NSTP-1-REVIEWER.docx

**NSTP 1 REVIEWER** **MODULE 1 : Physical Organization & Course Orientation** ***Objectives:*** - TO GIVE KNOWLEDGE ABOUT THE NATURE AND HISTORY OF NSTP - TO EXPLAIN THE CORE VALUES OF THE SUBJECT COURSE. ***Overview*** - This session focuses on the history and origin of NSTP and how it...

**NSTP 1 REVIEWER** **MODULE 1 : Physical Organization & Course Orientation** ***Objectives:*** - TO GIVE KNOWLEDGE ABOUT THE NATURE AND HISTORY OF NSTP - TO EXPLAIN THE CORE VALUES OF THE SUBJECT COURSE. ***Overview*** - This session focuses on the history and origin of NSTP and how it helps to the community and who are those people involved in this community services. ***NSTP as "de Jure"*** - **Republic Act No. 9163 which known as the National Service Training Program (NSTP) Act of 2001** - It is an act establishing the National Service Training Program (NSTP) for tertiary level students and is the result of the amendment of Republic Act No. 7077 or AFP Reservist Law and Presidential Decree No. 1706 or the National Service Law - The guiding principle of NSTP is stated in Article II of the 1987 Constitution; - it provides that while it is the prime duty of the government to serve and protect its people, in turn it shall be the responsibility of every citizen to defend the state and in fulfillment thereof, they shall be required by the state to render personal, military and civic services. - The constitution provides further that the state shall recognize the youth's vital role in nation-building, shall promote civic consciousness among them, develop their physical, moral, spiritual and social well-being, inculcate in them patriotism, nationalism, and advance their involvement in public and civic affairs. - In pursuit of these goals, the youth, the most valuable resource of the nation, shall be motivated, trained, organized and mobilized in military training, literacy, civic welfare and other similar endeavors in the service of the nation. ***A Primer on the NSTP Act of 2001*** - **WHAT IS NSTP?** - "National Service Training Program (NSTP)" is a program aimed at enhancing civic consciousness and defense preparedness in the youth by developing the ethics of service and patriotism while undergoing training in any of its three (3) program components. - Its various components are especially designed to enhance the youth's active contribution to the general welfare. - **What are the program components of the NSTP?** - "Reserve Officers' Training Corps (ROTC)"is a program institutionalized under Section 38 and 39 of Republic Act No. 7077 designed to provide military training to tertiary level students in order to motivate, train, organize and mobilize them for national defense preparedness. - "Literacy Training Service (LTS)" is a program designed to train students to become teachers of literacy and numerical skills to school children, out of school youth, and other segments of society in need of their service. - "Civic Welfare Training Service (CWTS)" refers to programs or activities contributory to the general welfare and the betterment of life for the members of the community or the enhancement of its facilities, especially those devoted to improving health, education, environment, entrepreneurship, recreation and morals of the citizenry. - **WHO SHALL TAKE THE NSTP?** - All incoming freshmen students, male and female, enrolled in any baccalaureate and in at least two (2) year technical-vocational or associate courses, are required to complete one (1) NSTP component of their choice, as a graduation requirement. - **Since when the NSTP been implemented?** - The NSTP has been implemented since the start of school year 2002-2003. - **How is the NSTP taken up?** - Each of the NSTP components is undertaken for an academic period of two (2) semesters and is credited for three (3) units per semester with fifty four (54) to ninety (90) training hours per semester. - **What if I cannot take the NSTP during the regular semester?** - A one-summer program in lieu of the two (2)-semester program may be designed, formulated and adopted by (DND), (CHED), and (TESDA), subject to the capability of the school and the Armed Forces of the Philippines (AFP) to handle the same. - **What if the NSTP component of my choice is not offered in my school?** - Schools that do not meet the required number of students in order to conduct a program component or do not offer the component chosen by their students shall allow the students to cross enroll to other schools, irrespective of whether that school is under CHED or TESDA; and for the ROTC, whether they are managed by different AFP branches of service. - These students, however, shall be subjected to the existing rules and regulations of their school of origin and the accepting school. - **Are currently-enrolled students covered by the NSTP law?** - Male students currently enrolled but have taken any program components of the previous Expanded ROTC (E-ROTC)/National Service Program(NSP) are covered by the NSTP - **Will a student who has completed all his academic requirements except ROTC be allowed to graduate?** - A student who has completed all his academic requirements except for ROTC will be allowed to graduate provided that he is a certified candidate by the school on or before the effectively of the NSTP which is on March 23, 2002. - **What if a male student has completed two (2) semesters of the E-ROTC/NSP?** - He is deemed to have complied with the NSTP requirement. - **What if a male student has taken only one (1) semester of Basic ROTC or E-ROTC/NSP?** - He shall take one more semester of any of the NSTP components to qualify for graduation. - **What will become of NSTP graduates?** - Graduates of the non-ROTC components shall belong to the National Service Reserve Corps (NSRC) which could be tapped by the States for literacy and civic welfare activities. Graduates of the ROTC component shall form part of the AFP Citizen Armed Force, subject to DND requirements. - **How can a student continue to qualify for enlistment in the AFP reserve force?