COMMUNITY HEALTH NURSING RLE

URBANO FMILY

PART A. INITIAL DATA BASE

I. CHARACTERS:
A. What is the type of family structure?
✓ Nuclear Single - Parent
Extended Others (specify)
B. What is the type of family based on authority?
✓ Patriarchal
Matriarchal
C. Who makes decisions regarding health care? Mother (G.U)
D. What is the present family relationship?
with conflicts between members
✓ without conflicts between family members
E. Activities of daily living:
1. Sleeping pattern:
Retiring/getting up hours 9 PM – 4 AM
Nap during the day 4 PM – 5 PM
Do members sleep together Yes
2. Eating pattern
How many meals each day? 3-5
Who appears overweight? None
Who appears underweight? None
3. Leisure time activities
How does each member spend leisure hours? Cleaning (G.U) Sleeping (W.U,
D.U, R.U, I.U)
Is it appropriate for the sex and age group? Yes
What is the effect on the family? They can have a bonding
Any joint activity for leisure? None

II. FAMILY INFORMATION

Head of the family: Wilfredo Urbano
Address: 39- Sto.Rosario Kar Valenzuela City
Members of the household: None

NAME RELATIONSHIP AGE EDUCATIONAL ATTAINMENT

W.U Father 51 Highschool graduate
G.U Mother 31 Highschool graduate
D.U Son 9 Grade 3
R.U Daughter 7 Grade 1
I.U Son 3

/avg
 III. SOCIO-ECONOMIC AND CULTURAL FACTORS
A. Income

NAME OCCUPATION PLACE INCOME /

MONTH
W.U Delivery Man Around Metro Manila ₱ 8,000.00

1. Does the working family member meet the basic necessities?

Yes ✓ No
2. Who makes decisions regarding money matters? W.U (Father)
3. Religious affiliation: Roman Catholic
4. What roles does the family play in the community? None

IV. ENVIRONMENTAL FACTORS

A. Housing
1. Ownership
Owned Rented ✓ Rent-Free Others (specify)
2. Construction materials used
Light ✓ Mixed Strong
3. Living space
Adequate ✓ Inadequate
4. Sleeping arrangement: Sleeping in one room
5. Adequacy in furniture
Adequate ✓ Inadequate
6. Water source
✓ Private Public
7. Food storage
Refrigerator Jars/container None Others (specify)
8. Cooking facility
Electric stove ✓ Firewood Others (specify)
Gas Stove Kerosene
9. Drainage facility
✓ Open drainage Blind drainage None
10. Toilet facilities/type
Flushed Overhung latrine
Water-sealed latrine Bored-hole latrine
✓ Pail system Others (specify)
11. Sanitary condition
Fair ✓ Good Poor

Provide brief description: There is no bad odor but the garbage are visible and scattered on the
compound

12. Neighborhood
✓ Congested Slum Other
/avg
 13. Availability of Health Care Facility
Describe briefly: 3S Karuhatan, they give free vitamins and free check-up.

14. Garbage disposal

Dumped at street corner ✓ Picked up by garbage collector
Buried Burned then buried Others(specify)

V. HEALTH MEDICAL HISTORY

NAME PAST ILLNESS DIAGNOSED / ILLNESS STATE HEALTH ACTION
UNDIAGNOSED TAKEN

VI. VALUE PLACED ON PREVENTION OF

DISEASE Vaccinations

NAME AGE COMPLETE INCOMPLETE

W.U 51 ✓
G.U 31 ✓
D.U 8 NO COVID VACCINE

R.U 7 NO COVID VACCINE

I.U 3 ✓

Other preventive practices employed by the family: Sleeping early, and taking vitamins
Sources of Health Care:
✓ Health Center ✓ Government Hospital
Private Hospital Others (specify)

/avg
 PART B.

DETERMINE AT LEAST 3 FAMILY HEALTH PROBLEMS. IF NONE, DETERMINE THE FAMILY’S PROMOTIVE OR PREVENTIVE
PRACTICES.
FAMILY HEALTH PROBLEMS. / TYPOLOGY OF HEALTH PROBLEM
(WELLNESS STATE , HEALTH DEFICIT,HEALTH THREAT,
(IF NONE, FAMILY’S PROMOTIVE OR FORESEEABLE CRISIS)
PREVENTIVE PRACTICES.)

