The Family Health and Family Nursing Process

Question 1

The practical science of preventative and remedial support to the family in order to help the family system unit independently and autonomously maintain and improve its family functions.

Answer 1

Family Health Nursing

Question 2

Is an orderly, systematic steps to assess the health needs, plan, implement and evaluate the services to achieve health.

Answer 2

Family Nursing Process

Question 3

It helps in achieving desired goals of health promotion, prevention and control of health problems.

Answer 3

Family Nursing Process

Question 4

Steps of Family Health Nursing Process

Answer 4

Assessment, Diagnosis, Planning, Implementation, and Evaluation

Question 5

This involves sets of actions by which the nurse measures the status of the 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.

Answer 5

Assessment

Question 6

It includes data collection, data analysis, or interpretation and problem definition or nursing diagnosis

Answer 6

Assessment

Question 7

Assessment includes

Answer 7

data collection, data analysis, or interpretation and problem definition or nursing diagnosis

Question 8

Family Structure, Characteristics and Dynamics

Answer 8

1. Members of the household and relationship to the head of the family
2. Demographic data - age, sex, civil status, position in the family
3. Place of residence of each member - whether living with the family or elsewhere
4. Type of family structure - e.g. matriarchal or patriarchal, nuclear or extended
5. Dominant family members in terms of decision-making, especially in matters of health care
6. General family relationship/dynamics presence of any obvious/readily observable conflict between members; characteristic communication/interaction patterns among members

Question 9

Socio-economic and Cultural Characteristics

Answer 9

1. 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 decisions about money and how it is spent
2. Educational attainment of each member
3. Ethnic background and religious affiliation
4. Significant Others role(s) they play in family’s life
5. Relationship of the family to larger community - Nature and extent of participation of the family in community activities

Question 10

Home and Environment

Answer 10

1. Housing
   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 hazards
   e. Food storage and cooking facilities
   f. Water supply - source, ownership, portability
   g. Toilet facility - type, ownership, sanitary condition h. Garbage/refuse disposal - type, sanitary condition
   i. Drainage system - type, sanitary condition
2. Kind of neighbourhood, e.g. congested, slum, etc.
3. Social and health facilities available
4. Communication and transportation facilities available

Question 11

is a nursing judgment on wellness state or condition based on client’s performance, current competencies or clinical data but no explicit expression of client desire.

Answer 11

Wellness potential

Question 12

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

Answer 12

Readiness for enhanced wellness state

Question 13

Data Collection Methods

Answer 13

Observation
Physical Examination
Interview o Review of Records/ Reports and Laboratory results
Assessment of Home and Environment

Question 14

Family Data Analysis

Answer 14

Socio-economic and Cultural characteristics
Home and Environment
Family health status
Family values and health practices

Question 15

A classification system of family nursing problems was developed to facilitate the process of defining the family nursing problem.

Answer 15

Family Nursing Diagnosis

Question 16

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

Answer 16

Family nursing care plan

Question 17

Steps in developing the family nursing care plan

Answer 17

The prioritized condition/s or problems
The goals and objectives of nursing care
The plan of interventions
The plan for evaluating care

Question 18

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

Answer 18

Goal

Question 19

refer to more specific statement of the desired result or outcome of care

Answer 19

Objectives

Question 20

Health Status of Each Family Member

Answer 20

1. Medical and nursing history indicating current or past significant illnesses or beliefs and practices conducive to health and illness
2. Nutritional assessment (specially for vulnerable or at-risk members)
   a. Anthropometric data: Measures of nutritional status of children - weight, height, mid- upper arm circumference; Risk assessment measures for Obesity: body mass index (BMI = weight in kgs. divided by height in meters²), waist circumference (WC: greater than 90 cm. in men and greater than 80 cm. in women), waist hip ratio (WHR = waist circumference in cm. divided by hip circumference in cm. Central Obesity: WHR equal to or greater than 1.0 cm. in men and 0.85 in women).
   b. Dietary history specifying quality and quantity of food/nutrient intake per day
   c. Eating/feeding habits/practices
3. Developmental assessment of infants, toddlers, and preschoolers e.g., Metro Manila Developmental Screening Test (MMDST).
4. 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
5. Physical assessment indicating presence of illness state/s (diagnosed or undiagnosed by medical practitioners)
6. Results of laboratory/diagnostic and other screening procedures supportive of assessment findings

