Community Health Nursing PDF

COMMUNITY HEALTH NURSING 12 Cranial Nerves 1 O Olfactory Sensory Primary Goal: 2 O Optic Sensory...

COMMUNITY HEALTH NURSING 12 Cranial Nerves 1 O Olfactory Sensory Primary Goal: 2 O Optic Sensory o Health in the hands of the people. 3 O Oculomotor Motor 4 T Trochlear Motor Ultimate Goal: 5 T Trigeminal MIXED o To raise the level of health of the citizen. 6 A Abducens Motor 7 F Facial MIXED Community: 8 A Auditory Sensory Group of people interacting with each other. 9 G Glossopharyngeal MIXED Sharing common values, interests, and goals. 10 V Vagus MIXED Health: 11 A Spinal Accessory Motor Optimum level of functioning. 12 H Hypoglossal Motor State of complete physical, mental, and social well-being. Nursing: VACCINES Art and science of rendering care. – An act of assisting the sick and the well. Bacillus Calmette–Guerin Vaccine (BCG) - At birth (1st 2 months of life) 3 Types of Community - Intradermal (Deltoid) (10° - 15° degree angle ▪ Urban = High View of Health Needle Position) ▪ Rural = Agricultural community - 12 months = 0.1mL EPI\NIP Purified Protein Derivative (PPD) skin test - 48 – 72 hours (2 – 3 days) RA 10152: Mandatory Infants and children health Results: immunization act of 2011. 5mm (+) Positive All vaccines are free for children 14 days), Refer for TB ass. 7 Principles of PHN o Recurrent wheezing, o Decentralization o Refer for asthma ass. o Social participation o Safe remedy o Community participation o Recognition between health and government CLASSIFY o Accessibility and availability of health service No signs of DOB o Provision of quality basic health services Or very sever disease o Self-reliance COUGH OR COLD: o Wheezing: Bronchodilator for 5 days Elements o Cough (>14 days), Refer for TB ass. Treatment of locally endemic diseases. o Recurrent wheezing, Refer for asthma ass. Immunization o Safe remedy Maternal and Child health and family planning. Environmental sanitation Control of communicable disease Health Education  - DEHYDRATION o Treat dehydration Does the child have diarrhea o Refer to hospital o If with other severe class: CLASSIFY o Refer URGENTLY! - Sunken eyes - Unable to drink/drink poorly CLASSIFY - Skin pinch goes back VERY SLOWLY NO DEHYDRATION - Unconscious o PERSISTENT Give minerals (zinc) for 14 days o DIARRHEA FFUP: 5 DAYS SEVERE DEHYDRATION o ZING SUPPLEMENTATION o No other severe class: Plan C o 2 mos to 6 mos ½2 TAB OD for 14 days o If with other severe class: o 6 mos or more 1 TAB OD for 14 days o Refer Urgently with mother giving o ORS on the way - DYSENTERY o Advise to cont. BF CLASSIFY PLAN C: BLOOD IN THE STOOL - Give 100ml/kg of PLR If not available, give PNSS. o Give Ciprofloxacin for 3 Under 12 months o DYSENTERY days o 30 ml/kg = 1 HOUR o 70 ml/kg = 5 HOURS CIPROFLOXACIN ADMINISTRATION Above 12 months - 15 mg/kg BID for 3 days o 30 ml/kg = 30 MINS - Less than B months o 70 ml/kg = 2½ HOURS - 250 mg/tab: ½ tab - 500 mg/tab: ¼ tab What if I can't give IV? - 6 months to 5 yrs REFER URGENTLY TO THE HOSPITAL (if within 30 - 250 mq/tab: 1 tab mins nearby) Instruct mother to give ORS on the way - MALARIA What if no hospital 30 mins nearby? Does the child has fever? Give ORS by NGT (or mouth) 20 ml/kg/hr for 6 hours TOTAL: 120 ml/kg CLASSIFY - After 6 hours, reassess the child. HIGH OR LOW MALARIA RISK What if I'm not trained to insert NGT? CLASSIFY Refer URGENTLY to the nearest hospital for IV and NGT GS (any) treatment. Stiff neck VERY SEVERE FEBRILE DISEASE CLASSIFY o Give first dose of artesunate/quinine o Drinks eagerly, thirsty o Give first dose of antibiotic