Family Nursing Care Plan: Assessment & Diagnoses in Family Nursing Practice

First level Assessment wellness or realize health potential. Examples are

the following:
The process of determining existing and potential
health conditions or problems of the family. These A. Presence of risk factors of specific diseases
health conditions are categorized as: (e.g. lifestyle diseases, metabolic syndrome,
smoking)
I. Presence of Wellness Condition
B. Threat of cross infection from communicable
Stated as “Potential” or “Readiness”; a clinical or disease case
nursing judgment about a client in transition from a
specific level of wellness or capability to a higher
level. Wellness potential is a nursing judgment on C. Family size beyond what family resources can
wellness state or condition based on client’s adequately provide
performance, current competencies, or
performance, clinical data or explicit expression of D. Accident hazards specify.
desire to achieve a higher level of state or function
in a specific area on health promotion and
maintenance. Examples of this are the following ● Broken chairs
● Pointed /sharp objects, poisons
and medicines improperly kept
A. Potential for Enhanced Capability for: ● Fire hazards
● Fall hazards
● Healthy lifestyle-e.g. ● Others specify.
nutrition/diet, exercise/activity
● Healthy maintenance/health
management
● Parenting E. Faulty/unhealthful nutritional/eating habits
● Breastfeeding or feeding techniques/practices. Specify.
● Spiritual well-being-process of
client’s developing/unfolding of
● Inadequate food intake both in
mystery through harmonious
quality and quantity
interconnectedness that comes
● Excessive intake of certain
from inner strength/sacred
nutrients
source/God (NANDA 2001)
● Faulty eating habits
● Others. Specify.
● Ineffective breastfeeding
● Faulty feeding techniques

B. Readiness for Enhanced Capability for:

F. Stress Provoking Factors. Specify.
● Healthy lifestyle
● Health maintenance/health
● Strained marital relationship
management
● Strained parent-sibling
● Parenting
relationship
● Breastfeeding
● Interpersonal conflicts between
● Spiritual well-being
family members
● Others. Specify.
● Care-giving burden

II. Presence of Health Threats

G. Poor Home/Environmental
Condition/Sanitation. Specify.
Are conditions that are conducive to disease and
accident, or may result to failure to maintain
● Inadequate living space
 ● Lack of food storage facilities ● e.g. child assuming mother’s role,
● Polluted water supply father not assuming his role.
● Presence of breeding or resting
sights of vectors of diseases
● Improper garbage/refuse disposal
● Unsanitary waste disposal M. Lack of Immunization/Inadequate
● Improper drainage system Immunization Status Especially of Children
● Poor lightning and ventilation
● Noise pollution
● Air pollution N. Family Disunity

● Self-oriented behavior of
member(s)
H. Unsanitary Food Handling and Preparation ● Unresolved conflicts of
member(s)
I. Unhealthy Lifestyle and Personal ● Intolerable disagreement
Habits/Practices. Specify.

● Alcohol drinking O. Others. Specify._________

● Cigarette/tobacco smoking
● Walking barefooted or inadequate
footwear III. Presence of health deficits
● Eating raw meat or fish
● Poor personal hygiene These are instances of failure in health
● Self medication/substance abuse maintenance.
● Sexual promiscuity
● Engaging in dangerous sports
● Inadequate rest or sleep Examples include:
● Lack of /inadequate
exercise/physical activity A. Illness states, regardless of whether it is
● Lack of/relaxation activities diagnosed or undiagnosed by medical
● Non use of self-protection practitioner.
measures (e.g. non use of bed nets
in malaria and filariasis endemic
areas). B. Failure to thrive/develop according to normal
rate

C. Disability
J. Inherent Personal Characteristics

Whether congenital or arising from illness;

● e.g. poor impulse control
transient/temporary (e.g. aphasia or temporary
paralysis after a CVA) or permanent (e.g. leg
amputation, blindness from measles, lameness from
polio)
K. Health History, which may
Participate/Induce the Occurrence of Health
Deficit IV. Presence of stress points/foreseeable crisis
situations
● e.g. previous history of difficult
labor. Are anticipated periods of unusual demand on the
individual or family in terms of adjustment/family
resources. Examples of this include:

L. Inappropriate Role Assumption A. Marriage

B. Pregnancy, labor, puerperium

C. Parenthood C. Attitude/Philosophy in life, which hinders
recognition/acceptance of a problem
D. Additional member-e.g. newborn, lodger
D. Others. Specify _________
E. Abortion
II. Inability to make decisions with respect to
taking appropriate health action due to:
F. Entrance at school
A. Failure to comprehend the nature/magnitude
G. Adolescence of the problem/condition