Question 21

E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

Answer 21

1. Immunization status of family members
2. Healthy lifestyle practices. Specify.
3. Adequacy of:
   a. rest and sleep
   b. exercise/activities
   c. use of protective measures - e.g. adequate footwear in parasite-infested areas; use of bednets and protective clothing in malaria and filariasis endemic areas
   d. relaxation and other stress management activities
4. Use of promotive-preventive health services

Question 22

Presence of Wellness Condition
Potential for Enhanced Capability for:

Answer 22

1. Healthy Lifestyle - e.g. nutrition/diet, exercise/activity
2. Health Maintenance/Health Management
3. Parenting
4. Breastfeeding
5. Spiritual Well-being - process of a client’s developing/unfolding of mystery through harmonious interconnectedness that comes from inner strength/sacred source/God (NANDA 2001)
6. Others, specify:

Question 23

Presence of Wellness Condition
B. Readiness for Enhanced Capability for:

Answer 23

1. Healthy Lifestyle
2. Health Maintenance/Health Management
3. Parenting
4. Breastfeeding
5. Spiritual Well-being
6. Others, specify:

Question 24

Presence of Health Threats

Answer 24

A. Presence of risk factors of specific diseases (e.g. lifestyle diseases, metabolic syndrome)
B. Threat of cross infection from a communicable disease case
C. Family size beyond what family resources can adequately provide
D. Accident hazards. Specify:
1. Broken stairs
2. Pointed/sharp objects, poisons, and medicines improperly kept
3. Fire hazards
4. Fall hazards
5. Other (specify):
t. Faulty/unhealthful nutritional/eating habits or feeding techniques practices. Speсіту:
1. inadequate food intake both in quality and quantity
2. excessive intake of certain nutrients
3. faulty eating habits
ineffective breastfeeding
4. faulty feeding techniques
F. Stress-provoking factors - specify:
1. strained marital relationship
2. strained parent-sibling relationship
3. interpersonal conflicts between family members
4. care-giving burden
G. Poor home/environmental condition/sanitation - specify:
1. inadequate living space
2. lack of food storage facilities
3. polluted water supply
4. presence of breeding or resting sites of vectors of diseases (e.g. mosquitoes, flies, roaches, rodents, etc.) 15
5. improper garbage/refuse disposal
6. unsanitary waste disposal
7. improper drainage system
8. poor lighting and ventilation
9. noise pollution
10. air pollution
H. Unsanitary food handling and preparation
G. Poor home/environmental condition/sanitation - specify:
1. inadequate living space
2. lack of food storage facilities
3. polluted water supply
4. presence of breeding or resting sites of vectors of diseases (e.g. mosquitoes, flies, roaches, rodents, etc.) 15
5. improper garbage/refuse disposal
6. unsanitary waste disposal
7. improper drainage system
8. poor lighting and ventilation
9. noise pollution
10. air pollution
H. Unsanitary food handling and preparation
1. Unhealthful lifestyle and personal habits/practices - specify:
1. alcohol drinking
2. cigarette/tobacco smoking
3. walking barefooted or inadequate footwear
4. eating raw meat or fish
5. poor personal hygiene
6. self-medication/substance abuse
7. sexual promiscuity
8. engaging in dangerous sports
9. inadequate rest or sleep
10. lack of/inadequate exercise/physical activity
11. lack of/inadequate relaxation activities
12. non-use of self-protection measures (e.g. non-use of bednets in malaria and filariasis endemic areas)
J. Inherent personal characteristics - e.g. poor impulse control
K. Health history which may participate/induce the occurrence of a 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 children
N. Family disunity - e.g.
1. self-oriented behaviour of member(s)
2. unresolved conflicts of member(s)
3. intolerable disagreement
O. Others, specify:

Question 25

Presence of Health Deficits

Answer 25

A. Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner
B. Failure to thrive/develop according to normal rate
C. 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)

Question 26

Presence of Stress Points/Foreseeable Crisis

Answer 26

A. Marriage
B. Pregnancy, labor, puerperium
C. Parenthood
D. Additional member - e.g. newborn, lodger
E. Abortion
F. Entrance at school
G. Adolescence
H. Divorce or separation
1. Menopause
J. Loss of Job
K. Hospitalization of a family member
L. Death of a member
M. Resettlement in a new community
N. Illegitimacy
O. Others, specify

