Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : June 25, 2012 Objective: 1.

To receive instruction clearly from the Coordinator and Clinical Instructor on how to obtain family case study 2. To assist the Community Health Center Parompong on clinical activities and able to maintain good inter-personal relationship with the staff. 3. Able to understand comprehensively about the concept of family nursing process implicated in the family case study after reading the Family Nursing Syllabus and from the internet information. Name : Mrs. Siska Preceptor : Clinical Site: PKM Parompong Date Monday (June 25, 2012) 09.30 10.30 ( 1 hour ) Quarter : Day : 1 Activity Coordination meeting Community Health Parompong. Nurse Profession Program CLINICAL LOG Hours on this log : 8 hours Cumulative hours for quarter : Cumulative hours for program : Outcome Received clear information on how to get cases data, either from the CHC outpatient datas or from the Puskesmas Pembantu outpatient datas. Able to work cooperatively with the CHC staff and at the same time observing/learning the patients sicknesses; practice the clinical nursing skills. Able to get one name from the outpatient data at the CHC Parompong, which will be used as a family case study Understand the big picture about Family Nursing and knowledge on Hypertension. Competencies N/A

at the Center,

10.30-12.30 ( 2 hours )

Assist clinical activities such as vital signs taking, preparing medicines and give explanation on how to consume the medicines.

Improve/maintain good interrelationship with others; Maintain/improve nursing skills. N/A

Search names for future family case study from varied sources available in CHC or Pustu office.

19.00-23.00 ( 4 hours )

Reading the family nursing syllabus; browsed internet about family nursing subject; browsed

N/A

also about hypertension. 04.00-05.00 (an hour)

my

case

on

Writing down activities for the new

day.

N/A

N/A

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : June 26, 2012 Objective: 1. Conduct family nursing assessment based on the current growth and development of the main family health service Name : Mr. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu. Date Tuesday (June 26, 2012) 08.00 08.30 ( 0.5 hour ) Quarter : Day : 2 Activity Nurse Profession Program CLINICAL LOG Hours on this log : 7.5 hours Cumulative hours for quarter : Cumulative hours for program : Outcome Received instruction on how to visit each cases house. Competencies N/A

Together with the group met

midwife Eet, the area coordinator of Cihanjuang Rahayu

08.30-10.00 ( 1.5 hours )

Together with the group as well paid a home visit to each group member cases house

The group able to meet each of

the cases families; cooperatively work together as a team.

N/A

10.00-12.10

Collected demographic/bio-data

General data about Mr. Es family partially collected

General data of the family collected.

(2 hours)

of Mr. Es family; conducted physical assessment (including the disease history); inquired his perception and on on his disease including the knowledge, attitude behavior medication adherence.

19.00-22.30 ( 3.5 hours ) Browsed internet for review and further understanding about the family nursing concepts/theories; noted down the activity todays activities; prepare activities for the next day.

N/A

N/A

Name

: Jedeth Mamora

Submitted to : Mrs. Evelyn Tambunan Date : June 27, 2012 Objective: 1. Conduct family nursing assessment based on the current growth and development of the main family health service 2. Establish problem found. 3. Problem priorities Name : Mr. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu. Date Wednesday (June 27, 2012) 08.30 12.00 ( 3.5 hours ) Quarter : Day : 3 Nurse Profession Program CLINICAL LOG Hours on this log :6.5 hours Cumulative hours for quarter : Cumulative hours for program : Outcome General data on Mr. Es family fully collected. The familys internal environment is conducive and open (the communication pattern captured at the complete case report); external environment with the neighbors are good no dispute or argument reported. The familys stage was analyzed using Duvalls developmental theory. The family categorized on the stage of Aging Family however the theory is in contradictory due to the spouse is still actively engage at work. Both parents of the client (Mr. Competencies General data of the family collected Datas about familys environment.

Activity Assessed the economic and social issues of the family; assessed the familys internal and external environment;

analyzed the family present development which have been fulfilled or not yet fulfilled;

Datas on present development.

familys

assessed the previous family development (Mr. Es parents and siblings) and assessed the nuclear family of Mr. E as

Datas on present development.

familys

well;

assessed the strength, communication pattern, role structure and values/norms of the family

E) have been passed away due to normal aging as well as the wifes parents. Not able to detect precisely both of their death causes due to limited/no knowledge of diseases.

