Communicable Diseases Chn Review PDF

**CHN** **COMMUNICABLE DISEASES\ ** **TUBERCULOSIS** **INFECTIOUS AGENT:** Mycobacterium Tuberculosis **MODE OF TRANSMISSION:** - Airborne droplet - Direct invasion - Bovine tuberculosis **SUSCEPTIBILITY AND RESISTANCE:** - First 6-12 months after infection - Children under 3...

**CHN** **COMMUNICABLE DISEASES\ ** **TUBERCULOSIS** **INFECTIOUS AGENT:** Mycobacterium Tuberculosis **MODE OF TRANSMISSION:** - Airborne droplet - Direct invasion - Bovine tuberculosis **SUSCEPTIBILITY AND RESISTANCE:** - First 6-12 months after infection - Children under 3 years old - HIV Infection **SIGNS AND SYMPTOMS:** - Cough for two weeks or more - Fever - Chest or back pains not referable to any musculo-skeletal disorders - Hemoptysis or recurrent blood-streaked sputum - Significant weight loss - Other signs and symptoms such sweating, fatigue, body malaise - and shortness of breath **METHODS OF CONTROL** - Prompt diagnosis and treatment of infectious cases - BCG vaccination of newborn, infants and grade 1/ school entrance - Educate the public in the mode of spread - Improve social conditions - Make available medical, laboratory and x-ray **TREATMENT** - Anti TB drugs (Isoniazid, Rifampicin, Pyrazinamide and ethambutol) **NURSING RESPONSIBILITIES:** - Interview and open treatment cards for identified tuberculous children - Perform tuberculin testing and Maintain NTP records (Treatment card) - Manage requisition and distribution of drugs **SCHISTOSOMIASIS** **INFECTION AGENT:** Schistosoma japonicum, Schistosoma mansoni, Schistosoma haematobium **MODE OF TRANSMISSION:** - Transmitted when skin comes in contact with contaminated fresh water in which a certain snail that carries schistosomes **SUSCEPTIBILITY AND RESISTANCE:** - Mostly farmers and their families in the rural area **SIGNS AND SYMPTOMS:** - Diarrhea - Bloody stools - Enlargement of abdomen - Splenomegaly - Weakness - Anemia - Inflamed liver **METHODS OF CONTROL** - Educate the public in endemic areas regarding mode of transmission and methods of protection - Dispose feces and urine so that viable eggs will not reach bodies of fresh water containing intermediate snail host - Improve irrigation and agriculture practices - Treat snail breeding sites with molluscicides - Use of rubber boots - Treat patients in endemic areas to prevent disease progression **FILARIASIS** **INFECTIOUS AGENT:** Wuchereria Bancroft, Brugia Malayi and or Brugia timori **MODE OF TRANSMISSION:** - Transmitted to a person through bites of infected female mosquito primarily Aedes poecilius **SIGNS AND SYMPTOMS:** - Asymptomatic stage characterized by presence of microfilariae in the peripheral blood - Acute stage starts when there are already manifestation of lymphadenitis/ lymphangitis and in some case male genitalia is affected like orchitis - Chronic stage is develop 10-15 years from the onset of the first attack - Chronic signs and symptoms like Hydrocele, lymphedema and elephantiasis - Chest or back pains not referable to any musculo- skeletal disorders **METHODS OF CONTROL** - Environmental sanitation - Spraying insecticides - Use of mosquito nets - Use of long sleeves, long pants and socks - Application of insect repellants / screening of houses **TREATMENT** - Treatment of cases endemic communities - Diethylcarbamazine citrate(DEC) or Hetrazan - Surgery for elephantiasis and hydrocele **NURSING RESPONSIBILITIES:** - Advised to observe personal hygiene by washing the affected area with soap and water at twice a day or prescribed antibiotics or antifungals for infection - Health education **INFLUENZA** **INFECTIOUS AGENT:** Influenza virus A, B, C **MODE OF TRANSMISSION:** - By direct contact, through droplet infection or by particles freshly soiled with discharges of nose and throat of infected person - Airborne **SUSCEPTIBILITY AND RESISTANCE:** - Universal but of varying degrees as shown by frequent unapparent and typical infection during epidemics **SIGNS AND SYMPTOMS:** - Chills - Aches or pains in the back and limbs - Respiratory symptoms include coryza , sore throat and cough **METHODS OF CONTROL/ TREATMENT** - Education of the public as to sanitary hazard from spitting sneezing and coughing - Avoid use of common towels glasses and eating utensils - Active immunization of influenza vaccine **NURSING RESPONSIBILITIES:** - Keep patient warm and free from drafts in bed - Tepid sponge bath for fever and use Perform tuberculin testing a - Health teaching for proper waste disposal PNEUMONIA - **INFECTIOUS AGENT:** Pneumoccocus / Diplococcus pneumonia **PREDISPOSING CAUSES :** - Fatigue - Overexposure to inclement weather - Exposure to polluted air - Malnutrition - Convulsions may occur - Flushed face - Dilated pupils - Severe chill in young children - Pain in affected lung - High colored urine with reduced chlorides and increase urates **DIAGNOSIS:** - Based on history and clinical signs and symptoms - Dull percussion noted on affected side (lung) - X-ray **COMPLICATIONS:** - Emphysema or pleural effusion - Endocarditis or pericarditis with effusion - Pneumococcal meningitis - Otitis Media in children - Hypostatic edema and hyperemia of unaffected lung in elderly - Jaundice - Abortion **TREATMENT/ MANAGEMENT:** - Bedrest - Adequate salt, fluid, calorie and vitamin intake - Tepid sponge for fever - Frequent turning from side to side - Antibiotics based on care acute respiratory infection (CARI) of DOH **SEVERE ACUTE RESPIRATORY SYNDROME (SARS)** **INFECTIOUS AGENT:** Novel human coronavirus **MODE OF TRANSMISSION:** - Respiratory droplet secretion from SARS patient coughs sneezes or talks **SIGNS AND SYMPTOMS:** - Fever 38 C - Diarrhea - With 2-7 days the illness may proceed to this stage characterized by dry, nonproductive cough with or without respiratory distress - Hypoxia - Crackles or rales - Dullness on percussion and decreased breath sounds **DIAGNOSIS:** - Serological and molecular tests - PCR test **PREVENTIVE MEASURES AND CONTROL:** - Establishment of TRIAGE - Assign specific area of triage of patients who have SARS - Patient wear mask - Screen patients for travel history, symptoms and/ or close contact cases - Admit if they meet case definition - Identification of Patient - Isolation of suspected probable case - Tracing and monitoring of close contact - Barrier nursing technique for suspected and probable cases **NURSING CARE:** - The Infection Control goals should be the following: - Provide best possible clinical like - Detect early suspect case - Implement appropriate isolation measures - Protect health personnel - Protect other patients - Protect family and community members - Utilize personal protective equipment (PPE) - Handwashing **COVID 19** **INFECTIOUS AGENT:** Coronavirus **MODE OF TRANSMISSION:** - Respiratory droplet secretion from COVID 19 patient coughs sneezes or talks. **SIGNS AND SYMPTOMS:** - Fever 38 C - Dry cough - Tiredness - Diarrhea - Sore throat - Headache - Conjunctivitis - Loss of taste or smell **DIAGNOSIS:** - Chest x-ray - PCR test Serological and molecular tests - Chest CT scan - IgM/IgG combo test - CBC **PREVENTIVE MEASURES AND CONTROL:** - Establishment of TRIAGE - Assign specific area of triage of patients who have COVID 19 - Patient wear mask - Screen patients for travel history, symptoms and/ or close contact cases - Admit if they meet case definition - Identification of Patient - Isolation of suspected probable case - Tracing and monitoring of close contact - Barrier nursing technique for suspected and probable cases **NURSING CARE:** - The Infection Control goals should be the following: - Provide best possible clinical like - Detect early suspect case - Implement appropriate isolation measures - Protect health personnel - Protect other patients - Protect family and community members - Utilize personal protective equipment (PPE) - Handwashing **MODULE 1** **Planning Community Health Intervention** **PLANNING -** Is a logical process of decision making to determine which of the identified health concerns requires more immediate consideration (priority setting & what action may be undertakes to achieve goals. **CRITERIA PRIORITY SETTING** 1. **Significance of the Problem** - is based on the number of people in the community affected by the problem or condition 2. **The Level of Community Awareness** - The priority its member give to the health concern is a major consideration. - Related to the community gives to the health concern, Shuster & Geoppinger (2004) - Community motivation to deal with condition 3. **Ability to Reduce Risk -** Related to the availability of the expertise among the health team in the community itself - This criterion involves the health team\'s level of influence in decision making related to actions in resolving the community health concern. 4. **Determining cost of Reducing Risk** - The nurse has to consider economic, social & ethical requisites and consequences of planned action 5. **Ability to identify the target population** - For the intervention is a matter of availability of data resources such as FHSIS, census, survey reports or case/screening finding. 