Family case study OBG. Use for Assignment

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JG COLLEGE OF NURSING
AHMEDABAD
SUBJECT: OBSTETRICS & GYNECOLOGICAL NURSING
TOPIC : FAMILY CASE STUDY
SUBMITTED TO, SUBMITTED BY,
Ms. Rekhamol Sidhanar, Ms.Sonal Patel
Assistant Professor, F.Y.M.Sc(N).
J.G College of Nursing, J.G College of Nursing,
Ahmedabad. Ahmedabad.

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objectives:
FOR STUDENTS:
1) To Gain Co-operation of family and their members.
2) To teach the mothers and other family members for maintenance of their own health
status.
3) To provide knowledge about health and health services by communication with them.
4) To provide comprehensive care to all family members accordingly their needs.
5) To provide need based health services by communicating for bringing normal health life
for all family members.
6) To motivate target couple for permanent family planning method.
7) To give sex education to adolescent girls.
8) To give education regarding old age care.
9) To develop competence of each individual member of the family member and help them
to cope up with their problem.
FOR FAMILY:
1) To Gain Co-operation of family members.
2) To provide general basic care at community level.
3) To established good rapport with the family members.
4) To find out problems/needs of the family members and to provide general care according
to those problems.
5) To perform specific tasks in the form providing need based care to the family members.
6) To help the family to get health services provided by Govt.
7) To develop skill in performing procedure demonstration and health talk according to need
of family.
8) To learn about how to find out the needs of family members.
9) To guide the family members as a community health nurse regarding their health
problems and health services.
10) To bring awareness about national health programmes, Pharmacy
Services, health project, public private partnership i.e. about Janni
Suraksha yojana, chiranjeevi yojana.

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 FAMILY IDENTIFICATION:
1. Name of the head of the family: Govindash Mangaldash Patel
2. Address : Near Primary school patel Vas sanathal
3. Cast : Hindu Koli Patel
 FAMILY CHARACTERISTICS:
Type of family : Joint Family
Size of the Family : Five members
Religion : Hindu
Mother Tongue : Gujarati
Diet : vegetarian
 HEALTH HABITS:
Govindash
 Smoking: Addiction of chewing tobacco for 10 years.
 Alcohol : No Addiction
 Drug : No Habit
 No any other habit he is having.
In Family, no one has any Type of Bad Habits.
 HOUSING AND SANITATION CONDITION:
 Type of House
a) Kachcha Pucca : Pacca
b) Own Rented : This house is their own. The house is
under the ownership of Govindash, It
Was constructed before 16years.
 Number of Rooms:
 There are 1 Room
 One Kitchen
 Courtyard-1
 Toilet-1
 Washroom-1
 A Small Corridor.

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 Ventilation:
 There are four windows and two doors in the home.
 Kitchen also has -1 window and a door.
 Ventilation is inadequate because, usually two doors remain close.
 Due to this space is not enough for ventilation.
 There is no facility for cross ventilation.
 Source of Light Electricity:
 Natural lighting during the day.
 Artificial sources are tube lights run by electricity.
 Sources of Water Supply:
 Drinking water is being stored in two mud pots.
 They are cleaned daily and fresh water is filled.
 For utilization of washing clothes, vessels etc. Water is stored in buckets, tubs and
plastic drum.
 Drainage System:
 From the Latrine all excreta goes to the pit made below latrine. It is a water seal
latrine.
 From bathroom it goes to gutter pipeline.
 Latrine:
 Type of latrine in this home is water seal latrine.
 It is kept clean.
 Kitchen Condition:
 They have a Separate kitchen.
 Hand washing facility is not present.
 Kitchen is congested with less ventilation.
 Good cleanliness is maintained, all the vessels have been kept neatly whatever
space available.
 They use wood for cooking purpose sometimes. otherwise Gas facility is
available.