** - He/She may qualify for enlistment in the AFP reserved force as long as he/she has completed the two (2) semesters of basic ROTC. - **What lead agencies will monitor the implementation of the NSTP?** - CHED regional offices, TESDA provincial and district offices and DND-AFP through major service reserve commands and their ROTC units shall oversee and monitor the implementation of the NSTP under their respective jurisdiction to determine if the trainings conducted are in consonance with RA 9163. - **Is the NSTP available in all schools and universities?** - All higher and technical-vocational educational institutions offer at least one (1) of the NSTP components while State universities and colleges offer the ROTC component and at least one other NSTP component. Private schools that have at least 350 student cadets offer the ROTC components through its Department of Military Science and Tactics (DMST). Guidelines for the Establishment of the National Service Reserve Corps (NSRC) - Background - Section 11 of RA 9163 or the National Service Training Program Act of 2001 specifically provides for the creation of a National Reserve Corps (NSRC), composed of graduates of the non-ROTC Components: the Civic Welfare Training Service (CWTS) and Literacy Training Service and Literacy Training Service (LTS). Members of this Corps may be tapped by the State for Literacy and civic welfare activities, through the joint efforts of DND, CHED, and TESDA. - The National Service Reserve Corps - Mission - To provide a trained and motivated manpower pool that can be tapped by the State for civic welfare, literacy, and other similar endeavors in the service of the nation. - Functions - To assist in the disaster preparedness, mitigation, response, and rehabilitation programs - To serve as an auxiliary to the Disaster Coordinating Council (DCC) response units. - To assist in the promotion of civic welfare activities. - To assist in the implementation of literacy programs. - To assist in socioeconomic development. - To assist in environmental protection. - To perform other similar endeavors. - Composition - The NSRC shall be composed of the graduates of CWTS and LTS components of the NSTP - Organization - The NSRC is organized under the umbrella of the National Disaster Coordinating Council (NDCC). It shall have a national, regional, provincial, and city/municipal level of organization parallel to the Disaster Coordinating Council (DCC) structures at all levels. Objectives of NSTP - To enable all citizens to render their obligatory national service towards self-help and service to others; - To inculcate in the minds of the youth our long cherished traditional and cultural Filipino values; - To enable the citizens to contribute to the country's development and welfare and in the attainment and preservation of a just and orderly society; - To enhance the respect for law and duly constituted authorities; - To promote and develop civic consciousness and citizen's participation in national defense preparedness; - To motivate, train and develop the citizens, particularly the youth, with regard to their responsibilities as citizens; - To organize, mobilize and utilize youth manpower of community development; and - To harness citizen manpower for the promotion of national development programs and goals. Core Values of NSTP - Unity - Patriotism - Faith in God - Respect for life - Truth - Justice - Freedom - Equality - Peace - Concern for Family - Concern for the Environment - Volunteerism **MODULE 2 : VALUES AND ETHICS** Objectives - To know the definition of what is ethics and values. - To determine the causes of unethical behavior and how to respond from it. Overview - This session focuses on the definition of ethics and values and its relevance in developing a holistic person. The Character of Values and Ethics - Values can be defined as those things that are important to or valued by someone. That someone can be an individual or, collectively, an organization. One place where values are important is in relation to vision. - Values are the embodiment of what an organization stands for, and should be the basis for the behavior of its members. - Values provide the basis for judgments about what is important for the organization to succeed in its core business. - To behave ethically is to behave in a manner that is consistent with what is generally considered to be right or moral. Ethical behavior is the bedrock or mutual trust. - Individually or organizationally, values determine what is right and what is wrong, and doing what is right or wrong is what we mean by ethics. To behave ethically is to behave in a manner consistent with what is right or moral. What does "generally considered to be right" mean? That is a critical question, and part of the difficulty in deciding whether or not behavior is ethical is in determining what is right or wrong. - Perhaps the first place to look in determining what is right or wrong is society. Virtually every society makes some determination of morally correct behavior. - In Islamic countries, a determination of what is right or moral is tied to religious structures. - In societies more secular, the influence of religious beliefs may be less obvious but still a key factor. - The Ten Commandments, for many people, define what is morally right or wrong. Societies not only regulate the behavior of their members, but also define their societal core values. - Experience often has led societies to develop beliefs about what is of value for the common good - One example is the notion of reciprocity. ("One good deed deserves another.") - Another is the notion of good intent. ("A gentleman's word is his bond.") - Yet, a third is the notion of appreciation of merit in others regardless of personal feelings. ("Give the Devil his