3. STEPS OF FAMILY NURSING PROCESS
Assessment of client’s
problem
Diagnosis of client
response needs that nurse
can deal with
Planning of client’s
care
Implementation of
care
Evaluation of the success
of implemented care
5/19/2017 3
5. MEANING OF PLANNING
• Planning is a very important to determine the course of action
to be implemented to meet family health needs and resolve
family health problems
• Family health planning is a systematic process and involve
logical decision making at each step of its process.
5/19/2017 5
6. IMPORTANCE OF PLANNING
• Helps to provide individualize care to clients
• Helps in setting priorities by providing information about the
• Promotes systematic communication
• Continuity of care
• Minimizes gaps and duplications in the services provided
• Facilitates the coordination of care
5/19/2017 6
7. STEPS IN FAMILY HEALTH PLANNING
5/19/2017 7
Evaluation/
Follow up
care
Formulating
family health
action plan
to achieve
the
objectives
Setting goals
and
objectives
Establishing
priorities
Analysis
health needs
/health
problems
9. HEALTH NEEDS/PROBLEMS IDENTIFIED(contd…)
•High risk of Communicable diseases
•Educational need of child
•Unhealthy & hygienic practices
•Unmet need of contraception
•Poor Environmental sanitation
5/19/2017 9
10. ESTABLISHING PRIORITIES
Bailon and Maglaya developed the Criteria for prioritizing &which is depends on:
• Types of problems
• Extent
• Severity
• Salience
• Preventive potential
• Modifiability of the problem
5/19/2017 10
11. SCALE FOR PRIORITIZING PROBLEMS
CRITERIA TYPES OF
PROBLEMS
EXTENT OF
PROBLEM
SEVERITY OF
CONSEQUENCES
SALIENCE PREVENTIVE
POTENTIAL
MODIFIABILITY
OF THE
PROBLEM
RATING
SCALE
03
02
01
Health
Deficit
Health
Threats
Foreseeable
crisis
High
Prevalence
Moderate
Prevalence
Low
Prevalence
Very Severe
Moderately
Severe
Very Few Severe
A serious
problem
A problem
but much
attention
not needed
Not much
problematic
High
Moderate
Low
Fully Modifiable
Partially
Modifiable
Very little or not
Modifiable
5/19/2017 11
12. 5/19/2017 12
HEALTH DEFICIT
• Respiratory problem
• Imbalanced nutrition
• Low Hemoglobin level
• Faulty dietary habits
• Environmental sanitation
• Insensitive towards good handwashing technique
13. HEALTHTHREAT PRACTICE
5/19/2017 13
Frequent respiratory problems
among children
Unaware about the health
services
Incomplete Immunization status
Unmet need of contraception
Tobacco abuse
14. 5/19/2017 14
HEALTH THREAT PRACTICE(Contd…)
Cooking stove
Open defecation
Barefoot
Using public toilets
Cope up with the situation
15. 5/19/2017 15
FOESEEABLE CRISIS OR STRESS
• Home accidents
• Risk for Communicable diseases
• Unwanted Pregnancy
• School drop out
16. 5/19/2017 16
For example:-
Health
problem
Types Extent Severity Salience Preventive
potential
Modifia
bility
Total
score
Rank
Respiratory
Problem
03 03 02 03 03 03 17 1
Low
Hemoglobin
03 03 01 02 03 03 15 2
17. 5/19/2017 17
PRIORITISING OF PROBLEMS
PRIORITISING RANKING
RESPIRATORY PROBLEM 1
ANEMIA 1
MALNUTRITION 2
CONTRACEPTION 2
ENVIORNMENTAL SANITATION 3
UNHEALTHY PRACTICE 3
21. The study of respiratory disease is
known as Pulmonology
Respiratory disease is responsible for
over 10% of hospitalizations and over
16% of deaths worldwide.
5/19/2017 21
ANSWER
24. NURSING DIAGNOSIS ON RESPIRATORY PROBLEMS
• Ineffective airway clearance related to the inflammatory process,
and increased production of secretions.
• Altered physical comfort related to fever, cold and cough.
• Potential for developing Pneumonia as evidence by frequent
respiratory infections.
• Risk for spread of infection to the other child
5/19/2017 24
25. Nursing Diagnosis: Ineffective airway clearance related to the inflammatory process,
and increased production of secretions
GOAL: To promote airway clearance, airway patency & ventilation
INTERVENTION
• Monitored the vital signs (respiratory rate ,rhythm and depth)
• Chest auscultation
• Provided the comfortable position
• Steam inhalation ,chest physiotherapy and postural drainage
• Promoted coughing to remove secretion and observe sputum
• Maintain adequate hydration
• Referral to CH(SC),Pune5/19/2017 25
28. NURSING DIAGNOSIS ON Malnutrition
• Inappropriate growth and development related to inadequate nutrition
• Imbalanced nutrition less than body requirements.
• Knowledge deficit in identification of nutritional requirement as per
age.
