II.

FAMILY CONSTELLATION This section discusses the description of all the family members in order for them to be easily identified and distinguished from one member to another. Family constellation provides important demographic data that are deemed significant in assessing the health status of the family. It includes age, ordinal position, gender, educational status and overview of the present health status of each family member based from the initial assessment done by the student-nurses. The family is composed of the mothers mother, father, mother and seven children, wherein the mother and father are married, they are considered as an Extended type of family.

Name

Age

Position in the family Grandmother

Sex

Educational status Present Health Status on the initial interaction 6th grade elementary General Appearance: She was cooking that time; she was wearing a striped shirt and shorts. She has a dark brown complexion, with thick black and white hair.

Granny

65 year old

Female

Vital Signs: Temperature: 37.1C Pulse rate: 89 bpm Respiratory rate: 20 cpm Blood Pressure: 110/80 mmHg. Height: 5 feet and 1 inches Weight: 73 kilograms BMI: Obese I

Mr. Prince

34 years old

Father

Male

5th grade elementary

General Appearance: Mr. Prince wears white shirt and shorts. He was conscious and coherent he was relaxed and coordinated movements. Mr. Prince was smoking and helping his mother in law when the student researchers saw him. Upon seeing him Mr. Prince was oriented to time, place and person. His hair is medium haircut. The student researchers was able to understand his speech, has a moderate pace and exhibits thought. Mr. Prince was able to state his full name, residence, time of the day and names of the members of the family. Mr. Prince was able to recall all the birthdays of his children. Can express one by speaking. Mr.Prince has presence of cough and colds for 3 days. His finger nails and toenails are long and dirty. Mr. Prince appeared interested and coherent upon assessment as evidenced by answering the questions student researchers asked. Vital Signs: Temperature: 36.5C Pulse rate: 71 bpm Respiratory rate: 24 cpm Blood Pressure: 120/80 mmHg. Height: 5 feet

Weight: 67 kilograms BMI: Obese I Snow White 34 years old Mother Female 3rd Grade Elementary Not Going to School General Appearance: She was carrying her baby at that time wearing a flowerprinted shirt and pajama. She has a dark brown complexion, with thick black dry hair tied up. She looks unkempt. Vital Signs: Temperature: 37C Pulse rate: 66 bpm Respiratory rate: 18 cpm Blood Pressure: 120/80 mmHg. Height: 5 feet and 2 inches Weight: 60 kilograms BMI: Overweight Sneezy 13 years old First/ Eldest Child Female Grade 6 General Appearance: During the initial encounter with Sneezy, she was helping her grandmother in preparing for their lunch. She was wearing white sleeveless shirt and white shorts. Sneezy was observed to have long and dirty fingernails, was wearing dirty clothes and seen to be walking barefooted. She was oriented to person, place and time and was able to answer questions asked by the researchers clearly and willingly.

Vital Signs: Temperature: 36C Pulse rate: 66 bpm Respiratory rate: 16 cpm Blood Pressure: 100/70 mmHg. Height: 4 feet and 7 inches Weight: 40 kilograms BMI: Normal

Grumpy

12 years old

2nd Eldest

Female

Going to School (Elementary)

General Appearance: Upon seeing Grumpy she is wearing an orange shirt and shorts. She cuddles her youngest sister and she has unkempt appearance and odor. Grumpy is oriented to time and place and also the people around her. She is relaxed and has coordinated movements. She is conscious and coherent. She was able to answer all the questions given to her. Her affect is appropriate to the situation and her speech is understandable, moderate pace and exhibit thought. She was able to state her full name, residence, time of the day and the names of the members of the family. Can express oneself by speaking, she was able to entertain the student nurses. Upon assessment, Grumpy has a fair complexion and evenly distributed hair, black in color, dry, and uncombed there is presence of

pediculosis. She has dental caries. She has dirty and untrimmed fingernails and toenails. And presence of cerumen in the ears.

