1

University of Mindanao
College of Health Science Education
3rd floor, DPT Building, Matina Campus, Davao City

Family Case Study

In Partial Fulfillment of the Requirements in

NCM 104N Community Health Nursing (Individual and Family)

Submitted to:
Gamela Kate Mostero, RN, MN

Submitted by:
Acasio, Ianee C.
Ajos, Karyl Eunice
Antonio, Karille Ann
Asimpen, Janura
Auditor, Kharelbob
Bacalso, Vanessa Mae
Bolario, Celeste
Bañez, Renz Ace
Bendulla, Archelle
Cabaden, Ira Monique

Date
September 2021
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II. TABLE OF CONTENTS

I.TITLE PAGE -------------------------------------------------------------------------------------------1

II.TABLE OF CONTENTS----------------------------------------------------------------------------2
III. ACKNOWLEDGEMENT -------------------------------------------------------------------------3
IV. INTRODUCTION ----------------------------------------------------------------------------------4
V. OBJECTIVES OF THE CASE--------------------------------------------------------------------
6
VI. IDENTIFICATION OF THE CASE--------------------------------------------------------------
7
VII. FAMILY BACKGROUND------------------------------------------------------------------------7
VIII. SOCIO-ECONOMIC BACKGROUND ------------------------------------------------------8
IX. FAMILY MEDICAL and HEALTH HISTORY -----------------------------------------------9
X. GENOGRAM ---------------------------------------------------------------------------------------10
XI. FAMILY APGAR ----------------------------------------------------------------------------------
12
XIII. FAMILY COPING INDEX ---------------------------------------------------------------------
12
XIV. NURSING THEORY ---------------------------------------------------------------------------
17
XV. MANAGEMENT
A.MEDICAL MANAGEMENT-----------------------------------------------------------------------
18
B.NURSING MANAGEMENT
B.1 Problem List (Maslow’s Hierarchy)----------------------------------------------------------32
B.2 Problem Identification (Health Threat/Deficit/Foreseeable Crisis)-------------------33
B.3 Family Nursing Care Plan----------------------------------------------------------------------
34
B.4 Health Teachings (Three Levels of Prevention)-----------------------------------------36
XVI. SUMMARY --------------------------------------------------------------------------------------37
XVII. IMPLICATION ---------------------------------------------------------------------------------37
XVIII. HEALTH UPDATES -------------------------------------------------------------------------39
XIX. REFERENCES ---------------------------------------------------------------------------------40
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ACKNOWLEDGEMENT

The success and the final result of this project demanded a lot of guidance
and support from numerous people, and we are greatly honored to have made this
all along with the completion of our project work. Everything we have accomplished
is simply due to such guidance and support, and we will not forget to appreciate
them.

We appreciate and thank Mrs. Gamela Kate T. Mostero, RN, MAN, for
providing us an opportunity to do this case study presentation and rendering us all
the support and guidance, which made us finish the project on time. We're truly
grateful for her endless support, patient, and understanding spirit throughout our
case study presentation, though she had a busy schedule managing school stuff.

We are genuinely thankful that we managed to accomplish this project within

the time allotted. This project cannot be achieved without the support, effort,
participation, and teamwork of each members of the group; Acasio, Ianee; Ajos,
Karyl Eunice; Antonio, Karille Ann; Asimpen, Janura; Auditor, Kharelbob; Bacalso,
Vanessa Mae; Balorio, Celeste; Banez, Renz Ace; Bendula, Archelle; Cabaden, Ira
Monique, classmates, and friends.

Lastly, we would like to express our heartfelt gratitude to our parents for
understanding our late-night grinds and for the undying support and encouragement
throughout the process of making this project. Also, we would like to extend our
sincere appreciation to the CABADEN FAMILY for allowing us to interview them.
Without their full cooperation and support, this assessment would not be possible.
Above all, we thank our Almighty God for the guidance and strength, for his
power everything is possible.
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INTRODUCTION

Since the family is the smallest member of the community and the natural
essential focus of the society, it is seen as the primary beneficiary of nursing care,
which contributes to the community's development and advancement through active
participation and self-responsibility of each member. It is made up of man and
woman, formed into one, working together to promote a positive environment
between the family members.

Each family's impression or status will always have an impact on the

community as a whole. People's health needs are met by community health nursing.
It is not centered on a specific social class or family. It takes a broad approach.
Community health care is not a one-time event; it necessitates constant observation
and monitoring of the entire community. The major goal of community health nursing
is to improve and maintain the health of different clients (family, community, group,
or individual).

A community is an organized body of people who share the same

geographical boundaries, as well as common values and interests. 2004 (Maglaya)
There are no two communities alike. A nurse who is exposed to the community
determines how to engage with a variety of people and adapt to their needs. In
community health nursing, the family is seen as the most basic unit of care. A
member's health attitudes, beliefs, and practices are formed in the family. A person's
health behaviors are heavily influenced by his or her family. As a result, families in a
community must be aware of health-related issues and practices.

Community health nursing, it is fair to say, plays a significant part in nursing

education. The student nurse learns nursing in the community rather than in the
hospital because she is exposed to a different level of orientation. As a student nurse
seeks to provide quality care using the health center's limited resources, the phrase
"nursing is an art" can be applied in the community.
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Conducting a family case study allows a student nurse to connect with and sense the
community through its most fundamental structure - the family. It's a tool for
determining a family's health status through assessment and inspection. This
identifies health-related issues, offering the student nurse an indication as to where
to act and how to intervene. It's also a way to improve the health of the community's
residents, allowing them to be more productive. A student nurse feels fulfilled when
she does a family case study because she can use her skills, knowledge, and time to
alleviate and improve the living conditions of a family.

The family picked by the student nurse represents the majority of families in our
country: a family living in a poor environment with insufficient resources, a family
lacking important health information, and a family dealing with various socio-
economic issues. Reaching out to this family and mingling with them, as exhausting
as it is, gives the student nurse a sense of fulfillment as she donates her knowledge,
expertise, and time to help improve the family's situation. 
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OBJECTIVES OF THE CASE

General Objective:
After the interactions of the chosen family and student nurse, the chosen
family will be able to enhance their health status and become self–sufficient in
preserving their health through suitable interventions in the given time.

