family Structure Socio-Economic Health cond Home /Envt. Health Promotion

Data analysis Health condition Home/Immediate Environment Family characteristic – development

Data Interpretation - Cope

ASSESSMENT

FIRST LEVEL ASSESSMENT

Typology of Nursing Problem

I. Presence of Wellness Condition-stated as potential or Readiness

-a clinical or nursing judgment about a client in transition from a specific level of wellness or capability to a higher level. Wellness potential is a nursing judgment on wellness state or condition based on client’s performance, current competencies, or performance, clinical data or explicit expression of desire to achieve a higher level of state or function in a specific area on health promotion and maintenance.

I. Presence of Wellness ConditionA. Potential for Enhanced Capability for:1. Healthy lifestyle-e.g. nutrition/diet, exercise/activity2. Healthy maintenance/health management3. Parenting4. Breastfeeding5. Spiritual well-being-process of client’s developing/unfolding of mystery through harmonious interconnectedness that comes from inner strength/sacred source/God (NANDA 2001)6. Others. Specify.

B. Readiness for Enhanced Capability for:1. Healthy lifestyle2. Health maintenance/health management3. Parenting4. Breastfeeding5. Spiritual well-being6. Others. Specify.

II. Presence of Health Threats-conditions that are conducive to disease and accident, or may result to failure to maintain wellness or realize health potential.

Examples of this are the following:A. Presence of risk factors of specific diseases (e.g. lifestyle diseases, metabolic syndrome)B. Threat of cross infection from communicable disease caseC. Family size beyond what family resources can adequately provideD. Accident hazards specify.1. Broken chairs2. Pointed /sharp objects, poisons and medicines improperly kept3. Fire hazards4. Fall hazards5. Others specify.E. Faulty/unhealthful nutritional/eating habits or feeding techniques/practices. Specify.1.Inadequate food intake both in quality and quantity2.Excessive intake of certain nutrients3.Faulty eating habits4.Ineffective breastfeeding5.Faulty feeding techniques

F. Stress Provoking Factors. Specify.1.Strained marital relationship2.Strained parent-sibling relationship3.Interpersonal conflicts between family members4.Care-giving burden

G. Poor Home/Environmental Condition/Sanitation. Specify.1. Inadequate living space2. Lack of food storage facilities3. Polluted water supply4. Presence of breeding or resting sights of vectors of diseases5. Improper garbage/refuse disposal6. Unsanitary waste disposal7. Improper drainage system8. Poor lightning and ventilation9. Noise pollution10. Air pollution H. Unsanitary Food Handling and Preparation I. Unhealthy Lifestyle and Personal Habits/Practices. Specify.1. Alcohol drinking2. Cigarette/tobacco smoking3. Walking barefooted or inadequate footwear4. Eating raw meat or fish5. Poor personal hygiene6. Self medication/substance abuse7. Sexual promiscuity8. Engaging in dangerous sports9. Inadequate rest or sleep10. Lack of /inadequate exercise/physical activity11. Lack of/relaxation activities12.Non use of self-protection measures (e.g. non use of bed nets in malaria and filariasis endemic areas).

J. Inherent Personal Characteristics-e.g. poor impulse controlK. Health History, which may Participate/Induce the Occurrence of Health Deficit, e.g. previous history of difficult labor.L. Inappropriate Role Assumption- e.g. child assuming mother’s role, father not assuming his role.M. Lack of Immunization/Inadequate Immunization Status Specially of ChildrenN. Family Disunity-e.g.1. Self-oriented behavior of member(s)2. Unresolved conflicts of member(s)3. Intolerable disagreementO. Others. Specify._________

III. Presence of health deficits-instances of failure in health maintenance.Examples include:A. Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner.B. Failure to thrive/develop according to normal rateC. Disability-whether congenital or arising from illness; transient/temporary (e.g. aphasia or temporary paralysis after a CVA) or permanent (e.g. leg amputation secondary to diabetes, blindness from measles, lameness from polio)

IV. Presence of stress points/foreseeable crisis situations-anticipated periods of unusual demand on the individual or family in terms of adjustment/family resources. Examples of this include:A. MarriageB. Pregnancy, labor, puerperiumC. ParenthoodD. Additional member-e.g. newborn, lodgerE. AbortionF. Entrance at schoolG. AdolescenceH. Divorce or separationI. MenopauseJ. Loss of jobK. Hospitalization of a family memberL. Death of a memberM. Resettlement in a new communityN. IllegitimacyO. Others, specify.___________

Idntify 4 health Problems

Data analysisHealth conditionHome/Immediate EnvironmentFamily characteristic – development

Others: Wellness State

Data Interpretation - Cope

Identify 4 health Problems

1.Presence of Mastitis as Health Deficit 2.Poor Home/Environmental

Condition/Sanitation: Improper diaper disposal As Health Threat

3.Adjustment Task - Child rearing As Foreseeable Crisis

4. Readiness for Enhanced Capability for Parenting as Wellness State

S C A L I N G

PRIORITY SETTING

Problem 1: Alcohol Drinking as Health Threat

Criteria Weight Score Justification

1.NATURE OF THE PROBLEM* Health Threat 2 1 0.67

Excessive alcohol drinking or binge drinking can have short-term negative impacts such as violence, injuries, and accidents; long-term negative impacts can spike blood pressure levels, further increasing the risks of liver cancer, heart problems, and mental health issues among many others (Centers for Disease Control and Prevention, 2020).