due.") Causes of Unethical Behavior - INDIVIDUAL - Complexity of strategic issues obscure ethics - Competition for scarce resources/power/position - Conflicting loyalties - GROUP - Groupthink - Presence of ideologues - Negative organizational response to dissent There are three qualities individuals must possess to make ethical decisions: - The first is the ability to recognize ethical issues and to reason through the ethical consequences of decisions. The ability to see second and third order effects, one of the elements of strategic thinking, is very important. - The second is the ability to look at alternative points of view, deciding what is right in a particular set of circumstances. This is similar to the ability to reframe. - And the third is the ability to deal with ambiguity and uncertainty; making a decision on the best information available. Ethical Responses - Exit is the most direct response: - if you can't live with behavior that does not meet your own ethical standards, leave. However, exit is not only a direct response; it is a final one, so the personal and organizational consequences must be considered. - The most important personal consequences are the costs. - Where do you go from there? - What other options are available? - How marketable are you? - Can you afford the financial loss? **Module 3: Citizenship Training** What is Constitution? - Constitution refers to "the body of rules and maxims in accordance with which the powers of sovereignty are habitually exercised." What is the Constitution of the Philippines? - The Constitution of the Philippines may be defined as that written instrument by which the fundamental powers of the government are established, limited, and defined and by which these powers are distributed among the several departments or branches for their safe and useful exercise for the benefit of the people. Who are Citizens of the Philippines? - Section 1 of the Philippine Constitution provides that the following are citizens of the Philippines: - Those who are citizens of the Philippines at the time of the adoption of the Constitution; - Those whose fathers or mothers are citizens of the Philippines; - Those born before January 17, 1973, of Filipino mothers, who elect Philippine Citizenship upon reaching the age of majority; and - Those who are naturalized in accordance with law What are the duties and obligations of Citizens? - We have to realize that for every right we are enjoying as enumerated in the Bill of Rights of the Philippine Constitution, there is a corresponding obligation. There will be no chaos in our society if only everybody will perform his or her duties and obligations. - Hereunder are the important duties and obligation of every citizen in a democracy society. - To be loyal to the Republic. - To defend the State. - To contribute to the development and welfare of the State. - To uphold the Constitution and obey the laws. - To cooperate with duly constituted authorities. - To exercise rights responsibly and with due regard for the rights of others. - To engage in gainful work. - To register and vote. How can we become Good Citizens? - We can become good citizens by living in accordance with good citizenship values which we can derive from the preamble of the Constitution such as; - Faith in God - Unity - Patriotism - Work - Respect for life - Respect for Law and Government - Truth - Justice - Freedom - Love - Equality - Peace - Promotion of a Common Good - Concern for the Family and Future Generations - Concern for the Environment and Order Preamble of the 1987 Philippine Constitution - We the sovereign Filipino people, imploring the aid of Almighty God, in order to build a just and humane society and established a Government that shall embody our ideals and aspirations, promote the common good, conserve and develop our patrimony and secure to our selves and our posterity, the blessing of independence and democracy under the rule of law and a regime of truth, justice, freedom, love, equality and peace, do ordain and promulgate this Constitution. **MODULE 4: HEALTH PROGRAM NUTRITION AND HYGIENE** Nutrition - Nutrition is the science that studies the process by which living organisms acquire all the things that are necessary for them to live and grow. - Nutrition focuses on the role of nutrients, which are defined as substances that the body cannot make on its own and include things like vitamins, minerals and certain macromolecules. - Basically, nutrition consists of diet (what you take in) and metabolism (what happens to it after it enters your body) Food Guide Pyramid - The Food Pyramid, developed by the US Department of Agriculture (USDA), is an excellent tool to help you make healthy food choices. - The food pyramid can help you choose from a variety of foods so you get the nutrients you need, and the suggested serving sizes can help you control the amount of calories, fat, saturated fat, cholesterol, sugar or sodium in your diet - Bread, Grain, Cereal and Pasta Form the Base - At the base of the food pyramid, see the group that contains breads, cereals and pasta. - These foods provide complex carbohydrates, which are an important source of energy, especially for a low fat meal plan. - You can make many low-fat choices from foods in this group. - Need 6 to 11 servings of these foods in a day. - One serving of this group can be - 1 slice of bread - ½ cup of rice, cooked cereal or pasta - 1 CUP OF READY-TO-EAT CEREAL - 1 FLAT TORTILLA - TRY TO EAT WHOLE-GRAIN BREADS, CEREAL AND PASTA FOR MOST OF YOUR SERVINGS FROM THIS GROUP. WHOLE-GRAIN FOODS (WHICH ARE MADE WITH WHOLE WHEAT FLOUR) ARE LESS PROCESSED AND RETAIN MORE VALUABLE VITAMINS, MINERALS AND FIBER THAT FOODS MADE WITH WHITE FLOUR. - Fruits and Vegetable - Fruits and vegetables are rich in nutrients. - Many are excellent sources of vitamin A, vitamin C, folate or potassium. - They are low in fat and sodium and high in fiber. - The Food Pyramid