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Group 5 Grand Family Case Presentation

Group 5 Grand Family Case Presentation. Abela Caro Cosalan Dator De Castro J. Hernandez L. Hernandez Ishimura Pascua A.Que. Index Case: A.E. 3 year-old male Chief complaint: M ultiple pustular skin lesions on scalp and both upper and lower extremities of 1 week duration.

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Group 5 Grand Family Case Presentation

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  1. Group 5 Grand Family Case Presentation Abela Caro Cosalan Dator De Castro J. Hernandez L. Hernandez Ishimura Pascua A.Que

  2. Index Case: A.E. • 3 year-old male • Chief complaint: • Multiple pustular skin lesions on scalp and both upper and lower extremities of 1 week duration

  3. History of Present Illness 1 week PTC • Development of multiple erythematous pruritic pustules on scalp and lower extremities • Lesions were noted to be gradually increasing in size and number • No associated symptoms of fever, cough and colds, diarrhea, loss of appetite, and weakness • No medications taken CONSULT

  4. Past Medical History • Recurrent viral URTIs since birth • Family History • Unremarkable • Birth History • Born full-term via NSD • 29-yr old G4P4 (4004) • Birth attended to by a midwife at a lying-in clinic • Unrecalled birth weight; No perinatal/neonatal complications • Completed EPI vaccinations from health center

  5. Nutritional History • Breastfed exclusively until 6 months • Formula: Bear Brand • No food allergies and specific food preferences • Developmental History • Milestones are at par with developmental age group

  6. Physical Examination • General survey • Active and cooperative • Stable vital signs • Unremarkable systemic PE • Skin • Multiple furuncles with sizes ranging from 1x1 cm to 2x2 cm • Lesions in different stages of healing concentrated on the scalp and lower extremities

  7. Assessment • Furunculosis • Plan • Cloxacillin suspension 0.6 ml 3x a day for 7 days • Mupirocin ointment to be applied 2x daily on lesions • Daily bathing with antibacterial soap with a change of clean clothes

  8. Case Summary

  9. Family Map 32 28 32 ACUTE MI 12 11 8 7 3 4 mo

  10. Home Situation • Currently live in a 1-room unit in an apartment-type complex • Unit on 2nd floor; Accessed by a single narrow wooden staircase • Rent: P700 monthly • Single room acts as a living room, dining area, bedroom, and storage space • “Dirty kitchen”-like space with a charcoal stove and makeshift sink • Dimly lit by a single light source • Windows provide moderate ventilation

  11. Home Situation • Appliances owned: Single light bulb and radio • Communal toilet and poso • Located outside the unit • Shared by other tenants of the complex • Also doubles as a bathing area and laundry area • Water supply from communal faucet • Stray animals wander freely around the area

  12. Family Profile • Parents are both high school undergraduates • Primary breadwinner: Stepfather • Part-time mason/welder • Occasional parking attendant at a mall • Earns ~P200 per day • Primary caregiver: Mother • Maintenance of the house • Oversees children’s school activities and health concerns

  13. Family Profile • 5 children (ages ranging 4 mos-12 years old) • Eldest child (12 y/o male) lives separately with maternal grandmother in the province • 2nd eldest (11 y/o female) is out of school and helps mother with household chores • Only 1 child in school (7 y/o male)

  14. Family Profile • Few resources for basic amenities (food and clothing • Recreational activities • Visiting the plaza • Going to mass • Minor health concerns directed to health center • Children have all completed vaccinations • No major illnesses necessitating hospitalization

  15. Family APGAR Score

  16. SCREEM

  17. SCREEM

  18. Family Promotive Care Plan

  19. Overall Promotive Health Care Plan • Educate family about importance of good hygiene and sanitation practices • Prevent spread of communicable diseases • Boost immunity • Improvement of overall health and well-being in the community

  20. Recommendations • Cultural limitations within a community may hinder adaptation to hygiene education • Change is brought about by experience and experimentation • A community’s inherent knowledge, beliefs, & values are integral to developing proper health education and hygiene programs • Family meeting dialogues allow people to discuss problems freely and make sense of them and their proposed solutions

  21. Biological & Psychosocial Assessment • Index patient’s main health issue is related to improper hygiene and sanitation practices • Primary caregiver should be educated regarding basic aspects of good hygiene: • Handwashing with soap & water • Daily baths • Use of slippers/proper footwear

  22. Insights • Proper hygiene and sanitation play a big role in preventive health measures. • A disease’s biomedical aspect is only the tip of the iceberg when dealing with a patient’s problems. • Family meeting is both a diagnostic and curative tool in assessing the family’s overall state of health

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