Question 27

Inability to recognize the presence of the condition or problem

Answer 27

A. Lack of or inadequate knowledge
B. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specifically:
1. Social-stigma, loss of respect of peer/significant others
2. Economic/cost implications
3. Physical consequences
4. Emotional/psychological issues/concerns
C. Attitude/philosophy in life which hinders recognition/acceptance of a problem
D. Others, specify

Question 28

Inability to make decisions with respect to taking appropriate health action

Answer 28

A. Failure to comprehend the nature/magnitude of the problem/condition
B. Low salience of the problem/condition
C. Feeling of confusion, helplessness and/or resignation brought about by perceived magnitude/severity of the situation or problem, i.e., failure to break down problems into manageable units attack
D. Lack of/inadequate knowledge/insight as to alternative courses of action open to them
E. Inability to decide which action to take from among a list of alternatives
F. Conflicting opinions among family members/significant others regarding action to take
G. Lack of/inadequate knowledge of community resources for care
H. Fear of consequences of action, specifically:
1. Social consequences
2. Economic consequences
3. Physical consequences
4. Emotional/psychological consequences
I. Negative attitude towards the health condition or problem By negative attitude is meant one that interferes with rational decision making
J. Inaccessibility of appropriate resources for care, specifically:
1. Physical inaccessibility
2. Cost constraints or economic/financial inaccessibility
K. Lack of trust/confidence in the health personnel/agency
L. Misconceptions or erroneous information about proposed course(s) of action
M. Others, specify

Question 29

Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable / at-risk member of the family

Answer 29

A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications, prognosis and management);
B. Lack of/inadequate knowledge about child development and care
C. Lack of/inadequate knowledge of the nature and extent of nursing care needed
D. Lack of the necessary facilities, equipment and supplies for care
E. Lack of inadequate knowledge and skill in carrying out the necessary interventions/treatment/procedure/care (e.g., complex therapeutic regimen or healthy Lifestyle program)
F. Inadequate family resources for care, specifically:
1. absence of responsible member
2. financial constraints
3. limitations/lack of physical resources - e.g., isolation room
G. Significant person’s unexpressed feelings (e.g., hostility/anger, guilt, fear/anxiety, despair, rejection) which disable his/her capacities to provide care.
H. Philosophy in life which negates/hinder caring for the sick, disabled, depended, vulnerable/at-risk member
I. Member’s preoccupation with own concerns/interests
J. Prolonged disease or disability progression which exhausts supportive capacity of family members
K. Altered role performance - specify
1. role denial or ambivalence
2. role strain
3. role dissatisfaction
4. role conflict
5. role confusion
6. role overload
L. Others, specify

Question 30

Inability to provide home environment conducive to health maintenance and personal development

Answer 30

A. Inadequate family resources, specifically:
1. financial constraints/limited financial resources
2. limited physical resources - e.g. lack of space to construct facility
B. Failure to see benefits (specifically long-term ones) of investment in home environment improvement
C. Lack of/inadequate knowledge of importance of hygiene and sanitation
D. Lack of inadequate knowledge of preventive measures
E. Lack of skill in carrying out measures to improve home environment
F. Ineffective communication patterns within the family
G. Lack of supportive relationship among family members
H. Negative attitude/philosophy in life which is not conducive to health maintenance and personal development
I. Lack of/inadequate competencies in relating to each other for mutual growth and maturation (e.g. reduced ability to meet the physical and psychological needs of other members as a result of family’s preoccupation with current problem or condition)
J. Other, specify

Question 31

Failure to utilize community resources for health care

Answer 31

A. Lack of/inadequate knowledge of community resources for health care
B. Failure to perceive the benefits of health care/services
C. Lack of trust/confidence in the agency/personnel
D. Previous unpleasant experience with health worker
E. Fear of consequences of action (preventive, diagnostic, therapeutic rehabilitative), specifically:
1. Physical/psychological consequences
2. Financial consequences
3. Social consequences - e.g., loss of esteem of peer/significant others
F. Unavailability of required care/service
G. Inaccessibility of require care/service due to:
1. cost constraints
2. physical inaccessibility, i.e. location of facility
H. Lack of or inadequate family resources, specifically:
1. manpower resources - e.g., baby sitter
2. financial resources - e.g., cost of medicine prescribed
I. Feeling of alienation to/lack of support from the community, e.g., stigma due to mental illness, AIDS, etc.
J. Negative attitude/philosophy in life which hinders effective/maximum utilization of community resources for health care
K. Others, specify

