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Questions and Answers
Which of the following roles is NOT included as a Client-oriented role of a community health nurse?
Which of the following roles is NOT included as a Client-oriented role of a community health nurse?
The use of Bahala na is generally considered a sign of fatalism and a passive acceptance of fate by Filipinos.
The use of Bahala na is generally considered a sign of fatalism and a passive acceptance of fate by Filipinos.
False
What is the main goal of the Integrated Management of Childhood Illness (IMCI) strategy?
What is the main goal of the Integrated Management of Childhood Illness (IMCI) strategy?
To reduce death and the frequency and severity of illness and disability, and to contribute to improved growth and development.
Which of the following is NOT a principle of IMCI?
Which of the following is NOT a principle of IMCI?
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Which of the following is NOT a key symptom to assess in a child with cough or difficult breathing?
Which of the following is NOT a key symptom to assess in a child with cough or difficult breathing?
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A child with a general danger sign always requires immediate referral to a hospital.
A child with a general danger sign always requires immediate referral to a hospital.
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What are the three main components of the IMCI strategy?
What are the three main components of the IMCI strategy?
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Which of the following is a sign of 'Severe Dehydration' in a child?
Which of the following is a sign of 'Severe Dehydration' in a child?
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Anti-diarrheal drugs are generally recommended for children under five years of age with acute diarrhea.
Anti-diarrheal drugs are generally recommended for children under five years of age with acute diarrhea.
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Which of the following is NOT a common complication of measles?
Which of the following is NOT a common complication of measles?
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A child with fever and a runny nose does not need an antimalarial drug if the malaria risk is low.
A child with fever and a runny nose does not need an antimalarial drug if the malaria risk is low.
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Which of the following is NOT a possible cause of fever in children?
Which of the following is NOT a possible cause of fever in children?
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A child with fever and a stiff neck requires urgent treatment with injectable antibiotics and referral to a hospital.
A child with fever and a stiff neck requires urgent treatment with injectable antibiotics and referral to a hospital.
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The presence of a bulging fontanelle in an infant under 12 months of age can be a sign of meningitis.
The presence of a bulging fontanelle in an infant under 12 months of age can be a sign of meningitis.
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Which of the following is NOT a contraindication for immunization in a child?
Which of the following is NOT a contraindication for immunization in a child?
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What is the recommended dose of vitamin A for a child between 6 months and 12 months of age?
What is the recommended dose of vitamin A for a child between 6 months and 12 months of age?
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The presence of visible severe wasting in a child is a sign of Kwashiorkor.
The presence of visible severe wasting in a child is a sign of Kwashiorkor.
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Children diagnosed with Severe Malnutrition or Severe Anemia require immediate referral to a hospital.
Children diagnosed with Severe Malnutrition or Severe Anemia require immediate referral to a hospital.
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The IMCI strategy recommends the use of anti-diarrheal drugs for children under five years of age with acute diarrhea.
The IMCI strategy recommends the use of anti-diarrheal drugs for children under five years of age with acute diarrhea.
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Children with fever who have had measles within the past three months should NOT be classified specifically for fever.
Children with fever who have had measles within the past three months should NOT be classified specifically for fever.
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The presence of an abnormal stiff neck is an indicator of possible meningitis.
The presence of an abnormal stiff neck is an indicator of possible meningitis.
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A child with fever, but no general danger signs, should be classified as which of the following if the malaria risk is low?
A child with fever, but no general danger signs, should be classified as which of the following if the malaria risk is low?
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Dengue hemorrhagic fever (DHF) is usually characterized by a long, drawn-out fever lasting more than a week.
Dengue hemorrhagic fever (DHF) is usually characterized by a long, drawn-out fever lasting more than a week.
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A child with fever and black stools might be a sign of DHF.
A child with fever and black stools might be a sign of DHF.
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Which of the following IS NOT a sign of shock in a child?
Which of the following IS NOT a sign of shock in a child?
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The Tourniquet test is most accurate for detecting bleeding in children with confirmed DHF.
The Tourniquet test is most accurate for detecting bleeding in children with confirmed DHF.
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If a child has pus draining from the ear for less than 2 weeks, the child should be classified as having a chronic ear infection.
If a child has pus draining from the ear for less than 2 weeks, the child should be classified as having a chronic ear infection.
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If a child has an ear infection, but the eardrum has not ruptured, the child does not need treatment.
If a child has an ear infection, but the eardrum has not ruptured, the child does not need treatment.