6. **Availability of Resources -** To intervene in the reduction of risk entails technological, financial & other material resources of the community, the nurse, the health agency. Accessibility of outside resources & link are taken into account 7. **Group** - It is a flexible process using the nominal group technique wherein each group member has an equal voice and decision-making, thereby avoiding control of the process by the more dominant members of the group **CRITERIA:** - From the scale of 1 to 10, 1 being the lowest, the members give each criterion based on their perception of its degree of importance in solving the problem. From a scale of 1 to 10, 1 being the lowest, each member ratesthe criteria in terms of likelihood of the group being able to influence or change the situation. - Collate the weights (from step 1) and ratings (from step 2) made by the members of the group. - Compute the total priority score of the - problem by multiplying collated weight and rating of each criterion. The priority score of the problem is calculated by adding the production obtained in step 4. **FORMULATING GOALS & OBJECTIVES** - In family health nursing, goals are the desired outcomes at the end of interventions, whereas objectives are the short term changes in the community that are observed as the health team & the community works towards attainment of goals. Objectives serve as instructions, defining what should be detected in the community as interventions are being implemented. **SMART Process:** For us to attain our goal and objective we must be smart - **Specific** - be clear and specific to your goals that are easier to achieve. This would also help you to know how and where to get started. - **Measurable** - goal must be reached allowing you to see your progress. Tells you when your goals are complete - **Attainable** - your goal is realistic and you must have the tools or resources to attain it - **Relevant** - realistic or relevant to avoid over well and unnecessary stress and frustration - **Time-Bound** -a date help us stay focused and motivated, inspiring us and providing something to work towards **Sample and Objectives of a Community Health Plan** Problem: Risk of maternal complication leading to maternal mortality in bagong silang Goal: To reduce maternal mortality rate from 132/ 100.000 live births to 80/100.00 Objectives: At the end of the year, the community of barangay bagong silang will: 1. Demonstrate ability to organize groups participate in the community has process from assessment to evaluation 2\. Increase the proportion of facility-based births from 10% to 15% 3\. Lower proportion of untrained hilot attended births from 20% to 10%. 4\. Reduce the prevalence of nutritionally at risk pregnant women to 20% 5\. Reduce the prevalence of anemia among pregnant women by 20%. **Deciding on Community Interventions** - The group must analyze the reasons for people\'s health behavior and directs strategies to respond to the underlying causes - But if the reason is sociocultural, the planning team me opt to concentrate on providing opportunities for skills development of traditional birth attendants or exerting more effort to gain trust and confidence of women and families - The group should take into consideration the demographic, physiological, social, cultural and economic characteristic of the target population and one hand and the available health resources on the other hand **Implementing the Community Health Interventions** - Referred to as the action phase - Able to deal with recognize priority health concern - To facilitate the process rather than directly implement the planned interventions **Importance of Partnership and Collaboration** - The problem are complicated and too many for the nurse and the people or their organization to handle - They must work with other people or groups to increase the probability of accomplishing the goals that they have set. - The nurse must plan to establish and maintain valuable working relationship. D. **IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS** **1. Importance of Partnership and Collaboration** **Effective partnerships** are essential for community-based solutions for advancing health equity by making it a shared vision and value, increasing the community\'s capacity to shape outcomes, and fostering multi-sector collaboration. Partnerships are important because they enable action on the determinants of health, which is vital in order to address health inequalities. Learning from research on building better partnerships to develop more effective and sustainable partnerships is also explored. The quality collaboration that brings together healthcare stakeholders to achieve common and improved objectives is key for healthcare improvement. Collaboration may result in optimizing the development of resources, enhancing communication, coordination, and consequently a better healthcare performance. **2. Activities Involved in Collaboration and Advocacy** - **Advocacy**- any action that speaks in favor of, recommends, argues