NCM 113 Midterm Exam PDF

NCM 113- MIDTERM NCM 113 RLE Birth Certificate Form SPOT MAP → Form 102 It's a process of creating maps to gain a visual → Signatory: Birth...

NCM 113- MIDTERM NCM 113 RLE Birth Certificate Form SPOT MAP → Form 102 It's a process of creating maps to gain a visual → Signatory: Birth Attendant representation of community-specific data 1. Physician organized by geography. 2. Nurse It is possible to track where you or other staff 3. Midwife have performed outreach, or plan to perform PD 651 outreach, by marking these sites on your → registration of birth within 30 days community map. RA 3753 WHY DO SPOT MAPPING? → requires registration of births and To identity client housing areas deaths to the Office of the Civil Registrar To identity potential transportation barriers RA 3753 To target and track prime outreach sites A. Cities – City Health officer can make a strong case for critically needed B. Municipalities – Municipal Treasurer social services. Death Certificate Form It is easier to identity and analyze patterns based → Form 103 on location → Signatory: Either of the following: Assess present status of their community and 1. Health Officer (Physician) diagnose the problems they think that needs 2. Local Chief Executive (City or Municipal Mayor) attention 3. Licensed Embalmer and Undertaker (LEU) DEMOGRAPHIC DATA Demographic data refers to statistical information about populations, including COMMON VITAL STATISTICAL INDICATORS‼️ characteristics such as age, gender, ethnicity, 1. Crude Birth Rate (CBR) education, income, employment, marital status, - a measure of one characteristic of the natural and more. Demographic data is crucial for growth or increase of population. various purposes, including market research, total # of live births registered in a given calendar social policy planning, and public health —--------------------------------------------- x 1000 initiatives. estimated population as of July 1 of same year DEMOGRAPHIC VARIABLES - Total population and population 2. Crude Death Rate (CDR) density - a measure of one mortality from all causes which - Age and sex composition, population may result in a decrease of population. pyramid - Sex ratio total # of deaths registered in a given calendar - Civil status —--------------------------------------------- x 1000 - Population movement/patterns of estimated population as of July 1 of same year migration - Growth rate, life expectancy - Crude birth rate, crude death rate 3. Infant Mortality Rate (IMR) - Measures the risk of dying the 1st year of life. It VITAL STATISTICS‼️ is a good index of the general health of a - refers to the systematic study of vital events such as community births, illnesses, marriages, divorce, separation and deaths. Total # of death under 1 year of age registered in a given calendar Use of Vital Statistics: —--------------------------------------------- x 1000 1. indices of the health and illness status of a community. total # of registered live births of same calendar year 2. serves as bases for planning, implementing, monitoring and evaluating community health nursing programs and 4. Maternal Mortality Rate (MMR) services. - measures the risk of dying from causes related Sources of Data: to pregnancy, childbirth, and puerperium 1. population census total # of deaths from maternal causes registered for a 2. registration of vital data given year 3. health survey —--------------------------------------------- x 1000 4. studies and researches total #of live births registered of same year Philippine Statistic Authority 5. Fetal Death Rate (FDR) → statistic on population and the - measures pregnancy wastage. death of the characteristics such as age & sex product of conception occurs prior to its  NCM 113- MIDTERM complete expulsion ORIENTATION total # of fetal deaths registered in a given calendar —--------------------------------------------- x 1000 MANILA HEALTH DISTRICT total # of live births registered on same year VISION To be a strong and dominant force in the 6. Neonatal Death Rate (NDR) healthcare system of Manila by providing high - measures the risk of dying 1st month of life. it standards of health care services. serves