H. Divorce or separation B. Low salience of the problem/condition

I. Menopause C. Feeling of confusion, helplessness and/or

resignation brought about by perceive
magnitude/severity of the situation or problem,
J. Loss of job i.e. failure to break down problems into
manageable units of attack.
K. Hospitalization of a family member
D. Lack of/inadequate knowledge/insight as to
L. Death of a member alternative courses of action open to them

M. Resettlement in a new community E. Inability to decide which action to take from

among a list of alternatives

N. Illegitimacy
F. Conflicting opinions among family
members/significant others regarding action to
O. Others, specify.___________ take.

Second-Level Assessment G. Lack of/inadequate knowledge of community

resources for care
Second level assessment identifies the nature or
type of nursing problems the family experiences in H. Fear of consequences of action, specifically:
the performance of their health tasks with respect to
a certain health condition or health problem.
● Social consequences
● Economic consequences
I. Inability to recognize the presence of the ● Physical consequences
condition or problem due to: ● Emotional/psychological
consequences
A. Lack of or inadequate knowledge

B. Denial about its existence or severity as a

result of fear of consequences of diagnosis of I. Negative attitude towards the health condition
problem, specifically: or problem-by negative attitude is meant one
that interferes with rational decision-making.

● Social-stigma, loss of respect of

peer/significant others J. In accessibility of appropriate resources for
● Economic/cost implications care, specifically:
● Physical consequences
● Emotional/psychological ● Physical Inaccessibility
issues/concerns ● Costs constraints or
economic/financial inaccessibility
K. Lack of trust/confidence in the health J. Prolonged disease or disabilities, which
personnel/agency exhaust supportive capacity of family members.

L. Misconceptions or erroneous information K. Altered role performance, specify.

about proposed course(s) of action
● Role denials or ambivalence
M. Others specify._________ ● Role strain
● Role dissatisfaction
● Role conflict
III. Inability to provide adequate nursing care to the ● Role confusion
sick, disabled, dependent or vulnerable/at risk ● Role overload
member of the family due to:

A. Lack of/inadequate knowledge about the

disease/health condition (nature, severity, L. Others. Specify._________
complications, prognosis and management)

IV. Inability to provide a home environment

B. Lack of/inadequate knowledge about child conducive to health maintenance and personal
development and care development due to:

C. Lack of/inadequate knowledge of the nature A. Inadequate family resources specifically:

or extent of nursing care needed
● Financial constraints/limited
D. Lack of the necessary facilities, equipment financial resources
and supplies of care ● Limited physical resources-e.i.
lack of space to construct facility

E. Lack of/inadequate knowledge or skill in

carrying out the necessary intervention or
treatment/procedure of care (i.e. complex B. Failure to see benefits (specifically long term
therapeutic regimen or healthy lifestyle ones) of investments in home environment
program). improvement

F. Inadequate family resources of care C. Lack of/inadequate knowledge of importance

specifically: of hygiene and sanitation

● Absence of responsible member D. Lack of/inadequate knowledge of preventive

● Financial constraints measures
● Limitation of luck/lack of
physical resources
E. Lack of skill in carrying out measures to
improve home environment

G. Significant persons unexpressed feelings (e.g.

F. Ineffective communication pattern within the
hostility/anger, guilt, fear/anxiety, despair,
family
rejection) which his/her capacities to provide
care.
G. Lack of supportive relationship among
family members
H. Philosophy in life which negates/hinder
caring for the sick, disabled, dependent,
vulnerable/at risk member H. Negative attitudes/philosophy in life which is
not conducive to health maintenance and
personal development
I. Member’s preoccupation with on
concerns/interests
I. Lack of adequate competencies in relating to I. Feeling of alienation to/lack of support from
each other for mutual growth and maturation the community

Example: reduced ability to meet the physical and ● e.g. stigma due to mental illness,
psychological needs of other members as a result of AIDS, etc.
family’s preoccupation with current problem or
condition.

J. Negative attitude/ philosophy in life which

J. Others specify._________
hinders effective/maximum utilization of
community resources for health care
V. Failure to utilize community resources for health
care due to:
K. Others, specify __________

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 :

● Physical/psychological
consequences
● Financial consequences
● Social consequences

F. Unavailability of required care/services

G. Inaccessibility of required services due to:

● Cost constraints
● Physical inaccessibility

H. Lack of or inadequate family resources,

specifically

● Manpower resources, e.g. baby

sitter
● Financial resources, cost of
medicines prescribe