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 Presence of Domestic Animals:
 No, they do not rear any domestic animal.
 Presence of Insects:
 There are mosquitoes, flies breeding over there.
 Situation near the house is clean but surrounding environment is very dirty as
wastewater and dry waste.
 Presence of Rodents:
 Rodents like rats are present in the home.
 Presence of Stray Dogs:
 There are 5-7 stray dogs in this area.
 Accidental Hazards Observed:
 No During my visit, I have not observed any incident.
 Transport and communication:
 Types of Roads are concrete made pukka roads.
 They use public transportation buses like AMTS.
 For communication, they are having a Mobile Phone.
 Through T.V. and radio, they entertain as well as get information.
 Channel of communication is by both kinship mass media.
 N.G.O. in Surrounding Areas :
 Chetna Institute for women’s health.
 Lions club organization (An eye care center).
 Educational Institutions in Surrounding Areas.
 Anganwadi - 2.
 primary School-1.
 high School-1.
 Health Services Utilized by Family:

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 From Civil Hospital Ahmedabad. Gandhinagar
 Primary Health center, Sugadh
 Private practinor
 M.Sc Nursing, B.sc Nursing, MBBS Students coming for field experience and
providing health services.
 Food Pattern:
 Food Habit : Diet is vegetarian.
 Dietary Pattern:
o Numbers of Meals : 3 meals day.
o Staple Food: Rice, wheat, bajara.
o Source: Purchase from Sabji Market.
o Common Vegetables used: Brinjal, beans, carrot, Cabbage, green
leafy vegetables, potatoes etc.
o Use of fruits occasionally when seasonal fruits are made available
and cheap.
 Total Consumption of family per day capita.
Calories - 1300 kcal
CHO - 250 gm
Protein - 12 gm
Fats - 15 gm
Vitamins - 08 mg
 Adequacy of Nutritional consumption –Inadequate
 Cooking Practice:
 Use of Polished rice- yes
 Drains the rice after cooking.
 Washing the vegetables after cutting.
 Cuts the vegetables in very small size.
 Adding table salt in dal, Sabji etc.
 Female members always eat at last after eating other family members.
 Snacks of school going children is not good, it’s not nutritious
i.e. Mamra, toast etc.
 Food Storage:
 Food Storage is done through hygienic manner.

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 Food serving is done in hygienic manner.
 General nutritional status of family members is normal.
 Statement of Income and Expenditure:
 This family has only one earning member.
1. Mr. Gonindash Patel- 4000 Rs/ month
2. Mr.Ashish Govindash 3000 RS/Month
Total Income: Rs. 7000/mth.
 Expenditure Statement:
Sr.No Items Amount Spent Percentage
1 Food 3500 Rs 50%
2 Clothing 1400 Rs 20%
3 House Rent - -
4 Medicine 175 2.5%
5 Children education - -
6 Recreation 350 5%
7 Saving 1225 17.5%
8 Debt 140 2%
9 Any Other 140 2%
 MATERNAL AND CHILD HEALTH
 Mrs. Manguben Govindash patel attained menarche at the age of 15 years and
became pregnant at the age of 24 years of the first pregnancy. And second time
pregnancy was after 2years.
 Antenatal treatment has been received in private practitioner.
 Family welfare services.
1. For spacing, she is not using any method . At present she is in menopose period
family planning method used by her.
2. All children immunization is fully completed.
Mrs Shilpaben Ashish Patel is daughter in law of Govindash she attained
menarche at age of 12 year , she was married at 20 year and become first
pregnan at 21 year now she is using birthspacing temporary method copper T. All
scheduled vacation has been given to her child.
 RELATIONSHIP OF FAMILY MEMBERS
 With The family member –good.
 With other family members –good in community.
 With the health personal – good.

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 GENERAL HEALTH OF THE FAMILY MEMBERS
 The family member are not completely superstitions but in some matter. They follow
their traditional believes.
 Manguben believes that there must be three brothers in family for better company in
future.
 HEALTH PROBLEMS FELT BY THE FAMILY
1. Govindash is having a Problem of severe coughing and sore throat.
2. Manguben is having a backache as well as she is feeling lethargic in her routine
work.
3. Ashishbhai having bad habits of chewing tobacco and taking less diet.
4. Shilpaben is having tiredness in her routine work.
5. Jilka is having Diarrhea and having less weight.
 HEALTH PROBLEMS FELT BY THE INVESTIGATOR.
1. Severe Anemia due to poor Dietary Pattern.
2. Malnutrition.
3. Poor personal hygiene as manifested by warm infestation.
4. Severe common cold and cough.
5. Knowledge deficit regarding Nutrition.
6. Knowledge deficit regarding Family Planning.
7. Knowledge deficit regarding prevention of accidents
8. Lack of knowledge regarding cooking Method.
9. Knowledge deficit of Immunization of children.
10. Lack of awareness regarding importance of cleanliness.
11. Lack of knowledge regarding prevention of communicable diseases.