as an index of the effects of prenatal care MISSION and OB management Conduct healthcare services in the highest form # of deaths under 28 days of age registered in a given of professionalism guided by high standard of calendar year competence, integrity, and excellence —--------------------------------------------- x 1000 # of live births registered of same year SIX (6) THRUST PROGRAMS OF MHD 1. Maternal and Child Health 7. Incidence Rate (IR) 2. Communicable Disease Control - measures the frequency of occurrence of the 3. Non-Communicable Disease Control phenomenon during a given period of time. 4. Environmental Health (NEW CASES) 5. Dental Health 6. School Health # of new cases of a particular disease registered during a specified period of time MHD (HEALTH CENTERS SCHEDULE) —--------------------------------------------- x 1000 Estimated population as of July of same year Monday to Friday 7AM – Admission / Registration 8. Prevalence Rate (PR) 8AM - 8:15AM – Health Education - measures the proportion of the population which 8AM - 12NN – Consultation exhibits a particular disease at a particular time - seasonal disease (BURDEN/LONG DURATION Dental OF A DISEASE) Immunization Animal Bite Treatment # of new and old of a certain disease Postpartum / Newborn registered at a given time COVID Vaccination —--------------------------------------------- x Milk Letting 1000 Provisions of Essential Meds total # of persons examined at same Risk Assessment and WHODAS given time Monday, Wednesday, Friday – 1PM-5PM 9. Attack Rate (AR) Prenatal Check Up - a more accurate measure of the risk of exposure OB UTZ (OUTBREAK) Syphilis / Hepa / HIV # of persons acquiring a disease registered Risk Assessment in a given year WHODAS (WHO Disability Assessment —--------------------------------------------- x 100 Schedule) # of exposed to same disease in the same year Tuesday and Thursday – 1AM-8:30AM Laboratory Test 10. Case Fatality Ratio (CFR) - index of a killing power of a disease and is Tuesday and Thursday – 1PM-5PM influenced by incomplete reporting and poor Family Planning and Counseling morbidity data (SEVERITY) ECG # of registered deaths from a specific disease for a Adolescent Clinic given year Subdermal Implant Insertion —----------------------------------------------- x 100 PAP Smear # of registered cases from same specific disease in Visual Inspection with Acetic Acid same year Risk Assessment and WHODAS  NCM 113- MIDTERM Dental Services MO-IV Fluoride Application Noemi Lumibao MD Cleaning Restoration incl Pasta and Extraction MO-III Physicians Laboratory Tests Alarise Chan MD CBC, FBS, BUN, CREA, SGOT, SGPT, Margin Benemento MD Cholesterol, Triglycerides, & Uric Acid Joan Uyehara MD Jonah Pantoja MD – Trained for Urinalysis, Fecalysis, OGTT subdermal implant Family Planning Oral Contraceptive Pills Injectables & Implants Midwife V Lactation Amenorrhea Method Lita Escobido RM IUD & Condom Imelda Zapata RM Vasectomy and Bilateral Tubal Ligation Esmeralda Corral RM Midwife Midwife IV Health Office Dr. Dolores Manese Fidela Baltazar RM District Officer Marilyn Butihen RM Ma’am Rosemarie Lim Ma. Lelita P. Montejo RM Nursing Faraida Bansao RM Supervisor Ma’am Teresa De Jesus Eulalia Sapnul RM Midwife Ma’am Pilipinas Guillermo Charito Flores Nursing Janet Andaya Admin Officer Ma’am Velasco Attendant Mie Bueza Ma. Lyn Maypo Total Health Centers → 44 Teresa Dimaya Total Lying In Clinic → 2 1. Tondo Foreshore Lying in Clinic 2. Dr. M. Icasiano Lying In Clinic SERVICE OFFERED ICASIANO LYING IN CLINIC ₱1,800 – Newborn Screening Situated at District V Medication – Free (Antibiotics, FeSO4, Pain Delivery Room – 2 Beds Reliever, Vit. A, Amoxicillin) 8 Bed Capacity – Ward Vaccination – Free For complicated cases patients are referred to 24 hours from labor until delivery Sta. Ana Hospital SHIFT: 8AM to 5PM (8 hours) & 3PM to 9AM (16 CRITERIA BEFORE ADMISSION hours) Age 19 to 34 years old Per shift consist of: AOG 37 to 41 weeks 1 MD HT: 4’10” 1 RM BP: 90/60 to 120/80 mmHg 1 NA Fundal HT: 28-32cm 1 Ambulance Driver FHT: 120 to 160/min 1 SG (Night Shift) Intact BOW (case to case basis) Absence of profuse bleeding DESIGNATION OF STUDENTS Cephalic