Specific Objectives:
After the interaction of the student nurse to the chosen family, the student will be
able to:

1. Integrate knowledge and abilities on how to provide family health education to

the identified situation;
2. Discuss and explain the etiology, causes, and effects of the priority problem,
as well as strategies to prevent it;
3. Construct a genogram for Mrs. A to help in the visualization of a hereditary
pattern;
4. Demonstrate the family Apgar score, which illustrates the relationship
between family function;
5. Identify the several nursing theories that apply to Mrs. A condition, concerns,
and issues;
6. Formulate a detailed and concise plan of action to address the family existing
health issues;
7. Provide health assessments on the family identified medical problem;
8. Determine whether the highlighted health issues are a health threat, a health
deficit, or a foreseeable crisis;
9. Established a nursing care plan that would be helpful to the family; and
10. Provide a set of potential remedies or nursing actions to address the most
pressing health complications.
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IDENTIFICATION OF THE CASE

Patient’s Code Name: Mrs. A

Age: 42 years old
Nationality: Filipino
Civil Status: Married
Occupation: Teacher
Sources of Information: Mrs. A

FAMILY BACKGROUND

Mrs. A is 42 years old and was born on December 14, 1978, living in Purok 6,
Calachuchi, Brgy. Libudon Mati City. She was married on November 6, 2001 at the
age of 22 to Mr. B. They have 3 children, all girls and all of them are currently
studying. The eldest daughter, Ms. C is 19 years old and is a 2nd year college
student in Bachelor of Science in Nursing at University of Mindanao, the middle
child, Ms. D is a 15-year-old 10 th grade student at Libudon National High School,
while the youngest, Ms. E is a 6-year-old grade 1 student at Francisco C. Hinayon
Elementary School. Mrs. A is a public teacher at Francisco Hinayon Elementary
school. They owned a barber shop managed by her husband near their resident
house.

Mrs. A’s family belongs to an extended type of family. The extended type of family is
consisting of three generation which may include married siblings, and their families
and or grandparents. In the case of Mrs. A, her father and brother (including the
daughter of his brother) is living in the same roof.
Mrs. A's father is 79 years old, the second head of the family. He is involved in
decision making and is able to provide financial support. However, he is dependent
sometimes or in need of assistance in terms of preparing his meals and changing his
diapers.
Mrs. A together with his husband, father and brother are working hand on
hand in terms of managing the Family’s finances. Each member consults and
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formulates agendas about their monthly food supplies, house bills and other house
responsibilities, even talks about financial conflicts.
The household members do their respective duties, the daughters of Mrs. A,
Ms. C and Ms. D is responsible for the household chores like washing the dishes,
cleaning the rooms, and swiping the floors, since Mrs. A have a no time to do the
household chores due to hectic schedules in school. Ms. E the niece of Mrs. A and
Ms. F the youngest daughter of Mrs. A, are the runners of the family, in which they
do minimal errands such as arranging books in the bookshelf, and swiping the floors
of the balcony. On the other hand, Mr B. And Mr.G are busy handling their source of
income. Mr. B owns and works as a barber on his Barbershop, while Mr. G manages
the family’s agricultural land.
Mrs. A is very concern to the health matters of each members of the family.
Aside from being busy on her duties in school, she managed to check the condition
of the whole family. These include monitoring the sick members, providing
adequate amount of foods and spend her leisure time with them. They loved eating
and go for an outing during their leisure time. Mrs. A make sure that everyone will
be able to eat at least thrice a day and able to sustain the needs of everyone.

SOCIO – ECONOMIC BACKGROUND

Mrs. A's family has plenty of sources of income, they owned a small business
such as barber shop and printing shop and each is earning approximately 5,000php
per month. Her father and brother owned a lot for lease. Sometimes Mr. G and Mr.
H could provide approximately 5,000 per month from the land they use for lease, a
total of 10,000 per month. On the other hand, Mrs. A earns about 20,000php per
month from teaching. The overall income of the family is sufficient for their daily
needs and other expenses such as tuition fees, clothing, medicines and other
miscellaneous. Aside from that, there is also money set aside in times of emergency.
Mrs. A is responsible for budgeting all the expenses needed by family. The family
works hand in hand to support each member financially and emotionally.

All of them are affiliates of Southern Baptist. Mrs. A is a religious person and
goes to church every Sunday. She is an active affiliate in their church along with her
daughters. Her husband and brother do not often go to church. They do not actively
participate in church activities due to some works. Meanwhile, their father chooses
not to the church anymore due to his age and asthma.
For the significant others, Mrs. A’s family are close to their relatives and some
neighbors. They are connected to their relatives and communication is well observed
in order to prolong good relationships. They are able to build a strong relationship
with their neighbors. They treated them well and cooperation is highly appreciated in
terms for the development of their neighborhood.
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FAMILY MEDICAL AND HEALTH HISTORY

In 2010 Mr. H was diagnosed with Tuberculosis (TB) and Asthma. In 2018, Mr. H
was hospitalized in St. Camillus Hospital in Mati City due to a sudden Asthma attack.
He was not able to maintain good respiration and experienced severe difficulty of
breathing. He was set for an Endotracheal Intubation (EI) and was referred to a
tertiary facility at Davao Regional Hospital, Tagum City. Currently, Mr. H’s TB is no
longer present, it was treated way back 2012. However, he still has asthma and is
monitored and provided with modification methods such as inhalers, nebulizers and
an oxygen tank. Moreover, Mr. H is now a widowed individual, his wife died last
March 31, 2019 at the age of 69 due to heart failure. His wife was also diagnosed
with Nephrolithiasis same as Mrs. A’s and Anemia.
Mr. H’s daughter Mrs. A was diagnosed with stage 1 hypertension (mild
stroke) and was hospitalized in St. Camillus Hospital, Mati City in the year 2012. In
2019, Mrs. A was diagnosed with a disease called Nephrolithiasis and was observed
by having the presence of kidney stone in her left kidney. Mrs. A acquired
complications from the disease, this includes severe urinary tract infection . Mrs. A is
also diabetic and has increased level of bad cholesterols. She has allergies to insect
bites or bee stings and too much fragrance or strong scents of perfumes around her.
She also acquired chickenpox and mumps during her childhood times. Mrs. A is not
consistently taking her maintenance or medicines. Since according to her, by taking
these medicines it causes her to experience pain in each sides of her abdomen. She
even verbalizes the following “magsakit akong kilid mga pila ka oras basta maka
inom kog tambal, tapos naa pay mugawas na bato basta mangihi ko, sakit sad iihi”
Mrs. A’s daughter Ms. C was diagnosed with asthma in the year 2006 and
was hospitalized at the St. Camillus Hospital, Mati City. In the year 2007, Ms. C
suffered DEN T1 or Dengue virus 1 and was referred to Davao Regional Hospital,
Tagum City. Ms. C was hospitalized again with DEN T2 or Dengue virus 2 in the
year 2015, and was referred to the same hospital at Davao Regional Hospital,
Tagum City. Ms. D the middle child of Mrs. A, was also diagnosed with DEN T1 or
Dengue virus 1 in the year 2007, and was hospitalized in the same hospital. She was
also diagnosed with Asthma in 2010. Mrs. A’s youngest daughter, Ms. E was
diagnosed with Amebiasis in 2018 and was hospitalized in St. Camillus Hospital,
Mati City. .
Mrs. A’s husband, Mr. B has a history of motorcycle accident in 2014, and
was treated with 15 wound sutures at the anterior head part of the patient. Mr. B was
hospitalized at that time in St. Camillus Hospital, Mati City.
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Ms. F the niece of Mrs. A suffered from Chicken pox last year, and was
treated as outpatient. She had done her medical checkup at Paredes Clinic, Mati
City. Mr. G the father of Ms. F is alive and well and was not diagnosed and
hospitalized with any types of diseases.
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GENEGRAM
Paternal Genogram Grandfather Grandmother