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Which of the following IS a sign that a child may have a severe complication of measles?
Which of the following IS a sign that a child may have a severe complication of measles?
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A child with fever and pus draining from the eye should be classified as having 'Measles with eye or mouth complications' if the child also has a generalized rash.
A child with fever and pus draining from the eye should be classified as having 'Measles with eye or mouth complications' if the child also has a generalized rash.
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It is acceptable to administer multiple doses of vitamin A to a child with suspected malnutrition within a short period of time, regardless of when their last dosage was provided.
It is acceptable to administer multiple doses of vitamin A to a child with suspected malnutrition within a short period of time, regardless of when their last dosage was provided.
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A child with a generalized danger sign does not require immediate referral to the hospital if they respond positively to rehydration with Plan C.
A child with a generalized danger sign does not require immediate referral to the hospital if they respond positively to rehydration with Plan C.
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A child with an acute ear infection always requires antibiotics.
A child with an acute ear infection always requires antibiotics.
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The presence of palmar pallor in a child indicates malnutrition.
The presence of palmar pallor in a child indicates malnutrition.
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You should recommend iron supplementation to a child with suspected anemia, regardless of their age.
You should recommend iron supplementation to a child with suspected anemia, regardless of their age.
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Children who have had diarrhea for 14 days or more should be immediately referred to a hospital, regardless of whether they have signs of dehydration.
Children who have had diarrhea for 14 days or more should be immediately referred to a hospital, regardless of whether they have signs of dehydration.
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The main goal of the IMCI strategy is to prevent death from diarrhea.
The main goal of the IMCI strategy is to prevent death from diarrhea.
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It is recommended to administer mebendazole to any child with suspected anemia.
It is recommended to administer mebendazole to any child with suspected anemia.
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A child with a history of fever and diarrhea for more than 14 days should be automatically classified as having 'Severe Persistent Diarrhea,' regardless of whether they are dehydrated.
A child with a history of fever and diarrhea for more than 14 days should be automatically classified as having 'Severe Persistent Diarrhea,' regardless of whether they are dehydrated.
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The IMCI strategy emphasizes the importance of early identification and immediate treatment of dysentery, especially in infants and children who have been recently vaccinated.
The IMCI strategy emphasizes the importance of early identification and immediate treatment of dysentery, especially in infants and children who have been recently vaccinated.
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Even with signs of severe malnutrition, a child with no other medical concerns and who is responding well to treatment can be managed as an outpatient.
Even with signs of severe malnutrition, a child with no other medical concerns and who is responding well to treatment can be managed as an outpatient.
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A child with fever but no other signs of illness should be classified as 'Fever: No Malaria' if the area does not have a high risk of malaria transmission.
A child with fever but no other signs of illness should be classified as 'Fever: No Malaria' if the area does not have a high risk of malaria transmission.
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A high fever, persistent abdominal pain, and vomiting in a child with suspected DHF should be managed with oral rehydration therapy (ORS) only.
A high fever, persistent abdominal pain, and vomiting in a child with suspected DHF should be managed with oral rehydration therapy (ORS) only.
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A child with fever and pus draining from the ear for less than 14 days should be given an antibiotic, but only if they have a general danger sign.
A child with fever and pus draining from the ear for less than 14 days should be given an antibiotic, but only if they have a general danger sign.
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The presence of palmar pallor in a child indicates malnutrition; therefore, it is sufficient to simply provide iron supplementation to address the condition.
The presence of palmar pallor in a child indicates malnutrition; therefore, it is sufficient to simply provide iron supplementation to address the condition.
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The IMCI strategy focuses solely on improving the health system and providing guidelines on managing common childhood illnesses, but does not address the importance of educating families and communities about preventive care.
The IMCI strategy focuses solely on improving the health system and providing guidelines on managing common childhood illnesses, but does not address the importance of educating families and communities about preventive care.
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A child with generalized rash and cough is considered to have measles, regardless of other potential symptoms like runny nose or red eyes.
A child with generalized rash and cough is considered to have measles, regardless of other potential symptoms like runny nose or red eyes.
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The use of mebendazole is always recommended in children with confirmed hookworm or whipworm infection to effectively treat the condition.
The use of mebendazole is always recommended in children with confirmed hookworm or whipworm infection to effectively treat the condition.
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A child with a history of fever and diarrhea for more than 14 days, but no signs of dehydration, can be managed with oral rehydration therapy (ORS) and zinc supplements only.