for a cause, supports or defends, or pleads on behalf of others. - **Health advocacy** aims to bridge the gaps within our healthcare systems to ensure that people can access affordable, effective, and high-quality healthcare. **3. Community Organizing And Social Mobilization** **Community Organizing Definition** - **Maglaya -** Process whereby community members develop the capability -To assess their health needs and problems -Plan and implement actions to solve these problems -Put up and sustain organizational structures -Support and monitor implementation of health initiatives by the people - **Human Resource Development Program (HRDP**) - A continuous and sustained process -It is working with the people collectively and efficiently, discover their immediate and long-term problems and mobilizing the people to develop their capabilities and readiness to respond and take action on their immediate needs toward the solution of their long term problems **Objectives of Community Organizing** 1.To make people aware of social realities 2.To form structures that hold the people\'s basic interests 3.To initiate responsible actions **Elements of Community Organizing** - **Power** - ability to make something happen -getting people understand the source of problem, devise solutions, strategies, take on leadership and move to action thru campaigns that win concrete changes - **Relationship building** - people are accountable to one another for their activities on behalf of the group. **2 kinds of relationship** a.one on one b\. public relationships - **Leadership developmen**t-must build a base of members for them to see the root of the problem and get them involved to develop them as leaders - **Political education** -form of training whether formally or informally about issues, social movements and history of the organization - **Strategy-over-all approach to achieving objectives** - way that a community is using its power to win what it wants by: a\. campaigns b\. research c\. collaboration and alliances - **Mobilization**-essential process of moving people to action - **Action**- a public showing of an organization\'s power -takes place during campaigns - **Winning** - organizing focuses on winning -unless the organization wins concrete, measurable benefits for those who participate, it will not last long - **Movement building-** groups engage in broader social justice activities that are not solely connected to winnable campaigns or self-interest of community - **Evaluation**-monitors and improves performance (action-reflection-action) -continuous process of assessing actions whether the goals are met or not **4. Principles of Community Organizing** 1\. People are motivated by self-interest 2\. It is a dynamic process 3\. Learns to deal with conflicts and confrontations 4\. Takes into account the fundamental definition of an issue 5\. Tactics should be within the experience of the people and outside the experience of the target 6\. Man learns effectively from his own actual experiences 7.Man needs to deepen and widen his horizon 8.People must make their own decisions **Phases of Community Organizing (Maglaya)** A. **Guidelines**: - Recognize the role and position of local authorities - Adopt a lifestyle in keeping with that of the community - Choose a modest dwelling - Avoid raising expectations of the people **B. Organizational Phase** 1\. Social preparation 2\. Spotting and developing potential leaders 3\. Core group formation-represented by different sectors of the community The core group serves as the training ground for developing potential leaders in: \>Democratic and collective leadership **MODULE 2** **Nursing Process in the Care of Population Groups and Community** A. **Community Health Assessment Tools** **Collecting Primary Data** 1. Rapid observation of a community may be done through an ocular or windshield survey, either by driving or riding a vehicle or walking through it.This gives the nurse the chance to observe people as well as take note of environmental conditions and existing community facilities. Participant observation is a technique that suits community organizing and participatory action research. 2. Survey is necessary when there is no available information about the community or specific population group to be studied. It is made up of a series of questions for systematic collection of information from a sample of individuals or families in a community and maybe written or oral. 3. Informant interview are purposeful talks with either key informants or ordinary members of the community. Key informants consist of formal or informal community leaders or persons of position and influence, such as leaders in local government, schools or business. 