(Old Age) (Horse Accident)

S2 H1 Mr. H Wife S4 S5 H2
S1 S3 S6

71
A/W (Pneumonia) (Unknown) A/W (Unknown) A/W A/W (Liver Disease) A/W
Asthma

Mr. G Brother 2
Sister 1 Wife Mrs. A Mr. B

38 42 43
Legend: A/W A/W A/W

- Male

- Female Ms. F

- Deceased Male or Female

Ms. C Ms. D Ms. E
6
- Compound Family Member A/W

- Family member living separate house

19 15 6
Asthma Asthma Amebiasis
A/W – Alive & Well
DEN T1 DEN T1
( ) - Cause of death DEN T2
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Interpretation:
The figure presented is a Paternal Genogram from the first to third generation.
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Family APGAR
This design is intended to allow for a qualitative measurement of each of the
five main components of family function by the members of the family.
Almost Some of Hardly
always (2) the time ever (0)
(1)
A I am satisfied that I can turn to my 2
family for help when something is
troubling me.
P I am satisfied with the way my family 2
talks about things with me and shares
problem with me.
G I am satisfied that my family accepts 2
and supports my wishes to take on new
activities or directions.
A I am satisfied with the way my family 2
expresses affection and responds to my
emotions such as anger, sorrow, and
love.
R I am satisfied with the way my family 2
and I share time together.

Family Coping Index

This is an assessment tool that evaluates about the measurements of the
family capacity on how they will come up with their problem related to health care.
CRITERIA IDEAL ACTUAL RATIN JUSTIFICATION
G
1. Physical Is concerning The family 5 All the members of the
Independence in the ability members are family are well with no
each member mobile. disabilities. Everyone
to move in Independent in has the ability to do
getting out of all of the independent activities
the bed, could activities in a on a daily basis such
take care of daily basis as bathing, eating,
daily such as, and doing house hold
grooming, eating, bathing chores.
walking and and etc.
other activities
that involves
it.
2. Therapeutic Includes in the Afford to buy 3 The family are
Competence procedure or medicine if capable of buying
treatment that needed, could medicines if needed,
is being provide there’s a first aid kit in
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prescribed for nutritious meal, their home with

the caring of has first aid kit available stock of OTC
the ill such as,and has stocks medicines and they
medication, of on the also stated that they
exercising and counter can provide nutritional
relaxation, medicines at meals however, they
dressing, and home, but is don’t exercise
special diets. not doing regularly.
exercises.
3. Knowledge Concerning Were able to 5 The family has a
of Health with each understand knowledge and are
Condition health signs and able to recognize any
condition that symptoms, presence of health
is occasion for could condition. In addition
care like as, recognize to that they are
knowledge of possibilities of already aware the
present complication if possible affect if it is
disease or left untreated. left untreated.
wellness
state.
4. Application Concerning Doing fogging 5 The client has it own
of Principles with the family to minimize the ways to minimize the
of General action the number of number of mosquitoes
Hygiene relates in mosquitoes, in order to avoid
maintaining using of getting dengue such
the family mosquito net, as using set fire and
nutrition, ensured that used the method of
securing an there are no fogging to get rid of
adequate rest water stoked, mosquitoes, using
and relaxation avoidance of mosquito net before
for each prohibited sleeping, ensuring that
family foods, usage of there are no signs of
member, oxygen, knows stock water inside the
fulfilling how to use house to stop the
accepted nebulizer, has breeding of
preventive BP apparatus, mosquitoes. As well
measures like axillary as they have a
immunization thermometer complete of
of the baby. for Vital sign emergency kit with
monitoring. OTC medicines,
nebulizer and an
apparatus to check
vital signs.

5. Health Concerning If one member 5 If there’s a family

Attitudes with the way is sick and has member who got sick
of the family gotten 1-2 days they typically
feels about is immediately administer an OTC
the health in brought to medicine, keeping an
general that specialist to eye of his/her food
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includes, have check-up, intake and observed

preventive day 1 of being after 2 days.
measures, sick
caring of immediately
illness, and take OTC
public health medicines,
measures. tracking of food
consume if
prohibited food
or not are
done.
6. Emotional Concerning in All members 5 All of the family
Competence the family are able to members are capable
maturity and understand and to understand each
integrity that is matured other and as well they
were able to enough, typically consult every
meet the consultation to member of the family
usual stresses one another before deciding.
and problems, before making
and planning decisions for
for a fruitful the good in
and happy general, and
living. the family are
understandable
to each other
enough.
7. Family Concerning The members 5 In terms of finances
Living largely with has bonding if and decision making
the family there are they typically involved
interpersonal occasions, all every family member
or group are involve in to avoid
aspects of the decision misunderstanding,
life of the making, in and they also tend to
family like terms of get together in a
how well are finances most special occasion.
the family of the members
members in are involved,
getting along everyone
with each understands
other, their each other that
ways in is why there is
making no chaos.
decisions that
affects the
whole family.

8. Physical Concerning For the home: 3 There is an adequate

Environment with the The house is at living space for the
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home, the compound, whole family however,

community, near the church their house isn’t free
and the and is made of from the risk of getting
environment mix cement dengue since it is near
of the work as and wood. Well from the clogged
it affects the ventilated, with canals. Also, there
health of the electric fans, 4 house roof is not in
family. rooms with good condition, with
electric fans. holes and usually
Lightning are leaks if a sudden rain
functioning will occur.
well, both front
and back have
light. The
house is beside
the canal and
is dirty, and
clogged. In
which makes it
prone to
dengue due to
barangays no
action. No risk
even though is
near of the
canal because
the water could
flow easily. The
roof has holes.
Has no data
internet
connection and
just depending
to the Wifi
Tower in
Wistap Mati.
Has electricity
problem,
brown-out
happened
always.

For the school:

High school
and elementary
schools is 5
minutes away
from home.
College is
away, needs to
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travel 45
minutes to get
there.

For work:
Near and
would just take
15 minutes
walking
distance.
9. Use of Keeps The family 5 The client stated that
Community appointments does not go to they tend to seek
Facilities generally. their health services from
Follow center regularly barangay center
referrals. but able to especially if there’s a
Concern with participate if problem of car
the family needed like for services for the
degree of the census, delivery of oxygen and
usage and having their medical needs.
awareness of weight
the checked. Seek
community help in their
available barangay such
facilities for as vehicle, for
education and medical needs
welfare. for the
grandfather
most especially
in delivery of
oxygen. And,
seeks help in
the barangay
for permits and
most especially
when dealing
about their
land.
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Nursing Theory
In Florence Nightingale’s 13 cannons of environment, she pointed out that
“the act of utilizing the environment of the patient to assist him in his recovery.” As
eloquently stated by Nightingale in the environmental factors about the effective
drainage she stated that “ all the while the sewer may be nothing but a laboratory
from which epidemic disease and ill health are being installed into the house”. The
current location of the client’s house increases the risk of exposure to dengue fever,
especially that their barangay officials doesn’t assess their problem about the
clogged canals. On top of that, although there is adequate space for their whole
family and a well-ventilated house with four electric fans in each room. The roof has
its tiny hole that can lead to roof leaks during rainy season.

