Running head: FAMILY CARE OF PLAN

A Family Care of Plan

Maggie M. Fabry
California State University Stanislaus

A Family Plan of Care

A critical component of public health nursing is family assessments. Throughout
this semester, several individual assessments were performed during home visits as well
as brief family evaluations. However, this more in depth family care plan allows one to
better understand the dynamics and overall well being of the family. For this family
assessment, four family members from the G. family were chosen. The G. family is a
three-generation Hispanic and Catholic family of seven. F.G. is a 34-year-old female and
mother of four with no outstanding medical history who recently fractured her fibula
during a ground level fall. F.G. currently wears a brace on her right ankle and complains
of low levels of pain surrounding the ankle area. S.G. is the healthy nineteen-year-old
daughter of F.G. who recently gave birth to her three-month-old son D.B. S.G. is
seemingly an attentive and caring mother who also has the support of the father of the
baby. D.B. is the healthy breastfed infant of D.B. and grandson of F.G. who was one
month premature and has no outstanding medical issues with the exception of pain
related to teething. Also, D.B. is in the 95th percentile for weight and the 5th percentile
for height. Finally, Y.G. is the seventeen-month-old daughter of F.G. Y.G. is healthy and
exhibits appropriate cognitive and physical development. F.G. was referred to the
program after the recent birth of Y.G. After the first home visit, it became obvious that
her oldest daughter S.G. and her infant could benefit from home visits as well, and they
were then added as clients.
Tapias Level of Functioning and Bowens Theory
Through observation and subjective data collection, it is clear that the G. family is
at Tapias adulthood level of functioning (Tapia, 1972). At this level, families still have

problems but have solutions to them. The G. family matches Tapias description of the
adult family being stable and happy and a capability for providing emotional functioning
and physical security. An example of this was excellent bonding displayed between both
sets of moms and their babies. In addition, both moms regularly asked questions about
their babies health and for information on various topics of child development. In
congruence with this this level of functioning, preventative health teaching was the
primary nursing action employed during the home visits (Tapia, 1972).
The concept of the Bowen Family Systems Theory that best suits the G. family is
the multigenerational transmission process, which states that emotional processes are
transferred and maintained over the generations (Thompson, 2014). In the G. family,
family planning patterns have been passed through the generations as evidenced by the
young age of both F.G. and S.G. during their first pregnancy. In addition, there were
many similarities in child rearing methods between the two mothers displayed. This was
an interesting observation and one that cannot be so easily observed in many families.
The fact that three generations were observed interacting at young ages allows for good
comparing and contrasting.
Nursing Diagnoses
Although this family is seemingly healthy and without any health related issues of
concern, there are nursing diagnoses that can be applied to each member. F.G. has a risk
for caregiver role strain related to the presence of two small children in the home and her
fractured fibula as evidenced by observed difficulties getting around in her brace and the
high energy levels of the toddler. S.G. has a risk for ineffective childbearing process
related to knowledge deficit regarding care of infant as evidenced by frequent questions

regarding development of the infant. D.B. has pain related to teething as evidenced by
mom stating that baby is fussier and that the crowns of the teeth are becoming visible.
Y.G. has a risk for injury relate to unbalanced coordination as evidenced by frequent
losses of balance while running. These nursing diagnoses are based on observations and
subjective data gathering through interviewing the clients.
Although all four diagnoses are relevant and important, the risk for ineffective
childbearing process will be the main focus of this paper due to the young age of the
child and the vital importance of his healthy development. In addition, this diagnosis was
chosen based on the fact that this young moms knowledge deficit was the dominant issue
being addressed during our home visits.
Goals
There were goals set and evaluated for each member of the family throughout
these home visits. The goal directly related to the diagnosis of focus for this teen mom is
to increase moms knowledge base of infant care, child development and family planning
through verbal discussion, handouts and demonstration.
Interventions
Throughout the course of the home visits, many teaching topics were addressed to
meet the above goal and were mostly based on the questions presented by mom. During
the visits, teething, growth chart placement, babys first solid foods, the results of the
ASQ, birth control methods and breastfeeding were topics being addressed. Pamphlets
regarding teething were given to mom and discussed. These pamphlets focused on the
signs and symptoms of teething and ways to help babies through the process. D.B. was
also plotted on the height and weight chart so that mom could see where he was in

relation to other infants of his age. Mom was informed that because she was exclusively
breastfeeding, the babys weight is not something to have concern about. An ASQ was
performed to assess the babys physical and cognitive development. D.B. scored very
well on the assessment and there were no outstanding areas of concern. During one home
visit, mom asked about when she should start feeding the baby solid foods. Handouts
were given during the following visit that explained when to start giving the solid foods,
how to give them and what sorts of foods to give first. Lastly, family planning was
discussed with mom and current contraceptive use was explored. In addition to verbal
teaching, paper handouts were also given to reinforce the information.
Evaluation
S.G. demonstrated good understanding of all teaching topics throughout the
duration of the home visits. In addition to stating that she understood the information,
she was able to repeat what she learned during following home visits and had actually put
portions of the teaching into practice. All interventions were seemingly appreciated and
well understood. S.G. stated that she plans to start birth control, as it is not in her plan to
have another child for at least three years. The goal of increasing the teen moms
knowledge regarding the care of child, childhood development and family planning was
met as was evident both subjectively and objectively.
Conducting a family assessment can be beneficial to both nurse and family.
Home visits offer the opportunity for a deeper understanding of family functioning and
the well-being of the family, which can enhance the nurse-patient relationship and allow
for a better learning environment.

Resources
Tapia, J.A. (1972). The nursing process in family health. Nursing Outlook, 20(4). 348349.
Thompson, E. (2014). What are the eight interlocking concepts of bowen family systems
theory? Vermont Center for Family Studies. Retrieved at
http://www.vermontcenterforfamilystudies.org/bowen_family_systems_theory/eig
ht_concepts_of_bowen_theory/