Genogram for nursing Assignment

Genogram for nursing Assignment

Create your imaginary family and fill all the information of the family assessment

Box 13-7 Family Assessment Guide

I Identifying Data

Name: ___________________________________________________________________________________________________

Address: __________________________________________________________________________________________________

Phone number(s):_____________________________________________________________________________________________

Household members (relationship, gender, age, occupation, education):____________________________________________________

Financial data (sources of income, financial assistance, medical care; expenditures):___________________________________________

Ethnicity: __________________________________________________________________________________________________

Religion: __________________________________________________________________________________________________

Identified client(s):______________________________________________________________________________________________

Source of referral and reason: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

II Genogram

Include household members, extended family, and significant others

Age or date of birth, occupation, geographical location, illnesses, health problems, major events

Triangles and characteristics of relationships

III Individual Health Needs (for each household family member)

Identified health problems or concerns: ________________________________________________________________________________

Medical diagnoses: _____________________________________________________________________________________________

Recent surgery or hospitalizations: _________________________________________________________________________________

Medications and immunizations: _________________________________________________________________________________

Physical assessment data: ______________________________________________________________________________________

Emotional and cognitive functioning: _______________________________________________________________________________

Coping: _____________________________________________________________________________________________________

Sources of medical and dental care: ____________________________________________________________________________

Health screening practices: ____________________________________________________________________________________

IV Interpersonal Needs

Identified subsystems and dyads:________________________________________________________________________________

Prenatal care needed: _________________________________________________________________________________________

Parent–child interactions:_______________________________________________________________________________________

Spousal relationships:_________________________________________________________________________________________

Sibling relationships:_________________________________________________________________________________________

Concerns about older members:___________________________________________________________________________________

Caring for other dependent members:________________________________________________________________________________

Significant others:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

V Family Needs

A. Developmental

Children and ages:____________________________________________________________________________________________

Responsibilities for other members: _____________________________________________________________________________

Recent additions or loss of members:_____________________________________________________________________________

Other major normative transitions occurring now:____________________________________________________________________

Transitions that are out of sequence or delayed:_____________________________________________________________________

Tasks that need to be accomplished:_______________________________________________________________________________

Daily health-promotion practices for nutrition, sleep, leisure, child care, hygiene, socialization, transmission of norms and values: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Family planning used:_______________________________________________________________________________________

B. Loss or Illness

Nonnormative events or illnesses:______________________________________________________________________________

Reactions and perceptions of ability to cope:________________________________________________________________________

Coping behaviors used by individuals and family unit:_________________________________________________________________

Meaning to the family:_________________________________________________________________________________________

Adjustments family has made:________________________________________________________________________________

Roles and tasks being assumed by members:_________________________________________________________________________

Any one individual bearing most of responsibility:_____________________________________________________________________

Family idea of alternative coping behaviors available:____________________________________________________________________

Level of anxiety now and usually:_________________________________________________________________________________

C. Resources and Support

General level of resources and economic exchange with community:_________________________________________________________

External sources of instrumental support (money, home aides, transportation, medicines, etc.):____________________________________

Internal sources of instrumental support (available from family members):___________________________________________________

External sources of affective support (emotional and social support, help with problem solving):_____________________________________

Internal sources of affective support (who in family is most helpful to whom?): _________________________________________________

Family more open or closed to outside?______________________________________________________________________________

Family willing to use external sources of support?_______________________________________________________________________

D. Environment

Type of dwelling:________________________________________________________________________________________________

Number of rooms, bathrooms, stairs; refrigeration, cooking:_______________________________________________________________

Water and sewage:______________________________________________________________________________________________

Sleeping arrangements:_____________________________________________________________________________________________

Types of jobs held by members:_______________________________________________________________________________________

Exposure to hazardous conditions at job:___________________________________________________________________________

Level of safety in the neighborhood:____________________________________________________________________________________

Level of safety in household:________________________________________________________________________________________

Attitudes toward involvement in community:___________________________________________________________________________

Compliance with rules and laws of society:____________________________________________________________________

How are values similar to and different from those of the immediate social environment?_____________________________________

E. Internal Dynamics

Roles of family members clearly defined?______________________________________________________________________

Where do authority and decision making rest?_____________________________________________________________________

Subsystems and members:__________________________________________________________________________________

Hierarchies, coalitions, and boundaries:________________________________________________________________________

Typical patterns of interaction:_______________________________________________________________________________

Communication, including verbal and nonverbal:__________________________________________________________________

Expression of affection, anger, anxiety, support, etc.:________________________________________________________________

Problem-solving style:________________________________________________________________________________________

Degree of cohesiveness and loyalty to family members:___________________________________________________________________________________________________________________________________________________________________________

Conflict management:________________________________________________________________________________________

__________________________________________________________________________________________________________

VI Analysis

Identification of family style:__________________________________________________________________________________

Identification of family strengths:_____________________________________________________________________________

Identification of family functioning:____________________________________________________________________________

What are needs identified by family? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What are needs identified by community/public health nurse?___________________________________________

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