• Impaired growth of children as evidenced by growth chart
5/19/2017 28
29. Nursing Diagnosis: Imbalanced nutrition less than body
requirements
GOAL: To maintain the nutritional status of the family
INTERVENTION:
• Physical Assessment (Height, weight)
• Determined the type , pattern , amount of food intake by each member
• Obtained Nutritional History
• Plan one day menu & encourage the mother towards daily log
• Deworming with Albendazole
• Preparation of nutritious laddoo
5/19/2017 29
32. NURSING DIAGNOSIS ON Anemia
• Activity intolerance related to inadequate tissue perfusion
• Potential for decreased cardiac tissue perfusion
• Risk for infection related to low Hb level
5/19/2017 32
33. Nursing diagnosis: Activity intolerance related to inadequate tissue
perfusion
GOAL: Promote activity tolerance with energy conservation
INTERVENTION
• Monitored vital parameters
• Assessed the Hb level with Sahli’s haemoglobnometer
• Taught energy conservation techniques
• Planned daily activity and supervised
• Taught menu plan for iron rich diet
• Referral to CH(SC),Pune
5/19/2017 33
37. What is a concept unmet need of contraception
5/19/2017 37
38. Unmet need of contraception means a gap between women’s
reproductive intention and their contraceptive behavior
High Among in :
Adolescents
Migrant
Urban slum
Refugees
Post partum women
5/19/2017 38
ANSWER
39. Nursing Diagnosis: Potential for unwanted pregnancy related to Unmet needs of
contraception
Goal: To educate and meet unmet need of contraception
INTERVENTION:
• Assessed the level of understanding on contraception
• Health Education on family Planning Methods
• Promoted towards terminal method
• Planned a suitable family planning method with couple
participation.
• Motivated to choose best from Basket of Contraception
• Referral for insertion of IUD
5/19/2017 39
46. First line generation:- Lippes Loops
Second Line Generation:-Copper IUD contains copper
Third Line Generation:-Hormone-releasing IUDs –
(Progestogen hormone)
5/19/2017 46
ANSWER
47. ACTION OF INTRA UTRINE DEVICES
IUD works is by preventing fertilization of
the egg.
The copper or the hormone from the IUD
stops the sperm movement
The IUD stops the implanting of fertilized
egg into the Uterus.
5/19/2017 47
ANSWER
48. What is the ideal time for Copper-T insertion
5/19/2017 48
49. Ideal time for copper –T insertion is
within 10 days of menstruation
5/19/2017 49
ANSWER
51. •Risks for home accidents related to unawareness and
unsafe home environment related accidents
•Risk for communicable diseases related to environmental
sanitation and overcrowding
5/19/2017 51
Potential Risks :
52. • Risk for vector born diseases related to
unhealthy and unhygienic drainage
system.
• Risk for non-compliance to treatment
due to poor economic status.
• Risk for meeting educational need as
related with school drop out
5/19/2017 52
Potential Risks (contd…)
53. Goal: To prevent potential risks
INTERVENTIONS:
• Early detection of risk by assessment of etiological factors
• Awareness about the factors to family
• Participation of family members in early detection
• Education on managing the risks
• Community participation
5/19/2017 53
55. • Deficient knowledge (Learning Need) regarding condition, treatment
plan, care of child
• Knowledge deficit in detecting sign & symptoms of diseases under
IMNCI
• Knowledge deficit on risk of diseases without immunization as
evidenced by incomplete immunization status of child
5/19/2017 55
OTHERNURSING DIAGNOSIS :
56. • Knowledge deficit in monitoring growth and development of child as
evidenced by impaired nutrition of child
• Ineffective health maintenance related to substance abuse as evidenced
by tobacco use and tobacco smelling breath
• Knowledge deficit for disposal of waste as evidence by not throwing
waste into receptacles implanted by PCB
• Knowledge deficit regarding environmental sanitation5/19/2017 56
Other Nursing Diagnosis (Contd):
57. 5/19/2017 57
• Care of the baby while having
respiratory symptoms
• Identify the symptoms of diseases
under IMNCI
• Immunization
• Dietary plan
• Family planning methods
• De-addiction
• Compliant to treatment
• Preparation of Nutritious laddoo
• Referral for Copper –T insertion
69. FUTURE PLAN
5/19/2017 69
• To make the family self- sufficient in taking care of children
& monitor their Growth & Development
• To improve the family’s living conditions with the available
resources
• To improve family’s overall health seeking behaviour
• To witness family making healthy lifestyle modifications
70. FOLLOW UP
Regular home visits were carried out for assessment of reformed life-style
Positive Inter-personnel relationship
Improved Nutritional status of family
Hemoglobin level was within normal limit
Compliant to treatment
Following healthy practices
Maintaining environmental sanitation
5/19/2017 70
71. FOLLOW UP (Contd…)
Mrs Basanti was found with fungal infection
for which referral was done and proper
treatment was taken.
Baby Sapna was diagnosed with Pneumonia for
which immediate Pediatrics referral was done
and further treatment has been done.
5/19/2017 71
72. AIM OF THE PRESENTAION
• To impart knowledge on how work with the family as a unit.
• To identify the family health needs
• To manage the health problems by preventive , promotive and curative
services
• To divert the attention towards levels of preventions
5/19/2017 72
