Community Health Nursing 1 - National Immunization Program PDF

NuCM 104 Community Health Nursing 1 NATIONAL IMMUNIZATION PROGRAM (NIP) formation within 12 weeks...

NuCM 104 Community Health Nursing 1 NATIONAL IMMUNIZATION PROGRAM (NIP) formation within 12 weeks or 3 months  Immunization - essential public health service and is the 2. Koch's phenomenon: an No management is needed process of conferring artificial immunity to population acute inflammatory groups reaction within 2-4 days  Immunity - resistance and protection from disease after vaccination usually attributed to the presence of antibodies in the blood indicated previous exposure to tuberculosis UFC - Under Five Children (0-59 months) 3. Deep (subcutaneous) Refer to the physician for WARA - Women on Reproductive Age abscess at vaccination site; incision and drainage almost invariably due to General goal: reduce morbidity and mortality among infants subcutaneous or deeper and children caused by childhood immunizable diseases Injection 4. Indolent ulcer. An ulcer Treat with Isoniazid (INH) Specific goals: which persists after 12 powder  Immunize all infants against vaccine preventable weeks from vaccination diseases ate  Sustain polio-free status of the Philippines 5. Glandular enlargement: If suppuration occurs, treat  eliminate maternal and neonatal tetanus enlargement of the lymph as deep abcess  control diphtheria, pertussis, hepatitis b infection, and glands draining the German measles Injection site  prevent extra pulmonary tuberculosis among children - BCG IND - Incision and Drainage FIC - Fully Immunized Child Hepatitis B Vaccine (Monovalent)  Disease: Hepatitis B Related Policies and Laws  Components: Pasma derivative or RNA recombinant Cloudy, liquid providing compulsory basic  Age: at birth PD No. 996 of 1976 immunization for infants and children  Dose: 0.5 ml below 8 years old  Route: IM Inclusion of Hepatitis B immunization  Site: Vastus lateralis RA 7846 of 1994 for infants and children below 8 years  Side effects: Local soreness at the injection site old  Nursing Management: no treatment necessary;may Mandatory Infants and Children Health apply cold compress Immunization Act of 2011 for children up to 5 years of age and inclusion of Pentavalent Vaccine (DPT-HepB-Hib) new vaccines: Hepatitis B, Mumps,  Disease: Diphtheria, Pertussis, Tetanus, Hepatitis B, RA 10152 of 2011 Rubella, Hemophilus Influenza Type B Hemophilus Influenza B (Hib). This repealed PD 996 and is  Components: considered as the current legal basis of D - weakened toxins the NIP P - killed bacteria Implementing a United Nations Goal T- weakened toxins Presidential on Universal Immunity by 1990; and liquid clear Proclamation No. 6 designating Wednesdays as  Age: 6,10,14 weeks of 1996 Immunization day.  Dose: 0.5 ml  Route: IM Vaccines of the NIP in the Philippines  Site: Vastus lateralis Bacillus Calmette Guerin (BCG) SIDE EFFECTS NURSING MANAGEMENT  Disease: Tuberculosis and Leprosy Fever that usually last for Advise parents that soreness  Components: Live-attenuated bacteria; Freeze-dried only 1 day. will disappear after 3-4 days with special diluent Fever beyond 24-hours is not  Age: at birth due to the vaccine but to  Dose: 0.05 ml other causes  Route: ID Local soreness at the Reassure parents that  Site: Right upper arm/deltoid injection site soreness will disappear after 3-4 days SIDE EFFECTS NURSING MANAGEMENT Abscess after a week or more May give paracetamol for 1. Wheal for 30 minutes Normal Reaction usually indicates that the fever and pain. following by ulceration injection was not deep Incision and drainage may be within 2 weeks then scar enough, or the needle was necessary KARIZMA LETIGIO BSN BATCH 2027 1  NuCM 104 Community Health Nursing 1 not sterile Convulsions, although very Proper management of General Considerations on Implementing the Immunization rare, may occur in children convulsions; may give DT Program in the Country older than 3 months caused next vaccination a) Remind caregivers of children to comply with the by pertussis component prescribes schedule of routine immunization of the