Identification structure.

of

family

assessed the affective function of the family; assessed the health function of the family; assessed the social function of the family; assessed the reproductive function of the family; assessed the economic function of the family;

The strength of the family lies on their close, bound relationship between husband and wife as well as to the children.; the role of being a bread winner which supposed to be shouldered upon the client are now shifted to the wife due to clients sickness. In terms of family important decision, the wife and the first son usually in charge of it. The family valued good, honest citizenship. The client has a free, easy taking and opens spirit which influences the emotion to be in calm and cheerful. This feeling clearly disseminated to his wife and children thus, the overall family emotion are in good, calm manner; the health function are not fully in function for example: the house lack of free sunlight due to the close window curtain during the day; the client practice smoking inside the house; grand children

BP taking of the client and inquired client if he has taken the routine medication.

freely allowed to buy unhealthy snacks; both client and wife has a enough income and each of the grown up children has their own separate budget.

The client has a second degree of hypertension, identified at: 160/100 mm Hg. The Catoprile has out of stock but the client sees adherence in taking routine medication as not important as to the necessity of routine pray at the mosque (5x/day).

Physical Examination individual in the family

by

Identification of familys growth and development problem;

The problem identified as to the lack of financial income to fulfill some of the needs of the client due to lack of financial management skills to budget the monthly income and failed to differentiate which is healthy and cheaper prize of foods. The level of education and lack of information perhaps contribute to the web problem. The client has create the habit of non-filtered cigarette since the age of 8 yrs and could

Identification of familys health problem

Priorities of problem: not healthy, health threatening issues and potential health problem

finish 2 packs in a day; has a habit of black coffee drinks 23 cups a day; preferred to eat fried foods and consumed a little only due to the effect of smoking depressed the appetite to eat. Identified of having a hypertension after getting a light stroke on early January 2012 and hospitalized.

Problem identified and classified based on the severity action taken which is divided unto: not healthy as not adhering to doctors medical prescription as to take daily routine antihypertension drugs; habit of smoking and coffee drink. Risk health behavior which will contribute to unhealthy household is indoor smoking and insufficient sunlight in house. Potential unhealthy attitude is enjoying life by taking it for granted; having a concept of life is in Gods hand and so enjoy while being a life presently; consuming unhealthy snacks, foods that use cooking ingredients of MSG, over use salt and oily foods.

health teaching about

hypertension to the family and client. 19.00-22.00 (3 hours)

The client perception on hypertension is normal for old age to have a high blood pressure.

Making a new plan for the next day meeting Browsed internet to get more information on the assessed family datas.

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : June 28, 2012 Objective: 1. Identify family function 2. Making of strategic plan to solve the problem Name : Mr. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu. Date Thursday (June 28, 2012) 08.30 12.00 ( 3.5 hours ) Quarter : Day : 4 Nurse Profession Program CLINICAL LOG Hours on this log : 7.5 hours Cumulative hours for quarter : Cumulative hours for program : Outcome The disability of the client seems not interfere his joy in life, perhaps it has to do with his close bound with the Competencies Identification of stress and family copping strategies

Activity Continued to assess stressor indentify in the family such as: disability due to stroke, the wife become the single

breadwinner at home, ineffective family financial management;

children and having a positive acceptance of his current life and able to adapt it. I was not able to meet the wife yet in order to discuss the family financial management and to know her perception as a sole breadwinner for the husband. The close bound between the parents and children helps the client to cop with the health problem. They support each other emotionally and financially. The children mainly close with the mother (wife of the client.) It is the client that seems can not understand completely that he has been attack with stroke and a radical new life style should be taken in place.

assessed on how the family do the copping strategy;

assessed the dysfunction adaption strategy of the family.

Stimulated family awareness on the problem by continuing giving information to the client and family about hypertension and how to maintain the stable blood pressure (exercise, less salt usage.) Identified client health needs and hope; Encouraged the client and family to have a healthy copping emotion toward the

Stimulate familys awareness/acceptance on the present health problem and the health needs.

Client needs to consume more fruits and vegetables and use less salt. His hope is being able to go to heaven when he dies.

health problem

Identified health consequences of not doing the action and discussed the issues with the family; Identified family resources to maintain clients health status/ discussed consequences of every action not being taken as well. I taught one of the family members on BP taking BP taking of the client and asked if the client has taken medication.

Has discussed the importance to take routinely medication but the side effect of diuretic drugs made him lazy to take it (it bothers to urinate often especially at mosque.)

Stimulate the family to make decision on a right nursing care for the client

19.00-23.00 (4 hours)

The client finally went to the PKM Parompong and received anti hypertensive medicines but still the drug that give a diuretic effect he wont consume it. the client likes to eat belimbing and has eaten one whole size of belimbing.

Browsed internet to get more information on herbal medication on hypertension; foods and cooking style for client with hypertension/alternative natural anti-hypertension (belimbing or cucumber) and family financial management.