suggests 3 to 5 servings of vegetables each day. - One serving of vegetables can be: - 1 cup of raw leafy vegetables - ½ cup of other vegetables, cooked or raw - ¾ cup of vegetable juice - The Food Pyramid suggests 2 to 4 servings of fruit each day. - One serving of fruit can be: - 1 medium apple, orange or banana - ½ cup of chopped, cooked or canned fruits - ¾ cups of fruit juice - Beans, Eggs, Lean, Meat and Fish - Meat, poultry and fish supply protein, iron and zinc. - Nonmeat foods such as dried peas and beans also provide many of these nutrients. - The Food Pyramid suggests 2 to 3 servings of cooked meat, fish or poultry. - Each serving should be between 2 and 3 ounces. - The following foods count as one ounce of meat: - 1 egg - 2 tablespoons of peanut butter - ½ cup cooked dry beans - 1/3 cup of nuts - Choose lean meat, fish and dry beans and peas often because these are the lowest in fat. - Remove skin from poultry and trim away visible fat on meat. Avoid frying these foods. - Moderation is the watchword when it comes to nuts because they are high in fats. - Dairy Products - Products made with milk provide protein and vitamins and minerals, especially calcium. - The Food Pyramid suggests 2 to 3 servings each day. - If you are breastfeeding, pregnant, a teenager or a young adult age 24 or under, try to have 3 servings. - Most other people should have 2 servings daily. Interestingly, cottage cheese is lower in calcium that most other cheeses one cup counts as only ½ serving of milk. - Go easy on high-fat cheese and ice cream. - Choose non-fat milk and yogurt and cheeses made from skim milk because they are lowest in fat - Fats and Sweets - A food pyramid's tip is the smallest part, so the fats and sweets in the top of the food pyramid should comprise the smallest percentage of your daily diet. - The foods at the top of the food pyramid should be eaten sparingly because they provide calorie but not much in the way of nutrition. - These foods include salad dressings, oils, cream, butter, margarine, sugars, soft drinks, candies and sweet desserts The human body requires seven major types of nutrients - A nutrient is a source of nourishment, an ingredient in a food, e.g. protein, carbohydrate, fat, vitamin, mineral fiber and water. - Macronutrients are nutrients we need in relatively large quantities. - Micronutrients are nutrients we need in relatively small quantities - Energy macronutrients -- these provide energy, which is measured either in kilocalories (kcal) of Joules. 1 kcal = 4185.8 joules - Carbohydrates -- 4 kcal per gram - Molecules consist of carbon, hydrogen, and oxygen atoms. - Carbohydrates include monosaccharide (glucose, fructose, lactose), disaccharide, and polysaccharide (starch) - Nutritionally, polysaccharide are more favored for humans because they are more complex molecular sugar chains and take longer to break down -- the more complex a sugar molecule is the longer it takes to break down and absorb into the bloodstream, and the less it spikes blood sugar levels. - Spikes in blood sugar levels are linked to heart and vascular diseases - Proteins -- 4 kcal per gram - Molecules contain nitrogen, carbon, hydrogen and oxygen. - Simple proteins, called monomers, are used to create complicated proteins, called polymers, which build and repair tissue. - When used as a fuel the protein needs to break down, as it breaks down it gets rid of nitrogen, which has to be eliminated by the kidneys - Fats -- 9 kcal per gram - Molecules consist of carbon, hydrogen and oxygen atoms. - Fats are triglycerides -- three molecules of fatty acid combined with a molecule of the alcohol glycerol. - Fatty acids are simple compounds (monomers) while triglycerides are complex molecules (polymers) Other macronutrients. These do not provide energy - Fiber - Fiber consists mostly of carbohydrates. - However, because of its limited absorption by the body, not much of the sugars and starches get into the blood stream. - Fiber is a crucial part of essential human nutrition. - Water - About 70% of the non-fat mass of the human body is water. - Nobody is completely sure how much water the human body needs -- calims vary from between one to seven liters per day to avoid dehydration. - We do not know that water requirements are very closely linked to body size, age, environmental temperatures, physical activity, different states of health, and dietary habits. - Somebody who consumes a lot of salt will require more water than another person of the same height, age and weight, exposed to the same levels of outside temperatures and similar levels of physical exertion who consumes less salt. - Most blanket claims that 'the more water you drink the healthier you are' are not backed with scientific evidence. - The variables that influence water requirements are so vast that accurate advice on water intake would only be valid after evaluating each person individually Micronutrients - Minerals - Dietary minerals are the other chemical elements our bodies need, apart from carbon, hydrogen, oxygen, and nitrogen. - The term "minerals" is misleading and would be more relevant if called "ions" or "dietary ions." People whose intake of foods is carried and well thought out -- those with a well balanced diet -- will in most cases obtain all their minerals from what they eat. - Minerals are often artificially added to some foods to make up for potential dietary shortages and subsequent health problems. - The best example of this is iodized salt iodine is added to prevent iodine deficiency, which even today affects about two billion people and causes mental retardation and thyroid gland problems. - Iodine deficiency remains a serious public health problem in over half the planet - Potassium - ***What it does***: A systematic (affects entire body) electrolyte, essential in co-regulating ATP (an important carrier of energy in cells in the body, also key in making RNA) with sodium - ***Deficiency***: Hypokalemia (can profoundly affect the nervous system and heart) - ***Excess:*** Hyperkalemia (can also profoundly affect the nervous system and heart) - Chloride - ***What it does***: Key for hydrochloric acid production in the stomach, also important for cellular pump functions - ***Deficiency:*** Hypochloremia (low salt levels, which if sever can be very dangerous for health) - ***Excess:*** Hyperchloremia (usually no symptoms, linked to excessive fluid loss) - Sodium - ***What it does:*** A systematic electrolyte, and essential in regulating ATP with potassium. - ***Deficiency:*** Hyponatremia (cause cells to malfunction; extremely low sodium can be fatal) - ***Excess:*** Hypernatremia (can also cause cells to malfunction; extremely high levels can be fatal) - Calcium - ***What it does***: Important for muscle, heart and digestive health. Builds bone, assists in the synthesis and function of blood cells. - ***Deficiency:*** Hypocalcaemia (muscle cramps, abdominal cramps, spasms, and hyperactive deep tendon reflexes). - ***Excess:*** Hypercalcaemia (muscle weakness, constipation, undermined conduction of electrical impulses in the heart, calcium stones in urinary tract, impaired kidney function, and impaired absorption of iron leading to iron deficiency) - Magnesium - ***What it does***: Processes ATP and required for good bones. - ***Deficiency:*** Hypomagnesemia (irritability of the nervous system with spasms of the hands and feet, muscular twitching and cramps, and - ***Excess:*** Hypermagnesemia (nausea, vomiting, impaired breathing, low blood pressure. Very rare, and may occur if patient has renal problems, - Phosphorus - ***What it does:*** Component of bones and energy processing - ***Deficiency:*** Hypophosphatemia, an example is rickets - ***Excess:*** Hyperphosphatemia, often a result of kidney failure. - Zinc - ***What it does***: Required by several enzymes. - ***Deficiency:*** Short stature, anemia, increased pigmentation of skin, enlarged liver and spleen, impaired gonadal function, impaired wound healing, and immune deficiency. υ - ***Excess:*** Suppresses copper and iron absorption - Iron - ***What it does:*** Required for proteins and enzymes, especially hemoglobin. - ***Deficiency:*** Anemia - ***Excess:*** Iron overload disorder, iron deposits can form in organs, particularly the heart - Manganese - ***What it does:*** A cofactor in enzyme functions - ***Deficiency:*** Wobbliness, fainting, hearing loss, weak tendons and ligaments. Less commonly can be cause of diabetes - ***Excess:*** Interferes with the absorption of dietary iron - Copper - ***What it does:*** Component of many redox (reduction and oxidation) enzymes. υ - ***Deficiency:*** Anemia or pancytopenia (reduction in the number of red and white blood cells, as well as platelets) and a neurodegeneration. - ***Excess:*** Can interfere with body's formation of blood cellular components, in severe cases convulsions, palsy, and insensibility and eventually death (similar to arsenic poisoning) - Iodine - ***What it does***: required for the biosynthesis of thyroxine (a form of thyroid hormone) - ***Deficiency:*** Developmental delays, among other problems. - ***Excess:*** Can affect functioning of thyroid gland. - Selenium - ***What it does:*** Cofactor essential to activity of antioxidant enzymes. - ***Deficiency:*** Keshan disease (myocardial necrosis leading to weakening of the heart), Kashing Beck disease (atrophy degeneration and necrosis of cartilage tissue) - Molybdenum - ***What it does***: Vital part of three important enzyme systems, xanthine oxidase, aldehyde oxidase, and sulfite oxidase. It has a vital role in uric acid formation and iron utilization, in carbohydrate metabolism, and sulfite detoxification. - ***Deficiency:*** May affect metabolism and blood counts, but as this deficiency is often alongside other mineral deficiencies, such as copper it is hard to say which one was the cause of the health problem. - ***Excess***: there is very little data on toxicity, therefore excess is probably not an issue. **MODULE 4: HEALTH CARE PROGRAM** 10 ways to stay healthy at home with your family - IMMUNIZE - KEEP MOVING - EAT RIGHT - CONTROL STRESS - BE SMOKE FREE - AVOID DRUGS AND EXCESSIVE ALCOHOL - PURSUE HEALTHY PLEASURES - THINK WELL OF YOURSELF - PROMOTE PEACE 7 DIMENSIONS OF WELLNESS - PHYSICAL WELLNESS - It is the dimension commonly associated with being healthy. - EMOTIONAL WELLNESS - Involves the ability to understand one's own feelings, accept limitations, and achieve emotional stability. - MENTAL WELLNESS - A good health condition where an individual can recognize one's own intellectual abilities, apply the things that one has learned, create opportunities to learn more, and cope with usual stress and challenges in life - SOCIAL WELLNESS - Often accompanied by positive self-image and facility in communicating with ease and confidence. - ENVIRONMENTAL WELLNESS - Refers to the effect that our surroundings have on our well being. - OCCUPATIONAL WELLNESS - Occupational wellness encourage collaboration and interaction among co-workers, which fosters a sense of teamwork and support. - SPIRITUAL WELLNESS - Prayer is a signpost of our spiritual wellness at the core of most spiritual experience **MODULE 5: HIV and AIDS: Situation, Responses, and Challenges AND FAMILY PLANNING** Died from AIDS - Rock Hudson - Sarah Jane Salazar At the Crossroads of an Epidemic - The Philippines is one of ONLY seven countries in the world where new cases are rising - (The others are Bangladesh, Armenia, Georgia, Kazhakhstan, Kyrgyzstan, & Tajikistan) Geographic Distribution - All 17 regions are reporting HIV cases - 72 of the 80 provinces are reporting HIV cases Most at Risk areas - Metro-Manila - Metro-Cebu - Metro-Davao Target Population - Most At-Risk Population - PIP - MSM - IDU - Vulnerable Population - MARCY - Clients of CSW - OFW and partners What is HIV: - HUMAN - This