presentation Delivery Room : 2 students (actual, assist, and First pregnancy uncomplicated immediate newborn) Up to 4th uncomplicated pregnancy Ward Area : 2 to 3 students No history of STI, Hepa B, and HIV Triage Area : 2 to 3 students Not high risk or no complication PRIOR DELIVERY No need for routine enema Light meals allowed Not necessary to insert IV  NCM 113- MIDTERM UPON DELIVERY Once baby is out, give 10 “U” oxytocin before SAN NICOLAS HEALTH CENTER placenta out Wipe baby Delayed cord clamping (no more pulsation) 1 to Dr. Ma. Agnes Paderanga 3 mins, no milking PHYSICIAN IN CHARGE 90 minutes Unang Yakap Emily Bonalos Encourage Breastfeeding PHYSICIAN IN CHARGE Weigh and measure baby Paula Climalosa Administration of Vitamin K and Hepa B 2ND PHYSICIAN IN CHARGE Administration of BCG before discharge Emerita L Catedrilla NURSE IN CHARGE HEALTH EDUCATION Agnes Mendez Breastfeeding NURSE V Immunization Christine Mary Bernal Nutrition NURSE IV Responsible parenthood and family planning counseling NURSE IV Personal hygiene SCHEDULE: PAP Smear 7AM – Admission / Registration Danger signs of mother and baby 8AM - 8:15AM – Health Education 8AM - 12NN – Consultation Dental Immunization Animal Bite Treatment Postpartum / Newborn COVID Vaccination Milk Letting Provisions of Essential Meds Risk Assessment and WHODAS Monday, Wednesday, Friday – 1PM-5PM Prenatal Check Up OB UTZ Syphilis / Hepa / HIV Immunization Risk Assessment WHODAS (WHO Disability Assessment Schedule) OTHERS LINKS SAMPLE QS: https://www.proprofs.com/quiz-school/story.php?title=chapt MABINI HEALTH CENTER er-15-community-assessment >letche<  NCM 113- MIDTERM SURVEY DATA COLLECTION [SURVEY FORM] INITIAL DATA BASE FOR FAMILY NURSING PRACTICE A. FAMILY STRUCTURE, CHARACTERISTICS, AND DYNAMICS POSITION NAME OF FAMILY CIVIL AGE SEX IN THE RESIDENCE MEMBERS STATUS FAMILY 1. 2. 3. 4. 5. Note: 1. Specify “Residence” if permanent, temporary, and indicate length of stay 2. Members of the family not living during the time of survey will not be included 3. Children below 13 years old are classified as “Child” under Civil Status column STRUCTURE REMARKS 1. Nuclear (husband, wife, and their immediate children) 2. Extended (nuclear family and other persons related by blood and voluntary relationship) 3. Blended (two divorced families joined together through remarriage) 4. Matriarchal (mother is dominant in terms of decision-making specially in matters of health care) 5. Patriarchal (father is dominant in terms of decision-making specially in matters of health care) 6. Others (specify) DYNAMICS REMARKS Is there a presence of any obvious/readily observable conflict between members? What is the characteristics of communication/interaction patterns among members?  NCM 113- MIDTERM B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS PLACE FAMILY ETHNIC EDUCATIONAL RELIGION OCCUPATION OF MEMBER BACKGROUND ATTAINMENT WORK With the use of a table and graph, present the Family’s Monthly Statement of Income and Expenses INCOME EXPENSES TOTAL: C. HOME AND ENVIRONMENT 1. Lot Rented Owned Rented free Squatter Ownership 2. Home Owned Rented Ownership 3. Housing Concrete Mixed Wood Materials 4. Housing Bungalow 2 storey (or Squatter Type more) 5. No. of All purpose One Rooms bedroom (specify) 6. Flooring Cemented Wood Ground Others 7. Ventilation Door only 1 Window 2 Windows (or more)  NCM 113- MIDTERM COMPUTE FOR THE TOTAL FLOOR AREA (TFA): LENGTH X WIDTH (SQ.M) WIDTH COMPUTE FOR THE TOTAL SPACE REQUIREMENT (TSA) USING THE FOLLOWING VALUES: Total Space Requirement per Individual Adult > 18 years old = Child > 17 years old = Infant > 18 years old = (A) No. of Adults (0) X 3 sq.m = sq.m (B) No. of Child (0) X 1.5 sq.m = sq.m TSA (A+B) = = sq.m Interpret: TSA < TFA = adequate living space TSA > TFA = inadequate living space COMPUTE FOR THE VENTILATION PERCENTAGE (%) 𝑇𝑜𝑡𝑎𝑙 𝑊𝑖𝑛𝑑𝑜𝑤 𝑂𝑝𝑒𝑛𝑖𝑛𝑔 𝑋 (𝐿 𝑋 𝑊) 𝑉𝑒𝑛𝑡𝑖𝑙𝑎𝑡𝑖𝑜𝑛 % = 𝑇𝑜𝑡𝑎𝑙 𝐹𝑙𝑜𝑜𝑟 𝐴𝑟𝑒𝑎 𝑋 100 Interpret the result using the following values: Good Ventilation = 20% up Fair = 16-19% Poor = 0-15% 8. Type of Lighting Use Electric Good Kerosene Fair Others (specify) Poor  NCM 113- MIDTERM 9. Water Supply Facilities Level I (point sources/balon) Level II (communal