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 VULNERABLE FAMILY MEMBERS:
Sr.No Number Health Assessment Problems Identified.
1. Toddler 1  Head to Toe examination is
done.
 Conjunctiva looks pale. Skin
became wrinkled and dry.
He looks lethargic.
 The weight of the baby is
7.5 kg only. and hight-65 cm
 Diarrhea.
 Anemia and malnutrition
2 Lactating
Mother
- - -
3. Antenatal
Mothers
- - -
4 School
Children
- - -
5. Adolescent -
-
-
6. Elderly 2  Done Health Assessment.  Severe Coughing due to
smoking.
 Anemia.
 Back Pain.
 Lethargy.
8. Challenged
Physically
Mentally
- - -
9. Other adults - - -

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 LEARNING OUTCOME:
a. Knowledge :
 Increased knowledge of personal hygiene and food hygiene, Immunization of
Children, taking well balanced diet, Family Planning.
 Get oriented with the Food and Nutrition.
 Improved knowledge regarding Prevention of communicable diseases.
 Gain knowledge of prevention of accidents including at home and road side.
b. Skill:
 Improved skill preparing ORS solution and care of skin.
 Developed skill in Proper Method of cooking.
c. Attitude:
 Wrong attitude is change regarding gender bias.
 Ready to adopt permanent Family Planning Method.
 Improvement in personal, food and environment hygiene.
 Understood the Importance of Education.
 Ready to leave Bad habits of chewing tobacco

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 FAMILY COMPOSITION:
1 2 3 4 5 6 7 8 9 10 11 12
Sr
No
Name Of The
Family member
Relation
ship with
head of
family
Age Sex Educa-
tion
Occupa-
tion and
income
Marital
status
Immuni
zation
Status
F.P.
practice
Sickness/D
eviationFr
omNormal
Health
Present
Rem
ark
1. Govindash M.
Patel
Head 60yrs M Illiterate Mill worker
4000Rs/
month
Married - - Severe
coughing
-
2. Manguben G.
Patel
Wife 55 yrs F Illiterate House wife Married - - Back pain -
3. Asish G.Patel Son 24yr M 9th
std Mill worker
3,000
Rs/month
Married BCG Scar
present
Not
adopted
Tobacco
chewing
-
4. Shilpa A. Patel Daughter
in law
24yr F 5th
std House wife Married BCG Scar
present
Not
adopted
- Anemia
- Weakness
-
5. Jilka A. Patel Grand
daughter
2.0 yrs F - - - Fully
immunized
- -Diarrhea
-Anemia
And
Malnutri-
tion.
-

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 FAMILY CARE PLAN
Sr.
No
Name Age Sex Health Need Nursing Goal Nursing Intervention Evaluation
1. Jilka A. Patel 2.0
yrs
F Mild
Dehydration
due to
Diarrhea
Short Term goal
To stop Diarrhea
and maintain Body
Electrolyte by
providing ORS.
Give Exclusive
Breast Feeding at
lest 6 month.
Do not give Bottle
Feed to baby.
Long Term goal
To give Health
Education
regarding
prevention of
Diarrhoea.
 I have prepared ORS for
baby, and given to the her
and advise to her that give
the her every hourly.
 Done assessment of the
baby for Dehydration.
 I taught to the Mother that
give food according to
choice of her with attract
manner.
 I taught to the Mother that
Do not give Bottle Feed to
baby.
 Advised Mother to keep
clean the baby, and wear a
dry cloth to baby.
 Advised Mother that if
diarrhea is not subside than
immediately contact to the
Doctor and take treatment
from Doctor.
Diarrhea was stop and
baby became healthier.