virus can only infect human beings - IMMUNO-DEFICIENCY - The effect of the virus is to create a deficiency (a failure to work properly) within the body's immune system - VIRUS - This organism is a retro virus, which means it can reproduce itself by taking over the machinery of the human cell FOUR BODY FLUIDS KNOWN TO TRANSMIT HIV - Blood - Semen - Vaginal/Cervical fluid - Breastmilk HIV TRANSMISSION RISK 1 - Sexual transmission of HIV HIV TRANSMISSION RISK 2 - Infected blood and blood products - Blood transfusion from an HIV infected donor & sharing of infected syringes and needles HIV TRANSMISSION RISK 3 - Mother to child - From an HIV infected mother to her child - During pregnancy - Natural delivery - Breast-feeding Impact on Individuals - Psychosocial and Emotional - Social exclusion, stigmatization and isolation - Physical effects (health) - Difficulty finding assistance and support Impact on the Family - Psychological stress caused by anger, sorrow, frustration, and inability to cope with the needs of the PLHIV - Stigmatization and discrimination within the family - Health costs associated with HIV and AIDS Impact on the Community - Increased opportunities for violence and other discriminatory acts against PLHIVs in the community - Economic impact on the community - increased health costs - loss of productivity ABCDE OF PREVENTION - ***ABSTINENCE*** - Do not have sex. In the case of adolescents, delaying sexual debut (age of first sexual encounter) will help. - ***BE monogamous*** - Have ONE sexual partner - ***CORRECT AND CONSISTENT USE OF CONDOM*** and safer sex practice - ***DO NOT*** inject drugs - ***Education & Early*** detection REPUBLIC ACT No. 8504 - Complete Title - An Act Promulgating Policies and Prescribing Measures for the Prevention and Control of HIV/AIDS in the Philippines, Instituting a Nationwide HIV/AIDS Information and Educational Program, Establishing a Comprehensive HIV/AIDS Monitoring System, Strengthening the Philippine National AIDS Council, and for other Purposes - KEY PROVISIONS OF RA 8504 - Article I - ♠ Education and Information - Article II - ♠ Safe Practices and Procedures - Article III - ♠ Testing, Screening, and Counseling - Article IV - ♠ Health and Support Services - Article V - ♠ Monitoring - Article VI - ♠ Confidentiality - Article VII - ♠ Discriminatory Acts and Policies - Article VIII - ♠ The PNAC 5^th^ AMTP Strategies Framework - GOAL - By 2016, the country will have prevented the further spread of HIV infection and reduced the impact of the disease on individuals, families, sectors and communities - STRATEGIC OBJECTIVES - To improve the coverage and quality of prevention programs for persons at most risk, vulnerable and living with HIV - To improve the coverage and quality of TCS programs for people living with HIV (including those who remain at risk and vulnerable) and their families - To enhance policies for scaling up implementation, effective management and coordination of HIV programs at all levels - To strengthen capacities of the PNAC and its members to oversee the implementation of the 5th AMTP - To strengthen partnerships and develop capacities for the 5thAMTP implementation of LGUs, private sector, civil society, including communities of at-risk, vulnerable, and living with HIV - KEY STRATEGIES - Develop evidence-based, targeted, comprehensive programs - Capacitate service providers - Provide equitable access to programs - Enhance decentralized implementation - Provide enabling environment - Expand, build, strengthen management, partnerships and collaboration - Develop capacity of partners THE EDUCATION SECTOR RESPONSE HIGHLIGHTS - Has issued policies on advocacy and integration of HIV & AIDS in the curriculum - Power of You project - Has held seminars and workshops for elementary and secondary school health personnel on HIV & AIDS and adolescent reproductive health - Has developed and rolled out an HIV & AIDS module as an IEC material Major challenges to the country response - Lack of political support (national and local) - Lack of policy guidelines for efficient execution of programs - Monitoring and evaluation challenges - Low funding for HIV and AIDS programs - Low public awareness of the disease Family Planning & Birth Control - Family planning - is having the number of children you want, when you want them. Different parents have different reasons for wanting to limit the size of their family. - Some parents may decide to delay having any children until they have worked and saved enough so that they can afford to care for them well. - Some parents may decide that a small number of children is enough, but others may want more. - Others may want to space their children, so their mother will be healthier. - There are several methods to prevent women from becoming pregnant for as long as she wishes. - These are methods of birth control or contraceptive. Choosing a Method of Birth Control - Birth Control Pills (Oral Contraceptives) 2 - The Condom - Withdrawal or Pulling Out (Coitus Interruptus) - Intrauterine Device (IUD) - Diaphragm - Injections - Sponge Method - Breast Feeding - The Rhythm (Calendar) Method - The Mucus Method **MODULE 6: HEALTH PROGRAM VITAL SIGNS** VITAL SIGNS - VITAL SIGNS INCLUDE THE HEART BEAT, BREATHING RATE, TEMPERATURE AND BLOOD PRESSURE. - THESE SIGNS MAY BE WATCHED, MEASURED AND MONITORED TO CHECK AN INDIVIDUAL'S LEVEL OF PHYSICAL FUNCTIONING VITAL - NORMAL VITAL SIGNS CHANGE WITH AGE, SEX, WEIGHT, EXERCISE TOLERANCE AND CONDITION. - NORMAL RANGES FOR THE AVERAGE HEALTHY ADULT VITAL SIGNS ARE: - BLOOD PRESSURE: 120/80 MM/HG - BREATHING: 12-18 BREATHS PER MINUTE - PULSE: 60-80 BEATS PER MINUTE (AT REST) - TEMPERATURE: 97.8 DEGREES FAHRENHEIT/AVERAGE 98.6 FAHRENHEIT OR 36.5 TO 37.5 DEGREES CENTIGRADE PULSE RATE CHART - DEFINED, AS THE RATE AT WHICH THE HEART BEATS IN ONE MINUTE, PULSE RATE OR THE HEART BEAT IS INDICATIVE OF THE HEALTH OF THE PERSON. - AS THE HEART PUMPS