Question 32

Family Health Nursing Objectives

Answer 32

• To identify health & nursing needs and problems of each
  family.
• To ensure family’s understanding and acceptance of these
  needs and problems.
• To plan and provide health and nursing services with the
  active participation of family members.
• To help families develop abilities to deal with their health
  needs and health problems independently
• To contribute to family’s performance of developmental
  functions and tasks.
• To help family make intelligent use of promotive, preventive, therapeutic and rehabilitative health and allied facilities and services in the community.
• To educate, counsel and guide family members to cultivate
  good personal health habits, practice safe cultural practices
  and maintain wholesome physical, psychosocial, and spiritual environment.

Question 33

Family Health Nursing Principles

Answer 33

• Provide services without discrimination
• Periodic and continuous appraisal and evaluation of
  family health situation
• Proper maintenance of record and reports.
• Provide continuous services
• Health education, guidance and supervision as integral
  part of family health nursing.
• Maintain good IPR.
• Plan and provide family health nursing with active
  participation of family.
• Services should be realistic in terms of resources
  available.
• Encourage family to contribute towards community
  health.
• Active participation in making health care delivery
  system.

Question 34

a clinical judgment about a client in transition from a specific wellness or capability to a higher level

Answer 34

Presence of Wellness Condition

Question 35

Conditions that are conducive to diseases and accidents, and or may result to failure to maintain wellness or realize health potential.

Answer 35

Presence of Health Threats

Question 36

Defines the nature of the or type of nursing problems that the family encounters in performing the health task with respect to a given health condition or problem and the etiology or barriers to the families assumption of this task

Answer 36

Second Level Assessment

Question 37

It explains the families problem related to maintaining health and wellness.

Answer 37

Second Level Assessment

Question 38

It specified the measures that the family did not due to INABILITY

Answer 38

Second Level Assessment

Question 39

Data Collection Methods

Answer 39

• Observation
• Physical Examination
• Interview o Review of Records/ Reports and Laboratory results
• Assessment of Home and Environment

Question 40

Family Data Analysis

Answer 40

• Socio-economic and Cultural characteristics
• Home and Environment
• Family health status
• Family values and health practices

Question 41

Tools for assessment

Answer 41

• Initial Data Base
• Family Health Task
• Family Coping Index
• Genogram
• Ecomap
• Family Assessment Guide

Question 42

The objective of this indicator is to present bench mark for approximating the nursing needs of a particular family

Answer 42

Family Coping Index

Question 43

It is the coping capacity and not the underlying problem that is being rated, and it is designed to record the family rather than individual coping capacity. In public health nursing, the family cannot be seen only as a factor that affects health; rather, the family is the patient.

Answer 43

Family Coping Index

Question 44

This category is concerned with the ability to move about, to get out of bed, to take care of daily grooming. walking.etc.

Answer 44

Physical Independence

Question 45

This includes all the procedures or treatments prescribed for the care of illness, such as giving medications, of using appliances, dressings, exercises and relaxation, special diets, etc.

Answer 45

Therapeutic Independence

Question 46

This concerned particular system is with the health condition that is the occasion for care.

Answer 46

Knowledge of health Condition

Question 47

This is concerned with family action in relation to maintaining family nutrition, adequate relaxation members, accepted securing rest and for family carrying out preventive measures such as immunizations, and medical appraisal, safe home making habits in relation to storing and preparing foods

Answer 47

Application of Health Principles on Personal Hygiene

Question 48

This is concerned with the way the family feels about health care in general, preventive including services, care of illness and public health measures.

Answer 48

Health care attitude

Question 49

This has to do with the maturity and integrity

Answer 49

Emotional Competence

Question 50

This is concerned largely with the interpersonal or group aspects of family life- how well the family members of the family get along with one another, the ways in which they make decisions affecting the family as a whole, the degree to which they support one another and do things as a family, the degree of respect and affection they show for one another, the ways in manage which they the budget. the family kind discipline that prevails.

Answer 50

Family Living Pattern

Question 51

This is concerned with the home. the community and the work environment as it affects family health.

Answer 51

Physical Environment

Question 52

It has to do with the degree of the family’s use and awareness of the available community facilities for health education and welfare

Answer 52

Use of Community Facilities