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The family can be defined simply as any group of people who live together. The role of the family is to help meet the basic human needs of society. (LeMone, Lillis, and Taylor 2001, p 27). The family is the social system and the larger biological context within which medical problems arise and are managed over time. Thus, knowledge of the family can be significant for understanding the etiology of illness and therapeutic resources for managing the problem. In total, the family affects the health of the individuals and the family is affected by the health of its members.
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Therefore, the family assessment is an essential component of family- centered community health. “Assessment can be viewed as a systematic evaluative process that leads to specific judgments about a given person’s current and potential level in variety of setting” (Hanson, 2001). According to Roffman (1998) family assessment is very important as it helps in full understanding and unbiased view of the family; not just its problems; but also its strengths, values, and goals. Nursing practice as focus in the family wellness, solving health related problem, promote health and prevent diseases in the family. Through assessment we can identify the quality of family functioning, know the strength and weakness of the family unit and we will have general view of health status of family members. Furthermore, by identifying the actual and potential health problem we will help the family to manage their own health problems as well as conserve and strength community services for health care and health promotion.
Health promotion is defined as the process of enabling people to increase control over and to improve their health. (Ewles & Simnett, 1999). Also it is defined as the science and art of helping people in changing their life style and to move toward a state of optimal health, .( Edelman C.L & Mandle C.L, 1998).
The fundamental aspect of health promotion is that it aims to empower people to have more control over aspects of their lives which affect their health (social, economic and environmental aspect). It can be offered to all clients regardless of their health and illness status or age. It is more than the avoidance or prevention of disease. It includes primary prevention activities as well as wellness promotion activities. The individual will decide to make the changes that will help to promote a higher level of wellness.
Pender stated that health promotion is directed toward increasing the level of well being and self actualization of a given individual or group. Health promotion focuses on movement toward a positively balanced state of enhanced health and well being. (Pender, 1987).
Nurses need to assess the family’s health in order to make them able to adapt more effective attitude in regard to promote their health. In our case we found it easy to contact and approach our client since she is very pleasure, cooperative, and understandable woman. We found Mrs. F.A.A in the mother and child department as she was known case of diabetes and the community health nurses know her so they asked her to be our patient for the assigned project but in the beginning she refused and then she agreed after thinking about that. We talked to her and took appointment to visit her in her house. She welcomed us and opened her heart with thoughts and concerns and we found that attitudes very helpful to complete our project successfully with the benefits to the clients.
General Patient Profile:
F.A. is 53 years Bahraini female house wife, holding file number1/819/734.Has history of many diseases, Diabetes type 2, Rheumatoid Arthritis, Bronchial Asthma, Ischemic Heart Disease and Epilepsy with Depression.
Assessment is the collection of data about the individual’s health state. (Carolyn J.4th ed.p 2) and part of assessment is physical examination. Physical examination is the process by which a physician or a nurse examines the patient’s body parts for signs or clues of disease.
Mrs. F. is 53 years, young and well developed according to her age. Skin uniformly white in color, soft, warm, moist, and elastic. No edema or lesions. Hair is straight, black and white in color and well distributed. Nails are firm no clubbing, breaking or cyanosis, capillary refill <3sec.
Neck: full range of motion in all direction.
Temporomandibular joint (TMJ): no slipping or crepitation.
Upper extremities (UE): Arms symmetrical, she is able to move her shoulders and elbows, but weak muscle strength. She can perform active ROM in both arms and elbows, but it is slightly limited.
Lower extremities (LE): legs symmetrical, she is able to move her leg and feet, but weak muscle strength. There is crepitation in her both knees.
General: Mrs. F. is alert, oriented to time, place and person, can recall recent and past events.
UE: able to distinguish sharp from dull on face and UE, feel vibration, unable to identify objects that kept in hands.
LE: unable to distinguish sharp from dull, she cannot feel vibration.
All reflexes are present.
Heart and Peripheral Examination of Mrs. F.:
Heart: No lifts, thrills, or abnormal pulsations. P.M.I. palpated between 5th and 6th intercostals space (ICS), (MCL). PMI is 2.5 Cm wide. Apical pulse 99 beat/min, heart sounds S1 and S2 with normal characteristics. No Murmur heard. Internal Jugular Vein present with supine position and absent with sitting. No bruits over carotid artery.