2. MODIFIABILITY OF THE PROBLEM* Partially Modifiable

1 2 1

Health teaching about the significance of cutting back on alcohol intake, as well as the risks it entails and the proven methods or ways to cut back alcohol intake, can be easier said than done. However, cutting down alcohol intake can be very difficult for individuals who do it on a normal or daily basis, thus strong determination, willfulness, and voluntariness and strong social support are highly needed to effectively lessen alcohol consumption (Smith, Robinson, & Segal, 2020).

3. PREVENTIVE POTENTIAL* Highly Preventable

3 1 1

Future health concerns are highly preventable if excessive alcohol drinking is addressed and preventive measures are taken seriously. With the help of IEC, the patient will be able to learn effective ways to cut down alcohol intake, such as setting goals, intake tracking, removing alcohol in the house, and asking for support (Harvard Medical School, n.d.).

4. SALIENCE* Not a felt/needed problem

0 0 0

The client (father) does not see excessive alcohol drinking as a health threat, per his verbatim: “Wala naman problema sa pag-inom e hehe. Hirap din kasi nakasanayan na, araw araw. Stress din kasi pagtapos sa work, di talaga maiwasan hehe. Ok naman kami ni J., e ok lang.”

Total Score 2.67

Which problem is “Priority” ?

Type of HP?

Solution?

Prevent other/future problems?

Impt?

Nature of Health Problem

???? Priority ????

Teenage Pregnancy Cold Bottle

Feeding

4 Nature of Health Problem

Wellness State …………………3 1

Health Deficit…………………..3 1• Dse ( diagnose/undiagnosed)• Disability• Developmental Failure

Health Threat………………….2 .66

Foreseeable Crisis - ---------1 .33• Weight …………………………………..1

Modifiability of the Problem… COLDS-solve? ….reduce?..... No soln?

Easy Modifiable……………….2

Partially Modifiable…………1

Not Modifiable………………..0

Weight…………..2

Preventive Potential

High………….….3

Moderate…….2

• Weight……….. 1

Low……………..1

High

3 ________ X 1

3 = 1

Preventive PotentialFuture Problems that could be avoided/

prevented?

COLD Acute/Chronic Ear Problem Sinusitis Pneumonia

Salience……Important/urgent (family)?

Teenage Pregnancy ?

Colds ?

Bottle Feeding ?

salience

Needs STAT attention…………………..2

Not needing STAT attention…………1

Not perceived as a problem………..0• Weight………………………….. 1

2nd Level Assessment

Health Problem – health needsEx. Mrs. Cruz not performing BF

Family - Nursing Problem Health Tasks

- Recognize HP- Decide- Care

- Maintain Home/Envt- Use Community Health Resources

Ex. Inability to recognize presence of HP ….

ASSESSMENT

- INABILITY TO Recognize HEALTH PROBLEM - INABILITY TO Decide - INABILITY TO Care

- INABILITY TO Maintain Home/Envt - INABILITY TO Use Community Health Resources

FAMILY - NURSE PROBLEM

Planning Intervention

Short Term Plan Within 1 day of Nursing

Interventions Mrs. Cruz will decide to initiate/perform breastfeeding

Long Term Plan Within 1 year of Nursing

Interventions, Mrs Cruz will be able to provide appropriate care to her infant and family by giving alternative supplemental nutritious food.

Thinker Doer Feeler

Family Health Nursing Process

FNCPFamily Nursing Care Plan

FNCP

Health Problem • Non

performance of Breastfeeding by Mrs. Cruz to her newborn infant.

Family Nursing Problem• Inability to make decisions with

respect to taking appropriate health action due to low salience of the problem/condition

• Inability to provide appropriate CARE to her newborn due to inadequate skills in carrying out the procedure/BF

FNCP

• Within 1 week Mrs. Cruz will perform BF on-demand in a daily basis.Goals of Care

• Within 1 week Mrs. Cruz will :• a. List 5 benefits of breastfeeding for the mother,

infant and family• b. Demonstrate the correct position during BF• c. Agree to perform BF on - demand, daily.

OBJECTIVES OF CARE

FNCP - Interventions

The PHN will…1. Teach the benefits of breastfeeding

a. for the mothera. Prevents breast cancer / ovarian cancerb. Natural contraceptivec. _____________d. _____________e. _____________

b. For the infanta. Immunityb. Improves IQc. Bondingd. ____________e. ____________

FNCP - Interventions

The PHN will…1. Teach the benefits of breastfeeding

a. for the familya. Economicalb. Saves Timec. Less Garbaged. _____________e. _____________

FNCP - Intervention

2. Demonstrate correct position during BF 2.a. Baby straight body 2.b. Mother holds whole 2.c. Baby close to mother 2.d. Baby’s nose directly the nipple of the mother

3. Discuss the correct attachment of BF 3.a. Mouth wide open 3.b. etc. 3.c. etc.4. Guide the mother during BF5. Motivate the family to continue BF

Method of Family Nurse ContactClinic visitHome vist

Industrial ContactSchool contact

Telephone contact

Home visit Initial Visit: June 10, 2009 Follow up visit: June 11 – June 13 Farewell visit: June 17, 2009

Resources Required….3M

Manpower Staff of Barangay X Health Center CI Student of Group Y

Materials Public Health Bag Survey Tool, Ballpen Umbrella 3 M - Material - IEC - H. Teaching -

Flip Chart on BF

Money for transportation

Evaluation

After 1 week Family Cruz :1. Listed 5 benefits of BF for M,I,F2. Demonstrated the 4 attachment of BF3. Demonstrated the correct position of BF4. Used and considered BF as an appropriate

feeding method for their newborn

Web link for helpful materials:https://assets.ltkcontent.com/files/list-adjectives-describe-tone-feelings-emotions.pdf?mtime=20201028231709&focal=none

Useful tools: