Community Health Nursing Day 3 Flashcards
What is the GOAL of Maternal and Child Health?
Goal: to decrease Maternal Mortality Rate (MMR)
How many prenatal visits to promote?
1 - first trimester
1 - second trimester
2 - third trimester
- held by DOH
- Quality Assurance Program
Sentrong Sigla
- all pregnant women are considered high risk pregnancy
- concept: address common problem of pregnancy
Basic Emergency Obstetrical Care (BEmOC)
Under BEmOC:
- training for midwives, doctors, and nurses
Capability Building
Basic Emergency Obstetrical Care (BEmOC):
Ex:
- hemorrhage is common in pregnancy - give _____ to prevent bleeding
- give ____; for infection
- preeclampsia can lead to convulsion; give _____ such as _____ (antidote: calcium gluconate)
- hemorrhage - give oxytocin
- infection - give antibiotics
- preeclampsia - give anticonvulsants like Magnesium sulfate (MgSO4); *antidote: calcium gluconate
Basic Emergency Obstetrical Care (BEmOC):
Ex:
- give steroids, like _____ for pre-term labor and helps with lung maturity
- assisted delivery, also called ______
- manual removal of ____/retained products of conception
- steroids like Betamethasone
- forceps delivery
- placenta
What is the advanced form of BEmOC?
What are the two under this?
- B
- C
Comprehensive Emergency Obstetrical Care (CEmOC) - (advanced)
- Blood Transfusion
- Caesarean Section
- community-based care
- Unang Yakap
- evidence-based practice
Essential Intrapartal Newborn Care
EINC: Time-bound
What are the 4 priorities intervention?
- D
- E
- D
- B
- D - ry infant immediately; the act of drying will stimulate the baby to cry
- E - early skin-to-skin contact; place the baby on mother’s abdomen
- D - elayed cord clamping; wait for the pulsations to stop
- B - reastfeeding; exclusively for 6 months
What do you call the DOH Program of Expanded Program on Immunization (EPI)?
National Immunization Program (NIP)
What law is also called EPI (Expanded Program on Immunization) Law?
- all children below 8 years old will received free vaccination
- Due to vaccination, polio and other diseases were decreased or no cases at all.
P.D. 996 (1976), also called EPI Law
What law is called the Mandatory Immunization?
R.A. 10152 (2011), also called Mandatory Immunization
R.A. 10152: Mandatory Immunization
- target: below 5 years old (since prior to this there’s BCG 2)
What are the 5 vaccinations under this Law?
- Pentavalent (5in1); Diptheria-Pertussis-Tetanus (DPT), Hepatitis B (Hepa B), Haemophilus Influenza B Hib (prevents Meningitis and Pneumonia)
- IPV - Inactivated Polio Vaccine; oral and injectable
- Rota vaccine; prevents acute gastroenteritis (AGE) and diarrhea
- PCV - Pneumococcal Conjugate Vaccine; prevents pneumococcal meningitis/pneumonia
- MMR - Measle, Mumps, and Rubella
What are the 5 elements of EPI?
- S -
- I -
- C -
- A -
T. T -
- S - urveillance
- I - nformation Education Communication
- C - old chain and logistics management
- A - ssessment and Evaluation
T. T - arget setting
What element of EPI?
- searching for cases = for evaluation
Surveillance
What element of EPI?
- National Immunization Day = Wednesday
- vaccine: monthly
- all vaccines are sensitive to heat
IEC - Information Education Communication
What element of EPI?
- storage and transport of vaccination
What 3 vaccines are most sensitive to heat?
- should be placed in the freezer in what temperature?
- Cold chain and logistics Management
3 vaccines sensitive to heat: Varicella, Oral polio vaccine, MMR
Temp: -15 to -25 Celsius
Element of EPI: Cold chain and logistics Management
What 7 vaccines are least sensitive to heat?
- should be placed in the body of refrigerator in what temperature?
7 vaccines least sensitive to heat: BCG, Pentavalent, IPV, Hepa B, Rota, PCV, T.T./T.D. (2in1 - Tetanus and Diptheria)
Temp: +2 to +8 Celsius
What element of EPI?
- Why MMR is to be given late?
Assessment and Evaluation
- because the baby still has the mother’s antibodies that could interfere the effectiveness of the vaccine
Element of EPI: Assessment and Evaluation
Pentavalent:
- What are the Side Effects and what medication to give?
- What are the Adverse Effects and what vaccinations not to give?
S/E:
- fever - give paracetamol every 6 hours for 24 hrs
- local tenderness - apply cold compress
A/E:
- seizures; pertussis (don’t give Pentavalent 2 and 3)
Element of EPI: Assessment and Evaluation
BCG:
- What kind of attenuated microorganisms in BCG?
- BCG prevents _____ meningitis
- What to use in cleaning the site?
- Is having a scar normal?
- What are the Side Effects and the Nursing Management/Treatment?
- Live attenuated microorganisms
- TB (Tuberculous) Meningitis
- Water; don’t use alcohol coz the bacteria will be killed
- (+) scar is normal - means that effective vaccination
- S/E: Abscess (na-na): put Isoniazid/INH powder
Deep Abscess: Incision and drainage + INH powder
Element of EPI: Assessment and Evaluation
OPV:
- also called _____
- ___ attenuated vaccine; not allowed to _____
- __ the tongue
- What to do if it was spitted?
- What to do is it was vomited within 30mins or after 30mins?
- What is the Nursing responsibility after administration?