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : June 28, 2012 Objective: 1. To receive accurate information on the tasks given by the Clinical Instructor Name : Mr. Evelyn Tambunan Preceptor : Clinical Site: Campus Date Friday (June 29, 2012) 08.00 10.00 ( 2 hours ) Quarter : Day : 5 Activity Class meeting with the Clinical Instructor; discussed the way to answer each of the assignments. Outcome Nurse Profession Program CLINICAL LOG Hours on this log : 5 hours Cumulative hours for quarter : Cumulative hours for program : Competencies

14.00-17.00 ( 3 hours)

Answered assignments and browsed internet related with the assignments.

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : July 01, 2012 Objective: 1. Interview with the wife in order to gain more information of the family Name : Mrs. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu and working place. Date Sunday(July 01, 2012) 05.30 6..30 ( 1 hour ) Quarter : Day : 6 Outcome Nurse Profession Program CLINICAL LOG Hours on this log : 2 hours Cumulative hours for quarter : Cumulative hours for program : Competencies

Activity Early morning walk to the house of the clients family.

06..30-07.30 (1hour)

Met with the wife face to face and discussed about her work and effect to her health condition, her perception on her husband sicknesses and her view on being a sole bread winner for the family.

Sees the importance to discuss further with her including the rest of the family on how to manage financial income in order to improve overall health condition of the client and also the wife and the rest of the familys member.

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : July 02, 2012 Objective: 1. Interview with the wife in order to gain more information of the family Name : Mr and Mrs. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu Date Monday (July 02, 2012) 10.00 16.00 ( 6 hours ) Quarter : Day : 7 Outcome Nurse Profession Program CLINICAL LOG Hours on this log : 9 hours Cumulative hours for quarter : Cumulative hours for program : Competencies

Activity Type the Introduction report as well as the Clinical Log in the laptop.

16..00-19.00 (3hours)

Assessed the wife of Mr. Es perception on his husband disability Assessed her ways on managing the family income. Re-taught the wife including the family on health education of hypertension and how to manage it. Taught the wife on cooking style for hypertension and how to manage family income. Continue to identify the consequences of not doing the

Initially the wife gave an excuse answers of not being able to meet the health needs; however, after emphasizing and repeating the importance of healthy life especially for the husband, the wife eventually give a positive respond by accepting the idea of being healthy and asked how to cook healthy foods.

actions: development failed, not being optimal, complication occurrence, disability and death. Identify source of family fund/income, family knowledge and motivation Increase the familys self confidence about the consequences of the action, in terms of: steps of growth and development, an increase of health status, disability and death. Increase the care for the sick family member by demonstrating the family care on: growth and development, family with health problem (chronic disease , such as: hypertension) Usage of house utilities such as: BP set, thermometer and wriest watch. Supervise the family in redemonstrating family care: measuring vital sign and prepare balance nutrient foods with less salt (a half tea spoon salt/day) the daily use of natural diuretic medication to maintain stable BP such as

Belimbing fruit twice a day since the client often skipped the use of Furosemid tablet; personal hygiene, exercise and medication adherence (two times a day morning and evening-of Captoril 25 mg.) Create healthy environment by identifying sources such as: family funds, present utilities at home and community; Conducted family environment changes as optimum as possible by family environment modification; environment comfort; environment safety. To increase family and client usage of present health facilities such as: health village posts, health community center, private practice medical doctor, private/government midwives and hospitals. Assist the family on using the community health facilities in terms of: referral health system, consultation and services. Conduct daily evaluation on

the current health problem.

Name : Jedeth Mamora Submitted to : Mrs. Evelyn Tambunan Date : July 03, 2012 Objective: 1. Supervised and evaluate the nursing family action Name : Mr and Mrs. Engka Preceptor : Clinical Site: Home (RT 03/RW 12) Cihanjuang Rahayu Date Tuesday (July 03, 2012) 09.00 15.00 ( 6 hours ) Quarter : Day : 8 Outcome Nurse Profession Program CLINICAL LOG Hours on this log : 9 hours Cumulative hours for quarter : Cumulative hours for program : Competencies

Activity Type the Introduction report as well as the Clinical Log in the laptop.

17.00-19.00 (3hours)

Met with the wife and other family members to observe food cooking process; supervised the daughters ability in doing BP measurement with BP set and the measure pulse with the watch; evaluate the current health status of the client including medication intake, the food

That evening the mother did not prepare food due to tiredness after work; he preferred to eat 12 cookies and rest. The daughter performed well on BP measurement of the father (the client) and also the mother. The father BP: 160/100 mm Hg/the mother: 110/80 mm Hg. The

consume cigarette exercise.

today, taken

the and

total daily

father conume Catopril but not the Furosemid due to the side effect given was often urinating; instead he ate Belimbing.