Nola Pender’s Health Promotion Model talks about a person’s unique

experiences and their personal characteristics that affects their succeeding actions.
Their health promoting behavior could lead them to their desired result such as
improvement of their health, enhancement of their functional ability, and the
betterment of life quality in all developmental stages. In relation to the client family,
Mrs. A is showing a positive sign of coping in her health problem, she is experiencing
hypertension and good thing she is taking medicines occasionally and following her
proper diet. And so as for Mr. H, has knowledge of the needs of oxygen. And all in
for the family in general are showing signs of health promotion. The knowledge and
competence of each family member in contributing to their family’s health are factor
in helping one another to achieve the betterment of the health problems due to their
health coping attitudes and application of health promotion in their family.
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MEDICAL MANAGEMENT FOR HYPERTENSION

Overview of Hypertension

One of the most frequent lifestyle disorders nowadays is high blood pressure,
commonly known as hypertension, is a condition in which the blood pressure is
greater than usual. Your blood pressure fluctuates throughout the day depending on
what you do. Blood pressure readings that are persistently higher than normal might
lead to a diagnosis of high blood pressure (or hypertension). The higher your blood
pressure, the greater your chance of developing additional health issues including
heart disease, heart attack, and stroke.

Classification

There are four types of hypertension, each of which has no convincing

reasons. These four categories rely on the patient's blood pressure measurements,
which must be collected precisely.

• Normal – The normal range for blood pressure is between, less than 120
mmHg and less than 80 mmHg.

• Elevated – The elevated stage begins with a systolic blood pressure of 120
mmHg to 129 mmHg and a diastolic blood pressure of less than 80 mmHg.

• Stage 1 hypertension – When a patient's systolic pressure is 130 to 139

mmHg and their diastolic pressure is 80 to 89 mmHg, they are in Stage 1.

• Stage 2 hypertension – When the systolic pressure is greater than or equal to

140 mmHg and the diastolic pressure is greater than or equal to 90 mmHg, stage 2
begins.

Cause

High blood pressure is a condition that often develops over time. It can occur
as a result of poor lifestyle choices, such as a lack of regular physical activity.
Certain medical disorders, such as diabetes and obesity, might also raise the risk of
high blood pressure. During pregnancy, high blood pressure is also a possibility.
 20

There are several causes of hypertension, just as there are numerous causes
of fever. The following variables have been linked to the development of
hypertension:

• Sympathetic nervous system activity has increased. Because the autonomic

nervous system is dysfunctional, sympathetic nervous system activity rises.

• Renal reabsorption increased. A genetic mutation in the mechanisms through

which the kidneys manage salt causes an increase in sodium, chloride, and water
reabsorption.

• RAAS activity has increased. The renin-angiotensin-aldosterone system

becomes more active, causing extracellular fluid volume to increase and systemic
vascular resistance to rise.

• Vasodilation of the arterioles is reduced. Because of the reduction in arteriole

vasodilation, the vascular endothelium is injured.

Ideal Medical Management for Hypertension

The aims of hypertension nursing care planning include decreasing or

managing blood pressure, adhering to the treatment regimen, making lifestyle
changes, and avoiding consequences.

Over the last 50 years, the nurse's role in improving hypertension control has
grown, complementing and augmenting that of the physician. Nurses' engagement
began with blood pressure (BP) measurement and monitoring, as well as patient
education, and has evolved into one of the most successful techniques for improving
BP control. Nurses and nurse practitioners (NPs) are now involved in all aspects of
hypertension management, including (1) detection, referral, and follow-up; (2)
diagnostics and medication management; (3) patient education, counseling, and skill
development; (4) coordination of care; (5) clinic or office management; (6) population
health management; and (7) performance measurement and quality improvement.

A fundamental element of effective care models that have been proven to

enhance care procedures and control rates is the patient-centered, multidisciplinary
team. Nurses lead clinic and community-based research to improve the hypertension
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quality gap and ethnic disparities by holistically examining social, cultural, economic,
and behavioral determinants of hypertension outcomes and designing culturally
sensitive interventions to address these determinants, in addition to their clinical
roles.

Laboratory and Diagnostic tests for Hypertension

Before starting therapy for high blood pressure, routine lab testing are advised
to evaluate organ or tissue damage, as well as other risk factors. Urinalysis, blood
cell count, blood chemistry (potassium, salt, creatinine, fasting glucose, total
cholesterol, and HDL cholesterol), and an ECG are among the lab tests available
(electrocardiogram). Depending on your situation, further testing may be required.

• Urinalysis is performed to check the concentration of sodium in the urine

though the specific gravity.

• Blood chemistry (e.g. analysis of sodium, potassium, creatinine, fasting

glucose, and total and high density lipoprotein cholesterol levels). These tests are
done to determine the level of sodium and fat in the body.

• 12-lead ECG. ECG needs to be performed to rule presence of cardiovascular

damage.

• Echocardiography. Echocardiography assesses the presence of left

ventricular hypertrophy.

• Creatinine clearance. Creatinine clearance is performed to check for the level

of BUN and creatinine that can determine if there is renal damage or not.

• Renin level. Renin level should be assessed to determine how RAAS is

coping.

• Hemoglobin/hematocrit: Not diagnostic but assesses relationship of cells to

fluid volume (viscosity) and may indicate risk factors such as hypercoagulability,
anemia.

• Blood urea nitrogen (BUN)/creatinine: Provides information about renal

perfusion/function.
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• Glucose: Hyperglycemia (diabetes mellitus is a precipitator of hypertension)

may result from elevated catecholamine levels (increases hypertension).

• Serum potassium: Hypokalemia may indicate the presence of primary

aldosteronism (cause) or be a side effect of diuretic ¬therapy.

• Lipid panel (total lipids, high-density lipoprotein [HDL], low-density lipoprotein

[LDL], cholesterol, triglycerides, phospholipids): Elevated level may indicate
predisposition for/presence of atheromatous plaques.

• Thyroid studies: Hyperthyroidism may lead or contribute to vasoconstriction

and hypertension.

• Urinalysis: May show blood, protein, or white blood cells; or glucose suggests
renal dysfunction and/or presence of diabetes.

• Creatinine clearance: May be reduced, reflecting renal damage.

• Urine vanillylmandelic acid (VMA) (catecholamine metabolite): Elevation may

indicate presence of pheochromocytoma (cause); 24-hour urine VMA may be done
for assessment of pheochromocytoma if hypertension is intermittent.

• Uric acid: Hyperuricemia has been implicated as a risk factor for the
development of hypertension.

