Transcript Family Group

Family Group
November 2009
Family name
Address and
Telephone
number
LOMOHAN
939 Dos
Castillas St.
Sampaloc,
Manila
#0908
5204944
Mini-Nutrirional
Assessment:
malnourished
Type of
Family
Life cycle
stage
Unilaterally
extended
Family in
later life
Role and
Functions
1.Breadwinner
Mary Jane
(daughter)
Index Patient
Fernando
Lomohan
Diagnosis
Latest Lab
Results and
Medications
s/p CVA, R
MCA (June
2008);
Amlodipine
5mg/tab 1 tab
OD
HPN st.II
controlled
Aspirin 80mg/tab
1 tab OD pc
Male
2.Decision
maker
Lourdes
Lomohan (wife)
3. 1˚ Caregiver
Lourdes
Lomohan (wife)
4.MCSI
Madalas- 3
Minsan- 3
Halos hindi- 4
64 y/o
Multivitamins
1 tab OD
Plans
Medical:
1.Update immunization
(pneumococcal, influenza,
tetanus)
2.Daily BP monitoring
3.Maintain good personal
hygiene
Rehabilitative:
1.Passive ROM exercises c/o
caretakers
2. Refer to Rehab Med for PT
Wellness:
1.Encourage diet rich in
protein, low salt, high fiber
(green leafy vegetables, citrus
fruits)
2.Strict compliance with
medications
3.Ensure 2 glasses and
encourage 8 glasses of water
a day
Psychosocial:
1.Seek and maintain personal
interests (listening to the
radio, reading the newspaper,
watching TV)
2.Encourage involvement with
friends
LOPEZ
957 Dos
Catillas St.
Sampaloc,
Manila
Unilaterally
extended
Family in later
years
1.Breadwinner
Eden Lopez
(wife)
Dominador
Lopez
Male
# 7313224
2.Decision
maker
Eden Lopez
(wife)
Mini-Nutrirional
Assessment
malnourished
3. 1˚ Caregiver
Eden Lopez
(wife)
4.MCSI
Madalas- 1
Minsan- 10
Halos hindi- 1
76 y/o
Parkinson’s
disease
s/p
tracheostomy
s/p PEG
insertion
Biperidine 2mg
OD
Medical:
1.Continue strict compliance
with medications
Levodopa/Carbid 2.Regular follow up
opa 200/50mg/tab 3.Maintain position that
1 tab OD
provides optimum ventilation
4.Continue strict turning
Multivitamins 1
schedule to avoid bed sore
tab OD
formation
5.Perform passive ROM
Acetylcytsteine
exercises
prn
6. Suctioning of secretions
from tracheostomy tube as
needed
7.Asepsis and anti sepsis
technique in handling and
cleaning tracheostomy tube
and PEG
Wellness:
1.Continue vitamin
supplementation
2. Ensure two glasses daily
Psychosocial
1.Sharing of responsibilities in
taking care of patient
San Pedro
Extended
965 Adelina St. Life Cycle
Sampaloc
Stage
Manila
Phone #
735-6775
MiniNutritional
assessment::
not at risk for
malnutrition
GDS - normal
MMSE-
1.Breadwinner
Beatriz San
Pedro
2.Decision
maker
Magdalena
Amoranto
(sister)
Beatriz San
Pedro
Hypertension
Vitamin B
St. I, controlled Complex OD
Female
Bronchial
asthma, NIAE
Nifedipine 20 mg
OD
Osteoarthritis,
both knees
Levothyroxine
100 mg OD
83 y/o
Hypothyroidism Cilostazol 50 mg
s/p total
BID
thyroidectomy
(1988)
Calcium BID
s/p CVA (2004) Simvastatin 40
mg ½ tab OD
Medical
1. Continue present
medications
2. BP monitoring
3. Follow-up with physician
4. Multivitamins 1 tab OD
5. Refer to Rehab
6. Vaccination –
Pneumococcal, Tetanus,
Influenza
Wellness
1. Advice balanced diet, with
low fat, low salt, high fiber diet
(green leafy vegetables and
citrus fruits)
2. Encourage to drink 8-10
glasses of water daily
3. Educate patients on benefit
of healthy living and seeking to
improve one’s health
San Pedro
965 Adelina St.
Sampaloc
Manila
# 735-6775
Nutritional
assessment:
not at risk for
malnutrition
GDS- normal
MMSE
Extended
1.Breadwinner
self
2.Decision
maker
Self
Magdalena
San PedroAmoranto
female
St. II,
controlled
Cataract s/p
EOL,OS
Felodipine
Medical
5mg/tab, 1 tab 1. Continue medications
BID
2. BP monitoring
3. Increase oral fluid intake
5. Vaccination – Tetanus,
Influenza, Pneumococcal
79 y/o
Wellness
1. Advice balanced diet, with low
fat, low salt, high fiber diet (green
leafy vegetables, citrus fruits)
2. Encourage to drink 8-10
glasses of water daily
3. Educate patients on benefit of
healthy living and seeking to
improve one’s health
Rosales
Blended
Address
1070 Don
Quijote St.
