Community Health Nursing Flashcards
True or False: The patient is healthy in CHN
True
Primary Responsibility of CHN
Health Education
Health Teaching
What is the focus on Health Education and Teaching in CHN
Health Promotion
Illness Prevention
Health Promotion
Increases lvl of Health
Promote Healthy Lifestyle (DERS)
Promotion of Healthy Lifestyle
Diet
Exercise
Rest
Stop/ Avoid Smoking
Formula for BMI
Wt (kg) / H (m)^2
Normal BMI
18-23
BMI of an Obese Client
> 30
Top 3 Chemicals of Cigarette’s
Nicotine (addictive)
Carbon Monoxide (interfere oxygenation)
Tar (paralyze cilia)
Ways to Stop Smoking
Educate (ask, advice, assist and arrange)
Legislation
Law to stop or prevent smoking
Tobacco RA 9211
Tobacco RA 9211
Smoking law that Prohibits…
Public places
Advertise
Sell within 100m away from schools
Illness Prevention
Maintain Health
Use Specific Protection
R.A. 7305
Magna Carta PHW
Salary Grade 15
35k/month
Department of Health (DOH)
National authority of health
Vision of DOH
Filipinos are the healthiest in Southeast Asia by 2022
Filipinos are healthiest in Asia by 2040
Mission of DOH
Lead the country in the development of PREP health
- Productive
- Resilient
- Equitable
- People Centered
Executive Order 102
3 Main Function of DOH (LEA)
3 Main Functions of DOH
Leadership (set policies)
Enabler and Capacity Builder (new strategies and trainings)
Administrative Function (handles the tertiary facilities)
What facility does DOH handle
Tertiary Facilities
What are the Philippine Health Care Delivery System
Primary
Secondary
Tertiary
Primary Facilities
Basic Health Care Service
What facilities are in the Primary
Barangay Health Station
RHU/HC
Secondary Facilities
Common labs, medication and surgeries
What facilities are in the Secondary
District Hospital/ Emergency Hospital
Provincial Hospital
Tertiary Facilities
Advanced Health Care Facility
What facilities are in the Tertiary
Regional Hospital/Medical Center
National Hospital/National Medical Center/Specialty Hospital
Who are in the Barangay Health Station
Midwife and BHW
Who are in the RHU/HC
Complete Health Care Team
R.A. 7160
Local Government Code of 1991
(Decentralization and Devolution of whole government)
Transfer of power and implementation of Local Government Unit
Local Government Unit
Provincial Government
Municipal/City Government
Provincial Government
Manages secondary facilities
Chairperson: Governor
Vice Chairperson: Provincial Health Officer
Municipal/ City Government
Manages primary facilities
Chairperson: Mayor
Vice Chairperson: Municipal/City Health Officer
4 Clients of CHN
Individual
Family
Group/Aggregation
Community
Basic Unit of care in CHN
Family
People who share similar characteristics
Group/Aggregate
Primary client in CHN
Community
What lead to Alma Ata Conference
LOI 949 (Letter of Instruction)
LOI 949
(Letter of Instruction)
Legal basis of PHC
Implemented on October 1979 (President Marcos)
PHC
Primary Health Care
Vision of LOC 949
Health in the hands of the people (SELF RELIANCE)
Mission of LOC 949
Increase opportunity that people will manage their own health
Principles of PHC
Partnership with the people
Empowerment (transfer skills, knowledge and attitude)
Pillars of PHC
Active community participation
Intra and Inter sectoral linkages
Use of Appropriate Tech
Support mechanism made available
Intra
Within health care facilities
Inter
Outside Philippine health care delivery system
Characteristics of PHC
Community based Accessible (within 3-5km/30 min) Sustainable Affordable Self-reliance Available
Elements of PHC
Educational Locally Endemic Diseases Essential Drugs MCH (Mother Child Care) EPI (Expanded Program for Immunity) Nutrition Treatment of Communicable Diseases, Non-Communicable Diseases and Emergency Services Sanitation
What are the 3 lvls of prevention in Education (Element of PHC)
Primary, Secondary and Tertiary
Who and What is the activity for Primary Clients in Education
Who: Healthy
Activity: Health Promotion and Illness Prevention
Who and What is the activity for Secondary Clients in Education
Who: High Risk
Activity:
- Early detection and screening
- Early treatment (previous complication)
Who and What is the activity for Tertiary Clients in Education
Who: Post treatment
Activity:
- Rehab
- Palliative (supportive)
Epidemiology
Study of occurrence and distribution of diseases
Father of epidemiology
John Snow
1st Epidemiology
Hippocrates
Classification of Diseases