A child with a history of fever and diarrhea for more than 14 days, but no signs of dehydration, can be managed with oral rehydration therapy (ORS) and zinc supplements only.
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It’s always a safe practice to immediately administer an antimalarial drug to any child with fever in low malaria risk areas, especially if they exhibit signs of other potential illness.
It’s always a safe practice to immediately administer an antimalarial drug to any child with fever in low malaria risk areas, especially if they exhibit signs of other potential illness.
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If a child with fever and a stiff neck is able to move their head freely, the child does not have a stiff neck.
If a child with fever and a stiff neck is able to move their head freely, the child does not have a stiff neck.
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A child who has received all the recommended immunizations based on their age is considered to have received all necessary vaccines.
A child who has received all the recommended immunizations based on their age is considered to have received all necessary vaccines.
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It’s always recommended to administer an antibiotic to a child with both fever and an ear discharge, regardless of the duration of the discharge.
It’s always recommended to administer an antibiotic to a child with both fever and an ear discharge, regardless of the duration of the discharge.
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The presence of edema in both feet indicates a high risk of death in children, especially those who are severely malnourished.
The presence of edema in both feet indicates a high risk of death in children, especially those who are severely malnourished.
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Observing the child’s immunization status and treating any other health concerns is the last step in the IMCI assessment process.
Observing the child’s immunization status and treating any other health concerns is the last step in the IMCI assessment process.
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Study Notes
Community Health Nursing 2
- Course: Community Health Nursing 2
- Semester: 1st Semester
- Academic Year: 2022 - 2022
- Facilitator: Aileen G. Sypongco, MN, RN, RM
Current Trends in Public Health
- Global Health Issues (GHIs): Transcend national boundaries, requiring global cooperation for response, planning, prevention, preparedness, and equitable care.
- Complex Interprofessional/Interagency Collaboration: Involves governments, non-profits, and often private companies to address GHIs.
- Community Health Nurse Roles: Evolving due to changes in healthcare delivery, promoting lifelong holistic care, health promotion, and enhancing quality of life.
- Competent Health Care Professionals Crucial: Essential for quality delivery of care to diverse communities and groups.
- Expanding Roles for CHNs: Needed for primary, secondary, and tertiary care delivery.
- Key Roles of CHNs in Healthcare: assessment, diagnosis, planning, implementation, and evaluation (using critical thinking, skills, professional competence, and evidence-based knowledge).
- Client-Oriented Roles: caregiver, counselor, educator, referral resource, role model, and case manager.
- Delivery-Oriented Roles: coordinator, collaborator, and liaison
- Population-Oriented Roles: case finder, leader, change agent, community mobilizer, coalition builder, policy advocate, social marketer, and researcher
- **Clinician Role:**Utilizes the nursing process for home visits and in public health facilities, making referrals to appropriate services.
Duties and Responsibilities of the Community Health Nurse
- Comprehensive Care: Provides holistic care to individuals, families, communities, and populations.
- Utilizing the Nursing Process: Assessment, diagnosis, planning, implementation, and evaluation are crucial elements in delivering care, supported by evidence-based knowledge and professional competence.
Roles of the Community Health Nurse
- Advocate: Providing sufficient information and support for patients and families to make informed health decisions.
- Administrator: Overseeing nursing staff, motivating them, and managing health care settings effectively.
- Counselor: Provides emotional/psychological support to patients and their families, helping them to make healthy choices.
- Monitor/Diagnostician: Identifying patients' problems, causes, and risks, to create care plans for individuals, families, communities or populations. Alleviating suffering and preventing complications.
- Educator: Improving health knowledge, skills, and attitudes within individuals, families, and communities by conducting campaigns and teaching health promotion/disease prevention.
- Coordinator/Collaborator: Building connections with other professionals, government agencies, NGOs, the private sector, and community leaders to address community health needs. Establishes and maintains relationships for effective healthcare delivery.
- Supervisor: Oversees midwives and auxiliary health workers, providing staff development and training
- Manager: Organizing nursing services at local health agencies or government units
- Leader/Change Agent: Influencing people to engage in and affect positive change to improve health or their communities.
Responsibilities of the Chief Community Nurse (CHN)
- Develop/Implement Health Plans: Creates overall health plans, implements them, and evaluates their success within communities. Provides this high-level, system-planning care.
- Quality Nursing Services: Provides care based on the best available knowledge and skills for various populations.