Sampaloc,
Manila
Life Cycle
Stage
Launching
Family
Phone #
Nutritional
assessment:
At risk of
malnutrition
1.Breadwinn
er
Teresita
Rosales
Jerry Rosales DM type 2
Gender:
Male
SAH Stage 1,
controlled
2.Decision
maker
Genaro
Rosales
Age:
53 y/o
CKD sec to
DM
nephropathy
s/p AKA, L
secondary to
Diabetic foot
3. Caregiver
Lauro
4.MCSI
Psychosocial
problems
Emotional
support
Amlodipine
5mg/tab OD
Amlodipine
10mg/tab OD
Acarbose
50mg/tab TID
HN 18 ‘u’/SC
pre-BF and 8
‘u’/SC pre
dinner
Medical
1. Assure of compliance
with medications
2. Assure of compliance
with thrice a week
hemodialysis
3. Regular follow-ups
Wellness
1.Strict compliance to diet
provided by
physician/dietician
2.Suggest improvement of
home ventilation
3.Periodic BP monitoring
4.Annual Lipid profile/Renal
profile/Cardiac profile
5.Annual Opthalmologic
consult
Psychosocial
1.Suggest involvement in
social groups
2.Encourage more outdoor
activities
Cudal
Communal
1016 Eloisa St. Family in
Sampaloc
Later life
Manila
#735-7539
Mini-Nutritional
Assessment
Score:
1. Breadwinner: Cudal,
Dra. Efegenia
Dorothea
Solivendaughter who is Female
living in the USA
97 y/o
2. Decisionmaker: Dra.
Efegenia
Solivendaughter who is
living in the USA
GDS:
MMSE:
3. 1˚ Caregiver:
Cecilia Cabais
4.MCSI
MadalasMinsanHalos hindi-
Dementia
Hearing Loss,
AU
s/p hip
replacement
(2004)
Multivitamins, 1
tab OD
Calcium
Carbonate, 1 tab
BID
Medical
1. Continue Multivitamins and
Calcium
2. Osteoporosis screening
3. Maintain low salt and low fat
diet
4. Encourage passive ROM
exercises
Psychosocial
1. Patient has good personal
relationship with caregivers.
2. She is able to talk to her
daughter who lives in USA by
telephone. She sees her
daughter and family once a
year.
3 . We can encourage the
family to make their visit more
often and call her more often.
Miguel
Communal
1016 Eloisa
St.Sampaloc
Manila
Family in
Later years
1. Breadwinner : Miguel, Lydia
Lydia Miguel
60/F
SAH Stage II,
poorly
controlled
Atenolol
Medical
(Therabloc) 50mg, 1. Continue current
1 tab OD
medications.
2. Decision
maker: Lydia
Miguel
Multivitamins, 1
tab OD
3. Caregiver:
Mely Valdez
Folic Acid, 1 tab
OD
#735-7539
Mini-Nutritional
Assessment
Score:
GDS:
4.MCSI
MadalasMinsanHalos hindi-
MMSE:
*Patient owns
the house and
rents it to
boarders. It is
her source of
income.
*Patient is currently in Ilocos
for renovation of their house.
Caregiver said that they talk to
her often on the phone and
claims that she has good BP
control.
Psychosocial
1. Maintain good relationship
with caregiver.
2. Encourage her to vent
feelings regarding the
unexpected financial burden of
rebuilding her house which
was destructed because of the
typhoon Pepeng.
Lanot
1134
Prudencio St.
Sampaloc
Manila
#0907 162
8213
Mini Nutritional
Assessment
Score:
GDS & MMSE:
cannot be
assessed
Unilaterally
extended
Family in
Later years
1. Breadwinner : Lanot, Anicia
Susan Lanot
(daughter)
Female
2. Decision
maker: Susan
Lanot –
daughter
3. 1˚Caregiver:
Bella (informal
caregiver)
4.MCSI
MadalasMinsanHalos hindi-
76 y/o
Diabetes
Metoprolol
Mellitus type 2, 50mg/tab, 1 tab
uncontrolled
BID
Medical
1. Continue current
medications
2. Daliy BP monitoring
SAH stage II,
Amlodipine
3. Glucose monitoring TID
controlled
5mg/tab, 1 tab OD 4. Follow-up referral to ENT
(hearing loss) and Ophtha
ASHD, CAD,
Insulin 26 U am
(blurring of vision).
LVH, NIF,
and 14 U pm
Class IIB
*Patient is being seen by
Endo-Med as well, for her DM.
s/p CVA (2003)
Patient’s caregiver already
consulted the dietary for
s/p UGI
nutrition counseling for the
endoscopy
patient and is following their
11/3/08
advice.
s/p AKI
secondary to
Acute Blood
loss, resolving
*Patient had episodes of
Epigastric pain and was given
Domperidone which gave
relief.
5. Encourage passive ROM
exercises by caregiver
Psychosocial
1. Maintain good interpersonal
relationship with caregivers
and relatives in the household