CD control program Communicable diseases National Tuberculosis Control Program – key policies Case finding – direct Sputum Microscopy and X-ray examination of TB symptomatics who are negative after 2 or more sputum exams Treatment – shall be given free and on an ambulatory basis, except those with acute complications and emergencies Direct Observed Treatment Short Course – comprehensive strategy to detect and cure TB patients. Category and Treatment Regimen Category 1- new TB patients whose sputum is positive; seriously ill patients with severe forms of smear-negative PTB with extensive parenchymal involvement (moderately- or faradvanced) and extra-pulmonary TB (meningitis, pleurisy, etc.) Category 2-previously-treated patients with relapses or failures. Category 3 – new TB patients whose sputum is smear-negative for 3 times and chest x-ray result of PTB minimal Category 1new TB patients whose sputum is positive; seriously ill patients with severe forms of smearnegative PTB with extensive parenchymal involvement (moderately- or far- advanced) and extra-pulmonary TB (meningitis, pleurisy, etc.) Intensive Phase (given daily for the first 2 months)Rifampicin + Isioniazid + pyrazinamide + ethambutol. If sputum result becomes negative after 2 months, maintenance phase starts. But if sputum is still positive in 2 months, all drugs are discontinued from 2-3 days and a sputum specimen is examined for culture and drug sensitivity. The patient resumes taking the 4 drugs for another month and then another smear exam is done at the end of the 3rd month. Maintenance Phase (after 3rd month, regardless of the result of the sputum exam)-INH + rifampicin daily Category 2-previously-treated patients with relapses or failures. Intensive Phase (daily for 3 months, month 1,2 & 3)Isioniazid+ rifampicin+ pyrazinamide+ ethambutol+ streptomycin for the first 2 months Streptomycin+ rifampicin pyrazinamide+ ethambutol on the 3rd month. If sputum is still positive after 3 months, the intensive phase is continued for 1 more month and then another sputum exam is done. If still positive after 4 months, intensive phase is continued for the next 5 months. Maintenance Phase (daily for 5 months, month 4,5,6,7,& 8)-Isionazid+ rifampicin+ ethambutol Category 3 – new TB patients whose sputum is smearnegative for 3 times and chest x-ray result of PTB minimal Intensive Phase (daily for 2 months) – Isioniazid + rifampicin + pyrazinamide Maintenance Phase (daily for the next 2 months) - Isioniazid + rifampicin Stop TB ; Do it with DOTS Advocacy is a planned and continuous effort to inform people about issue and instigate change. Advocacy usually takes place over an extended period of time and includes a variety of strategies to communicate a specific message.

TB is the number one infectious killer in the world. One TB suspect can infect another 10 healthy persons Leprosy Control Program WHO Classification – basis of multi-drug therapy ▪ Paucibacillary/PB – noninfectious types. 6-9 months of treatment. ▪ Multibacillary/MB – infectious types. 24-30 months of treatment. Multi-drug therapy – use of 2 or more drugs renders patients non-infectious a week after starting treatment ▪ Patients w/ single skin lesion and a negative slit skin smear are treated w/ a single dose of ROM regimen ▪ For PB leprosy casesRifampicin+Dapsone on Day 1 then Dapsone from Day 2-28. 6 blister packs taken monthly within a max. period of 9 mos. All patients who have complied w/ MDT are considered cured and no longer regarded as a case of leprosy, even if some sequelae of leprosy remain. Responsibilities of the nurse ▪ Prevention – health education, healthful living through proper nutrition, adequate rest, sleep and good personal hygiene; ▪ Casefinding ▪ Management and treatment – prevention of secondary injuries, handling of utensils; special shoes w/ padded soles; importance of sustained therapy, correct dosage, effects of drugs and the need for medical checkup from time to time; mental & emotional support ▪ Rehabilitation-makes patients capable, active and selfrespecting member of society. Control of Schistosomiasis – a tropical disease caused by a blood fluke, Schistosoma Japonicum ; transmitted by a tiny snail Oncomelania quadrasi Preventive measures – health education regarding mode of transmission and methods of protection; proper disposal of feces and urine; improvement of irrigation and agriculture practices Control of patient, contacts and the immediate environment Specific treatment- Praziquantel – drug of choice Programs on Filariasis, Malaria and Dengue Hemorrhagic Fever Filariasis- a chronic prasitic infection caused by a nematode, Wuchereria bancrofti. Young and adult worms live in the lymphatic vessels and nodes, while the micro filariae are in the blood; transmitted through bites from an infected female mosquito, Aedes poecilius, that bites at night. ▪ Treatment: Diethylcarbamazine citrate or Hetrazan ▪ Elephantiasis and Hydrocoele are handled through surgery,

Chickenpox.4 C‘s in the Syndromic Mgt .Chlamydia. Tetanus – focused on health information campaigns and intensive immunization of children in barangays. Economic indicators Poverty level income Employment rate Types of industry present in the community Occupation common in the community iii. Population projection Note: Population groups that need special attentions: ▪ Indigenous people ▪ Socially dislocated groups as a result of disasters.Safe sex 2. Socio-economic & Cultural variables i. Exam & consult doctor. Contact tracing to treat partner . Trichuris. CBR. Community Needs Assessment/ Community Diagnosis Community Diagnosis A process by which the nurse collects data about the community in order to identify factors which may influence the deaths and illnesses of the population to formulate a community health nursing diagnosis and develop and implement community health nursing interventions and strategies Done to come up with a profile of local health situation Will serve as a basis of health programs and services to be delivered to the community Starts with determining the health status of the community 2 Types of Community Diagnosis 1. Massive liver damage and hepatocarcinoma . Cultural factors Variables that may break up people into groups within the community e. Age & Sex composition iii. calamities & development programs 2. Condom use . quiinine sulfate. Hep B ( the most serious type ‗cause of severe cx.q. Eg. Active immunization – body develops Ab against rabies up to 3 yrs. Selected vital indicators e.3.If it dies or shows rabies. Water and Land pollution iv. of Rabies Wash wound with soap and water. Mumps. DEMOGRAPHIC VARIABLES i. Patterns of migration v. kill then bring head for lab.prevention and supportive care Malaria – infection caused by the bite of the female Anopheles mosquito .q. starting from 1-2 weeks before entering the endemic area. Passive I – giving Ab to persons with head and neck bites. If nothing happens. Health Education re: ▪ Good personal hygiene ▪ Use of footwear ▪ Washing fruits and vegetables well ▪ Use of sanitary toilets ▪ Sanitary disposal of garbage ▪ Boiling drinking water at least 23 min. of age and yearly thereafter Prevention and Control on STIs .4. HIV/AIDS. contamination of mucous membranes or thin covering of the eyes.Universal precautions . Diphtheria. Comprehensive Community Diagnosis aims to obtain general information about the community 2. Hookworm) and Paragonimiasis in communities where eating of fresh or inadequately cooked crab is a practice Management: 1. multiple single deep bites.1. Compliance . Pertusis. Growth rate. Problem-Oriented Community Diagnosis type of assessment responds to a particular need ELEMENTS OF COMPREHENSIVE COMMUNITY DIAGNOSIS 1. Syphilis. CDR & Life expectancy rate iv. ▪ Ethnicity ▪ Social class ▪ Language ▪ Religion ▪ Race ▪ Political orientation . Ascaris. sustainable preventive and vector control meas Dengue H-fever 4 o‘clock habit Programs on Measles. Chemoprophylaxis – Chloroquine taken at weekly intervals. lips or mouth to provide immediate protection RPO – immunization of pets at 3 mos.no need for ttt.g. betadine or alcohol may be applied If dog is healthy observe for 14 days. house spraying. tetracycline. Counseling/ Education .Gonorrhea.Hep B vaccination . quinidine Insecticide treatment of mosquito nets. Trichomoniasis. Social indicators Communication network Transportation system Educational level Housing conditions ii. Environmental indicators Physical/geographical/topographical characteristics Water supply Waste disposal Air. from boiling point or chlorination Prevention and Control on Leptospirosis/ Weil’s Disease/ Mud fever/Flood fever/ Spirochetal Jaundice thru contact with the skin/ open wound with water or moist soil contaminated with urine of infected rat And Rabies Mgt. Prevention and Control Program on Parasitic Infestations ( STH e. Total population & Geographical distribution including Urban-Rural index & Population Density ii. stream seeding and clearing. Deworming 2.2. Anti-malarial drugs – sulfadoxine.

Planning is change-oriented. Situational Analysis gather health data tabulate. Numerical data . accuracy and reliability of the information collected.Cultural beliefs and practices that affect health Concepts about Health and Illness 3. health resources or health related problems b. and will also decide on the sources of these data. Identifying Community Health Nursing Problems a. DATA COLLATION – the nurse is now ready to put together all the information. DEVELOPING THE INSTRUMENT instruments/tools facilitate the nurse‘s data-gathering activities. Health Status Problems Increased/decreased morbidity. 1. 10. Planning is a systematic process. environmental and political factors that aggravate the illness-inducing situations in the community 11. 4.narrative reports numerical data. Health Related Problems Existence of social. Magnitude of the problem Severity of the problem which can be measured in terms of the proportion of the population affected by the problem c. controlling or eradicating the problem d. ACTUAL DATA GATHERING – the nurse supervises the data collectors by checking the filled-up instruments in terms of completeness. Planning is flexible. Most common instruments : survey questionnaire interview guide observation checklist 6.table or graphs 9. DETERMINING THE OBJECTIVES – the nurse decides on the depth and scope of the data she needs to gather. Political/Leadership patterns Reflects the action potential of the state and its people to address the health needs and problems of the community Mirrors the sensitivity of the government to the people‘s struggle for better lives PROCESS OF COMMUNITY DIAGNOSIS Consists of. Analyzing & interpreting health data Seek explanations for the occurrence of health needs and problems of the community 3. analyze and interpret data identify health problems 7. money. 1. materials or institutions necessary to solve health problems c. mortality fertility or reduced capability for wellness b. COLLECTING THE DATA – the nurse decides on the specific methods depending on the type of data to be generated. interview. Preventive potential Probability of controlling or reducing the effects posed by the problem e. Ocular survey. Health & illness patterns Leading cause of mortality Leading cause of morbidity Leading cause of infant mortality Leading cause of maternal mortality Leading cause of hospital admission 4. organizing & synthesizing data In order to identify the different factors that may directly or indirectly influence the health of the population 2. Health resources Manpower resources Material resources 5. Formulation of Community Health Nursing Diagnoses Will become the bases for developing and implementing community health nursing interventions and strategies STEPS IN CONDUCTING COMMUNITY DIAGNOSIS Descriptive data 8. Planning is a continuous and dynamic process. DATA PRESENTATION – will depend largely on the type of data obtained. Priority-setting a. DEFINING THE STUDY POPULATION – the nurse identifies the population group to be included in the study. Collecting. Social concern Perception of the population or the community as they are affected by the problem and their readiness to act on the problem PLANNING WHAT IS PLANNING? is a process that entails formulation of steps to be undertaken in the future in order to achieve a desired end. DETERMINING THE DATA TO BE COLLECTED – the objectives will guide the nurse in identifying the specific data she will collect. Health Resources Problems Lack of or absence of manpower. Modifiability of the problem Probability of reducing. DATA ANALYSIS – aims to establish trends and patterns in terms of health needs and problems of the community. Nature of the condition/problem presented Classified as health status. 3. 5. 2. Descriptive. THE PLANNING CYCLE: 1. economic. Concepts of Planning: Planning is futuristic. and records review.

Health risk profile (social. Change in ideology Knowledge. Demography 2.exposure to long term unemployment. opportunities and resources involved in initiating community health action . Assessing community capacity 1. Grass-roots. Implementation 4. Perception on the importance of the problem vi. COMMUNITY ORGANIZING A process whereby the community members develop the capability to assess their health needs and problems. Community interest 2. Welfare approach People esp. plan and implement actions to solve these problems. People participation 2. Demographic. is from the people to the people c. Types: a. social and economic profile of the community derived from secondary data.set priority 5. Choose an organizational structure. structure and resources) b. good listener and conflict resolution skills. Vital statistics 3. Strategy/Activity Setting Design CHN Program Ascertain resources Analyze constraints and limitations 4. 3. exploited and deprived sectors are most open to change. Evaluation determines outcomes specify criteria and standards Application of Public Health Tools (discuss in separate slide) Three important tools The health disciplines of 1. health education planning and mapping 5 components of community analysis 1. Assessing readiness to change 1. c. Maybe referred to as community diagnosis. behavioural and environmental risks) Behavioural. CO is based on the ff: a. Assessing community barriers v. Design and initiation 3. Defining the community 1. Establish a core planning group and select a local organizer.a group of citizens (510) emerge to form a partnership with . Epidemiology 3.Design and initiation STEPS: 2. Coalition. 5. The solutions of problems commonly shared by these sectors must be focused on collective organizations. e. Hence . Provide a community profile of the needs and resources and will become the Basis for designing prospective community interventions for health promotion 2.existing local leaders working for a common cause b. Studies conducted in certain target groups Steps in community analysis Steps in community analysis i. have the capacity to change and are able to bring about change. Requirements: Select 5-8 member in charge for core planning and management of the program With management skills. Change agents Capacity to influence others by setting a good example. Power must reside in the people b. Technological approach must be based on the poorest sectors of society. Principles of CO: 1. Determining the geographic boundaries of the target community ii. Collecting data iii.informal structures in the community like the neighbourhood residents.dietary habits and other life style concerns like alcohol.linking organizations and groups to work on community issues. 1. 2. Survey of current health promotion programs. planning and action 3. Health/wellness out comes profile (morbidity/mortality data) 4. Community analysis 2. ―lead‖ or official agency. This activate the community participation. the oppressed.a single agency takes the primary responsibility of a liaison for health promotion activities in the community.Community analysis The process of assessing and defining needs. Program maintenance – consolidation d. Synthesis data and set priorities 1. Social changes Building up social organizations (relationships. put up sustain organizational structures which will support and monitor implementation of health initiatives by the people maglaya COMMUNITY ORGANIZING Purpose: Empowerment or building the capability of people for future community action Approaches to community development a. low education and isolation. Entails an evaluation of the driving forces which may facilitate or impede the advocated change iv. beliefs and attitude c. Citizens panels. Dissemination – reassessment 1. Leadership board council. tobacco and drugs Social indicators. Transformatory approah should lead to self-reliant communities Five stages 1. Goal and Objective Setting define program goals and objectives assign priorities among objectives 3. 2. Development. community needs assessment.

Networks and consortia. respect. 6. Continuous feedback to the community on results of activities enhances visibility and acceptance of the organization. b. This may mean revision of goals and objectives and development of new strategies. Dissemination of information is vital to gain and maintain community support. Quantitative and qualitative methods of evaluation can be used to determine participation. values and norms have to be incorporated into the program. Community members may have to constantly monitor implementation steps. a dissemination plan may be helpful in diffusion of information to further boost support to the organization‘s endeavour. non-profit institution. select and recruit organizational members. Use comprehensive. who. Define the organization mission and goals. who. Generate broad citizen participation How? ▪ Organizing task force. Clarify roles and responsibilities of people involved in the organization. Thus. support and behavior change level of decision making and other factors deemed important to the program. Develop a sequential work plan Activities should be planned sequentially. b. Recognition of the programs accomplishment and individuals contribution to the success of the program and boost morale of the members. c. resources and participation? This may necessitate reorganization and new collaboration with other organizations.Program maintenance – consolidation The program a this point has experienced some degree of success and has weathered through implementation problems. times has to be modified as events unfold. Establish an ongoing recruitment plan. Dissemination-Reassessment Continuous assessment is part of the monitoring aspect in the management of the program a. This is done to establish a smooth working relationship and avoid overlapping of responsibilities. Disseminate results. 3. d. Maintenance: a. materials and messages. This is a result of good group process based on trust. Is there a change in leadership. Provide training and recognition. with appropriate guidance can provide the necessary support. Often.the government agency. 5. Establish a positive organizational culture. c. Chart future directories and modifications. which serves as a resource center assisting institutions and agencies through programs and projects geared toward the social human development of rural and urban communities Formerly known as The Population Center Foundation HISTORY OF HRDP HRDP I Trained the faculty. A positive environment is a critical element in maintaining cooperation and preventing fast turnover of members. a. where. Chosen representative have power for the group they represents 4. Identify. 4. medical/nursing students to provide health care services to the far flung barrios because of lack of man power for health services at the same time that similar activities fulfilled the curricular requirements of the f. As much as possible different groups. The Health Resource Development Program Community Health Organizing Utilizing COPAR HRDP Was developed and sponsored by the Philippine Center for Population and Development (PCPD) To make health services available and accessible to depressed and underserved communities in the Philippines PCPD is a non-stock.Implementation -put the design plan into action. It should be expected that volunteers may leave the organization. c. Some organization die because of the lack of visibility. Update the community analysis. This will specify the what. integrated strategies Generally the program utilize more than one strategies that must complement each other. d.network develop because of a certain concerns 3. The community language. the organization and program is gaining acceptance in the community. Integrate community values into the programs. Revitalization of collaboration and networking may be vital in support of new ventures. organizations sectors should be represented. 5. Summarize and disseminate results. . The organization and program is gaining acceptance in the community. b. Assess effectiveness of interventions/programs. and openness. Active involvement in planning and management of programs may require skills development training. when and extent of the organizational objectives. This requires a built in mechanisms for continuous recruitment and training of new members. d. Integrate intervention activities into community networks This can be affected through implementation problems.

o Consult key informants and residents. Formulate plans for institutionalizing COPAR. Make long/short list of potential communities. Identifying Potential Barangay o Do the same process as in selecting municipality. ENTRY PHASE 3. o No similar group or organization holding the same program. there were trained workers and organized health groups to take care of the needs of the community HISTORY OF HRDP HRDP III PCPD refined the program and resulted to what is now called HRDP III. their CI‘s and indigenous health workers are trained for community health work and around which all other project inputs will revolve HISTORY OF HRDP Community organizing as the main strategy to be employed in preparing the communities to develop their community health care systems and the establishment of community health organization to manage the community health programs Organizing work in the communities were done in 3 phases PAR as fascinating strategy for maximum community involvement through collective identification and analysis of community health problems and collective health action Available funds to finance community initiated projects COPAR? Since Management Leadership and Jurisprudence are courses taught in the classroom members of this group of students were trained to manage and acts as leaders of the different levels of the students who were involved in COPAR Principles of management were applied in carrying out primary health care The community members.students for public health The PCPD provides seed money for the income generating projects The CO uses his/her own strategy or method in developing the community Short-term service HISTORY OF HRDP HRDP II The 2nd cycle uses the same strategy but the program could not be sustained by the schools or hospitals and the incomegenerating projects eventually become the hindrance to the goal of achieving the health program because the people tend to be more interested in the income generated by the projects Both HRDP I and HRDP II have brought about some changes in the community life of the people Established basic health infrastructure. CHW‘s and leaders were empowered to manage their own health projects Conducted seminars and trainings as well as health education and services needed by community(exposure and immersion 6-8 weeks) THE HRDP-COPAR PROCESS 1. Criteria for Initial Site Selection o Must have a population of 100-200 families. o Take note of political development. basic health services were increased. o Economically depressed. . COMMUNITY STUDY/DIAGNOSIS PHASE/RESEARCH PHASE 4. COMMUNITY ACTION PHASE 6. Revise/enrich curriculum and immersion program. Pre-Entry Phase Preparation of the Institution Train faculty and students in COPAR. o Determine the need of the program in the community. o Pay courtesy call to community leaders. o Develop survey tools. o Should not belong to the rich segment. Coordinate participants of other departments. SUSTENANCE AND STRENGTHENING PHASE 1. o No strong resistance from the community. o Choose foster families based on guidelines. Do ocular survey of listed communities. Site Selection Initial networking with local government. o Develop community profiles for secondary data. Conduct preliminary special investigation. Identifying Host Family o House is strategically located in the community. PRE-ENTRY PHASE 2. o Coordinate with local government and NGOs for future activities. which has these unique features: ▪ Comprehensive training of the staff and faculty of the participating agency in which the community work was initiated ▪ Periodic training program and regular assistance to the participating agency were provided to strengthen the health outreach program to become community oriented ▪ PHC as the approach with which all nursing/medical students. Choosing Final Barangay o Conduct informal interviews with community residents and key informants. o No serious peace and order problem. COMMUNITY ORGANIZATION AND CAPABILITYBUILDING PHASE 5.

Prevention and Control of Cardiovascular Diseases heart – 1st leading cause of death blood vessels . Three major forms of treatment of cancer: Surgery Radiation Therapy Chemotherapy 3. primary or essential 5. Program on Mental Health and Mental Disorders 6. Programs on Blindness. patent ductus arteriosus. Smoking Minor RF: stress. DM.approach by key persons Isolates . maintenance of ideal body wt. Hypertension: Persistent elevation of the arterial blood pressure. aortic and pulmonary stenosis.approached by most people Opinion leader . Key persons .frequent among females but severe. skin cancer. Prevention and Control of Kidney Disease 5. results relayed through community assembly Leader Spotting Through Sociogram. Cancer Prevention and Early Detection Any malignant tumor arising from the abnormal and uncontrolled division of cells causing the destruction in the surrounding tissues. cervical cancer. primary or essential) . prostate cancer. and cyanosis. Prevention and Control of Cardiovascular Diseases 2. maternal diseases or genetic aberrations 2. Deafness and Osteoporosis 1. Cancer Prevention and Early Detection 3.establishing rapport with the people in continuing effort to imbibe community life. most prevalent in . speech. Nat‘l Diabetes Prevention and Control Program 4. Hypertension 4. regular BP check up 2. colon cancer. Rheumatic Fever or Rheumatic Heart Disease: Systematic inflammatory disease that may develop as a delayed reaction to repeated and an inadequately treated infection of the upper respiratory tract by group A beta-hemolytic streptococci. Ischemic Heart Disease/ Atherosclerosis: Condition usually caused by the occlusion of the coronary arteries by thrombus or clot formation. 2. o Avoid raising the consciousness of the community residents. cancer of the mouth. Activities in the Entry Phase Integration .) Incidence can only be reduced thru prevention and early detection NINE WARNING SIGNS OF CANCER: Change in blood bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty in swallowing Obvious change in wart or mole Nagging cough or hoarseness Unexplained anemia Sudden unexplained weight loss Prevention & Early Detection PRINCIPLES OF TREATMENT OF MALIGNANT DISEASES One third of all cancers are curable if detected early and treated properly.Nat‘l Diabetes Prevention and Control Program Aim: Controlling and assimilating healthy lifestyle in the Filipino culture ( 2005-2010) thru IEC 3. strong family history. diet . higher among males than females for the latter are protected by estrogen before menopause PF: HPN.never or hardly consulted 4. 4. behavior and lifestyle should be in keeping with those of the community residents without disregard of their being role model. Congenital Heart Disease (CHD): 2. Entry Phase Guidelines for Entry o Recognize the role of local authorities by paying them visits to inform their presence and activities. Program on the Elderly/Geriatric Nursing Services 9.malignant form is more common among males 5.low fat 3.NCD prevention and control program 1. breast cancer. alcohol/smoking avoidance 4. o Her appearance.o Respected by both formal and informal leaders. Program on Drug Dependence/ Substance Abuse 7. o No member of the host family should be moving out in the community. 2. obesity CVD CVD Primary Prevention: CVD Primary Prevention thru health education is the main focus of the program: 1. o Neighbours are not hesitant to enter the house.2nd Types: 1. Common Cancer: Lung cancer. Community-Based Rehabilitation Program 8. adopt a low-key profile.Congenital Heart Disease (CHD): Result of the abnormal development of the heart that exhibits septal defect. § living with the community § seek out to converse with people where they usually congregate § lend a hand in household chores § avoid gambling and drinking Deepening social investigation/community study verification and enrichment of data collected from initial survey conduct baseline survey by students. Ischemic Heart Disease/ Atherosclerosis 1. Rheumatic Fever or Rheumatic Heart Disease children Causes: environmental factors. Exercise 5. 3rd leading cause of illness and death ( Phil. 3.

