Pregnant Jenny Tongco and her 8 children are living in poverty in a tiny house. Mr. Tongco works as a pedicab driver but only brings home a small daily income after rent expenses. The family's daily food intake is only 1/3 of the recommended amount. Their youngest child was found to have pneumonia and a risk of tuberculosis during a medical checkup. The nursing teaching plan aims to educate the family on nutrition, the child's condition and treatment, through question and answer sessions and informative videos or lectures.

1. Pregnant Jenny
Tongco and her
8 children case

2. TABLE OF CONTENTS
2
01 04
05
02
03
Case Scenario
Patient Background, Overall
Assessment and Danger Sign
Color Coded
Nursing Teaching Plan
Urgent Referral and Underlying
Principles
Patient Diagnosis, Planning
and Intervention

3. 3
CASE SCENARIO
The Tongco Family reside in a squatter area in a tiny house, Mr. Pitong is a Pedicab Driver and her wife Mrs. Jenny
is a sweeper in the street. She was pregnant in her 9 child. His husband daily income that was earned reach for
about 200-100 pesos for the day. Follow by recompense the rent for pedicab which he pay 60 pesos for that reason
he will bring home with 40 pesos sometimes 100 if the trip is strong. In a one time Mr. Pitong hand over 15 pesos to
Mrs. Jenny that she brought 7 eggs and rice. To save electricity they borrow a rice cooker along with the rice that
being cooked they also put the egg inside together to be boiled. They split in half the boiled egg in day 1.
The daily intake of food in Tongco family was 1/3 according to the FNRI result that only one person get for
this family was only 1 spoon for each person. The rate of pregnant women in the country 43.9% anemic
and 20.1% vitamin A deficient due to lack of nutrients that high risk. The 8 children was also check-up that
discovered have different illness the youngest of them all have pneumonia and possible TB.
Breakfast Lunch Dinner
 Day 1: N/A  N/A  7 boiled eggs with
rice
 Day 2: 1 cup of
coffee
 1 cup of dinuguan
and 1 cup of upo
 ¼ kilo of pinangat na
babansi
 Day 3: 7 cups of
lugaw
 2 pcs. of lumpia  2 packs of noodles
 Day 4: N/A  1 bowl of toge  2 packs of noodles
 Day 5: 5 cups of
champurrado
 2 pc. bisugo  2 packs of noodles

4. 01
Patient
Background
AND Overall
Assessment
02 Danger Sign
AND Color
Coded

5. 5
Mrs. Jenny Tongco, 8 months pregnant mother, is living in a
squatter area in a tiny house with her 8 children and husband. Mr.
Tongco is a pedicab driver while Mrs. Tongco is a street sweeper.
His husband's daily income will reach about 200-100 pesos for the
day. However, there is a recompense for the rent for pedicab
which he pays 60 pesos, thus, it will leave him with 40 pesos. The
daily intake of food of the Tongco family is 1/3 according to the
FNRI result that only one person gets for this family is only 1
spoon for each person. The children of the Tongco family went to
the hospital to have their checkup. It later revealed that the
youngest child has pneumonia and a risk for tuberculosis,
alongside with their malnutrition condition
Patient’s Background

6. 6
Assessment
Malnutrition
 Patient has lacks adequate nutrition of good quality and quantity of
food.
 Patient displays an obvious big round tummy and has a skinny body.
Pneumonia
 Patient always has a gurgling sound or phlegm in his throat.
 Patient has found Severe Pneumonia and possible Tuberculosis upon
the Pediatrician's examination.
 Patient's rib sinks as he breathes due to Pneumonia.
 Patient was confined for a day and immediately discharged the next
day.

7. 7
Danger Signs Color
Coded of each
Assessment
Signs Classify As Identify Treatment
 Patient always has a
gurgling sound or
phlegm in his throat.
 Patient has found
Severe Pneumonia
and possible
Tuberculosis upon
the Pediatrician's
examination.
 Patient's rib sinks as
he breathes due to
Pneumonia.
 Patient was confined
for a day and
immediately
discharged the next
day.
 Fever
 Severe Pneumonia  Try to convince
Aling Jenny to
continue the
treatment for her
youngest in the
hospital.
 Discussed to Aling
Jenny the
importance of
treating the
pneumonia of her
child.

8. 8
Danger Signs Color
Coded of each
Assessment
Signs Classify As Identify Treatment
 Patient’s nutrition is
only ⅓ of the
required nutrition
intake according to
the FRNI.
 Very Low Weight  Assess the food
intake inclined to the
food box.
 Counsel Aling Jenny
about the family’s
food intake.
 Follow up after 30
days.

9. 9
Patient
Diagnosis,
Planning and
Intervention

10. 10
Diagnosis, Planning, &
Intervention
The patient is Mrs. Jenny Tongco she was pregnant with her 9th child.
Diagnosis Planning Intervention
• Imbalanced
nutrition: less than
the body
requirements as
evidenced by poor
nutrition and body
weight 20% or more
under ideal
pregnancy advice.
 To maintain the
normal
nutritional status.
 For education of
the patient for
appropriate
recovery from
nutritional
imbalance.
 Assessed the
general condition
of the baby to get
baseline data.
 Educate the client
regarding the
importance of
eating healthy
foods and it is
benefits to his
body.