4. Community forum is an open meeting of the members of the community. 5. Focus group differs from community forum in the sense that the focus group is made up of a much smaller group, usually 6-12 members only. **Secondary Data -** Are taken from existing data sources. Sources consist of vital registries, health records and reports, disease registries and publications. **Secondary data sources** **1. Registry of vital events** - **Act 3753** established the civil registry system in the Philippines and requires the registration of civil events, such as births, marriages and deaths. - **RA 7160** (Local Government Code) assigned the function of civil registration to local governments and mandated the appointment of Local Civil Registrars. The National Statistics Office (NSO) serves as the central repository of civil registries and the NSO Administrators and the Civil - **Registrar General** of the Philippines before 2014. All these functions are now under the Philippines Statistics Authority (PSA) by virtue of RA 10625 otherwise known as the \"Philippine Statistical Act of 2013 **2. Health Records and Reports** - As specified by EO No. 352, the FHSIS is the official recording and reporting system of the Department of Health and is used by the Philippine Statistics Authority to generate health statistics. The FHSIS is an essential tool in monitoring the health status of the population at different levels. **Recording Tools in FHSIS** a\. Individual treatment record b\. Target client list c\. Summary table d\. Monthly Consolidation table **Reporting Forms in FHSIS** a\. The monthly form (Program Report, Morbidity Report) b\. The quarterly form (Program Report, Morbidity Report) c\. The annual form **3. Disease registries -** A disease registry is a listing of persons diagnosed with a specific type of disease in a defined population. Data collected through disease registries serve as basis for monitoring, decision making and program management (DOH, 2011). 4. **Census data -** A census is a periodic governmental enumeration of the population **B. Community Diagnosis** **Eight Steps to Community Health Needs Assessment** 1\. Identify and engage in stakeholders. 2\. Define the community. 3\. Collect and analyse data. 4\. Select community priority health issues. 5\. Document and communicate. 6\. Plan improvement strategies. 7\. Implement improvement plans. 8\. Evaluate progress. **Basic Values in Community Organizing** 1\. Human rights 2\. Social Justice 3\. Social Responsibility **Participatory Action Research (PAR**) - is an approach to research that aims at promoting change among the participants. Members of the group being studied participate as partners in all phases of theresearch, including design, data collection, analysis and dissemination (Brown, 200ffi). **Community Organizing (CO)** is a process of educating and mobilizing members of the community to enable them to resolve community problems. The emphasis of community organizing in primary health care are the following: 1\. People from the community working together to solve their own problems 2\. Internal organizational consolidation as a prerequisite to external expansion 3\. Social movement first before technical change. 4\. Health reforms occurring within the context of broader social transformation.  **SCHEMES IN STATING THE COMMUNITY DIAGNOSIS** **Community Diagnosis -** Community diagnosis is the process determining the health status of the community and the factors responsible for it. 1. **NANDA -** nursing diagnostic labels focused more on individual rather than the community responses to health conditions, have included diagnosis at the community level **2. Shuster and Goppingen -** Proposed a practical adaptation of a format of nursing diagnosis for population groups previously presented by Green and Slade (2001). The three part consists of: a\. The health risk or specific problem to which the community is exposed. b\. The specific aggregate or community with whom the nurse will be working to deal with the risk or problem C. Related factors that influence how the community will responf to the health risk or problem.  **III. Deciding on Community Interventionstti Action Plan** Because of their inherent differences, what may work for one community may not be effective in another? The group analyzes the reasons for people\'s health behaviour and directs strategies to respond to the underlying causes. For example, reasons for preference of home delivery over facility-based delivery should be identified. If the majority of the women would choose to have a home delivery because of cost or lack of access of birthing facilities, strategies should then be focused on improving facility- based services