Upper and lower extremities with no edema, warm and all pulses present +3. No varicosities noticed in lower extremities.
Bp: 180/ 100mmHg.
Brows, lids, and lashes intact; no tearing, conjunctiva pink without discharge, Rt.pupil react equally to light and accommodation; Rt. Eye extra ocular movement intact, visual field not equal to examiner, red reflex present. Cornea, lens, and vitreous clear, retina pink, macula present. Snellen test done the result was Rt. Eye 6/18, Lt.6/12 and patient wearing glasses and following up in eye clinic in SMC regularly every 3 months. laser therapy done previously
Symmetrical breasts size, there was no palpable mass or discharge. Axillae were non tender with no lymphadenopathy. She did breast examination two times before in the national breast examination survey. Mrs. F. was instructed to do periodic self breast examination.
Symmetrical, round, no lesions, bowel sounds audible in all four quadrants, no bruit pulsation over aorta. No masses or tenderness. Liver edge was not palpable span of 7.5 cm at MCL. No CVA tenderness. No umbilical hernia.
The Client Community Setting
Mrs. F.A.A is living in A’ali village in an old ministry of housing 2 story unit with an extension of flats built in the back side and second floor of her house for her 4 children whom are living with their families, the setup of the block is very simple and has narrow roads between houses.
There is a small mini compound of few convenient stores (cold store, cafeteria, butchery shop, fruit and vegetable store and a bakery shop) that Mrs. F.A.A can walk to as well as the presence of a safe neighborhood; there is no major health hazard, just a nearby hose reconstruction that may cause noise disturbance.
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A’ali health center is a type A health center which is located approximately (0.7) km from her home. A’ali health center was officially opened in June 2000. It is located in the middle governorate. It is located in the middle of the catchments areas which serves approximately 31,000 clients. It provides health services to all the residents and expats.
Mrs. F.A.A. is visiting the health center less frequently for follow up because she is following all of her appointments at Salmaniya Medical Complex, she is well oriented to the health center’s facilities such as Diabetic clinic and health educator, but she is not following any of these clinics although the family physician had referred her.
There are so many community facilities surrounds her home such (matams) and a health club in a saloon nearby , she is well oriented also to these places ,but she stated that she do not like to be involved in such activities , moreover she visits the matams ( Al Qae’m Maatam ) only in special occasions such as ashoora .
There are so many recreational places such as a small open public garden near the health center which can be a good walking place as well as A’ali’s walking arena that was opened the past few years, and many historical land marks such as the famous A’ali burial tombs and the poetry factories, but she don’t have interest to be involved as well.
Primary health care activities in relation to the client’s health condition
A’ali health center is type A health center provide many services that contribute and promote Mrs. F. health condition for example Diabetic clinic, eye clinic, Laboratory services, X-ray department, Appointment system and Health Education.
The Health Center has one diabetic clinic only on Thursday, and it gives services from 7am to 2pm. The services of the clinic includes laboratory, diabetic foot care, health education, follow up and evaluation of diabetic patient’s status.
Our patient is not following in the diabetic clinic, all her appointment in S.M.C.
The health center provides appointment to patient to follow with the family physician in the health center.
The patient has several appointments to follow in Salmaniya Medical Center referred by the doctors from the health center as follow :
-Regular appointment in health center
Health education department:
Health education is another service available in the health center .There is one health educator in the health center, but Mrs. doesn’t like continuing appointment with health educator.
Treatment and medications
She is following regularly the collection of her medications from Salmaniya Medical Center. She is taken (Glucophage 1gm BD, Tegretol 200mg OD, Lipitor 20mg HS, Natrilix 1.5mg OD, Aproval 150 OD, Fersolate 1tab BD, Zertic 10 mg HS, Lisinopril 20mg, Amlodipine 10mg).
The patient doing investigation regularly in health center and with the result she is following with doctors in Salmaniya Medical Center.
The Client Community Setting
F.A.A is living in A’ali village in an old ministry of housing unit in a simple compound with an extension flats built in back side of her house for her 4 children whom are living with their families.