• Intravenous pyelogram (IVP): May identify cause of secondary hypertension,

e.g., renal parenchymal disease, renal/ureteral ¬calculi.

• Kidney and renography nuclear scan: Evaluates renal status (TOD).

• Excretory urography: May reveal renal atrophy, indicating chronic renal

disease.

• Chest x-ray: May demonstrate obstructing calcification in valve areas;

deposits in and/or notching of aorta; cardiac enlargement.

• Computed tomography (CT) scan: Assesses for cerebral tumor, CVA, or

encephalopathy or to rule out pheochromocytoma.

• Electrocardiogram (ECG): May demonstrate enlarged heart, strain patterns,

conduction disturbances. Note: Broad, notched P wave is one of the earliest signs of
hypertensive heart disease.
 23

Actual Medical Management

In the year 2012, Mrs. A was hospitalized in St. Camillus Hospital and
diagnosed with stage 2 hypertension by Dr. Blessilda N. Jaylo, MD and acquired
comorbidities such as diabetes, and High LDL.

In the 12th of August 2019, Mrs. A was diagnosed by Dr. Severo N. Arnao,
Jr., MD, to a disease called “Nephrolithiasis, left” and Mrs. A was observed by having
the presence of stone in her left kidneys. From the disease, she acquired
complications including severe Urinary tract infection and another kidney stone
located in both kidneys. Presently, Mrs. A is supervision with a health care provider
and follows prescribe treatment including the intake of maintenance drugs.

Telmisartan ( 40mg/ 12.5 mg - once a day) – treating high blood pressure,

was the past prescribe medicine taken by Mrs. A started in the year 2012 until
present .It was prescribed by Dr. Paredes.

Currently, Mrs. A has been taking the following medicines (capsules)

prescribe by Dr. Melinda R. Maduay , MD : Atorvastatin Calcium ( 40 mg - once a
day) – taken for reducing bad cholesterol, Sultamicillin Tosylate (750 mg- 2x a day),
- in treating urinary tract infections, Potassium Citrate ( 1080 mg - 3x a day) –
treating kidney stone condition. She started taking these following medicines in the
year 2019 until present. She stores her prescribe medicines to a safe place
unreachable by her kids.

Also, she kept these medicines in her bag in times of need. Mrs. A does not
experience any allergic reaction towards the medication. Though, she experienced
side effects (nauseated) when taking the medicines. Paracetamol is the over-the-
counter medication usually taken by Mrs. A in times of having a fever. Drinking
lemon juice is her home remedy in boosting its immune system.
 24

Drug Study

NURSING
USES AND AVAILABLE SIDE EFFECTS AND
MECHANISM OF CONSIDERATION/
MEDICATION ROUTES AND ADVERSE EFFECTS
ACTION INTERVENTIONS/CLIENT
DOSAGES AND CONTRAINDICATION:
EDUCATION

General Blocks vasoconstrictor Uses: Side Effect: Baseline Assessment:

Classification: and aldosterone
•Treatment of Occasional (7%–3%): Obtain B/P, apical pulse
secreting effects of
hypertension alone or in Upper respiratory tractimmediately before each dose, in
Pharmacotherapeutic angiotensin II, inhibiting
combination with other infection, sinusitis, back/legaddition to regular monitoring (be
Angiotensin II binding of angiotensin II
anti-hypertensives. pain, diarrhea. alert to fluctuations). If excessive
Receptor antagonist to AT1 receptors.
reduction in B/P occurs, place pt in
• Reduces cardiovascular Rare (1%): supine position, feet slightly
Clinical
risk in pts 55 yrs of age elevated. Assess medication
Antihypertensive. Therapeutic Effect: Dizziness, headache, fatigue,
and older unable to take history (esp. diuretics). Question
nausea, heartburn, myalgia,
Causes vasodilation , ACE inhibitors and at high for history of hepatic/renal
cough, peripheral edema.
decreases peripheral risk of major impairment, renal artery stenosis.
Generic Name:
resistance, decreases cardiovascular event (e.g.,
Telmisartan Adverse Effect/Toxic
B/P. MI, stroke). Obtain serum BUN, creatinine,
Reactions:
Hgb, Hct, vital signs (particularly
Brand Name: Over dosage may manifest as
Availability (Rx) B/P, pulse rate).
Micardis hypotension, tachycardia;
Tablets: bradycardia occurs less often. Intervention/Evaluation:
20 mg, 40 mg, 80 mg.
• Monitor B/P, pulse, serum
Administration/Handling electrolytes, renal function.
PO
• Monitor for hypotension when
• Give without regard to initiating therapy
food.
 25

INDICATIONS/ Contraindications: Patient/Family Teaching:

ROUTES/DOSAGE
Hypersensitivity to telmisartan. • Avoid tasks that require
Concurrent use with aliskiren alertness, motor skills until
• Hypertension in pts with diabetes. response to drug is established
PO: ADULTS, ELDERLY: (possible dizziness effect).
Initially, 20–40 mg once Cautions:
daily. Titrate based on pt’s • Maintain proper hydration.
Hypovolemia, hyperkalemia,
response up to 80 mg hepatic/renal impairment, renal • Avoid pregnancy.
once daily. artery stenosis (unilateral, • Immediately report suspected
bilateral), biliary obstructive pregnancy.
• Cardiovascular Risk disease, significant
Reduction aortic/mitral stenosis. • Report any sign of infection
PO: ADULTS, ELDERLY: Concurrent use with ramipril (sore throat, fever).
80 mg once daily. not recommended. Avoid
• Avoid excessive exertion
potassium supplements.
during hot weather (risk of
• Dosage in Renal dehydration, hypotension).
Impairment
No dose adjustment.

• Dosage in Hepatic
Impairment
Use with caution.
 26

SIDE EFFECTS AND NURSING

USES AND AVAILABLE
MECHANISM OF ADVERSE EFFECTS CONSIDERATION/
MEDICATION ROUTES AND
ACTION AND INTERVENTIONS/CLIENT
DOSAGES
CONTRAINDICATION: EDUCATION

General Inhibits HMG-CoA Uses: Side Effect: Baseline Assessment:

Classification: reductase, the enzyme
•Dyslipidemias: Primary •Common: Obtain baseline cholesterol,
that catalyzes the early
prevention of cardiovascular triglycerides, LFT. Question for
Pharmacotherapeutic: step in cholesterol Atorvastatin is generally possibility of pregnancy before
disease in high-risk pts.
Hydroxymethylglutaryl synthesis. Results in an well tolerated. Side effects initiating therapy. Obtain dietary
Reduces risk of stroke and
CoA (HMG-CoA) increase of expression are usually mild and history
heart attack in pts with type
reductase inhibitor in LDL receptors on transient.
2 diabetes with or without
hepatocyte membranes
evidence of heart disease. Obtain serum BUN, creatinine, Hgb,
Clinical and a stimulation of •Frequent (16%): Hct, vital signs (particularly B/P,
Anti-hyperlipidemic. LDL catabolism
• Reduces risk of stroke in Headache. pulse rate).
Therapeutic Effect: pts with or without evidence
of heart disease with •Occasional (5%–2%): Intervention/Evaluation:
Generic Name:
Decreases LDL and multiple risk factors other
Atorvastatin Calcium
VLDL, plasma Myalgia, rash, pruritus, • Monitor for headache.
than diabetes. Adjunct to
triglyceride levels; allergy • Assess for rash, pruritus, malaise.
Brand Name: diet therapy in management
increases HDL of hyperlipidemias (reduces
Lipitor •Rare (less than 2%–1%): • Monitor cholesterol, triglyceride lab
concentration. elevations in total
values for therapeutic response.
cholesterol, LDL-C, Flatulence, dyspepsia,
Apolipoprotein B, depression • Monitor LFTs, CPK.
triglycerides in pts with
Primary
Patient/Family Teaching:
hypercholesterolemia),
Adverse Effect/Toxic
homozygous familial • Follow special diet (important part
Reactions:
hypercholesterolemia, of treatment)
heterozygous familial Potential for cataracts,
hypercholesterolemia in pts photosensitivity, myalgia, • Periodic lab tests are essential part
10–17 yrs of age, females rhabdomyolysis. of therapy.
more than 1 yr • Do not take other medications
postmenarche.
 27

Contraindications: without consulting physician.

Availability (Rx)
Hypersensitivity to • Do not chew, crush, dissolve, or
Tablets: atorvastatin. Active hepatic divide tablets.
10 mg, 20 mg, 40 mg, 80 disease, breastfeeding,
• Report dark urine, muscle fatigue,
mg. pregnancy or women who
bone pain.
may become pregnant,
Administration/Handling unexplained elevated LFT • Avoid excessive alcohol intake,
PO results. large quantities of grapefruit
• Give without regard to products.
food or time of day. Cautions:
• Do not break, crush, Anticoagulant therapy;
dissolve, or divide film- history of hepatic disease;
coated tablets. substantial alcohol
consumption; pts with prior
INDICATIONS/ROUTES/ stroke/TIA; concomitant use
DOSAGE of potent CYP3A4
inhibitors; elderly
• Do not use in pts with (predisposed to myopathy).
active hepatic disease.

Note: Individualize dosage

based on baseline
LDL/cholesterol, goal of
therapy, pt response.
Maximum dose with strong
CYP3A4 inhibitors: 20
mg/day.
 28

• Dyslipidemias
PO: ADULTS, ELDERLY:
Initially, 10–20 mg/day (40
mg in pts requiring greater
than 45% reduction in LDL-
C). Range:
10–80 mg/day.

• Heterozygous
Hypercholesterolemia
PO: CHILDREN 10–17
YRS: Initially, 10 mg/day.
Maximum: 20 mg/day.

• Dosage in Renal
Impairment
No dose adjustment.

• Dosage in Hepatic
Impairment
See contraindications.
 29

NURSING
USES AND AVAILABLE SIDE EFFECTS AND
MECHANISM OF CONSIDERATION/
MEDICATION ROUTES AND ADVERSE EFFECTS
ACTION INTERVENTIONS/CLIENT
DOSAGES AND CONTRAINDICATION:
EDUCATION

General Ampicillin inhibits Uses: Side Effect: Baseline Assessment:

Classification: bacterial cell wall Sultamicillin is used in the Question for history of allergies, esp.
synthesis by binding Gastrointestinal: the most
treatment of infections peni cillins, cephalosporins; renal
Pharmacotherapeutic to PCN-binding frequent observed side
where β-lactamase impairment.
Penicillin. effects was diarrhea/loose
proteins. Sulbactam producing organisms
stool. Nausea, vomiting,
Clinical inhibits bacterial including uncomplicated Intervention/Evaluation:
epigastric distress and
Antibiotic. betalactamase, gonorrhea, otitis media
abdominal pain/cramps have
and respiratory tract and
• Promptly report rash (although
protecting ampicillin been observed. As with other common with ampicillin, may
from degradation. urinary tract infections.
ampicillin-class antibiotics, indicate hypersensitivity) or diarrhea
Generic Name:
enterocolitis and (fever, abdominal pain, mucus and
Sultamicillin Tosylate Therapeutic Effect: Availability (Rx)
pseudomembranous colitis blood in stool may indicate antibiotic-
Tab 375 mg x 100's. 750 rarely may occur. associated colitis).
Bactericidal in
mg x 50's.
Brand Name: susceptible • Monitor I&O, urinalysis, renal
Skin/Skin Structures: rash
Zunamyn microorganisms. function tests.
Administration/Handling and itching were infrequently
Storage: observed. • Be alert for superinfection: fever,
Store at temperatures not Miscellaneous: vomiting, diarrhea, anal/genital
exceeding 30°C. drowsiness/sedation, fatigue pruritus, oral mucosal changes
and headache have been (ulceration, pain, and erythema).
Usual adult dose: rarely observed.
• Provide an emesis basin within
One 375 mg FCT every 12 easy reach of the patient for
hours. Contraindications:
vomiting.
The use of this product is
For more severe contraindicated in individuals
Patient/Family Teaching:
infections: with history of an allergic
One 750 mg FCT every 12 reaction to any penicillins. • Take antibiotic for full length of
hours. treatment.
 30

For severe soft tissue Drug Interactions • Space doses evenly.

infections:
Probenecid decreases the • Report rash, diarrhea, or other new
2.25 g or one 750 mg FCT
renal tubular secretion and symptoms.
TID.
sulbactam. Concurrent use of
probenecid with Sultamicillin
may result in increased and
prolonged blood levels of
ampicillin and sulbactam. The
concurrent administration of
allopurinol and ampicillin
increases substantially the
incidence of rashes in
patients receiving both drugs
as compared to patients
receiving both drug as
compared to patients
receiving ampicillin alone.