o Irritable, restless o Give one dose of paracetamol (38.5 °C or above o Sunken eyes o Refer URGENTLY!!! o Skin pinch goes back SLOWLY CLASSIFY SOME DEHYDRATION: POSITIVE MALARIA TES o Give fluid, Zinc, and Food (PLAN B) MALARIA o If with other severe class: o Give oral antimalarial o Refer Urgently with mother giving o Give appropriate antibiotic o ORS on the way o Give one dose of paracetamol (38.5 o Advise to cont. o °C or above o BF FF UP: 5 DAYS o If fever is present › 7 days, REFER o FF up: 3 days (if fever persist) PLAN B - Up to 4 months = 200-450 ml CLASSIFY - 4 months-12 months = 450-800 ml NEGATIVE MALARIA TEST - 1yr to 2 yrs = 800-960 ml o Other cause of fever present - 2 yrs to 5 yrs = 960-1600 ml o FEVER: NO MALARIA o Give appropriate antibiotic CLASSIFY o Give one dose of paracetamol (38.5 NOT ENOUGH SIGNS o °C or above NO DEHYDRATION: o If fever is present » 7 days. REFER Give fluid, Zinc, and Food (PLAN A) FF UP: 5 DAYS o FF up: 3 days (if fever persist) PLAN A CLASSIFY - Give ORS MASTOIDITIS - Up to 2 YRS o Tender swelling behind ear o 50 TO 100 ML FOR EACH LOOSE STOOL o Give first dose of antibiotic - 2 yrs to 5 yrs o Give first dose paracetamol o 100 ML TO 200 ML FOR EACH LOOSE o Refer URGENTLYIII STOOL CLASSIFY DEHYDRATION IS PRESENT SEVERE PERSISTENT DIARRHEA: o No other severe class:  CLASSIFY - wash hands and kitchen utensils before and after ACUTE EAR PAIN preparing food o Pus is draining < 14 days Ear paín - sweep kitchen floors to remove food droppings o Sim antibiotic for 5 days o Give paracetamol for pain 3. Right cooking o Dry the ear by wicking - cook food thoroughly and ensure that temperature on all o FF up: 5 days parts of the food should reach 70 degrees centigrade - eat cooked food immediately CLASSIFY - wash hands thoroughly before and after o No ear pain o NO EAR INFECTION 4. Right storage o NO TREATMENT - Cooked foods should not left at room temperature for NOT more than 2 hours WATER SUPPLY SANITATION PROGRAM - store foods carefully: 4 -5 hours hot conditions: at least or above 60 degrees centigrade cold conditions: below or Approved type of water supply facilities: equal to 10 degrees centigrade LEVEL I (Point Source) - do not overburden the refrigerator - a protected well or a developed spring with an - reheat stored food before eating outlet but without a distribution system. -at least 70 degrees centigrade - serves 15 to 25 households - outreach must not be more than 250 meters from Rule in Food Safey: the farthest user “WHEN IN DOUBT, THROW IT OUT” LEVEL II (Communal Faucet System or Stand-Posts) - a system composed of a source, a reservoir, a piped MEDICINAL PLANT- SANTA LUBBY distribution network and communal faucets. With one faucet per 4-6 households ▪ S- Sambong - located at not more than 25 meters from the farthest – Anti-edema house – Diuretic – Anti-urolithiasis LEVEL III (Waterworks System or Individual House Connections) ▪ Ampalaya - a system with a source, a reservoir, a piped distributor – Diabetes Mellitus network and household taps, generally suited for densely populated urban areas requires minimum treatment or ▪ N- Niyug-niyogan disinfection – Anti-helminthic PROPER EXCRETA AND SEWAGE ▪ T- Tsaang Gubat DISPOSAL PROGRAM – Stomachache Approved types of toilet facilities: – Tsaang gubat – Diarrhea LEVEL I - Non-water carriage toilet facility – no water is necessary to wash the waste into the receiving space. ▪ Akapulko – Anti-fungal Ex. Pit latrines, Reed odorless earth closet Toilet facility requiring a small amount of water to wash the waste into ▪ L- lagundi (Vitex Negundo) the