A’ali health center is a type A facility which is located approximately (*****) km from her home.
She is living in a safe neighborhood; there is no major health hazard, just a nearby hose reconstruction that may cause noise disturbance.
F.A.A. is visiting the health center less frequently for follow up because she is following all
Of her disease condition at Salmaniya Medical Complex, she is oriented to the health centers facilities such as Diabetic clinic and health educator, but she is not following any of these although the family physician had referred her.
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A nursing assessment is a process where a nurse gathers, sorts and analyzes a patient's health information using evidence informed tools to learn more about a patient's overall health, symptoms and concerns.What is nursing role in family health? ›
Nurses assess the health of the entire family to identify health problems and risk factors, help develop interventions to address health concerns, and implement the interventions to improve the health of the individual and family. Family nurses often work with patients through their whole life cycle.Why is family health assessment important in nursing? ›
By noticing patterns of disorders among relatives, healthcare professionals can determine whether an individual, family members, or future generations may be at an increased risk of developing a particular condition.What is a family health assessment in nursing? ›
Family health assessment is a process of getting information from the family about health promotion and disease-prevention activities. Family assessment includes nurse's perceptions about family constitution, norms, standards, theoretical knowledge, and communication abilities.What are the five key roles of nurses? ›
- Administering medication. ...
- Recording and monitoring patient vital signs. ...
- Maintaining a detailed medical record. ...
- Drawing blood samples. ...
- Providing emotional support for patients.
Nurses are responsible for recognizing patients' symptoms, taking measures within their scope of practice to administer medications, providing other measures for symptom alleviation, and collaborating with other professionals to optimize patients' comfort and families' understanding and adaptation.Why is it important for nurses to identify family members role in the plan of care quizlet? ›
-To treat family holistically we must consider their family background, understand family dynamics and the context of their community. This can assist the nurse in planning care for the family. -Family provides environment conductive to physical growth and health.What is the nursing role in relation to family caregivers? ›
Nurses spoke of how they teach and instruct family caregivers to perform practical care tasks, such as washing their relative, turning them in bed or giving medicines. They also discuss which symptoms patients may experience and how family caregivers can support patients practically.
Family assessment is an opportunity to gather information about family dynamics, especially regarding the topics of food and weight, and also provide psychoeducation to family and significant others.What is family assessment and intervention? ›
Family Assessment and Intervention Service offers a range of parenting assessments and support services aimed at offering families an opportunity to address their difficulties and build on their strengths.
Questionnaires, structured and unstructured interviews and tasks, descriptions of observations in naturalistic settings and in the laboratory, and scoring systems have been developed to assess family life and describe the family along many different dimensions.How should the nurse assess the family structure? ›
Asking how family decisions are made helps the nurse to assess family structure. Asking about religious affiliation, ethnic background, and where the family lives provides identifying data but does not reveal lines of authority and relationships among family members.What is family systems assessment? ›
Family Voices, Inc. www.familyvoices.org 888-835-5669. 2. Family Engagement in Systems Assessment Tool (FESAT) The FESAT is an assessment tool that both family leaders and organization staff complete to assess how families are being engaged in a specific systems-level initiative, policy, or practice.What are family assessment tools? ›
Family assessment tools are a systematic way of understanding the family and aid them in evaluating the impact of illness on a person and on his/her role in the family.What is the most important role of a nurse? ›
The primary role of a nurse is to be a caregiver for patients by managing physical needs, preventing illness, and treating health conditions. To do this, nurses must observe and monitor the patient and record any relevant information to aid in treatment decision-making processes.What are 4 key responsibilities of the registered nurse? ›
RN Responsibilities and Duties
They care for injuries, administer medication, provide therapeutic interventions, and deliver interceptive treatments. Nurses also educate consumers and fellow employees about health topics.