child for every clinic visit Oral Polio Vaccine (OPV) b) Eligible age for Pentavalent vaccines - up to 5 years  Disease: Poliomyelitis c) Booster doses are not necessary  Components: d) Vaccines may be given on the same day at different sites Clear, pinkish e) When administering several vaccines in the same leg, it Live-attenuated virus - for GI mucosal immunity should be at least 2.5-5cm apart (mouth and GI tract) f) If several vaccines will be administered start with OPV,  Age: 6,10,14 weeks rotavirus then other vaccines  Dose: 0.5 ml/2 drops g) Observe "First expiry and first out" in utilizing vaccines  Route: PO h) Use cotton in cleaning the injection site. If with alcohol,  Site: mouth area should be thoroughly dry before injecting the  Side effects: none vaccine  Nursing Management/Consideration i) BCG, AMV (Anti Measles Vaccine), MMR have special Nothing per Orem (NPO) for 30 minutes to prevent diluents and should be discarded 6 hours after the child from vomiting and enhance absorption reconstitution or after clinic hours If child vomits, administer another dose j) Protect BCG from sunlight and Rotavirus from light If the child has simple diarrhea may give OPV but k) Inform caregivers of children for immunization about dose not counted and should be Instructed to common side effects and how to deal with it return for next due dose l) Reusable vaccines such as OPV, Pentavalent, Hepatitis B and Tetanus toxoid may last for maximum of 4 weeks Inactivated Polio Vaccine (IPV) provided the following conditions are met:  Disease: Poliomyelitis Has not passed the expiry date  Components: Liquid, clear Appropriate cold chain conditions have been  For serum Immunity (blood) observed  Age: 14 weeks Aseptic technique was observed during aspiration  Dose: 0.5 ml of the vaccine  Route: IM The vaccine vial monitor (VVM) has not reached its  Site: Vastus Lateralis discard portion  Side effect: Local tenderness The vaccine septum was not submerged in water Pneumococcal Conjugate Vaccine (PCV) In case for measles epidemic, a supplemental measles  Diseases: vaccine is administered depending on the age group: Pneumonia  For under 9 months - give Measles Rubella (MR) vaccine Meningitis to be reconstituted with 2 ampules of its special diluent  Components: Liquid, clear to make 6 ml then administered 0.5 mi subcutaneously  Age: 6,10,14 weeks to the child  For 2-5 years old give 1 dose  For 9 months to 5 years old - give Measles, Mumps  Dose: 0.5 ml Rubella (MMR) Vaccine  Route: IM  Site: Vastus Lateralis Absolute Contraindications  Management: Cold compress  Any serious condition that needs hospitalization  Immunocompromised condition such as AIDS Measles Mumps Rubella (MMR)  Diseases: Measles, Mumps German Measles The following are NOT Contraindications  Components: Live-attenuated virus dried freeze with  Fever up to 38.5 degrees C special diluent  Mild acute respiratory infection  Age: 9 month and 12-15 month  Simple diarrhea  Dose: 0.5 ml  Malnutrition - considered an indication  Route: SC  Site: Outer arm Recommended temperature for vaccine storage  Side effects: Local soreness, fever, Irritability and Vaccine Temperature Stability malaise in some children Most OPV, BCG, (-) 15 to (-)25oC  Nursing Management/Considerations: Sensitive MR Reassure parents and instruct parents to give Lest Pentavalent antipyretic to the child 2-8 C 8 hrs if in sensitive to Hepatitis B Give 200,000 IU of Vitamin A to promote Body of room heat/moist Diphtheria epithelialization and Increase immunity refrigerator temperature sensetive to Tetanus KARIZMA LETIGIO BSN BATCH 2027 2  NuCM 104 Community Health Nursing 1 cold Toxoid breastmilk and complementary feeding becomes Most necessary to fill the energy and nutrient. sensitive to 4-6 hours light Complementary Food required to be Complementary foods are introduced when the Recommended duration of storage for biologicals need for energy and nutrients exceeds what can Timely Regional Health Office 6 months be provided through exclusive and frequent Provincial/District Health Office 3 months breastfeeding Rural Health Unit 1 month They should