CHAP 4

• Assessment


  this involves a set of actions by which a nurse measures the states of a family as a client, its ability to maintain itself as a system and functioning unit and its ability to maintain wellness, prevent, control or resolve problems in order to achieve health and well-being among its members.
• Family Structure Characteristics and Dynamics


  i. Members of the household and relationship to the head of the family.

  ii. Demographic data-age, sex, civil status, position in the family

  iii. Place of residence of each member-whether living with the family or elsewhere
• Family Structure Characteristics and Dynamics

  iv. Type of family structure-e.g. patriarchal, matriarchal, nuclear or extended

  v. Dominant family members in terms of decision making especially on matters of health care

  vi. General family relationship/dynamics-presence of any obvious/readily observable conflict between members; characteristics, communication/interaction patterns among members.
• Socio-economic and Cultural Characteristics


  i. Income and expenses

  a.Occupation, place of work and income of each working member

  b. Adequacy to meet basic necessities (food, clothing, shelter)

  c. Who makes decision about money and how it is spent
• Socio-economic and Cultural Characteristics


  ii. Educational Attainment of each Member
• Socio-economic and Cultural Characteristics


  iii. Ethnic Background and Religious Affiliation

  iv. Significant others-role (s) they play in family’s life

  v. Relationship of the family to larger community-nature and extent of participation of the family in community activities
• Home Environment


  i. HousingAdequacy of living space

  a.Adequacy of living space

  b. Sleeping arrangement

  c. Presence of breeding or resting sites of vectors of diseases (e.g. mosquitoes, roaches, flies, rodents, etc.)

  d. Presence of accident hazard

  e. Food storage and cooking facilities

  f. Water supply-source, ownership, potability

  g. Toilet facilities-type, ownership, sanitary condition

  h. Garbage/refuse disposal-type, sanitary condition
• Home Environment


  ii. Drainage System- type, sanitary condition

  iii. Kind of Neighborhood, e.g. congested, slum etc.

  iv. Social and Health facilities available

  v. Communication and transportation facilities available
• Health Status of Each Family Member


  i. Medical Nursing history indicating current or past significant illnesses or beliefs and practices conducive to health and illness

  ii. Nutritional assessment (especially for vulnerable or at risk members)
• Anthropometric data


  measures of nutritional status of children-weight, height, mid-upper arm circumference; risk assessment measures for obesity
• body mass index


  weight in kgs. divided by height in meters2
• waist circumference


  greater than 90 cm. in men and greater than 80 cm. in women
• waist hip ration


  waist circumference in cm. divided by hip circumference in cm.
• Central obesity


  WHR is equal to or greater than 1.0 cm in men and 0.85 in women
• Health Status of Each Family Member


  iii. Developmental assessment of infant, toddlers and preschoolers- e.g. Metro Manila Developmental Screening Test (MMDST).
• Health Status of Each Family Member


  iv. Risk factor assessment indicating presence of major and contributing modifiable risk factors for specific lifestyle diseases-e.g. hypertension, physical inactivity, sedentary lifestyle, cigarette/ tobacco smoking, elevated blood lipids/ cholesterol, obesity, diabetes mellitus, inadequate fiber intake, stress, alcohol drinking, and other substance abuse.
• Health Status of Each Family Member


  v. Physical Assessment indicating presence of illness state/s (diagnosed or undiagnosed by medical practitioners )

  vi. Results of laboratory/diagnostic and other screening procedures supportive of assessment findings.
• Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.


  i. Immunization status of family members

  ii. Healthy lifestyle practices. Specify.

  iii. Adequacy of:

  • Rest and sleep
  • Exercise/activities
  • Use of protective measure-e.g. adequate footwear in parasite-infested areas; use of bed nets and protective clothing in malaria and filariasis endemic areas.
  • Relaxation and other stress management activities

  iv. Use of promotive-preventive health services (e.g. MCH, healthy life style-related)
• 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.
• Presence of Health Threats


  conditions that are conducive to disease and accident, or may result to failure to maintain wellness or realize health potential.
• Presence of health deficits


  instances of failure in health maintenance.
• Presence of stress points/foreseeable crisis situations


  anticipated periods of unusual demand on the individual or family in terms of adjustment/family resources.
• Family Coping Index


  is the best tool used in the community to assess the family’s ability to take care of the sick member and to maintain an environment conducive to healing.
• Family Coping Index


  to provide a basis for estimating the nursing needs of a particular family.
• Coping


  is defined as dealing with problems associated with health care with reasonable success.
• Coping


  has been selected as an index of nursing need because the particular contribution of nursing to health care is to strengthen or to supplement the capacity of the individual or family as it encounters the stress of illness, or the opportunity to prevent disease and to promote health.
• family nursing care plan


  s the blueprint of the care that the nurse designs to systematically minimize or eliminate the identified health and family nursing problems through explicitly formulated outcomes of care (goals and objectives) and deliberately chosen set of interventions, resources and evaluation criteria, standards, methods, and tools.
• goal


  is a general statement of the condition or state to be brought about by specific courses of action.
• PROMOTIVE


  Health Promotion allows individuals to increase control over their own health. Its extensive range of social and environmental interventions benefits and protects individual people’s health and quality of life.
• PROMOTIVE


  These interventions address and prevent the origin of ill health, not just focusing on treatment and cure.
• PREVENTIVE


  refers to measures that aim to avoid or reduce injuries and diseases, their sequelae and complications.
• PREVENTIVE


  is based on a health promotion strategy that involves a process to enable people to improve their health through the control over some of its immediate determinants. This includes a wide range of expected outcomes, which are covered through a diversity of interventions, organized as primary, secondary and tertiary prevention levels.
• CURATIVE


  encompasses health care contacts during which the principal intent is to relieve symptoms of illness or injury, to reduce the severity of an illness or injury, or to protect against exacerbation and/or complication of an illness and/or injury that could threaten life or normal function.
• REHABILITATIVE


  is an integrative strategy with the purpose of empowering persons with health conditions who are experiencing or are likely to experience disability so that they can achieve and maintain optimal functioning, a decent quality of life and inclusion in the community and society.
• REHABILITATIVE


  While curative services mainly emphasize the health condition, _ services focus on the functioning associated with the health condition.
• REHABILITATIVE


  stabilize, improve or restore impaired body functions and structures, compensate for the absence or loss of body functions and structures, improve activities and participation, and prevent impairments, medical complications and risks.
• bag technique


  is a tool by which the nurse, during her visit will enable her to perform a nursing procedure with ease and deftness, to save time and effort, with the end view of rendering effective nursing care to clients.
• public health bag


  is an essential and indispensable equipment of a public health nurse which she/he has to carry along during her home visits. It contains basic medications and articles which are necessary for giving care.
• home visit


  is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing this activity, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.