NURSING
USES AND AVAILABLE SIDE EFFECTS AND
MECHANISM OF CONSIDERATION/
MEDICATION ROUTES AND ADVERSE EFFECTS
ACTION INTERVENTIONS/CLIENT
DOSAGES AND CONTRAINDICATION
EDUCATION
 31

General Necessary for multiple Uses: Baseline Assessment:

Side Effect:
Classification: cellular metabolic
•Potassium acetate, Assess for hypokalemia
processes. Primary Occasional
potassium (weakness, fatigue, polyuria, and
Pharmacotherapeutic: action is intracellular. Nausea, vomiting, diarrhea,
bicarbonate/citrate: polydipsia). PO should be given
Electrolyte. flatulence, abdominal discomfort with food or after meals with full
Treatment, prevention of with distention, phlebitis with IV glass of water, fruit juice
Therapeutic Effect: hypokalemia when administration (particularly when
Clinical (minimizes GI irritation).
necessary to avoid potassium concentration of greater
Potassium Required for nerve
chloride or acid/base than 40 mEq/L is infused).
replenisher. impulse conduction, Obtain serum BUN, creatinine,
imbalance (requires
contraction of cardiac, Hgb, Hct, vital signs (particularly
bicarbonate). Rare:
Generic Name: skeletal, smooth B/P, pulse rate).
bicarbonate/citrate muscle; maintains Rash.
Potassium chloride normal renal function, Availability (Rx) Intervention/Evaluation:
acid-base balance. •Potassium Acetate Adverse Effect/Toxic Reactions:
Brand Name: •Monitor serum potassium,
Alkalinse Injection Solution:
2 mEq/mL Hyperkalemia (more common in calcium, phosphate.
elderly, pts with renal impairment) • If GI disturbance is noted, dilute
•Potassium Bicarbonate manifested as paresthesia, motor
preparation further or give with
And Potassium Citrate weakness, cold skin, hypotension, meals.
Tablets for Solution: confusion, irritability, paralysis,
(Effer-K): 10 mEq, 20 cardiac arrhythmias. Too-rapid • Be alert to decreased urinary
mEq, 25 mEq. (Klor-Con infusion may cause cardiac output (may be indication of renal
EF): 25 mEq. arrhythmia, ventricular fibrillation, insufficiency).
cardiac arrest. • Be alert to evidence of
hyperkalemia (skin pallor/coldness,
paresthesia, feeling of heaviness of
lower extremities).

Administration/Handling Contraindications: Patient/Family Teaching:

Rate of administration: Acetate: • Foods rich in potassium include
beef, veal, ham, chicken, turkey,
PO Severe renal impairment, adrenal
fish, milk, bananas, dates, prunes,
insufficiency, hyperkalemia.
• Take with or after meals, raisins, avocados, watermelon,
 32

with full glass cantaloupe, apricots, molasses,

of water (decreases GI beans, yams, broccoli, brussels
upset) sprouts, lentils, potatoes, spinach.
•.Liquids, powder, • Report numbness, feeling of
effervescent tablets: Mix, heaviness of lower extremities,
dissolve with juice, water weakness, and unusual fatigue.
before administering.
• Do not break, crush,
dissolve,
or divide tablets; give
whole.

Dosage in
Renal/Hepatic
Impairment
No dose adjustment. Use
caution with potassium
acetate (may increase
serum aluminum and/or
potassium).
 33

B. Nursing Management

Aims to assist patients attain normal blood pressure levels through both
independent and dependent treatments.

B.1 Problem list (Maslow’s Hierarchy of Needs)

Deficits

SELF- ACTUALIZATION
Unfulfilled

ESTEEM NEEDS
none

LOVE AND BELONGING NEEDS

none

SAFETY NEEDS
Prone to fire, Prone to Health risk

PSYCHOLOGICAL NEEDS
Shelter

The Maslow’s Hierarchy of needs is composed of five (5) stages including

Physiologic needs, Safety needs, Love and Belonging needs , Esteem needs and
self – actualization.

A. Physiologic Needs
 Shelter – although it contains adequate and ventilated area, the
family’s roof includes holes that are prone for leakage, especially in
rainy seasons.
 34

B. Safety and Security

 Prone to fire- It is an ancestral home made with mix and light materials.
Moreover, the house contains several gas tanks and oxygens tanks which
increases combustion.
 Prone to Health risk – The family is at risk in acquiring viral diseases such
as Dengue, since there are clogged canals due to lack of community
official’s action in response to the community problem.
C. Self – actualization
 Unfulfilled- client verbalized the need for modification in terms of their
health lifestyles for the improvement of their health status.

B.2 Problem Identification (Health Threat/ Deficit/ Foreseeable Crisis)

Health Threat
 Prone to accident hazard
- presence of gas tanks and oxygen tanks that increases combustion
 Prone to water contamination
- Because their drainage system is an open system
 Poor environmental condition
- presence of clogged canals, which can serve as a breeding or resting site of
vectors such as mosquitoes.
 Poor home condition
-roofs with holes, causes water leakage.
 Unhealthy lifestyle
-the family is not actively engaged in recreational activities such as exercise
due to hectic schedules./ lack of inadequate exercise
Health Deficit
 Mrs. A is diagnosed with Hypertension 1 (mild stroke), Diabetes Mellitus,
Nephrolithiasis
 Mr. H is diagnosed with Asthma

Foreseeable Crisis
 Unwillingness to go to the health center
- Possible complications may occur
 35

B.3 Family Nursing Care Plan

Health Family Nursing Goal of Care Nursing Method Resources
Problem Problem Intervention of required
Nurse-
family
Health Inability to After nursing > discuss with O Material
Deficit: provide a home intervention, the family the N resources:
environment the family will signs and L
Hypertensio conducive to make symptoms and I > Time and
n as a health health measures to complication N effort on the
deficit maintenance manage, that might arise E part of student
control, and due to nurse and
due to: lessen the hypertension. I family.
risk factors of > Promote N
-lack of hypertension healthy lifestyle T > Visual aids
cooperation . such as: E and materials
towards And able to A. Prevent R used during the
community maintain obesity through V presentation
officials on proper proper nutrition I such as:
resolving healthy diet. and exercise. E A. PPT
clogged canals B. Encourage W
which are prone to take healthy
for breeding and accurate VIA
and resting food for their
grounds health G
condition. O
-unperceived > Provide O
investment information G
benefits regarding L
towards community E
improving the resources. M
home > discuss E
conducive to the risk factors E
health of hypertension T
maintenance.
 36

Criteria Score Weight Presence of Hypertension

Asthma as a as a health
health deficit deficit
NATURE OF
THE PROBLEM
Wellness 3
Condition (3÷3) x 1= 1 (3÷3) x 1= 1
Health Deficit 3 1
Health Threat 2
Foreseeable 1
Crisis
MODIFIABILIT
Y OF THE
CONDITION
Easily 2
Modifiable (2÷2) x 2= 2 (2÷2) x 2= 2
Partially 1 2
Modifiable
Not Modifiable 0
PREVENTIVE
POTENTIAL
High 3 (3÷3) x 1= 1 (3÷3) x 1= 1
Moderate 2 1
Low 1
SALIENCE
A condition 2 (0÷2) x 1= 0 (2÷2) x 1= 1
needing
immediate
attention
A condition not 1 1
needing
immediate
attention
Not perceived 0
as a condition
needing change
SUM TOTAL: 4 5

B.4 Health Teachings (Three Levels of Prevention)

Medical Management
- Adherence to the medical regimen
- Awareness of potential problem
- Awareness and management of the disease process
Home Management
- Maintain a developmental environment
 37