- Sporadic
- Endemic
- Epidemic/Outbreak
- Pandemic
Sporadic
Occasionally (few cases)
Endemic
Always present
Immune = susceptible
Epidemic/Outbreak
Sudden increase of cases in a short period of time
Increase susceptible, decreased immunity
Pandemic
World wide epidemic (several countries are affected)
Types of Epidemic
- Point Source Epidemic
- Propagated Epidemic
- Cyclical Epidemic/ Seasonal Epidemic
- Secular Variation
Point Source Epidemic
Came from single event
Simultaneous Exposure
What type of epidemic is food poisoning
Point Source Epidemic
Propagated Epidemic
Transmission from person to person
True or False: Flu and Covid-19 virus is a propagated epidemic
True
Cyclical Epidemic (Seasonal Epidemic)
Seasonal health problems (lepto, dengue, heat stroke, rashes)
Secular Variation
change in diseases through time
What is the leading cause of death in the Philippines
Diseases in the heart
What is the second leading cause of death in the Philippines
Diseases in the blood vessels
Triple Burden Disease
Communicable Diseases
Non-Communicable Diseases
Diseases of Rapid Urbanization and Industrialization
R.A. 11223
Universal Health Care Law
All Filipinos are automatically enrolled on Phil Health Care
R.A. 8423
Traditional Alternative Medicine Act
Institute that tests and approves herbal medications in the Philippines
RITM (Research Institute of Topical Medications)
10 Approved Herbal Medications by RITM
LUBBY SANTA
Lagundi Ulasimang Bato (Pansit-Pansitan) Bayabas Bawang Yerba Buena (Peppermint)
Sambong Akapulco Niyog-Niyogan Tsaang Gubat Ampalaya
Lagundi
MOST USED
cephalocaudal use
Where is ASCOF used
Asthma
Cough
Fever
Ulasimang Bato (Pansit-Pansitan)
contraindicated w/ kidney stones
for URIC ACID (GOUT)
Bayabas
Antiseptic properties FOR WASH (mouthwash, wash wounds, diarrhea)
Bawang
Decrease cholesterol (HPN)
For toothache
“bawas dugo, bawas ngipin”
Yerba Buena (Peppermint)
methol For pain (headache, stomachache, muscle and bone pain)
Sambong
For edema
Diuretic
For Kidney Stones
CONTRAINDICATED for Kidney Infections
Akapulco
Fungi Infection
“Tinea” = fungal
Niyog-Niyogan
For parasitism
USE SEEDS!!!!
drink 2hrs after supper
Tsaang Gubat
for diarrhea, indigestion, constipation
Ampalaya
For type 2 diabetes (stimulate pancreas to release insulin)
Decoction
Boiling of herbal meds
Important points with Decoction
Fresh Leaves
Boil water first before adding leaves
Do not cover
Low Heat
Goal of Maternal Child Health
Decrease Maternal Mortality Rate
Strategies to achieve the Goal of Maternal Child Health
- 4 Prenatal Visits [Sentong Sigla Program by DOH] (8 Visits from WHO)
- Basic Emergency Obstetric Care (BEmoc)
- Comprehensive Obstetrics Care (CEmoc)
- EINC (Essential Intrapartal Newborn Care)
Basic Emergency Obstetric Care (BEmoc)
- All pregnant women are assumed to be High-Risk patients
- Common problems in pregnancy are addressed
- Capacity building is provided (trainings) [Oxytocin, antibiotics, anticonvulsants, steroids, assisted delivery, manual removal of placental/retained products of conception ]
Comprehensive Obstetrics Care (CEmoc)
Can perform blood transfusion and Cesarian Section
EINC (Essential Intrapartal Newborn Care)
Evidence based practice
UNANG YAKAP
Time Bound Unang Yakap interventions
Dry infant (within 30 sec)
Early skin to skin contact
Delayed cord clamping (wait for pulsation [1-3 min])
Breast Feeding
Non-Time Bound Unang Yakap Interventions
Erythropoietin Vit k BCG Hepa B Anthropometric Measurement APGAR score Wash after 6hrs
REMOVED Newborn Care interventions on UNANG YAKAP
Suctioning Immediate cord clamping Milking cord Clapping buttocks Stimulate heel Wash immediately Cover stump Use of Antiseptic
PD 996
EPI (Expanded Program on Immunity) Law [1976]
All children below 8 yrs old can be vaccinated for FREE
R.A. 10152
Mandatory Immunization [2011]
All children below 5 yrs old can be vaccinated for FREE
Pentavalent vaccine contains…
DPT (Diptheria, Pertusis, Tetanus)
Hepatitis B
Hib
IPV
Inactivated Polio Vaccine
PCV
Pneumococcal Conjugate Vaccine
MMR
Measles, Mumps Rubella
Rota Vaccine
Prevent rota virus
5 Elements of EPI
Surveillance
Information, Educate and Communication (National Immuno Day [every Wednesday])
Cold Chain and Logistic Management (proper storage and transport)
Assessment and Evaluation
Target Setting (PRIMARY ELEMENT)
Formula to determine Eligible Population
Infant = Total Population x 2.7%