receiving space. – S-kin diseases Ex. Pour flush toilet, Aqua privies – H-eadache – A-sthma, cough and fever LEVEL II - on site toilet facilities of the carriage type with – R-heumatism, sprain, insect bites water-sealed and flushed type with septic tank/vault – E-czema disposal facilities – Dysentery LEVEL III - water carriage types of toilet facilities ▪ U-Ulasimang bato connected to septic and/or to sewerage system to – Uric acid excretion treatment plant ▪ B- Bawang – Hypertension FOOD SANITATION PROGRAM (to lower cholesterol levels in the blood) – Toothache FOUR RIGHTS IN FOOD SAFETY: ▪ B- Bayabas/ Guavas 1. Right source – Diarrhea - Always buy fresh meat, fish, fruits and vegetables – Washing of wounds - check for expiry dates of processed foods – Gargle to relieve toothache - avoid buying canned foods with dents, bulges, deformation, broken seals and improper seams ▪ Y- Yerba Buena - use clean and safe water – S-wollen gums - if doubt of water source – boil water for at least 2 minutes – P-ain – I-nsect bites 2. Right preparation – T-oothache - avoid contact between raw and cooked foods – M-enstrual and gas pain - Always buy pasteurized milk and fruit juices – A-rthritis - wash vegetables well if eaten raw – N-ausea and fainting – D-iarrhea Reminders on the Use of Herbal Medicine ▪ O- OVULATION METHOD This method involves tracking changes in cervical mucus 1. Avoid the use of insecticides. to identify the fertile period when ovulation is likely to 2. Use a clay pot and remove cover while boiling at low occur. heat. ▪ L- Lactational Amenorrhea Method (LAM) 3. Use only the part of the plant being advocated. This method relies on exclusive breastfeeding and the 4. Follow accurate dose of suggested preparation. suppression of ovulation that occurs during breastfeeding 5. Use only one kind of herbal plant for each sickness. to provide temporary contraception in the postpartum 6. Stop giving in case with untoward reaction. period. 7. If signs and symptoms are not relieved after 2 or 3 ▪ T - Two-Day Method doses, consult a doctor This method involves checking cervical mucus for two consecutive days to identify the presence of fertile mucus, FAMILY PLANNING indicating the possibility of ovulation and fertility. Standard Days Method (SDM) FAMILY PLANNING This method relies on exclusive breastfeeding and the Family planning is far more than simply birth control, and suppression of ovulation that occurs during breastfeeding aims at improving the quality of life for everybody. to provide temporary contraception in the postpartum Family planning is an important part of primary healthcare period. and includes: ARTIFICIAL FAMILY OBJECTIVES PLANNING REMEMBER: ▪ P - Promote reproductive health: CAPSULE Family planning aims to promote reproductive health by providing individuals and couples with the information and ▪ C- Condom services they need to make informed decisions about This method involves the use of a barrier device, usually their sexual and reproductive lives. made of latex or polyurethane, to prevent sperm from ▪ R - Reduce unintended pregnancies: reaching the egg during sexual intercourse One of the main objectives of family planning is to reduce A- Abstinence the number of unintended pregnancies through the use of This method involves refraining from sexual intercourse contraception methods and education on their effective as a means of contraception. use. ▪ P- Pills ▪ E - Enhance maternal and child health: This method involves the use of oral contraceptive pills, Family planning helps to improve maternal and child which contain