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Republic of the Philippines
EASTERN SAMAR STATE UNIVERSITY
COLLEGE OF NURSING
Community Organizing
Participatory Action Research(COPAR)
Related Learning Experience (RLE)
Family Nursing Care Process
(FNCP)
With Individualized Nursing Care Process
(NCP)
Submitted by:
Submitted to:
Instructor
Date
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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FORM B: Family Nursing Care Process (FNCP) Format
Major Components of FNCP:
I.
II.
III.
Family Demographic Profile
Individualized Nursing Care Process (NCP)
Family Nursing Care Plan
a. Health Teaching Plan
b. Monitoring and Evaluation Plan
Specific Components
I.
Family Demographic Profile
a.
b.
c.
d.
No.
1.
2.
3.
4.
5.
6.
7.
Head of the family
Address
Type of family: Nuclear, extended, cohabitation, single parenthood, etc.
Profile (summary)
Name
Family Role
Age
Date of
Birth
Civil
Status
Nursing
Diagnosis
(*from individual
NCP)
Father
Mother
Daughter
Son
e. Floor plan (sketch of family living space)
Figure A. Sketch of living space of family _______
II.
Individualized Nursing Care Process (NCP) – (note: every member of the
family should have an individualized NCP)
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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A. Assessment:
1. Demographic profile
- Name
- Age
- Sex
- Nationality
- Religion
- Occupation
- Civil status: spouse’s name (if any)
- Educational attainment
2. Nursing History
1. History of Present Illness
2. Past Health History
– Injury
– Hospitalization
3. Immunization status
4. Family Health History
4.1 Father side
4.2 Mother side
5. Allergies
3. Gordon’s Typology of 11 Functional Health Patterns (*use the assessment tools provided
to you during NCP lecture)
1. Health-perception/health-management pattern. Describes the client’s perceived pattern of
health and well-being and how health is managed.
2. Nutritional/Metabolic pattern. Describes the client’s pattern of food and fluid consumption
relative to metabolic need and pattern indicators of local nutrient body.
3. Elimination pattern. Describes the pattern of excretory function (bowel, bladder, and skin).
4. Activity/exercise pattern. Describes pattern of exercise, activity, leisure, and recreation.
5. Sleep and rest pattern. Describes pattern of sleep, rest, and relaxation.
6. Cognitive/perceptual pattern. Describes sensory-perceptual and cognitive patterns.
7. Self-perception/self concept pattern. Describes the client’s self concept pattern and
perceptions of self (e.g., self-conception,/worth, comfort body image, feeling state).
8. Role/relationship pattern. Describes the client’s pattern of role participation and relationships.
9. Sexuality/reproductive pattern.
Describes the client’s pattern of satisfaction and
dissatisfaction with sexuality pattern; describes reproductive patterns.
10. Coping/stress tolerance pattern. Describes the client’s general coping pattern and the
effectiveness of the pattern in terms of stress tolerance.
11. Value/belief pattern. Describes the patterns of values, beliefs (including spiritual), and goals
that guide the client’s choices or decisions.
4. Physical assessment (Head-to-Toe assessment) (*use the assessment tools provided to
you during NCP lecture)
1.
Areas
GENERAL SURVEY:
2.
SKIN:
3.
HEAD:
4.
EYES:
5.
EARS:
6.
NOSE:
7.
MOUTH:
8.
PHARYNX:
9.
NECK:
10.
CHEST AND LUNGS:
11.
HEART:
12.
BREAST
Assessment Findings
AND
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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AXILLAE:
13.
ABDOMEN:
(sample only)
LUE
RUE
3-4/5
4/5
5/5
5/5
LLE
RLE
* The highest score is 5/5
14.
BACK AND
EXTREMITIES:
15.
GENITO-URINARY:
16.
NEUROLOGICAL
EXAMINATION
MENTAL STATUS:
GLASGOW COMA
SCALE:
CRANIAL NERVES:
17.
18.
19.
Olfactory:
Optic:
Oculomotor, Trochlear,
Abducens:
Trigeminal:
Facial:
Vestibulocochlear:
Glossopharyngeal:
Vagus:
Accessory
Hypoglossal:
20.
REFLEXES:
Tendon Reflexes
Right
Left
Biceps
Unable to Unable to assess
assess
Triceps
Unable to Unable to assess
assess
Radial
Unable to Unable to assess
assess
Patellar
++
++
Achilles
++
++
*Sample only ++++ is the highest score based on the
concept of Neurologic Health Nursing
Pathologic Reflexes:
(-) Babinski
(-) ankle clonus
(-) kernig’s signs
(-) brudzinsky’s sign
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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(-) decorticotaion
(-) decerebration
21.