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Sr.
No
2. All family
members
especially
Jilka A. Patel
-
2yrs
-
F
Poor personal
Hygiene due to
low
Socioeconomic
Level as well
as the living
style
Short term Goal
To do the
Procedure of Nail
cutting and Give
Health education.
Long Term Goal
To Give Complete
Health education
to His Family
member regarding
maintaining of
Hygiene.
 I have done procedure of
nail cutting & advised to
his mother that due long
nail dirt accumulates in
Nail and it leads disease.
 By showing hand washing
procedure and Pictures, I
have Explain regarding
maintaining of personal
Hygiene and told him and
his mother that why it is
important.
 Explain regarding Disease
and infection like warm
infestation, which occurs
due to not maintaining
Hygiene and not taking
care.
 His Mother understood
my advice and Follow
all, which I advised
her.

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Sr.
No
3 Jilka A.
Patel
2.0
yrs
F Risk of
malnutrition
and anemia
due to
inadequate diet
intake.
Short Term Goal
Plan to maintain her
optimum health
status and to
prevent wasting of
body.
Long Term Goal
Give Health
Education
 I asked her mother what she
eat in her regular meals. She
eat 3-4 rotis ,1 bowl sabji
and buttermilk;, and at night
khichadi ,kari.
 I advise her mother that she
must eat at list one eatery of
gram ,pulses or milk.
 I explain her that she should
increase her grain intake.
 I told her to give a lot of
green leafy vegetable and
plenty of fluid. I asked to eat
frequently and on ate small
quantity.
Her Mother has understood my
advise and she has start to
follow my all advise

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Sr.
No
4. Govindas
Mangalda
sh patel
60
Yrs
M Severe
Cough and
Cold due to
not
Maintaining
Proper
Physical
Care.
Short term Goal
To Provide care to
person which relive
the cough and cold.
Long Term Goal
To Give Health
Education to him for
prevention of Cough
and Cold
 Advised him and his wife to
apply Vicks balm on Head &
Chest it may also effective .
 Advised to Cover the body
with Cotton or Woolen
Clothes, So that he May not
get Cold.
 Advised that while going
outside cover head properly
and wear woolen or cotton
soaks..
 Advised him to take bath in
late Morning and with warm
Water. Don’t give bath in
evening time it may also give
cold to him.
Her Mother Understood my all
Advise and Started to follow it

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Sr.
No
5. Asish
G.Patel
24
yrs
M Lack of
knowledge
regarding
adverse
effects of
tobacco
chewing.
Short Term Goal
optimum health
status and reduce the
number of packets of
tobacco.
Long Term Goal
Give Health
Education
 I asked him about duration and
numbers of packets per day for
tobacco chewing.
 I also explained the
consequences of tobacco
chewing.
 Explained that only loss of
money and adverse effects on
health occurs.
 I told him to divert your mind
by adopting interested
activities like singing bhajans
and reading religious books.
He has understood my advice
and she has start to follow my
all advise

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Sr.
No
6. Manguben
govindash
patel
55
yrs
F She having a
joints Pain as
well as she is
feeling
lethargic in
morning and
routine work.
Short Term Goal
optimum health
status and to prevent
wasting of body.
Long Term Goal
Give Health
Education to reduce
joint Pain and feeling
relief.
 Explained regarding taking
high calcium diet includes
milk, banana, grain and
green leafy vegetables.
 Advised for doing sarso oil
massage.
 Advised for taking early
morning sunlight.
 Giving Health Education
Regarding Nutritive Diet
especially calcium rich diet
 Advised to do light exercises
including both extremities.
 After taking to Urban
Health Centre and
health check-Up she is
relieve tension about
her problem she feels
very better
psychologically.

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Shilpaben
A. Patel
24yr
s
F Lack of
awareness
regarding
family
planning
Short Term Goal
Plan to adopt at least
one temporary family
planning method.
Long Term Goal
Adopt family
planning methods.
 Gave education regarding
various family planning
method and its benefits.
 Explained the important of
family planning.
 Explained which method
suits to her.
 Explained government
provides various scheme and
benefits.
 After health education,
she and her mother in-
law ready to adopt
permanent family
planning method.