1. Unsanitary waste disposal as a health threat. Health threat

Health threat
2. Risk for falling: Poor lighting in stairs

Health threat
3. Inadequate living space to meet the family size

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 PART C.

DO THE SCALING OF THE 3 IDENTIFIED HEALTH PROBLEMS OR PROMOTIVE PRACTICES OF THE FAMILY.

HEALTH PROBLEM 1: INADEQUATE SPACE TO MEET THE FAMILY SIZE

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

NATURE OF THE PROBLEM

(Health Threat)
Inadequate space can
2/3 x 1 = 0.67 0.67 contribute to suffocation, and
it can increase the risk of
spreading a communicable
disease to the family
This is considered to be a
health threat, because it may
affect the members of the
family that may lead to
failure to maintain wellness.

MODIFIABILITY OF THE
PROBLEM The student nurse will do a
(Easily modifiable) promotion, and do health
2/2 x 2 = 1 1 teaching about the
importance of having
adequate space for the
family.
(The family’s
resources areinadequate to
provide a properliving space
to its members dueto
prioritized needs. But
theresources of the nurse
such ashealth teachings and
advisescan promote change
in theproblem.

PREVENTIVE POTENTIAL
The student nurse will make
(Highly Preventable)
3/3 x 1 = 1 1 sure that the family will
understand the importance
of having adequate living
space to move comfortable.
(The family’s
resources areinadequate to
provide a properliving space
to its members dueto

/avg
 prioritized needs. But
theresources of the nurse
such ashealth teachings and
advises can promote change
in theproblem.

SALIENCE
(Not a felt/need problem) “Binigay lang samin ‘to e,
0/1 x 0 = 0 0 anong magagawa namin?” As
stated by the mother.

TOTAL: 2.67

/avg
 HEALTH PROBLEM 2: PRESENCE OF FALL HAZARDS DUE TO DARK SURROUNDINGS

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

NATURE OF THE PROBLEM

2 x 1 = 2/3 = 0.67 0.67 This is considered to be a
(Health Threat)
health threat under
environmental hazards
because it can lead to
accident that can cause
serious injury and reduce
their ability to remain
independent.

MODIFIABILITY OF THE
PROBLEM 2 x 2 = 4/2 = 2 2 This is easily modifiable,
(Easily modifiable) because by just installing
lights the problem will be
solved and by the use of
proper promotion and
prevention.

PREVENTIVE POTENTIAL
3 x 1 = 3/3 = 1 1 By advising the family to be
(Highly preventable)
careful and install lights this
could be highly preventive.

SALIENCE
(A problem but not needing 1 x 1 = 1/2 = 0.5 0.50 “Delikado nga ‘yan, lalo na
immediate attention) maliliit pa anak ko. Kailangan
na lagyan ng ilaw yan.” As
stated by the mother who
worries about her child.

TOTAL : 4.17

/avg
 HEALTH PROBLEM 3: UNSANITARY WASTE DISPOSAL AS A HEALTH THREAT

CRITERIA COMPUTATION ACTUAL SCORE JUSTIFICATION

Nature of the problem 2 x 1 = 2/3 = 0.67 0.67 Even while they may
( Health threat ) appear to be harmless,
birds actually pose some
serious health dangers due
to the feces they leave
behind.

Modifiability of the 2 x 2 = 4/2 = 2 2 This is easily modifiable

problem because even though the
(Easily modifiable) family lacks resources and
lack of knowledge in
proper waste disposal with
the proper interventions
and health teaching of the
nurse the problem will be
easily modifiable to the
family.

Preventive potential 3 x 1 = 3/3 = 1 1 With the PHN proper

(Highly preventive) health teaching and
intervention together with
the participation of the
family and gaining the
understanding of proper
disposal of animal waste
the problem can be highly
preventive.

Salience 2 x 1 = 2/2 = 1 1 This is a serious problem

(A serious problem need that needs immediate
immediate attention) attention because Over 60
different diseases have
been linked to waste of
birds that can affect the
family if they don't dispose
of the waste properly .
“Kapag naulan
umaalingasaw
yung amoy.”
“Nahihirapan
kami huminga”
as stated by the mother.

TOTAL SCORE: 4.67

Surveyed by _________________________
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 Date ____________________________

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