MOTOR/CEREBELLAR:
(sample only)
Right
Shoulder (Arm flexion, extension, 3/5
Left
4/5
abduction)
Elbow (Flexion/extension)
3/5
4/5
Wrist (abduction/ opposition)
4/5
4/5
Thumb (Extension/abduction)
4/5
4/5
Finger (Flexion, adduction)
4/5
4/5
Hip (extension, abduction)
4/5
4/5
foot 5/5
5/5
Ankle
(inversion
dorsiflexion,
of
eversion,
plantar
flexion)
Toes
(Dorsiflexion/
plantar 5/5
5/5
flexion)
22.
5.
SENSORY:
Vital signs / Measurable cues / Anthropometric Data (use graphs; line, bar, pie charts for
multiple reading)
Parameter
Procedure
Normal
Value
Actual Findings
Analysis and
Interpretation
Height
Weight
BMI
BP
Pulse Rate
Respiration Rate
Temperature
6.
Drug Study (*if available or on maintenance medication, prescribed medication)
Drug and
content
Dosage /
Frequency
Indication
Contraindication
Drug
Interaction
Nurses
Responsibility
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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7.
Pathophysiology and Anatomy (use flow chart diagram) *if diagnosed with disease or
having acute or chronic disease/condition
Predisposing
Factors
Causative Agents
Signs and
symptoms
Figure __
8.
Laboratory/Diagnostic Study *if diagnosed with disease or having acute or chronic
disease/condition
Laboratory/Diagnostic
Procedure
Normal Values
Actual Findings
Analysis and
Interpretation
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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Form A: Gordon’s Functional Health Pattern
Gordon’s
Functional Health
Pattern
Health Perception
and Health
Management
Nutrition and
Metabolism
Elimination
Activity and
Exercise
Cognition and
Perception
Sleep and Rest
Self Concept
Roles and
Relationship
Sexuality and
Reproductive
Function
Stress and Stress
Response
Values and Beliefs
Nursing History
Subjective
PE
Objective
Laboratory
(if available or if
diagnosed)
Nursing Diagnosis
(at least one diagnosis
per typology)
Justification for the
Nursing Diagnosis
Prioritization of identified problem (use Maslow’s Hierarchy of Needs)
Health Problem
Cues
Justification
*states
the
Identified *list of supporting information based on *normal findings according to published study
abnormal
findings
or the assessment
maladaption
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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Form A: Summary of Gordon’s Functional Health Pattern
Assessment
Nursing Diagnosis
Planning
Intervention
Nursing History
Definition
PE
Diagnostic
Examination/Laboratory
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
Evaluation
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Worksheet C (Health Teaching Plan - Individual)
Teaching
Objectives
derived from nursing
care plan
*
Strategies
Learning Content
Time
Duration
Resources
* with reference
References: (very important, DO NOT FORGET to include this)
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
Evaluation
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III. Family Nursing Care Plan
A. Initial Data Base for Family Nursing Practice (Please refer to Table 2 on page 66
of Nursing Practice in the Community 4th edition of Araceli S. Maglaya for the
complete details) note: all the data must be provided completely as provided by table
2. The following areas below are only a summary. This should be presented in
narrative form.
a.
b.
c.
d.
e.
Family structure, characteristics, and dynamics
Socio – cultural and Cultural Characteristics
Home and Environment
Health status of each Family Member
Values, habits, practices on health promotion, maintenance and disease
prevention
B. Family Nursing Problems - Summary of First – Second Level Assessment
Cues/Data
Family Nursing Problems
* please see page 77-81 of Maglaya for
sample case
First level – second level
assessment
C. Problem – Priority Setting (see page 89 to 95 of Maglaya for sample case)
Criteria
Computation
Actual Score
Justification
1. Nature of the problem
2. Modifiability
of
the
problem
3. Preventive potential
4. Salience of the problem
Total Score
D. List of Prioritized Family Nursing Problems
Family Nursing Problem
1.
Score
* from highest score to the lowest
2.
3.
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
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E. Family Nursing Care Plan
Health Problem
Family Nursing
Problems
*First level – second
level assessment
Goals and
Objectives
Interventions
Resources
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
Evaluation
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F. Family Health Teaching Plan
Teaching
Objectives
derived from nursing
care plan
*
Strategies
Learning Content
Time
Duration
Resources
* with reference
References: (very important, DO NOT FORGET to include this)
Family Nursing Care Process (FNCP) format for CHN practice – ESSU College of Nursing 2015
Evaluation