provide enough energy, protein, Maximum transport period (with cold Adequate and micronutrients to meet a growing child’s 5 days nutritional health packs) Foods are hygienically nipples a prepared with Interpretation of the Vaccine Vial Monitor (VVM) Safely clean hands using clean utensils and not bottles The square if lighter that the If the expiry date is not and artificial nipples circle passed, use the vaccine Foods are consistent with a child's signals of The square matches the Do not use the vaccine appetite and satiety, and meal frequency and circle inform the supervisor Properly feeding method - actively encouraging the child, The square is darker than the Do not use the vaccine, Fed even during illness, to consume enough food circle inform the supervisor using fingers, spoon, or self-feeding - are suitable for age  Proper Vaccine Storage  First Expiry, First Out (FEFO) Deworming Program  Vaccine Vial Monitor  Shake Test  Help reduce risk of developing malnutrition among children CHILD HEALTH SERVICES (CHS) Recommended dose for deworming children Nutritional Program Albendazole 400 Mebendazole 500 Age mg/tab mg/tab Goal: to improve quality of life through better nutrition, 12 -23 months 1/2 tab 1 tab improve health and increase productivity. 24-59 months 1180 1 tab 4 Components Common adverse effects of deworming and corresponding management 1. Complementary feeding - 6 months ADVERSE EFFECTS MANAGEMENT 2. Micronutrient supplementation Local sensitivity or allergic Give antihistamine 3. Food fortification reacion 4. Deworming Mild abdomnal pain Give antispasmodic Diarrhea Give ORS Laws and Policies Regulate the Nutritional Program Pull out worms from mouth Erratic worm migration or nose or from other body RA 8172 "Asin Law" declared July as the Nutrition Month and ADOLESCENT HEALTH PD No. 491 created the National Nutrition Council declared December 7 as National Fortification Adolescent Sexual and Reproductive Health EO 382 Day Letter of Adolescent Health and Development Program (ADHP) mandates the integration of nutrition in the Instruction school curriculum  Aims to improve the health status of adolescents and 441 also known as the Philippine Fortification Act enable them to fully enjoy their rights to health. of 2009 - provides the mandatory fortification  Mission: Is to ensure that all adolescents have access to of the following products: comprehensive health care and services in an  Rice with iron adolescent-friendly environment RA 8976  Envisions a country with well-informed, empowered,  Wheat flour with Vitamin A and iron  Refined sugar with vitamin A responsible, and healthy adolescents who are leaders in  Cooking oil with Vitamin A society. 1. Adolescent Sexual and Reproductive Health (ASRH) Complementary Feeding  Slight decline was observed in the following: adolescent fertility rate, the proportion of women  From the age of 6 months, an infant's need for energy who have had a birth or are pregnant with the first and nutrients starts to exceed what is provided by child, the number of babies born to adolescent KARIZMA LETIGIO BSN BATCH 2027 3  NuCM 104 Community Health Nursing 1 parents, and the number of newly diagnosed HIV  NCDs are diseases that are usually brought about by positive cases among the 15-24 year age group having an unhealthy lifestyle.  The Philippines still has one of the highest adolescent fertility rates. Ten Leading Causes of Mortality - Philippines, 2016  Unmet need is still highest among the youngest age Number Rate per 100,000 Rank Disease group and the proportion of HIV positive cases of Deaths Population among the 15-24 age group more than doubled in Ischemic Heart 1 74,134 71.8 the past ten years. Disease 2 Neoplasm 60,470 58.5 2. Human papillomavirus vaccination 3 Pneumonia 57.809 56.0  To help protect adolescents form cervical, vaginal, Cerobrovascular and vulvar cancers associated with human 4 56,938 55.2 Disease papillomavirus (HPV) Infection, which IS sexually Hypertensive transmitted. 5 33,452 32.4 Diseases  The DOH, in collaboration with DepEd, held a 6 Diabetes Mellitus 33,295 32.3 nationwide HPV immunization for grade 4 female Other Heart learners aged 9-14 years old in public schools. 