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HEALTH EDUCATION:
1. DIET : I had adviced for taking well balanced diet, in that
high protein , low calorie diet. Increase the use of cereals, pulses
& green leafy vegetables. Avoid eating more oily and spicy food.
2. Exercise : I had adviced for the performing daily exercises in
that walking, swimming, aerobic exercises etc ,also adviced for
performing yoga ,pranayam, meditation.
3. SLEEP & REST: I had adviced for taking sleep atleast 8 hours
at night & 2 hours at the day times its helps to keep person
mentally & physically healthy.
4. MEDICATION: I had adviced client for taking medication as
per doctors orders. Explained to apply ointment on foot ulcer
atleast 3 times a day.
5. PREVENTION OF ACCIDENTS IN CHILDREN:
The infant is at risk for the accidents in the family. I have given
health education to the family members about the prevention of
those accidents. I have advised them to be with infant every time.
I have also advised to keep the sharp and other poisonous things
away from the child.
6. IMMUNIZATION
The family members are advised for the total immunization of the
child till the age of 5 years. I have explained the whole
immunization schedule to the mother. I have also explained the
importance of immunization schedule and it prevents which type
of diseases.
7. PREVENTION OF MALARIA:
There is storage of water out side of the house so increased
chances of spread of malaria in the family. I have advised them
not to allow the water to be collected surrounding the house and
change the stored water every day. I have instructed them to use

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the mosquito coil or the need leaves to kill the mosquitoes. I have
also advised them to wear the long sleeve clothes to prevent the
mosquito bite.
8. NUTRITION :
The family members are explained about the importance of
nutritious diet in the maintenance of health. I have explained
them to take the green leafy vegetables, pulses, cereals and fruits
occasionally according to the affordable of the family.
9. FOLLW UP : I had adviced for regular follow up and to visit the
hospital for any change in medications.
CONCLUSION:
We were posted at the PHC, sanathal for 1 week experience. I have selected
family and I have done the family case study in that family. When I have
visited the family at that time they were not much co-operative. I have faced
many problems in dealing with the family and in getting co-operation of the
family for my study. But once I have maintained the interpersonal
relationship with the family members, it was very easy for me to deal with
the family problems. I found the various different types of problems in the
family and I also suggested the solutions for those problems. I learned many
things from that experience. In the termination phase I also thanked all the
family members for their great co-operation to me in my study.

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BIBLIOGRAPHY:-
1) Basvanthappa B. T., “Community Health Nursing” 1st
-edition;
Published by: Jaypee Brothers Medical Publishers Ltd., New
Delhi 2006. Page No.268-278
2) Basu S. C.; “HAND BOOK OF PREVENTIVE AND SOCIAL
MEDICINE”;1st
edition, Calcutta, Saral Gupta
publications,1977. Page No.658-670
3) Byrne Monica & Bennett F J.; “COMMUNITY NURSING IN
DEVELOPING CONTRIES”;1st
edition,London, Oxford
University Press publication,1976. Page No.289-293
4) Corsa Leslie; “FAMILY PLANNING”; 1st
edition,New York,The
American Public Health Associated Ltd,1968. Page No.452-458
5) Dr. Dakshinamurty S.; “TEXT BOOK OF INTRODUTION TO
PREVENTIVE & SOCIAL MEDICINE WITH
EPIDEMIOLOGICAL AND ECOLOGICAL APPROACHES”;
6th
edition,Waltar, Andra University press.1998.Page No.556
6) Gulani. K., “COMMUNITY HEALTH NURSING” 1st
-edition;
Published by:KumarPublishing House, Delhi-2007.
Page No.560-566
7) Kamalam S., “ESSENTIALS IN COMMUNITY HEALTH
NURSING PRACTICE” 1st
edition; Published by: Jaypee
Brothers Medical Publishers Ltd,new delhi 2005.
Page No.232-234
8) Park K., “PREVENTIVE AND SOCIAL MEDICINE” 18th
-edition;
Published by:Jaypee Brothers Medical Publishers Ltd., New
Delhi-2006. Page No.220
WEB SITES
1. http://images.google.co.in/images
2. http://www.jea.com/community/education/afficiancy/wisely.html.

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