Pregnant Women = Total Population x 3.5%
Vaccines that are most sensitive to heat
Varicella
OPV
MMR
Best temperature of freezer for heat sensitive vaccines
-15 to -25 degrees Celsius
Vaccines that are least sensitive to heat
BCG Pentavalent IPU Hepa B Rota V PCV T.T./Td (Tetanus diphtheria)
Best temperature of refrigerator for less sensitive to heat vaccines
2 to 8 degrees Celsius
Vaccine Schedule
What should be given first, ROTA vaccine or OPV
ROTA vaccine (higher dose)
True or False: Injections should be given before oral medications
False
Best site of IM for infants
Vastus Lateralis
Best site for SQ for infants
Outer arm
ADS
Auto disable syringe
True or False: BCG is a live attenuated vaccine
True
BCG
Bacillus Calmette Guerin
Prevent TB meningitis
Nursing Interventions for BCG
Use sterile water when cleaning site
KOCHS PHENOMENON
Abscess -> apply INH powder
Deep Abscess -> incision and drainage + INH powder
Scar formation = good
No Scar formation = REPEAT
True or False: Hepatitis B Vaccine uses recombinant RNA
True
Nursing interventions for Pentavalent Vaccine
Fever -> paracetamol every 6hrs for 24hrs
Local Tenderness -> cold compress
True or False: OPV is given below the tongue
False (on the tongue)
Nursing interventions for OPV
Live antinuated
If spits -> REPEAT
If vomits
- within 30 min -> give again
- after 30 min -> DO NOT give
Nursing interventions for MMR
NOT GIVEN TO PREGNANT WOMEN
Fever -> paracetamol every 6hrs for 24hrs
Rashes -> KEEP DRY
Malnutrition
Problem with nutrition
Types of Nutrients
Macronutrients
Micronutrients
Macronutrients
Nutrients that should be taken in large amount (carbohydrates and protein)
Types of Macronutrient deficiency
Marasmus
Kwashiorkor
Marasmus
Decrease in carbohydrate and protein intake
Skinny, skin and bones, prominent ribs, wrinkled skin and apathy
Kwashiorkor
Enough carbohydrate intake but decreased protein intake
Thin extremities, edema, moon face, ascites and thin brittle hair
How is severe malnutrition assessed?
Using the MUAC (Mid Upper Arm Circumference)
Interpretation of MUAC
< 115 mm = RED (severe acute malnutrition)
Between 115 -125 mm = YELLOW (moderate acute malnutrition)
> 115 mm = NO acute malnutrition
Possible management for Malnutrition
RUTF (Ready to Eat Therapeutic Food)
Micronutrient
Nutrients that the body needs in small amount
SHOULD BE WATCHED OUT W/ 5yrs old
When is Araw nang Sangkap held
2x/yr (April and November)
Normal Dose of Retinol for 6-11 months
100,000 IU
Normal Dose of Retinol for 12-60 months
200,000 IU
Vitamin A deficiency symptoms
Corneal Dryness
Xerophthalmia (dryness)
Bitot’s Spot
Night Blindness
Non Communicable Diseases
Lifestyle related diseases
Behavioral
Risk factors for Non Communicable Diseases
Physical Inactivity
Unhealthy diet
Smoking
Disasters
Disruption in society
Types of Disaster
Natural: Act of God
Man-Made: human generated
Types of Disasters (Onset)
Acute: within days or weeks
Chronic/Creeping: within months or years
Principle of Disasters
Responsibility of ALL
Provide disaster drills
People are first priority and resources are second
R.A. 10121
NDRRMC (National Disaster Risk Reduction Management Council)
National Gov provides 2% of the budget to this council while LGU provides 5%
PD 856
Sanitation Code
PD 825
Garbage Disposal Act
4 Rights of Food Safety
Right Source (safety) Right Preparation (wash) Right Cooking (40 degrees Celsius) Right Storage (Cool: 10 degrees Celsius and Warm: 60 degrees Celsius)
How long is it safe to keep food at room temperature
2 hours
Who requires a Sanitary Permit in a restaurant
Owner of food establishment
Who are is required to have a health certificate in a restaurant
Food handlers
Class Rating of Food Sanitation
Class A: Excellent
Class B: Very Satisfactory
Class C: Satisfactory
Levels of Water Facility
Level 1 (Point Source) Level 2 (Communal Faucet/ Stand Posts) Level 3 (Individual Household Connection)
What are differences between Levels 1, 2, 3 of water facilities?
Level 1 (Point source): protected well, developed spring and should not be greater than 250m away from the source
Level 2 (Communal Faucet/Stand Posts): Shared (1:4-5 households)
Level 3 (Ind Household Connection): waterworks system
Levels of Toilet Facility
Level 1 (Non-Water Carriage): pit latrines [25m away from the house and small amount of water toilet facility]
Level 2: Water seal/flushed type (septic tank)
Level 3: LVL2 + Sewage system (treatment plant)