It also includes seven nursing roles: Stranger role, Resource role, Teaching role, Counseling role, Surrogate role, Active leadership, and Technical expert role.What is the role of the nurse in the care of the elderly patients? ›
Their primary responsibility is to help the elderly maintain their quality of life by administering medications, developing treatment plans, and monitoring vital signs. They also collaborate with other healthcare professionals to implement care plans and provide information and resources about patients.What makes a good nurse? ›
Integrity and advocacy: Core nursing strengths include a strong moral compass while providing care with integrity, and a strong focus on patient advocacy. Patients are often vulnerable and trust nurses to be honest and make decisions with their best interests in mind.How does the nurse demonstrate caring to family members? ›
An example of a nurse caring behavior that families of acutely ill patients percieve as important to patients' well-being is: Making health care decisions for patients. Having family members provide a patients total personal hygiene. Injecting the nurses perceptions about the level of care provided.
The “family as context” approach to nursing care focuses on the family as a whole, rather than on the individual members. This means that nurses take into account the family's values, beliefs, and traditions when providing care.Why is it important to engage patients and families in their healthcare? ›
Involving patients' family members in their healthcare process has been proven to lead to positive health outcomes; research studies have shown the implementation of these strategies has led to fewer hospital-acquired infections, reduced medical errors, and increased patient satisfaction with their care.What is the nursing process in family care? ›
The nursing process functions as a systematic guide to client-centered care with 5 sequential steps. These are assessment, diagnosis, planning, implementation, and evaluation. Assessment is the first step and involves critical thinking skills and data collection; subjective and objective.What are nursing interventions for family members? ›
Family nursing interventions are nursing programs, procedures or instructions that impact an entire family. These enable family members to care for an ill family member or support one another. An example of a family nursing intervention is educating family members on providing care for patients with chronic conditions.How do nurses behave towards patient and family? ›
Be Honest. Good nursing care also involves being honest with the patient and family. If the nurse is asked a question that they do not know, a good response would be to honestly tell the patient that you do not know but will get the correct answer for them — and be sure to follow through and actually do that.What is the main purpose of the family strengths and needs assessment? ›
By completing the Strengths & Needs with the family and others in the child/youth's life, the Care Manager learns that different people in the child/youth's life may have different information or even different opinions about the child/youth's needs.What is the family assessment of needs and strengths? ›
The family assessment of strengths and needs (FASN) is a tool designed to evaluate the presenting strengths and needs of the family of a child alleged or confirmed to have been a CA/N victim.What is a strengthening families assessment? ›
The Strengthening Families Framework is the model used to conduct child protection conferences. It emphasises the application of professional and family knowledge in assessing risk, promoting parental cooperation and engagement seeing parents as part of solution contributing to required change.What is the four step model of family assessment? ›
Salvador Minuchin and his colleagues (Minuchin, Nichols, & Lee, 2007) described this pro- cess as requiring four steps: (1) opening up the presenting complaint, (2) highlighting problem-maintaining interactions, (3) a structurally focused exploration of the past, and (4) developing a shared vision of pathways to change ...What is the four step model of family assessment and intervention? ›
We approach this task in four steps: (1) opening up the presenting complaint; (2) highlighting problem-maintaining interactions; (3) a structurally focused exploration of the past; and (4) an explo- ration of alternative ways of relating.
The McMaster Model relies on multiple instruments to assess six dimensions of functioning: (1) problem solving, (2) roles, (3) communication, (4) affective responsiveness, (5) affective involvement, and (6) behavior control.What are the questions for family assessment? ›
How do you think your family might describe you? What qualities or strengths might they say you have? Are there members of your extended family that you feel close to or feel that you have something in common with? Did you feel safe in your family?What initially should the nurse begin by doing this in completing a client's family assessment? ›
The nurse begins the family assessment by determining the client's definition of and attitude toward family and the extent to which the family can be incorporated into nursing care. The nurse also assesses family form and membership.What is the proper nursing assessment order? ›
Order of physical assessment: Inspect, palpate, percuss, auscultate. EXCEPT for assessing the abdomen: Inspect, auscultate, percuss, palpate (to avoid altering bowel sounds). Master the flow and sequence of a head-to-toe patient assessment with our health assessment flashcards for nursing students.Which tool is used to assess the basic patterns of health and illness in families? ›
The word genogram refers to a diagram illustrating a person's family members, how they are related, and their medical history. The genogram allows the patient to see hereditary patterns of behavior and medical and psychological factors that run through families.What is a family circle assessment? ›
The family circle method is a process that allows individuals to draw a schematic diagram of their family system. It is closely allied with family systems theory and family medicine philosophy. The method is readily understandable with brief instructions.What is a family assessment in nursing? ›
Comprehensive family assessment is the ongoing practice of informing decision-making by identifying, considering, and weighing factors that impact children, youth, and their families.What are the 5 assessment tools? ›
- Diagnostic assessments.