hormones to prevent ovulation and alter the health outcomes by spacing pregnancies appropriately, cervical mucus, making it difficult for sperm to reach the reducing the risks associated with closely spaced egg. pregnancies, and ensuring women have access to ▪ S- Sterilization prenatal and postnatal care. This method involves permanent surgical procedures to ▪ V - Voluntary and informed choice: block or interrupt the fallopian tubes in women (tubal Family planning emphasizes the importance of individuals lIgation) or the vas deferens in men (vasectomy), and couples making voluntary and informed choices preventing sperm and egg from meeting. about their reproductive health, including the decision to ▪ Intra U-terine Device use contraception or have children. This method involves the insertion of a small T-shaped ▪ E - Empower women and girls: device into the uterus. It can be hormonal or non- Family planning plays a crucial role in empowering hormonal and works by preventing fertilization and women and girls by giving them control over their implantation of the fertilized egg. reproductive lives, lives, enabling them to pursue ▪ L - Long-acting Reversible Contraceptives education, employment, and other opportunities, and (LARCs) reducing gender inequalities. This category includes contraceptive methods that ▪ N - Normalize healthy family sizes: provide long-term protection against pregnancy. Family planning encourages the concept of healthy family Examples include hormonal implants sizes, ensuring that families have the resources and and hormonal intrauterine devices (IUDs). support they need to provide for the well-being of their ▪ E - Emergency Contraception children and achieve their desired quality of life. This method involves the use of high-dose hormonal pills ▪ T - Tackle population growth and environmental or copper IUD within a specific time frame after concerns: unprotected intercourse to prevent pregnancy. Family planning contributes to addressing population growth and environmental concerns by helping to stabilize population growth rates, reducing strain on resources, and promoting sustainable development. REMEMBER THE MNEMONICS PREVENT NATURAL FAMILY PLANNING REMEMBER: F-BOLTS F - Fertility Awareness Method (FAM) This method involves tracking and interpreting changes in a woman's body to identify fertile and infertile days. It includes monitoring basal body temperature, cervical mucus, and menstrual cycle patterns. B- Billings Ovulation Method (BOM) This method focuses on monitoring changes in cervical mucus throughout the menstrual cycle to identify fertile and infertile days.  COMMUNICABLE DISEASE NOTE: Patient should be advised to stay well hydrated and to avoid aspirin (acetylsalicylic acid) A disease where an infectious agent spreads from one host to another, either directly or indirectly. 2. Communicable Disease: Filariasis BOARD EXAM QUESTION Causative Agent: Wunchereria Bancrofti A disease that easily spreads from one person to another Vector: is known as? INFECTIOUS DISEASE Africa: Anopheles America: Culex Chain of Infection Asia: Aedes and Mansonia Incubation Period: 10 – 12 Months Diagnostic Tests: Blood Smear Drug of Choice: Diethylcarbamazine 3. Communicable Disease: Leptospirosis (Weil’s Disease) Causative Agent: Leptospires (Spirochetes) Vector: Animal Urine Incubation Period: 5 – 14 Days Diagnostic Tests: Leptospira Agglutination Test Drug of Choice: Penecillin G. 4. Communicable Disease: Malaria Causative Agent: Plasmodia Vector: Female Anopheles Mosquito INFECTIOUS AGENT Incubation Period: 7 – 30 Days