Vital Signs: Temperature: 36C Pulse rate: 86 bpm Respiratory rate: 21 cpm Blood Pressure: 70/40 mmHg. Height: 4 feet and 7 inches Weight: 33 kilograms BMI: Underweight

Doc

9 years old

3rd eldest child

Male

Not going to school

General Appearance: Upon initial assessment Doc was wearing a brown shirt and a dark blue shorts. He is also wearing dirty slippers. Upon assessment he looked untidy, with presence of lesions on the face and wounds on his feet and with dirty untrimmed fingernails and toenails.

Vital Signs: Temperature: 36C Pulse rate: 74 bpm Respiratory rate: 21 cpm Height: 4 feet and 7

inches Weight: 25 kilograms BMI: Underweight Sleepy 8 years old 4rd eldest child Male Grade 2 (Going to School) General Appearance: During the initial encounter, Sleepy was wearing white shirt and yellow shorts; he was not that cooperative when being asked. Sleepy was playing outside with his friends and cousins during lunch time. During the initial assessment Sleepy does not look clean it was noted that Presence of dirty finger and toenails were seen, watery mucus secretions in both nostrils and yellowish cerumen in both ears. He stands and walks without difficulty and with coordinated movements. Vital Signs: Temperature: 36C Pulse rate: 85 bpm Respiratory rate: 17 cpm Height: 3 feet and 9 inches Weight: 25 kilograms BMI: Normal

Happy

5 years old

5rd eldest child

Female

Never Been To School General Appearance: During the initial encounter Happy is seen playing around with her playmates and was wearing blue stripe shorts and is

shirtless. During the initial assessment Happy does not look clean. She has long dirty fingernails and toenails and is wearing soiled shorts. He also stands and walks without difficulty and with coordinated movements. Also during the initial assessment Happy was not cooperative when being asked. Vital Signs: Temperature: 36C Pulse rate: 88 bpm Respiratory rate: 27 cpm Height: 3 feet and 2 inches Weight: 15 kilograms FNRI: Normal

Dopey

1 year old and 6th Eldest 10 months

Female

Not going to school

General Appearance: Upon initial assessment, Dopey was wearing white shirt and shorts. Before the initial assessment, Dopey was walking in front of their house barefooted. She stands and walks without difficulty and with coordinated movements. She was shy at first and hesitated to come near the student nurses. Unkempt appearance with presence of dirty fingernails and toenails were noted. Vital Signs:

Temperature: 36.5C Pulse rate: 122 bpm Respiratory rate: 35 cpm Height: 2 feet and 5 inches Weight: 13 kilograms FNRI: Normal

Bashful

1 month and 11 days

Youngest

Female

Not going to School

General Appearance: Upon initial assessment, Bashful was wearing white baby dress with gloves and socks. Before the initial assessment, Mrs. Snow White is carrying Bashful in her arms while sleeping. With unkempt appearance and smudges of dirt in her clothes. With presence of milia in her nose and cheeks. Vital Signs: Temperature: 36.2C Heart rate: 146 bpm Respiratory rate: 47 cpm Height: 1 feet and 6 inches Weight: 5 kilograms FNRI: Overweight

III. HEALTH ASSESSSMENT In order to become weavers of change, a community health nurse must be able to determine initially any abnormalities or deviations from clients health. Assessing the health status of a client is a major component of nursing care and has two aspects: (1) the nursing health history and (2) physical examination. One way by which health status of the family can be assessed is through physical examination using cephalocaudal approach. It is done using inspection, palpation, percussion and auscultation to identify areas for health promotion and disease prevention.

Family assessment begins with a complete health history. It is one of the most effective ways of identifying existing or potential health problems. History is followed by physical assessment of family members (Kozier, 2004).

Assessment enhances identification of physical and psychological needs. The amount, depth, and level of assessment skills vary with the knowledge and expertise of a nurse. Data about the present condition or status of the family are compared against norms or standards of problems.