11. 11
Diagnosis, Planning, &
Intervention
•Deficient Knowledge
regarding condition,
prognosis, treatment,
self-care, and discharge
needs related to the
lack of exposure,
unfamiliarity with
information resources
as evidenced by
inaccurate follow-
through of instructions.
After the interviewed
patient will demonstrate
knowledge of Childbirth
preparation, Health
education and verbalizes
understanding of desired
content and/or performs
desired skills.
 Render physical
comfort for the
patient.
 Provide an
atmosphere of
respect, openness,
trust, and
collaboration.
 Provide clear,
thorough, and
understandable
explanations and
demonstrations.

12. The patient is Mr. & Mrs. Tongco youngest child among their 8 children
12
Diagnosis, Planning, &
Intervention
Diagnosis Planning Intervention
• Ineffective
breathing pattern
related to acute
infection and
decreased in lung
capacity as
evidenced by
increased effort of
breathing.
 To maintain an
effective
breathing pattern,
as evidenced by
relaxed breathing
at normal rate
and depth.
 Evaluate client’s
respiratory status.
 Position the infant’s
head and neck in
neutral position.
 Maintain emergency
equipment in readily
accessible location and
include age or size
appropriate
endotracheal tubes.

13. 13
Diagnosis, Planning, &
Intervention
• Imbalanced nutrition:
less than the body
requirements as
evidenced by poor
nutrition.
 To maintain a healthy
nutritional status
 Use a nutritional
screening tool
designed for nurses
such as the pediatric
York hill malnutrition
score (PYMS) tool
 Work with the child
and parent to develop
an appropriate weight
gain plan.
• Ineffective airway
clearance related to
inability to maintain
clear airway as
characterized by rapid
and shallow breathing.
 To maintain
adequate patient’s
airway
 Monitor Respirations
and breath sounds,
noting rate and sounds.
 Suction nose, mouth,
and trachea prn using
correct-size catheter and
suction timing for child

14. Underlying
Principles
Urgent
Referral
14

15. 15
Urgent Referral
Pre-referral treatment/s needed
• Give oxygen therapy
• IV fluids if the child is unable to drink well
• Breathing treatments, as ordered by your child’s healthcare provider
• Give antibiotics by IV (intravenous) or by mouth (oral) for bacterial infection
Pre-referral treatment identified:
• Advice Aling Jenny to continue the treatment for her youngest in the hospital.
• Give medicine for cough
• Advice to drink more fluids
• Discussed to Aling Jenny the importance of plenty of rest in treating pneumonia of her
child.

16. 16
Underlying principles
• Child acute malnutrition can be identified in primary health centers and in the communities before
the onset of complications. Workers at facility and community level can be trained on the use of
Mid-Upper Arm Circumference (MUAC) tape and on recognition of bilateral pitting oedema.
• Whenever referred, it is crucial that caregivers understand the lifesaving importance of going
immediately to the recommended facility where their children will be fully assessed to determine
the type of care they should receive. Early detection and referral, coupled with decentralized
treatment make it possible to start management of acute malnutrition before the onset of life-
threatening complications.
• Detecting and referring children with acute malnutrition are the foundation for integrated
management of malnutrition at facility and community level.
• Division of roles for malnutrition screening and assessment: Community: Taking Mid-Upper Arm
Circumference (MUAC). MUAC Resources - Sources for MUAC straps Checking presence of
oedema.

17. 17
Underlying principles
• Referring children with acute malnutrition to sites with treatment services.
• All functional Health Centers: Taking Mid-Upper Arm Circumference (MUAC).
Checking presence of oedema. Referring children with acute malnutrition to
sites with treatment services. Health Centers with treatment services
(therapeutic and supplementary feeding programs):
• Taking anthropometric measurements (W/H and W/L, presence of oedema
and Mid-Upper Arm Circumference (MUAC))
• Diagnosis and decision on type of treatment. Referral forms for children with
acute malnutrition It is crucial that trained workers at facility and community
level locate the nearest facilities to refer cases with Severe/Moderate
Malnutrition

18. Nursing
Teaching
Plan
18

19. 19
Time Allowed Objectives Content Method &
Materials
Evalution
Method
Test Questions
20-30 minutes After the first
part of the
session the
client must be
able to state
what is
malnutrition.
After the
second part of
the session the
client must be
able to identify
what are the
risk of be in
malnutrition
• Poverty&
Malnutrition
 Question and
answer.
Lectures
 Question and
answer.
Lecture/
informative
videos
 Question and
answer.
Lecture/infor
mative videos
 Question and
answer.
Lecture/
informative
videos
 Question and
answer.
Lecture
 Review the
patient’s
own record
of self-
monitored
in their
daily
weights.
 Response to
treatment
assessed by
standard
outcome
for severe
and
moderate
acute
malnutritio
n.
 How does
poverty
lead to
malnutriti
on?
• Why do
children
still suffer
from
malnutritio
n, if we’re
working so
hard to
prevent it?

20. 20
 After the third part of the
session the client must be
able to understand and
identify the signs and
symptoms of malnutrition
 After the last part of the
session the client must be
able to understand and
identify the functions of
essential nutrients and their
examples.
• After the last whole part of the
session the client must be able
to know the importance of
having a complete healthy
meal.

21. 21
Group 2
Capulong, Patricia
Casugay, Kenishi Gaile
Cenzon, Alessandria
Cervantes, Ma. Jenina
Corpuz, Mary Grace
David, Michelle Anne
Dayrit, Alexandrea
De Guzman, Shiara Mae
Diamsay Danica
Diaz, Rae Shine
Dimalanta, Trishelle Louisse

22. 22
Thank You For
Listening