Infectious agents (pathogens) include not only bacteria Diagnostic Tests: Malarial Blood Smear but also viruses, fungi, and parasites. The virulence of Drug of Choice: Chloroquine these pathogens depends on their number, their potency, their ability to enter and survive in the body, and the 5. Communicable Disease: Bacterial Meningitis susceptibility of the host. Causative Agent: Neisseria Meningitis RESERVOIR Streptococcus Pneumonia A reservoir is any person, animal, arthropod, plant, soil or Haemophilus Influenza substance (or combination of these) in which an infectious Vector: agent normally lives and multiplies. The infectious agent Incubation Period: 3 – 4 Days with a range of 2 – 10 Days depends on the reservoir for survival, where it can Diagnostic Tests: Spinal Tap reproduce itself in such manner that it can Drug of Choice: be transmitted to a susceptible host. Penecillin ▪ Animate reservoirs include people, insects, birds, Ampicillin and other animals. Ceftriaxone ▪ Inanimate reservoirs include soil, water, food, feces, intravenous fluid, and equipment. 6. Communicable Disease: Poliomyelitis Causative Agent: Legio Debilitants PORTAL OF EXIT Vector: Feces of Infected Person Portals of exit is the means by which a pathogen exits Incubation Period: from a reservoir. For a human reservoir, the portal of exit Non Paralytic Poliomyelitis: 3 – 6 Days can include blood, respiratory secretions, and anything Paralytic Poliomyelitis: 7 – 21 Days exiting from the gastrointestinal or urinary tracts. Diagnostic Tests: Pandy’s Test Drug of Choice: NO CURE MODE OF TRANSMISSION Refers to how an infectious agent, also called a pathogen, 7. Communicable Disease: Tetanus can be transferred from one person, object, or animal, to Causative Agent: Clostridium Tetany another. Vector: Direct transfer of Clostridium Tetany spores from PORTAL OF ENTRY soil and excreta of animals and humans to Infectious agents get into the body through various portals wounds and cuts. of entry, including the mucous membranes, non-intact Incubation Period: 3 – 21 Days (Average: 8 Days) skin, and the respiratory, gastrointestinal, and Diagnostic Tests: genitourinary tracts. Drug of Choice: Metrodinazole SUSCEPTIBLE HOST 8. Communicable Disease: Schistosomiasis The final link in the chain of infection is a susceptible host, Causative Agent: Schistosoma Japonicum someone at risk of infection. Infection does not occur Vector: Transmitted by Water Snails automatically when the pathogen enters the body of a Incubation Period: 14 – 84 Days person whose immune system is functioning normally. Diagnostic Tests: Urine and Stool Examination for Ova Drug of Choice: Praziquantel COMMUNICABLE DISEASES 9. Communicable Disease: Typhoid Fever 1. Communicable Disease: Dengue Hemorrhagic Causative Agent: Salmonella Typhosa Fever Vector: Contaminated Food and Water Causative Agent: Flaviviridae Incubation Period: 6 – 30 Days Vector: Aedes Aegypti Diagnostic Tests: Blood, Urine, and Stool Examination Incubation Period: 2 - 7 days Drug of Choice: Chloramphenicol Diagnostic Tests: Tourniquet test  1. AMOEBIASIS GASTROINTESTINAL SUITABLE AND INCLUSIVE MILESTONES 2. CHICKEN POX RESPIRATORY o USE OF GENERICS 3. CHOLERA GASTROINTESTINAL o PHILHEALTH 4. DIPHTERIA RESPIRATORY o MILK CODE 5. GONORRHEA REPRODUCTIVE o GOOD GOVERNANCE PROGRAMS 6. HEPATITIS A GASTROINTESTINAL o FUNDING FOR UHC 7. HEPATITIS B BLOOD o FISCAL 8. HIV BLOOD o AUTONOMY 9. INFLUENZA RESPIRATORY o FOR GOV'T HOSPITALS 10. MEASLES RESPIRATORY o DEVOLUTION 11. PNEUMONIA RESPIRATORY o DOH RESOURCES 12. PTB RESPIRATORY 13. SYPHILIS