7 28,641 27.7 Diseases Respiratory 3. Elimination of Violence Against Women and Children 8 24,462 23.7 Tuberculosis  The Philippines continues to narrow the gender gap Chronic Lower between men and women in the country. 9 24,365 23.6 Respiratory Tract  Date from the Philippine National Police (PNP), Women Infection and Children Protection Center (WCPC) and DOH Remainder of Violence Against Women and Children (VAWC) Registry Diseases of the System show a declining trend in the reported cases of 10 19,759 19.4 Genitourinary violence against women and children over the past System three year. 4. Weekly Iron and Folic Acid Supplementation (WIFAS). Cardiovascular and Cerebrovascular Disease 5. Assessment of health and nutrition status and  Cardiovascular death is the most common cause of identification of nutritionally-at-risk adolescent girls, as NCDs mortality worldwide which accounts to 17.9 well as provision of RUSF or RUT for nutritionally-at-risk million deaths annually. (WHO) adolescent female, as appropriate.  Cardiovascular disease (also called heart disease) is the 6. Provision of appropriate immunization based on the general terms used to refer to disease that involve the latest DOH guidelines. heart of blood vessels (arteries, capillaries, and veins) 7. Provision of oral health including oral health assessment.  Cerebrovascular disease or stroke, on the other hand, is 8. Provision of anti-helminthic drugs for deworming. a group of brain dysfunction related to disease of the 9. Counseling on proper hand washing, environmental blood vessels supplying the brain. sanitation, and personal hygiene. 10. Provision of micronutrient supplements according to Most common causes of cerebrocardiovascular diseases: the guidelines of the DOH in partnership with the DepEd. 1. Hypertension 11. Promotion of consumption of iodized salt and foods  Or high blood pressure equal to or above 140 mm fortified with micronutrients that may be deemed Hg or a diastolic blood pressure equal or above 90 necessary. mm Hg (WHO) 12. Referral to appropriate health facilities to manage 2. Atherosclerosis menstruation Irregularities or abnormalities that  Is a disease of he blood vessels characterized by the contribute to anemia and blood loss, and to manage deposits of fats and cholesterol within the walls of complicated illnesses including moderate and severe the artery (WHO, 2011) acute malnutrition. 13. Counselling on proper nutrition, mental health, Classification of Blood Pressure avoidance of risk-taking behaviors, smoking cessation, adoption of healthy lifestyle practices, and family health. Blood Pressure Systolic (mmHg) Diastolic mmHg Category NONCOMMUNICABLE DISEASE PREVENTION AND CARE OF NORMAL Less than 120 Less than 80 AGING POPULATION ELEVATED 120-129 Less than 80 HIGH BLOOD Noncommunicable Diseases (NCD) PRESSURE 130-139 80-89 (HYPERTENSION)  NCD is a medical condition that is noninfectious and STAGE 1 nontransmissible HIGH BLOOD  Referred as "chronic diseases" due to their long PRESSURE 140 or Higher 90 or Higher duration (HYPERTENSION)  Also referred as " lifestyle-related diseases" STAGE 2 HYPERTENSIVE Higher than 180 Higher than 120 KARIZMA LETIGIO BSN BATCH 2027 4  NuCM 104 Community Health Nursing 1 CRISIS (consult Diabetes Mellitus (DM) your doctor  Is a serious chronic, metabolic disease characterized by immediately) high levels of blood sugar due to inability of the pancreas to produce enough insulin, or inability of the Classification of LDL, Total, and HDL Cholesterol (mg/dL) body to effectively use the insulin if produces (WHO, Values Interpretation 2016). LDL Cholesterol  Hyperglycemia or high blood sugar is a common effect < 100 Optimal of diabetes. 100-129 Above Optimal  Current guidelines for the diagnosis of diabetes is a 130-159 Borderline fasting blood sugar (FBS) level of ≥ 99 mg/dL. 160-189 High  Prevalence of diabetes among adults in the Philippines ≥190 Very High in 2017 is 6.2% or 3,721,900 Total Cholesterol  Expert predict the number to increase by 2025