Goal: To improve the quality of life and increase productivity of disabled. HPN.migration 4. LGUs – direct implementers of health programs & prime developers of health centers and hospitals making services accessible to every Filipino Pillars of SSM 1. alcohol. DHF. including impaired.: 1. Program on Drug Dependence/ Substance Abuse 7. and conduction of urine.. A & iron. The Public Health Nurse Definition and terms: Public Health Nursing refers to the practice of nursing in local/national health departments (which includes health . Program on Mental Health and Mental Disorders 6. provide quality services .Programs on Blindness. bronchitis. 5. 8. Awards Expected Outcome: SSM Empowered individuals adopting healthy lifestyle. collection. Quality Assurance 2. avoidance of alcohol. Sentrong Sigla Movement ( SSM) -a certification recognition program which develops and promotes standards for health facilities .main cause of childhood blindness.main cause Prevention of NCD/Role of Nursing in Health Promotion And Advocacy Yosi Kadiri. MENOPAUSE. measles. low fat. pneumonia. Urinary Tract Obstruction: A condition wherein the urine flow is blocked or clogged. iwas stress. diarrhea. handicapped persons. social welfare. health. Chronic Renal Failure: A progressive deterioration of renal function that ends as uremia and its complications unless dialysis or kidney transplant is performed.main causes of blindness VAD. CCOPD Malignant neoplasms Diabetes Nephritis Accidents 9. endocrine. disabled and handicapped persons as well. malaria) Involves family members and community in the health care process for physical growth and mental development & disease prevention IV. early detection and provision of rehabilitation services at the community level. Health Promotion 4. Flour-Vit. Deafness and Osteoporosis Cataract. Salt. . and metabolic functions.DOH – provides technical and financial assistance packages for health care 2. children below 6 yrs.Prevention and Control of Kidney Disease Acute or Rapidly Progressive Renal Failure : A sudden decline in renal function resulting from the failure of the renal circulation or by glomerular or tubular damage causing the accumulation of substances that is normally eliminated in the urine in the body fluids leading to disruption in homeostatic. Neprolithiasis: A disorder characterized by the presence of calculi in the kidney. old Osteoporosis special problem in women. smoking. or disease of the blood vessels. which involves measures taken at the community level to use and build on the resources of the community with the community people. improved health-seeking behavior and well-being & increased demand for quality health services Institutions will develop policies. highest bet. Oil and sugar – Vit. most serious eye problem of Fil. of the heart. Grant and Technical Assistance 3. pneumonia. TB. Acute Nephritis: A severe inflammation of the kidney caused by infection.Community-Based Rehabilitation Program A creative application of the primary health care approach in rehabilitation services. body wt. employment and labor. income. malaria. Renal Tubular Defects: An abnormal condition in the reabsorption of selected materials back into the blood and secretion. recreation. old. A.Main Concern: modifiable risk factors( diet. no smoking.iodine Integrated Management of Childhood Illness ( IMCI) Integrates management of most common childhood problems ( diarrhea.anti smoking Edi Exercise/Hataw-regular physical activity Tiya Kulit/ Iwas Sakit Diet-low salt. degenerative disease. education. healthy diet. malnutrition. birth wt. institute system for surveillance/ merits and advocate for laws Programs: SSM EPI Disease Surveillance CARI CDD Nutrition/ Micronutrient Supplementation*Food Fortification : Rice –iron. stress. Nephrotic Syndrome: A clinical disorder of excessive leakage of plasma proteins into the urine because of increased permeability of the glomerular capillary membrane Urinary Tract Infection: A disease caused by the presence of pathogenic microorganisms in the urinary tract with or without signs and symptoms. diseases. high fiber diet Mag HL – exercise. watch wt. culltural activities and housing Leading causes of illness:elderly Influenza. security.Joint effort bet. chickenpox Leading causes of death:elderly Diseases of heart and vascular system Pneumonia. sedentary living. Aim: To reduce the prevalence of disability through prevention. TB. Program on the Elderly/Geriatric Nursing Services 7 humanitarian issues: family. malignant neoplasm. 50—79 yrs.