BLOOD INTO THE BODY, THE BLOOD VESSELS CLOSE TO THE WRIST, UPPER ARM AND NECK START PULSATING AND THROBBING, WHILE THE NORMAL PULSE RATE FOR HUMANS IS USUALLY 60 TO 100 BEATS PER MINUTE, THERE ARE CERTAIN MEDICAL CONDITIONS SUCH AS CARDIAC ARRHYTHMIA WHICH MAY ALTER THE NORMAL PULSE RATE OF AN INDIVIDUAL. - THE OTHER INFLUENCING FACTORS ARE THE PERSON'S AGE, GENDER AND FITNESS LEVEL. SO AS TODDLER'S PULSE RATE IS SIGNIFICANTLY HIGH AT AROUND 110 BPM WHICH IS ALMOST CLOSE TO AN ADULT'S PULSE RATE AFTER A STRENUOUS EXERCISE. SIMILARLY FEMALES AGED 12 AND OLDER, TEND TO HAVE FASTER HEART RATES THAN MEN. ALSO ATHLETES, WHO DO A LOT OF CARDIOVASCULAR CONDITIONING, MAY HAVE HEART RATES NEAR 40 BEATS PER MINUTE. - IT IS ALSO OBSERVED THAT THE PULSE IS LOWER WHEN YOU ARE AT REST AND INCREASES WHEN YOU ARE INVOLVED IN ANY STRENUOUS EXERCISE. - HOW TO CALCULATE PULSE RATE? - YOU CAN CHECK YOUR PULSE RATE BY PLACING TIPS OF YOU INDEX, SECOND AND THIRD FINGERS ON THE PALM SIDE OF YOU OTHER WRIST, BELOW THE BASE OF THE THUMB OR ON HOW TO CALCULATE PULSE RATE? YOU LOWER NECK, ON EITHER SIDE OF YOUR WINDPIPE. - NOW COUNT THE BEATS FOR 10 SECONDS AND MULTIPLY THIS NUMBER BY SIX TO GET YOUR PULSE. - NOW USE A PULSE RATE CHART TO FIND OUT HOW WELL YOUR HEART IS WORKING AND YOUR GENERAL HEALTH AND FITNESS LEVELS. CHECKING YOUR PULSE RATES WHEN RESTING, DURING EXERCISES OR AFTER IT, CAN GIVE INFORMATION ABOUT THE OVERALL FITNESS. - NORMAL PULSE RATE CHART - RESTING PULSE RATE CHART: - IT IS OBSERVED THAT THE LOWER THE RESTING HEART RATES, THE HEALTHIER IS YOU HEART. FOR CALCULATING THIS, YOU HAVE TO SIT QUIETLY FOR 10 MINUTES BEFORE CHECKING YOUR PULSE RATES. HERE IS A TABLE TO DEMONSTRATE THE IDEAL RESTING HEART RATES. Babies to age 1 100-160 ------------------------------ --------- Children ages 1-10 60-140 Children ages 10+ and adults 60-100 Well-conditioned athelets 40-60 - HOW TO TAKE A RADIAL PULSE - THE RADIAL ARTERY IS FOUND CLOSE TO THE INSIDE PART OF YOUR WRIST NEAR YOUR THUMB. - YOU WILL NEED A WATCH WITH A SECOND HAND TO COUNT YOUR PULSE. - THE FOLLOWING STEPS MAY HELP YOU TAKE YOUR RADIAL PULSE - BEND YOUR ELBOW WITH YOUR ARM AT YOUR SIDE. - THE PALM OF YOUR HAND SHOULBE UP - USING YOUR MIDDLE (LONG) AND INDEX (POINTER) FINGERS, GENTLY FEEL FOR THE RADIAL ARTERY INSIDE YOUR WRIST. - YOU WILL FEEL THE RADIAL PULSE BEATING WHEN YOU FIND IT. - DO NOT USE YOUR THUMB TO TAKE THE PULSE BECAUSE IT HAS A PULSE OF ITS OWN - COUNT YOUR RADIAL PULSE FOR A FULL MINUTE (60 SECONDS). - NOTICE IF YOUR PULSE HAS A STRONG OR WEAK BEAT. - WRITE DOWN YOUR PULSE RATE, THE DATE, TIME AND WHAT WRIST (RIGHT OR LEFT) WAS USED TO TAKE THE PULSE. - ALSO WRITE DOWN ANYTHING YOU NOTICE ABOUT YOUR PULSE, SUCH AS IT BEING WEAK, STRONG, OR MISSING BEATS. - THE RADIAL ARTERY IS AN EASY ARTERY TO USE WHEN CHECKING YOUR HEART RATE DURING OR AFTER EXERCISE. RESPIRATION - RESPIRATION IS THE PROCESS THAT OCCURS WHEN OXYGEN IS INHALED INTO THE LUNGS, CONVERTED INTO ENERGY VIA A CHEMICAL REACTION AND EXPELLED AS CARBON DIOXIDE. - NORMAL RESPIRATION IS AN AUTOMATIC PROCESS AND DOES NOT REQUIRE CONSCIOUS EFFORT. HOWEVER, IN THE CASE OF ILLNESS OR TRAUMA, A VICTIM'S RESPIRATION RATE MAY BECOME UNUSUALLY HIGH OR LOW INDICATING THE NEED FOR IMMEDIATE MEDICAL ATTENTION. - THE RESPIRATORY RATE IS SIMPLY THE NUMBER OF BREATHS AN INDIVIDUAL TAKES PER MINUTE. - NORMAL RANGE - BY AGE - AVERAGE RESPIRATORY RATES BY AGE: - NEWBORNS: 30-40 BREATHS PER MINUTE - LESS THAN 1 YEAR: 30-40 BREATHS PER MINUTE - 1-3 YEARS: 23-35 BREATHS PER MINUTE - 3-6 YEARS: 20-30 BREATHS PER MINUTE - 6-12 YEARS: 18-26 BREATHS PER MINUTE - 12-17 YEARS: 12-20 BREATHS PER MINUTE - ADULTS OVER 18: 12-20 BREATHS PER MINUTE - STEPS - CONTACT AN EMERGENCY RESPONSE TEAM IMMEDIATELY IN THE EVENT OF A SERVER TRAUMA OR MEDICAL CRISIS. - MEASURE AN INDIVIDUAL'S RESPIRATORY RATE WHILE HE/SHE IS AT REST. TRY NOT TO LET THE VICTIM BECOME AWARE THAT YOU ARE MONITORING RESPIRATIONS IN ORDER TO OBTAIN A MORE RELIABLE COUNT - OBSERVE THE RISE AND FALL OF THE VICTIM'S CHEST AND COUNT THE NUMBER OF RESPIRATIONS OUT LOUD FOR ONE FULL MINUTE. - ONE RESPIRATION CONSISTS OF ONE COMPLETE RISE AND FALL OF THE CHEST, OR THE INHALATION AND EXHALATION OF AIR. - THE NORMAL RESPIRATORY RATE FOR A HEALTHY ADULT AT REST IS 12 TO 20 BREATHS PER MINUTE. - CATEGORIZE THE RHYTHM, EASE AND STRENGTH OF THE RESPIRATION. - NORMAL RESPIRATION CONSISTS OF DEEP, EVEN BREATHS DURING WHICH THE RIB CAGE FULL CONTRACTS AND RELAXES. - ABNORMAL RESPIRATION MAY APPEAR SHALLOW AND RAPID, LABORED, SHALLOW AND DEEP OR NOISY AND MAY INDICATE ILLNESS OR INJURY - RECORD THE CURRENT TIME, RESPIRATORY RATE AND RESPIRATORY CHARACTERISTICS, IF POSSIBLE. - REPEAT THE ABOVE STEPS FOR MEASURING AND RECORDING RESPIRATION RATE AND CHARACTERISTICS EVERY 10 MINUTES IN AN EMERGENCY SITUATION. - MAKE A NOTE OF ANY SIGNIFICANT CHANGES AND RELAY THE INFORMATION TO MEDICAL PERSONNEL. - TIPS - IF FIRST AID IS BEING PERFORMED ON A VICTIM, MONITOR RESPIRATION IMMEDIATELY AFTER MONITORING HIS OR HER PULSE RATE. - DO NOT INDICATE TO THE VICTIM THAT YOU ARE NOW MONITORING RESPIRATION AS HE MAY SUBCONSCIOUSLY CHANGE THE RATE, DEPTH OR STRENGTH OF HIS BREATHING. BODY TEMPERATURE - WHAT IS BODY TEMPERATURE? - BODY TEMPERATURE IS A MEASURE OF THE BODY'S ABILITY TO GENERATE AND GET RID OF HEAT. - THE BODY IS VERY GOOD AT KEEPING ITS TEMPERATURE WITHIN A NARROW, SAFE RANGE IN SPITE OF LARGE VARIATIONS IN TEMPERATURES OUTSIDE THE BODY. - WHEN YOU ARE NOT TOO HOT, THE BLOOD VESSELS IN YOUR SKIN EXPAND (DILATE) TO CARRY THE EXCESS HEAT TO YOUR SKIN'S SURFACE. - YOU MAY BEGIN TO SWEAT, AND AS THE SWEAT EVAPORATES, IT HELPS COOL YOUR BODY. - WHEN YOU ARE TOO COLD, YOUR BLOOD VESSELS NARROW (CONTRACT) SO THAT BLOOD FLOW TO YOUR SKIN IS REDUCED TO CONSERVE BODY HEAT. - YOU MAY START SHIVERING, WHICH IS AN INVOLUNTARY, RAPID CONTRACTION OF THE MUSCLES. - THIS EXTRA ACTIVITY HELPS GENERATE MORE HEAT. UNDER NORMAL CONDITIONS, THIS