faucet/stand post/deep well) Level III (water work system) Others (specify) 10. Water Usage Drinking Deep Well Delivered by Truck Nawasa Cooking Deep Well Delivered by Truck Nawasa General Household Deep Well Delivered by Truck Nawasa 11. Type of Water Storage for Drinking/General Household Use H20 Jug Drum Bottle Pail Purifier 12. Type of Food Storage Refrigerator Cupboard Hanging On the table basket with cover without cover 13. Toilet Facility Level I (pit latrine/no water/pour flush toilet) Level II (water sealed/flush system) Level III (with treatment plant) Balot System Toilet Ownership 14. Garbage Disposal Method Burning Burying Dumping Collected Estero 15. Kind of Neighborhood Congested Slum 16. Domestic Animals (specify): 17. Social and Health Facilities (specify): 18. Communication and Transportation facilities (specify):  NCM 113- MIDTERM D. HEALTH STATUS OF EACH MEMBER PRESENT ILLNESS MEDICAL FAMILY MEMBER DISEASE ATTENDANCE REMARKS (WITH/WITHOUT) DEATHS (LAST FIVE YEARS) MEDICAL CAUSE OF FAMILY MEMBER ATTENDANCE REMARKS DEATH (WITH/WITHOUT) OBSTETRICAL CONDITION INSTANT FEEDING  NCM 113- MIDTERM NUTRITIONAL ASSESSMENT WRIST Degree HT WT MEASURE of NAME AGE BMI Remarks Remarks (m) (kg) MENT Malnu- (cm) trition BMI COMPUTATION 1. Measure the person’s height in meter (1m = 3.3 ft = 39.6 in) 2. Measure the weight in kilograms (1 kg = 2.2 lbs) 𝑊𝐸𝐼𝐺𝐻𝑇 𝐼𝑁 𝐾𝐺𝑆 𝑘𝑔 3. Calculate the BMI using the following formula: 𝐵𝑀𝐼 = (𝐻𝐸𝐼𝐺𝐻𝑇 𝐼𝑁 𝑀)𝑠𝑞 or 2 𝑚 Guide for BMI Evaluation: 40 morbidly obese Computation of ideal body weight: For adult male – allow 106 lbs. for 5 ft. height and add 6 lbs. for each additional inch taller; below 5 ft. subtract 6 lbs. For adult female – allow 100 lbs. for 5 ft. height and add 5 lbs. for each additional inch taller; below 5 ft. subtract 5 lbs. COMPUTE FOR THE DEGREE OF MALNUTRITION 𝐴𝑐𝑡𝑢𝑎𝑙 𝑏𝑜𝑑𝑦 𝑤𝑒𝑖𝑔ℎ𝑡 𝐷𝑒𝑔𝑟𝑒𝑒 𝑜𝑓 𝑚𝑎𝑙𝑛𝑢𝑡𝑟𝑖𝑡𝑖𝑜𝑛 = 𝐼𝑑𝑒𝑎𝑙 𝑏𝑜𝑑𝑦 𝑤𝑒𝑖𝑔ℎ𝑡 𝑋 100 Interpretation: 110% and above - Obese 90-109% - Normal 75-89% - 1st Degree 60-75% - 2nd Degree 60% below - 3rd Degree  NCM 113- MIDTERM E. VALUES, HABITS, AND PRACTICES ON HEALTH PROMOTION, MAINTENANCE, AND DISEASE PREVENTION IMMUNIZATION STATUS OF EACH FAMILY MEMBERS FAMILY MEMBER AGE BCG MEASLES DPT OPV HEPA 1. 2. 3. 4. 5. UTILIZATION OF HEALTH FACILITIES None Self-medication Consultation with private physician (identify) Consultation with public health officer (identify) PERSON CURRENTLY ASSOCIATED WITH DISEASE (specify): None Yes No selfie-medi Private Public cation Undergoing Treatment Yes No Source of medicines for treatment Government Urban Health Center Barangay HC Hospital NGO Private MD Outreach Clinic LIFESTYLES DRUG HOURS SMOKING FAMILY FOOD EXERCISE ALCOHOL USAGE OF DURATION/ MEMBER PREFERENCE CONSUMPTION Y N Y N SLEEP CONSUMPTION  NCM 113- MIDTERM NCM 113 LEC action rather than appointed or selected by some external force or entity COPAR - A social development approach that aims to COMMUNITY ORGANIZING transform the apathetic, individualistic, and - the process whereby the community members voiceless poor into a dynamic, participatory develop the capability to assess their health and politically responsive community. needs and problems, plan and implement - A process, by which a community identifies its actions to solve these problems. needs and objectives, develops confidence to - carried out by the nurse with the goal of take action in respect to them and in doing so, motivating, enhancing and seeking wider extends and develops cooperative and community participation in decision-making in collaborative attitude and practices in the activities that have the potential to impact community. positively on community health IMPORTANCE OF COPAR - COPAR is an important tool for community STAGES INCLUDES THE FOLLOWING: development and people empowerment as this: helps the community workers generate Stage 1 : Community Analysis community participation in development - the process of assessing and defining needs, activities. opportunities and resources involved in maximizes community participation and initiating community health action programs. involvement. prepares people/clients to eventually take over the management of development programs in 5 Components: the future 1. demographic, social and economic profile 2. health risk profile PRINCIPLES OF COPAR 3. health/wellness outcome profile 1. People, especially the most oppressed, 4. survey of current health promotion exploited, and deprived (women sectors, programs children, handicapped, elderly, youth) open to 5. studies conducted in certain target groups change, have the capacity to change, and are Steps: able to bring about change. 