- Maintains Coordination and Collaboration: Works with various health team members, non-governmental organizations (NGOs), government agencies, and others. Ensuring seamless, connected care.
- Public Health Services: Initiates, coordinates, and performs research relevant to CHN services to ensure quality and improvement of delivery of care, providing education for staff development.
- Professional Development: Initiates and promotes continuing education for improved provision of health services and staff development
Responsibilities of the Community Health Nurse in the Care of Families
- Primary Health Care Services: Provides essential primary care services.
- Development and Implementation of Family Nursing Plans: Creates and carries out plans for the provision of care within families and communities.
- Community Organizing, Mobilization & Empowerment: Plays a role in engaging community members and fostering community development for improved health.
- Case Finding/Epidemiological Investigation: Conducts investigations to understand health problems in the community, identifying risks and needs.
- Program Planning, Implementation & Evaluation: Develop, implement, and monitor programs to meet community and individual health needs.
Important Health and Wellness Trends of 2021
- Telehealth
- Interoperability
- Healthcare Consumerization
- Preventive Medicine
- Personalized Medicine
- Remote Training
- Drug-based Therapies
- Sustainable Diet
- Smart Hospitals
- Immune-boosting Supplements
General Values of Filipino Nurses
- Work Ethic: Hardworking, responsible, and seldom complain, valued for job security. Often work overtime and multiple jobs.
- Spirituality: Deep faith in God (bahala na - trusting in God's plan), with indications of cultural values and beliefs.
- Sensitivity: Sensitive to the feelings of others, diplomatic in communication styles.
- Interpersonal Relationships: Value quiet behavior, respecting elders and authority (po). Maintaining cordial relationships, and valuing group harmony.
- Respect and Reverence: Respect for elders, leaders, and professionals in Philippine society.
- Modesty: Uncomfortable with receiving compliments, less inclined to promote themselves as a way of showing humility.
- Family Ties: Strong family connections which may serve both as strength and cultural burden in some situations.
- Preventive Health Practices: Self-diagnosing, self-medicating, use of alternative therapies like "Hilot" prevalent in rural parts of the Philippines.
Delivery of Health Care to the Filipino Family and Community
- General introduction about the increasing diversity of patients and caregivers.
- Cultural Background: Filipino nurses' cultural background influences their selection and practice of nursing. Caregiving for others is emphasized in Filipino culture.
Integrated Management of Childhood Illnesses (IMCI)
- Focus on Prevention / Early Intervention:
- Targeted Interventions: Aims to reduce mortality and improve children's health (aged 0-5 years).
Assessing for Diarrhea, Fever, Ear Problems, and other Disorders
- Diarrhea: Assessment of symptoms (consistency of stool, blood/mucus, duration, and other symptoms).
- Fever: Assess for danger signs (stiff neck, unusual sleepiness), duration, and other symptoms.
- Ear Problems: Assess for ear pain, discharge, and swelling.
- Malnutrition: Assess eating habits, weight for age, and physical signs.
- Anemia : Assess eating habits, physical signs, history, and other factors.
Treatment of Severe Persistent Diarrhea, Dysentery
- Severe Persistent Diarrhea: Requires referral to a hospital for appropriate treatment and fluid and electrolyte management. Often children needing hospitalization are dehydrated.
- Dysentery: Needs urgent referral and antibiotic treatment.
- Specific Feeding is important to recovery from Diarrhea and Dysentery.
Check the Child's Immunization Status, Vitamin A, and other problems
- Immunization Status: All sick children should be checked for vaccination status, using the national immunization schedule.
- Vitamin A: Children (6 months - 59 months) should receive routine doses of vitamin A every six months (200,000 IU).
- Assessing other problems: Identify and address any additional problems identified by the community nurse (e.g., malnutrition, anemia, other illnesses).
Referring a Child to Hospital
- Explanation and Agreement: Explain the need for referral and obtain the mother's agreement for taking the child to the hospital.
- Addressing Concerns: Understand and address any potential fears, safety concerns, or other problems to avoid delays.
- Clarifying Procedures: Inform about what will happen in the hospital to alleviate anxiety and encourage collaboration.
Management and Prevention of Disease
- Thorough Assessment: Comprehensive assessments are a crucial first step in identifying symptoms and problems.
- Referral if Necessary: Urgent referral to a hospital is needed for severe health complications.
- Early Treatment of Symptoms: Implementing early prevention and treatments using locally-available remedies before seeking further medical resources is beneficial and practical.
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