- also called, “Sabin Vaccine”
- Live attenuated vaccine; not to immunocompromised
- ON
- If spitted: Give another 2gtts (vax has no overdose)
- If vomited w/in 30mins: the vax is not yet absorbed, so give another dose
- If vomited after 30mins: the vax is already absorbed, do not give another dose
- N/R: NPO for 30mins
Element of EPI: Assessment and Evaluation
IPV:
- also called ____
- _____ vaccine; can give to ______
- also called, “Salk vaccine”
- inactivated vaccine; can give to immunocompromised
Element of EPI: Assessment and Evaluation
What vaccine is made of recombinant RNA
Hepa B
Element of EPI: Assessment and Evaluation
MMR:
- consists of M___, M____, R____
- ____ attenuated vaccine
- should or should not distance the child to pregnant women?
- What are the Side Effects and the Nursing Responsibilities?
- consists of Measles, Mumps, Rubella
- live attenuated vaccine
- SHOULD
- S/E:
Fever - give paracetamol every 6 hrs for 24 hrs
Rashes - keep it dry ( usually seen after few hrs/a day)
To remember:
- Syringes are used ____ ONLY
- What type of syringe where its plunger locks to prevent reusing?
- used ONE-TIME ONLY
- ADS (Auto Disable Syringe)
What element of EPI?
- primary element
- solve the eligible population
- What are the formulas for Eligible Population (Infants, Pregnant)?
Target Setting
Formulas:
Infants - Total Population x 2.7%
Pregnant: Total Population x 3.5%
Enumerate and Recite:
Vaccines, # of dose, Schedule, Route and Dosage
- BCG
- Hepa B
- Pentavalent
- OPV
- PCV
- Rota Vaccine
- IPV
- MMR
What is the nutrient called that includes CHO and CHON?
Macronutrient
What is the nutrient called that includes vitamins and minerals?
Micronutrient
Under Macronutrient:
What form of malnutrition is:
- (+) CHO
- (-) CHON (for muscles and fluid balance)
What are its Signs and Symptoms?
Kwashiorkor
S/Sx: thin extremities, edema (fluid shifting), full moon-faced, thin brittle hair
= Ascites
- measure the upper arm circumference to identify malnutrition
How many centimeters?
- Red - severe malnutrition
- Yellow - moderate malnutrition
- Green - normal/no malnutrition
Mid Upper Arm Circumference (MUAC)
Centimeters:
- <11.5cm
- 11.5 - 12.5cm
- > 12.5cm
Under Micronutrient,
What law is the Food Fortification Program?
- foods should be fortified
- fortified = added ____
R.A. 8976
fortified = means added nutrients
Under Micronutrient,
What law is the Food Fortification Program?
- foods should be fortified
- fortified = added ____
What is the program called which is a strategy in encouraging manufacturers to fortify foods?
- Salt Iodization
- Mandatory; rice (iron); flour (iron, vit. A., sugar, cooking oil, and vit. A)
- Voluntary for processed food
Kailan ang Araw ng Sangkap Pinoy Sealed?
R.A. 8976
fortified = means added nutrients
Sangkap Pinoy Sealed
Araw ng Sangkap Pinoy Sealed:
2x/year - Oct. April
Vitamin A (Retinol)
For normal: How many should you give?
Infant (6-11months): 100,000 IU
Child (12-60months): 200,000 IU
When should you give?
Infant (6-11months): 100,000 IU
Child (12-60months): 200,000 IU
Sched: Today, and 6 months after
Vitamin A (Retinol)
For VAD: How many should you give?
Infant (6-11months): 100,000 IU
Child (12-60months): 200,000 IU
When should you give?
What are the S/Sx of a child with VAD (Vitamin A Deficiency)?
Infant (6-11months): 100,000 IU
Child (12-60months): 200,000 IU
Sched: Today, tomorrow, and 2 weeks after
S/Sx:
- dry eye; xerophthalmia
- Bitot’s spots
- nightblindness
Treatment:
- disruption in society
What are the two types?
Two types based on Onset:
Acute: within days - weeks
Chronic/Creeping: months - years
Disaster
- Natural
Ex: Earthquake, Volcanic eruption - Man-made
Ex: Terroristic attack
What law is the National Disaster Risk Reduction Management Council?
- National Government: 2%; LGU: 5%
Principles: 1. It is a responsibility of ACC 2. Disaster Drills - before the impact of the disaster 3. FIRST Priority: \_\_\_\_\_ SECOND Priority: \_\_\_\_\_\_
R.A. 10121
First Priority: People
Second Priority: Resources
- it is a responsibility of all
_____: Sanitation Code
_____: Garbage Disposal Act
What are the 4 rights of Food Sanitation?
P.D. 856: Sanitation Code
P.D. 825: Garbage Disposal Act
4 rights:
- Right source
- Right preparation
- Right cooking: min. temp = 70 Celsius; dangerous max of 2 hrs
- Right storage: Cool = 10 Celcius, Warming = 60 Celcius
Approved: Water facility
Level 1: _____; protected well
- developed spring
- not more than 250 meters away from the source
Level 1: Point-source; protected well
Approved: Water facility
Level 2: _____; stand posts (poso)
- 1: 4-5 household
Level 2: Communal Faucet; stand posts
Approved: Water facility
Level 3: _____; individual household
Level 3: Waterworks System; individual household condition
Approved: Faucet facility
Level 1: _____
Ex: Pit Latrines (doesn't need water) - small amount water facility - konting tubig - poor flush toilet
Level 1: non water carriage
Approved: Faucet facility
Level 2: _____
- flushed type to septic tank
Level 2: Water-sealed
Approved: Faucet facility
Level 3: _____
- to treatment plant
Level 3: Level 2 + sewerage system