- Prevention of accident hazards

3 LEVELS OF PREVENTION
Primary Prevention
1. Health Promotion
- Measures to improve family diet
- Nutritional education
- Home economics
- Health education to the family about good nutrition and food hygiene.
- Family health environment
2. Specific Protection
- eliminates unwanted food for intake,
- separation of utensils
- use of mosquito nets
- insecticide, off lotion
- elimination of prohibited food or drink to be taken
Secondary prevention; early diagnosis and adequate treatment
1. Early diagnosis and treatment of diseases including Amebiasis and Asthma.
2. Early diagnosis and treatment of bacterial infection including Tuberculosis
3. Regular follow check-ups and maintenance
3. Tertiary prevention; nutritional rehabilitation
- Hospital Treatment
- Accelerate the cases
- Stay away from prohibited foods
 38

SUMMARY
Family X is an extended type of family, residing at Purok. 6 Calachuchi, Brgy.
Libudon, City of Mati in a compound type of house. Family X’s house is made of mix
with light materials and that is properly ventilated with the help of electric fans and
windows, has a continuous and open type drainage and water system, with
functioning light bulbs, restrooms and contains adequate space in terms of the
bedrooms, living area, and kitchen sufficient for the needs of the family.
The main source of income is from Mrs. A, which is a permanent teacher and
the head of the family that has an income approximately greater than P20,000
pesos. Mrs. A’s daughters, Ms. C and Ms. D are in charge of the household chores
such as washing dishes and swiping the floors. The family belongs to a Christian
group, and serve in a Southern Baptist Church.
The family is identified to have minimal environmental stress points such as
roof leakage if there’s an occurrence or sudden rain, clogged canals due to the
community official’s lack of action towards solving environment related problems.
In terms of their health aspect, Mrs. A and Mr. H are both categorized with a
health deficit, due to the presence of a diagnosed disease which are the
Hypertension and Asthma. However, Mr. H’s health status is highly modifiable than
Mrs. A’s condition, for it includes methods that amends its condition such as the
presence of nebulizers, inhalers and oxygen tank.
Nevertheless, the family has chances for environmental and health improvement in
the process. As we implement health education to the family during interview, they
integrate active response to the said implementation in promoting optimal health.
The family displays willingness to change their accustomed practices that affects
their health, through avoidance of prohibited diets to take and maintaining the
essential modifiable methods.

IMPLICATION
• Nursing Education
The conduct of Nursing Family Case study provided us with vision towards
how to handle family as the patient and an understanding towards the significance
of internalizing the role of nurses in medical care to promote and achieve optimal
health for the patients.
It provided us with opportunity to assess real-life situations and to practice
implementing and integrating our learned knowledge into skills, knowing that Nursing
is a skilled-related course and must acquire the essential skills to be proficient
enough in delivering the care.
 39

With nursing family case study, we are able to assess the essential needs of
the family, and provide their needed response through nursing interventions.
Moreover, it enables us to evaluate the impact of interventions or implementations
made such as health education concerning to Hypertension.

• Nursing Research
Hypertension or also called as High Blood Pressure, is one of the most
common disease perceived nowadays, which remains as a risk factors for individuals
with Coronary Heart disease, renal failures, and stroke. In the Philippines about 20%
hypertension prevalence is observed and nearly half of adults in United States.
The cause of this disease is associated more on an individual’s lifestyle.
Including its eating habits, exercise, and sleeping pattern. The causes of
hypertension are also classified into two levels, the Primary Hypertension and the
Secondary Hypertension. Primary (essential) hypertension usually takes place to
some adults with increased blood pressure, but the rooting cause is not identifiable,
and it tends to develop gradually over many years. On the other hand, Secondary
Hypertension is when an individual has high blood pressure associated to an
underlying condition or disease. People with Adrenal gland tumors, thyroid problems,
and kidney disease are most likely are considered at risk for acquiring hypertension.

 Nursing Practice

Nursing Profession is a group of various type of nurses integrated to provide

holistic care for all. It delivers evidence-based practices and promotes wellness and
health as one of the optimal goals of its profession. Nurses serves a vital role in the
multisectoral health care team, in which acted as the prominent advocates for
patients, willing to deliver care from primary through long term acute and home care.
They are sufficiently skilled and trained Nurses, and prioritized “caring” as an art that
does not only focuses on the physical matter, but in the holistic or overall health.
They are able to syndicate fundamental sciences and their skills to provide the finest
and most optimal service they can render.
 40

HEALTH UPDATES
Hypertension: Management and Treatment
Unhealthy lifestyle is one of the components that contributes acquiring
Hypertension. In response to this dilemma, there are several activities and methods
presented to aid hypertension. The following are by doing regular exercise, stress
reduction, medication, and modification of unhealthy diet.
It is recommended that regular exercise at least 5 days a week should be
done for hypertensive patients. With regular exercise, a stronger heart will be
distinguished in turn helps in decreasing the force of one’s arteries, lowering the
blood pressure. Walking, swimming, cycling and jogging are some of the
recommended suitable activities.
Stress reduction through meditation, yoga, long walks or warm baths can be
also be done. This will help a person control over its blood pressure.
In some patients, medication is recommended by doctor as a form of a
modifiable method. At first, a low dose Antihypertensive drug is prescribed with
minimal side effects, this includes drugs such as diuretics, beta and alpha blockers,
and others. Moreover, the choice of medication is dependent on the patient’s
underlying disease.
The most common recommended management to hypertension is modifying
unhealthy diet, by reducing salt intake, moderating alcohol consumption, eating more
vegetables, fruits and less fat. According to World Health Organization (WHO)
reduce intake of salt under 5 grams and eating plenty of leafy vegetables helps
hypertension and other underlying disease associated.

Summary and Reflection

Modified unhealthy diets, including the practice of regular exercise and lessen
consumption of alcoholic drinks can aid hypertension. It is a method that is less
expensive. Hence, to achieve the optimal level of health, it starts from the patient’s
disciplinary perceptions and knowledge how to cope up and lessen its complication.
 41

References
Belleza, M. (2021). Hypertension: Diagnostic tests. https://nurseslabs.com/hyperten
sio n/#nursing_management
Belleza, M. (2021). Hypertension: Nursing care management. https://nurseslabs.com
/hypertension/#nursing_management
Centers for Disease Control and Prevention. (2021). High blood pressure symptoms
and causes. https://www.cdc.gov/bloodpressure/about.htm
Felman (2019). Everything you need to know about hypertension. Medical news
today. https://www.medicalnewstoday.com/articles/150109#diet
Himmelfarb, C., Mensah, Y., & Hill, M. (2016). Expanding the role of nurses to
improve hypertension care and control globally. https://pubmed.ncbi.
nlm.nih.gov/27372529/

Notes, N. (2021). Family Coping Index - RNpedia. RNpedia. https://www.rnpedia.co

m/nursing-notes/community-health-nursing-notes/family-coping-index/.
MIMS. (2021). Zunamyn: Sultamicillin. https://www.mims.com/philippines/drug/info/z
unamyn?type=full
Kizior, R., & Hodgson, K. (2021). Saunders nursing drug handbook. Elsevier

Vera, M. (2021). 6 Hypertension nursing care plans. https://nurseslabs.com/hyperten

sion-nursing-care-plans/