1. Define the community. 2. COPAR should be based on the interest of the 2. Collect data. poorest sectors of society. 3. Assess community capacity. 3. COPAR should lead to a self-reliant community 4. Assess community barriers. and society. 5. Assess readiness for change. 6. Synthesis data and set priorities PROCESS USED: A PROGRESSIVE CYCLE OF ACTION REFLECTION-ACTION Stage 2 : Design and Initiation - which begins with small, local and 1. Establish a core planning group and select a concrete issues identified by the local organizer. people and the evaluation and 2. Choose an organizational structure. reflection of and on the action taken a. Leadership board or council – by them. existing local leaders working for a CONSCIOUSNESS-RAISING common cause - Experiential learning is central to the b. Coalition – linking organizations and COPAR process because it places groups to work on community issues emphasis on learning that emerges c. Lead or official agency – a single from concrete action and which agency takes the primary enriches succeeding action. responsibility of a liaison for health - promotion activities in the community d. Grass-roots – informal structure in COPAR is PARTICIPATORY AND the community like the neighborhood MASS-BASED because it is primarily residents directed towards and biased in favor of the e. Citizen panels – a group of citizens poor, the powerless and the oppressed. (5-10) emerge to form a partnership COPAR is GROUP-CENTERED AND NOT with a government agency. LEADER ORIENTED. Leaders are f. Networks and consortia – networks identified, emerged and tested through develop because of certain concerns.  NCM 113- MIDTERM 3. Identify, select and recruit organizational departments members. B. Entry Phase 4. Define the organization mission and goals. Integration with the community 5. Clarify roles and responsibilities of people Sensitization of the community; information involved in the organization. campaign 6. Provide training and recognition Continuing/Deepening social investigation Stage 3 : Implementation Core group formation: - put design into action 1. belongs to the poor sector of the society Generate broad citizen participation 2. responsible and committed Develop a sequential work plan. 3. able to communicate Use comprehensive, integrated strategies. Coordination with other community Integrate community values into the programs, organization materials and messages. Self-Awareness and Leadership Training (SALT)/ Action Planning Stage 4 : Program Maintenance - At this point the program has Best technique to identify potential leaders: experienced some degree of - observe people who are active in small success and has weathered through mobilization activities that motivate residents to implementation programs. start working. To maintain and consolidate gains of the program, the C. Community Study / Diagnosis Phase following are essential: Selection of the research team 1. Integrate intervention activities into Training on data collection methods and community networks. techniques 2. Establish a positive organizational culture. Planning for the actual gathering of data 3. Establish an ongoing recruitment plan. Data gathering 4. Disseminate results. Training on data validation Community validation Stage 5 : Dissemination - Reassessment Presentation of the community study/ - Continuous assessment is a part of the diagnosis and recommendations. monitoring aspect in the management of the Prioritization of community needs/problems for program. action - Formative evaluation is done to provide timely modification of strategies and activities. TYPES OF COMMUNITY DIAGNOSIS ➔ Update the community analysis. Is there a 1. Comprehensive Community Diagnosis change in leadership, resources