REPRODUCTIVE PERSISTENT INEQUITIES 14. THYPHOID GASTROINTESTINAL - Every year, 2000 mothers die due to pregnancy- related cx. 1. KOPLIKS SPOTS MEASLES - A child from the poorest family is 3 times more 2. HYDROPHIBIA RABIES likely. Not reach their 5th birthday 3. LANDRY'S SIGN POLIOMYELITIS - Every year, 1.5 families are pushed into poverty 4. LOCK JAW TETANUS due to healthcare expenditures 5. HANSEN'S DSE. LEPROSY - 3 out of 10 children are STUNTED 6. ROSE SPOTS TYPHOID FEVER - Php 4,000 per month health care expenses are 7. ACUTE PAROTITIS MUMPS considered catastrophic. 8. RICE WATERY STOOL CHOLERA 9. MORNING DROP GONORRHEA ALL FOR HEALTH –TOWARDS HEALTH FOR ALL 10. NIGHT SWEATS PULMONARY TB Lahat Para sa Kalusugan! Tungo sa Kalusugan Para sa Lahat UNIVERSAL HEALTH COVERAGE BOARD EXAMS QUESTIONS STRENGTHEN IMPLEMENTATION OF RPRH LAW 1. What is the difference between a communicable WAR AGAINST DRUGS disease and a non-communicable disease? ADDITIONAL FUNDS FROM PAGCOR Answer: A communicable disease can be passed from person to person, a non- GUARANTEE #1: communicable disease cannot. ALL LIFE STAGES AND TRIPLE BURDEN DISEASE - ALL LIFE STAGES 2. A disease is. - Pregnant- Newborn- Infant Answer: Recognize by a set of symptoms and - Child-Adolescent- Adults- Elderly results in abnormal conditions or dysfunction in the body. TRIPLE BURDEN DISEASE o Communicable disease 3. What is a term for mosquitoes transmitting a o Non-communicable disease and malnutrition disease such as the Zika Virus? o Diseases of rabid urbanization and industraltation Answer: Vector COMMUNICABLE DISEASES 4. What is the difference between a sterilant and a o HIV/AIDS, TB, Malaria disinfectant? o Diseases for Elimination Answer: A sterilant is more powerful than a o Dengue, Lepto, Ebola, Zika disinfectant because if kills of all living microbes, as opposed to most living microbes. NON-COMMUNICABLE DISEASES & MALNUTRITION o Cancer, Diabetes, Heart Disease and their Risk 5. What is the purpose of vaccine? Factors - obesity, smoking, diet, sedentary Answer: Vaccines improve the immune lifestyle system’s fight against disease. o Malnutrition DISEASES OF RAPID URBANIZATION & DUTERTE'S PHILIPPINE HEALTH AGENDA INDUSTRIALIZATION o Injuries BETTER HEALTH OUTCOMES o Substance abuse Filipinos attain the best possible health outcomes with no o Mental Illness disparity o Pandemics, Travel Medicine o Health consequences of climate change / FINANCIAL PROTECTION disaster Filipinos, especially the poor, marginalized, and vulnerable are protected from high cost of health care. GUARANTEE #2: SERVICE DELIVERY NETWORK o FULLY FUNCTIONAL (Complete Equipment, RESPONSIVENESS Medicines, Health Professional) Filipinos feel respected, valued, and empowered in all of o COMPLIANT WITH CLINICAL PRACTICE their interaction with the health svstem o GUIDELINES o PRACTICING GATEKEEPING VALUES PROVIDES HIGH-QUALITY SERVICES o AVAILABLE 24/7 & EVEN DURING DISASTERS (SES RESOURCES ARE EFFICIENTLY o LOCATED CLOSE TO THE PEOPLE (Mobile TRANSPARENT AND ACCOUNTABLE) Clinic of Subsidize Transportation) o ENHANCED BY TELEMEDICINE GUARANTEE #3: UNIVERSAL HEALTH INSURANCE o Services are financed by Philhealth A.C.H.I.E.V.E. ▪ Advance quality, health promotion and primary care ▪ Cover all Filipinos against health-related financial risk ▪ Harness the power of strategic HRH development ▪ Invest in eHealth and data for decision-making ▪ Enforce standards, accountability and transparency ▪ Value all clients and patients, especially the poor, and vulnerable ▪ Elicit multi-sectoral and multi-stakeholder support for ▪ health