- Formative assessments.
- Summative assessments.
- Ipsative assessments.
- Norm-referenced assessments.
- Criterion-referenced assessments.
- the context and conditions required for assessment.
- the tasks to be completed by the learner.
- a clear outline of evidence to be gathered from the learner.
- the evidence criteria for making a judgement on competency.
- the administration, recording and reporting requirements.
Nurses work to ensure equal treatment and access to quality health care. Early diagnosis of health problems and prompt treatment to prevent complications. Focuses on preventing complications of an existing disease and promoting health. Involves a life threatening of unstable situation.
The purpose of a nursing health assessment is to collect subjective and objective data to determine a client's overall level of functioning in order to make a professional clinical judgment. The nurse collects physiologic, psychological, socio-cultural, developmental, and spiritual data about the client.
Determine who can access patients' healthcare information, including how individuals obtain their personal medical records. Identify what data should be classified as protected health information (PHI) and how it should be stored and distributed for the purposes of treatment, payment and healthcare operations.What are the 4 types of assessment in nursing? ›
WHEN YOU PERFORM a physical assessment, you'll use four techniques: inspection, palpation, percussion, and auscultation.What are the 3 major roles of the professional nurse? ›
- Perform physical exams and health histories before making critical decisions.
- Provide health promotion, counseling and education.
- Administer medications and other personalized interventions.
- Coordinate care, in collaboration with a wide array of health care professionals.
Comprehensive or complete health assessment: Nurses collect a patient's full health history and complete a physical exam. This type of assessment is generally conducted when a patient is admitted to a hospital or long-term care facility or for new patient encounters at physician offices and outpatient clinics.What are the nursing responsibilities in the assessment phase of the nursing process? ›
During the assessment phase, the nurse collects objective and subjective data using proven methods to assess the patient. The most common methods for collecting data are the patient interview, physical examination, and observation.What is the primary purpose of health assessment? ›
Health assessments are usually structured screening and assessment tools used in primary care practices to help the health care team and patient develop a plan of care. Health assessment information can also help the health care team understand the needs of its overall population of patients.Which assessment should the nurse complete first? ›
A thorough medical history and physical assessment will be useful but is not the first action the nurse must take. The physician should be notified but the nurse must assess vital signs first.Which component would the nurse include when completing a health assessment? ›
A nursing health assessment includes physiologic, psychological, sociocultural, developmental, and spiritual data.What is the main responsibility of the registered nurse regarding patients? ›
A registered nurse's primary role is to ensure that every patient receives the direct and proper care they need, and they go about doing this in a number of ways. RNs assess and identify patients' needs, then implement and monitor the patient's medical plan and treatment.
Nurses are responsible for taking vital signs regularly, ensuring they can respond quickly if there is an emergency or change in the patient's condition. To take vital signs, nurses will use blood pressure cuffs and thermometers to measure pulse rate and temperature.What is the nurse's role and responsibilities in informed consent? ›
Nurses may serve to ensure patient comprehension, facilitate documentation of consent, address patient anxiety, and identify the appropriate surrogate decision-maker when needed .What are the three priority nursing assessments? ›
A = airway – ensure the airway is not obstructed or compromised. B = breathing – ensure patient is breathing, and if it is absent or labored to intervene immediately. C = circulation – check to ensure the patient has a pulse, and if patient is on cardiac monitoring (which they should be if circulation is a concern!)What are the 2 parts of health assessment in nursing? ›
- Assessment (gather subjective and objective data, family history, surgical history, medical history, medication history, psychosocial history)
- Analysis or diagnosis (formulate a nursing diagnosis by using clinical judgment; what is wrong with the patient)
An RN uses a systematic, dynamic way to collect and analyze data about a client, the first step in delivering nursing care. Assessment includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors as well.