and - aims to obtain general information about the participation? community. ➔ Assess effectiveness of Elements: interventions/programs. A. Demographic variables ➔ Chart future directories and modifications. B. Socio-economic and cultural variables ➔ Summarize and disseminate results C. Health and illness patterns D. Health resources PHASES OF COPAR E. Political/Leadership patterns A. Pre-Entry Phase 2. Problem-Oriented Community Diagnosis Community consultation/dialogues - type of assessment that responds to a Setting of issues/considerations related to site particular need. location Development of criteria for site selection: 1. high percentage of the family D. Community Organization and Capability Building income is below the national poverty Phase threshold Community meetings to draw up guidelines for 2. high malnutrition rate the organization 3. lack of primary or secondary hospital Election of officers within a 30- minute ride from the area Delineation of the roles, functions and task of 4. area must not have relative peace officers and members and order problem Action-Reflection-Action session 5. acceptance of the community - tool used to develop team-building and to Site selection promote an avenue to verbalize feelings, Preliminary social investigation opinions and suggestions and enable them to Networking with LGU’s, NGO’s and other participate in decision-making  NCM 113- MIDTERM Team building exercises - going around and motivating the person on Working out legal requirements for the a one on one basis to do something on the establishment of the CHO issue that has been chosen. Training of the CHO officers/ community leaders 5. THE MEETING - people collectively ratifying what they have E. Community Action Phase already decided individually. Organization and training of CHW’s - The meeting gives the people collective Setting-up of linkages/network referral system power and confidence Project Implementation Monitoring Evaluation - Problems and issues are discussed. (PIME) of health services Initial identification and implementation of 6. ROLE PLAYING resource mobilization schemes - means to act out a meeting that will take place between the leaders of the people F. Sustenance and Strengthening Phase and the government representative’s - begins when the community organization has - It is the way of training the people to already established community members who anticipate what will happen and prepare are actively participating in community wide themselves for such eventually undertakings activities. Formulation and ratification of constitution and 7. MOBILIZATION OF ACTION by-laws - actual experience of the people in Identification and development of “Secondary” confronting the powerful and the actual leaders exercise of the people's power. Setting up and institutionalization of a financing scheme for the community health activities 8. EVALUATION Formalizing and institutionalization of linkages, - the people reviewing the steps 1-6 so as to networks and referral systems determine whether they were successfully Continuing education and upgrading of or not on their objectives. community leaders, CHW’s and CHO members Development of medium/ long term community 9. REFLECTION health and development plans - dealing with deeper, ongoing concerns to look at the positive values CO is trying to build in the organization. CRITICAL STEPS (ACTIVITIES) IN BUILDING PEOPLE AND ORGANIZATION - It giv es the people time to reflect on the starch reality of life compared to the ideal. 1. INTEGRATION - A community becoming one with the people in order to: 10. ORGANIZATION A. Immerse himself in the poor community - The people's organization is the result of B. Understand deeply the culture, economy many successive and similar actions of the leaders, history rhythms and lifestyle in the people community. - A final organizational structure is set up with elected officers and supporting members. 2. SOCIAL INVESTIGATION - a systematic process of collecting and analyzing data to draw a clear picture of the community. - a process of systematically learning and analyzing the various structures and forces in the community - Also known as the “Community Study” 3. TENTATIVE PROGRAM PLANNING - CO to choose one issue to work on in order to begin organizing the people. 