KEEPS YOUR BODY TEMPERATURE WITHIN A NARROW, SAFE RANGE. - WHERE IS BODY TEMPERATURE MEASURED? - YOUR BODY TEMPERATURE CAN BE MEASURED IN MANY LOCATIONS ON YOUR BODY. - THE MOUTH, EAR, ARMPIT AND RECTUM ARE THE MOST COMMONLY USED PLACES. TEMPERATURE CAN ALSO BE MEASURED ON YOUR FOREHEAD. - WHAT IS NORMAL BODY TEMPERATURE? - MOST PEOPLE THINK OF A "NORMAL" BODY TEMPERATURE AS AN ORAL TEMPERATURE OF 98.6F. - THIS IS AN AVERAGE OF NORMAL BODY TEMPERATURES. TOUR TEMPERATURE MAY ACTUALLY BE 1F (0.6C) OR MORE ABOVE OR BELOW 98.6F. - ALSO, YOUR NORMAL BODY TEMPERATURE CHANGES BY AS MUCH AS 1F (0.6C) THROUGHOUT THE DAY, DEPENDING ON HOW ACTIVE YOU ARE AND THE TIME OF DAY. - BODY TEMPERATURE IS VERY SENSITIVE TO HORMONE LEVELS AND MAY BE HIGHER OR LOWER WHEN A WOMAN IS OVULATING OR HAVING HER MENSTRUAL PERIOD. - A RECTAL OR EAR (TYMPANIC MEMBRANE) TEMPERATURE READING IS 0.5 TO 1F (0.3C TO 0.6C) HIGHER THAN AN ORAL TEMPERATURE READING. A TEMPERATURE TAKEN IN THE ARMPIT IS 0.5 TO 1F (0.3 TO 0.6C) LOWER THAN AN ORAL TEMPERATURE READING. - PROCEDURE IN TAKING AN ORAL TEMPERATURE - WASH YOUR HANDS - RINSE THERMOMETER IN COLD WATER IF KEPT IN A CHEMICAL SOLUTION, AND WIPE DRY WITH TISSUE**. RATIONALE: CHEMICAL TASTE IS BITTER**. - GRASP THERMOMETER WITH THUMB AND FOREFINGER AND SHAKE VIGOROUSLY BY FLICKING WRIST IN DOWNWARD MOTION TO LOWER MERCURY LEVEL TO BELOW 95-96 DEGREES. - CHECK TEMPERATURE READING ON THERMOMETER - EXPLAIN PROCEDURE TO THE PATIENT - PLACE THERMOMETER IN PATIENT'S MOUTH UNDER TONGUE AND ASK PATIENT TO HOLD LIPS CLOSED. - LEAVE IN PLACE 3 TO 5 MINUTES. - REMOVE THERMOMETER AND WIPE IT WITH TISSUE FROM FINGERS DOWN TO BULB. DISCARD TISSUE. - READ TEMPERATURE BY ROTATING THERMOMETER UNTIL THE MERCURY LEVEL IS CLEARLY VISIBLE. SHAKE THERMOMETER DOWN. - RECORD PATIENT'S TEMPERATURE ACCORDING TO HOSPITAL PROCEDURE. - WASH HANDS - RECORD PATIENT'S TEMPERATURE ACCORDING TO HOSPITAL PROCEDURE. BLOOD PRESSURE - BLOOD IS CARRIED FROM THE HEART TO ALL PARTS OF YOUR BODY IN VESSELS CALLED ARTERIES. - BLOOD PRESSURE IS THE FORCE OF THE BLOOD PUSHING AGAINST THE WALLS OF THE ARTERIES. EACH TIME THE HEART BEATS (ABOUT 60-70 TIMES A MINUTE AT REST). - IT PUMPS OUT BLOOD INTO THE ARTERIES. YOUR BLOOD PRESSURE IS AS ITS HIGHEST WHEN THE HEART BEATS, PUMPING THE BLOOD. - THIS IS CALLED **SYSTOLIC PRESSURE**. WHEN THE HEART IS AT REST, BETWEEN BEATS, YOUR BLOOD PRESSURE FALLS. THIS IS THE DIASTOLIC PRESSURE. - BLOOD PRESSURE IS ALWAYS GIVEN AS THESE TWO NUMBERS, THE SYSTOLIC AND DIASTOLIC PRESSURES. - BOTH ARE IMPORTANT. USUALLY THEY ARE WRITTEN ONE ABOVE OR BEFORE THE OTHER, SUCH AS 120/80 MMHG. THE TOP SAY THAT IT IS "120 OVER 80." - NUMBER IS THE SYSTOLIC AND THE BOTTOM THE DIASTOLIC. - WHEN THE TWO MEASUREMENTS ARE WRITTEN DOWN, THE SYSTOLIC PRESSURE IS THE FIRST OR TOP NUMBER, AND THE DIASTOLIC PRESSURE IS THE SECOND OR BOTTOM NUMBER (FOR EXAMPLE, 120/80). - STEPS IN TAKING A BLOOD PRESSURE - GATHER THE EQUIPMENT. YOU WILL NEED S SPHYGMOMANOMETER (BLOOD PRESSURE CUFF), STETHOSCOPE, PEN AND PAPER. - NEXT YOU NEED TO IDENTIFY AND GREET THE PATIENT SO THAT THEY FEEL A LITTLE MORE COMFORTABLE. YOU CAN DO SO BY SAYING SOMETHING LIKE 'HI (PATIENT'S NAME) MY NAME IS (YOUR NAME). - THEN YOU WILL TELL THE PATIENT WHAT YOU ARE GOING TO DO. AGAIN THIS JUST MAKES THEM FEEL COMFORTABLE. IT ALSO LETS THEM KNOW WHAT YOU ARE GOING TO DO SO THEY ARE NOT SURPRISED WHEN YOU START DOING IT. YOU CAN DO SO BY SAYING 'I AM GOING TO TAKE YOUR PRESSURE.' - THEN YOU WILL ASK THE PATIENT TO EXPOSE ARM ON A FLAT SURFACE WITH ARM FACING UPWARD. IF THE ARM IS FACING UPWARD IT IS EASIER TO GET TO THEIR BRACHIAL PULSE. - NEXT YOU WILL EXPOSE THE ARM AS MUCH AS POSSIBLE BY ROLLING UP THE SLEEVE. BY ROLLING UP THE SLEEVE IT MAKES IT EASIER TO HEAR THE BRACHIAL PULSE. YOU SHOULD NOT ROLL UP THE SLEEVES IF THE SHIRT IS HEAVY OR TIGHT BECAUSE IT MAY DISRUPT THE BLOOD FLOW. IF YOU ARE NOT ABLE TO ROLL THE SLEEVES YOU WOULD ASK THE PATIENT TO PLEASE TAKE THEIR ARM OUT OF THE SLEEVE. - NOW, SQUEEZE THE CUFF TOGETHER IN YOUR HANDS. THIS REMOVES ACCESS IN AIR SO THAT IT IS EASIER TO PLACE THE CUFF ON THE ARM - THEN YOU TURN THE VALVE OF THE CUFF CLOCKWISE TO CLOSE IT. CLOSE IT SO THAT THE AIR DOES NOT ESCAPE WHEN I START TO PUMP THE CUFF. - NOW YOU ARE READY TO PLACE THE CUFF AROUND THE UPPER PART OF THE ARM ABOUT 1 INCH BELOW THE ARMPIT. ARTERY IS ON THE INSIDE OF YOUR ELBOW. - THEN YOU NEED TO LOCATE THE BRACHIAL PULSE WITH YOUR MIDDLE FINGER AND INDEX FINGER. THE BRACHIAL PULSE IS FELT ON THE BRACHIAL ARTERY. THIS - NOW YOU ARE GOING TO PLACE THE EAR PIECES OF THE STETHOSCOPE INTO MY EARS. THIS ENABLES YOU TO LISTEN FOR THE BLOOD PRESSURE. - NEXT YOU WILL PLACE THE DIAPHRAGM (THE LARGER SIDE LOCATED AT THE END OF THE STETHOSCOPE) OF THE STETHOSCOPE OVER THE BRACHIAL PULSE SITE. - YOU WILL HOLD THE RUBBER BULB THAT IS CONNECTED TO THE SPHYGMOMANOMETER IN THE PALM OF YOUR HAND, THE ONE NOT HOLDING THE STETHOSCOPE. - THEN YOU WILL INFLATE THE CUFF BY PUMPING THE BULB BETWEEN 170 TO 200 MMHG. BY INFLATING THE CUFF TO HIGH IT CAN BE PAINFUL TO THE PATIENT. BY INFLATING IT TO LOW YOU MAY NOT BE HIGH ENOUGH TO HEAR THEIR SYSTOLIC READING. - NEXT YOU LOOSEN THE VALVE BY TURNING IT SLOWLY COUNTER CLOCKWISE WHILE LISTENING CLOSELY FOR THE FIRST SOUND YOU HEAR. THIS SOUND IS CALLED THE SYSTOLIC READING. THEN CAREFULLY LISTEN FOR THE LAST SOUND YOU HEAR. THIS SOUND IS CALLED THE DIASTOLIC READING - THEN YOU NEED TO WRITE DOWN THE SYSTOLIC AND DIASTOLIC READINGS ON A PIECE OF PAPER. YOU ALSO WRITE THEM DOWN AS SOON AS YOU KNOW THEM SO YOU DO NOT FORGET. - THEN YOU DEFLATE THE CUFF BY LOOSENING THE VALVE. TO LOOSEN YOU WILL TURN THE VALVE COUNTERCLOCKWISE. - THEN YOU REMOVE THE CUFF FROM THE PATIENT'S ARM. - NOW YOU CAN TAKE THE EARPIECES OF THE STETHOSCOPE OUT OF YOUR EARS. - LAST YOU RECORD THE SYSTOLIC AND DIASTOLIC READING INTO THE CHART. THESE ARE THE SAME READINGS YOU WROTE DOWN EARLIER ON THE PIECE OF PAPER