4. GROUNDWORK  NCM 113- MIDTERM Integrated Management of Childhood Illnesses clinical signs are used What is IMCI? 5. A combination of individual signs leads to a Integrated Management of Childhood child's classification(s) rather than a diagnosis. Illness (IMCI) is a strategy for reducing the identify illness = Dx mortality and morbidity associated with the ✓ classify illness = classification major causes of childhood illness. 6. The guidelines do not describe the management IMCI is an integrated approach to child of trauma or other acute emergencies d/t accidents health that focuses on the well-being of the or injuries. whole child. 7. IMCI management procedures use a limited The IMCI Strategy: number of essential drugs and encourage active promotes the accurate identification of participation of caretakers. childhood illnesses 8. An essential component of the IMCI guidelines is ensures appropriate integrated treatment the counseling of caretakers. of all major illnesses strengthens the counseling of caregivers; THE IMCI STRATEGY identifies the need of and speeds up the referral of severely ill children. In the home setting: it promotes appropriate care-seeking behaviors; improved nutrition and preventative care; and the correct implementation of prescribed care. 2 Age Categories in IMCI 1. Young Infant up to less than 1 week up to 2 months (1 week up to 1 month and 29 days) 2. Young Child 2 months up to 5 years (2 months up to 4 years and 11 months) PRINCIPLES IN IMCI 1. All sick children must be examined for GENERAL DANGER SIGNS: C - Convulsions (fits, jerky movement, spasm) U - Unable to drink (not eat) V - Vomiting A - Abnormally sleeping(difficult to awaken) 2. Assess for MAIN SYMPTOMS: For Older Children For Young infants a. Cough/DOB a. Local bacterial b. Diarrhea Infection c. Fever b. Diarrhea d. Ear problems c. Jaundice 3. Assess for nutritional status, immunization status, vitamin A status,feeding problems, and other potential problems 4. Only a limited number of carefully selected  NCM 113- MIDTERM HOW TO PREVENT LOWERING OF BLOOD SUGAR LEVEL If the child is able to breastfeed: if the child is not able to breastfeed but is able to swallow: - give 30-50 ml milk or sugar H2O p.o. (sugar H2O: 4 tsp. sugar+200 ml H2O) Not able to swallow but conscious: - Insert NGT If the child is unconscious - (IVF) D10W 5 ml/kg body weight for a few minutes CLASSIFY COUGH TREATMENT CLASSIFY DIARRHEA  NCM 113- MIDTERM AGE AMOUNT OF ORS CHOLERA 1. First Line Antibiotic 1 week up to 4 mos. 200-400 ml Tetracycline old 400-700 ml 4 mos. up to 12 mos. 700-900 ml 2. Second Line Antibiotic 12 mos. up to 2 years 900-1400 ml Erythromycin old 2 years old up to 5 years old Mild vomiting during ORT stop ORS in 10 mins, after 10 mins continue ORS but give it in a slow manner Severe Vomiting during ORT stop ORS → IVF or refer! NCM 113- MIDTERM NCM 113- MIDTERM  NCM 113- MIDTERM complementary food 1-2 times a day GENTIAN VIOLET Half strength: for mouth ulcers - 15 ml GV+30-45 DW =.25% concentration Full strength: skin pustules & umbilical redness or pus - 15 ml GV+15 ml DW =.5% concentration PREPARATION & APPLICATION OF GENTIAN VIOLET MOUTH SKIN UMBILICAL ULCERS PUSTULES REDNESS/P US 1. Wash 1. Wash hands hands 1.Wash hands 2. Clean 2. Clean 2. Clean affected area affected affected area using soft area using using 70% RECOMMENDED FEEDING cloth dipped in soft cloth alcohol At birth up to 6 months salt water soaked with 3. Paint GV - exclusively breastfeed 3. Paint GV soap & water 4. Wash - 8 times or more than 8 times 4. Wash 3. Paint GV hands within 24 hours. hands 4. Wash hands SIGNS OF HUNGER: 1. Beginning to fuss. 2. Sucking fingers and fist 3. Sucking movements with their lips. 1. 6 months up to 12 months: - breastfeeding + 3 times a day complementary food. - If not on breastfeeding: —> 5 times a day complementary food. 2. 12 months up to 2 years old: - breastfeeding + 5 times a day of complementary food. 3. At birth up to 4 months: - exclusive breastfeeding 8 times in 24 hrs 4. 4 months up to 6 months: - breastfeeding with