personnel and administrators on the importance of the promotive and preventive aspects of health through health education. 3. government agencies. 9 Duties and responsibilities of the school nurses 1. Management function Inherent in the practice of PHN Organizes the nursing service of the local health agency Applications of 5 management Functions ―POSDC‖ in organizing the nursing service and the local health agency. teaching and non teaching personnel of the schools. Community organizing 4. Community outreach E. Collaborating and coordinating function Care coordinators for communities and their members Establishes linkages and collaborative relationships with other health professionals. private sectors. Community health nursing process 2. Conduct and participate in researches related to nursing care. teenage pregnancy. 3. Referrals and follow-up of pupils and personnel 6. Recording and reporting 7. Health advocacy 2. Training function Initiates the formulation of staff development and training programs for midwives and other auxiliary workers 7. Establish/ strengthen linkages with government and non-government organization/agencies ▪ for school community health work. Supervisory function Supervisor of the midwives and other health workers 3. Nursing care function Inherent function of the nurse Based on the science of art and caring Caring for all levels of clientele toward health promotion and disease prevention 4. NGO‘s people‘s organizations to address health problems 5.: ▪ attending community assemblies . Health and nutrition assessment including other screening procedures such as vision and hearing. Nursing procedures during clinic and home visits 3. 6 Specific : 1.Malnutrition. nutrition division Objectives of School Nursing Genera l: To promote and maintain the health of the school populace by proving comprehensive and quality nursing care. Health promotion and education function Activities goes beyond health teachings and health information campaigns 6.centers and rural health units) and schools. Provide quality nursing service to the school population 2. reduce risk taking behaviour and focus on issues such as prevention of drug and substance abuse.g. Create awareness among children. health 4 sections Medical Dental Nursing Health education 2. Surveillance 6. 5. CD and NCD founded by: Lillian Wald (1902) a member of the professional educational employed to aid students in developing their full health potential in health and education HNC (health and Nutrition Center) of the DepEd Mandated to safeguard the health and nutritional well-being of the total school population. Supervision of the health and safety of the school plant. 5. 4.. STD. Treatment of common ailments and attending to emergency cases. Providing nursing personnel with opportunities for continuing education and training. 2. 2 division 1. Research function Participates in the conduct of research and utilizes research findings in her practice Disease surveillance ▪ Measure the magnitude of the problem ▪ Measure the effect of the control program Competencies and skills 1. Home visits 7. Health promotion and education 5. Encourage the provision of standard functional facilities 4. SPECIAL FIELDS IN COMMUNITY HEALTH NURSING School nursing and occupational health nursing School nursing A type of public health nursing that focuses on the promotion of health and wellness of the pupils/students. It is a community health nursing practice in the public sector Public Health Nurses Refers to the nurses in the local/national health departments or public schools whether their official position title is public health nurse or nurse or school nurse Leaders in providing quality health services to the communities First level of health workers to be knowledgeable about new public health technologies and methodologies Usually the first ones to be trained to implement new programs and apply new technologies Qualifications Must be professionally qualified and licensed to practice in the arena of public health nursing Consistent with the nursing law of 2002 (RA 9173) 7 Roles and Functions 1. 6. The primary role is to support the student learning and ensure that educational potential is not hampered by unmet health needs Assist the students in making choices for a healthy life style. epidemiology IV.

classroom and others rooms. 5. arrangement of seats.▪ and organizing school community health councils. Health habits 4. school clinics. space and sanitation. and student) 10. location. Organization of school-Community Health and Nutrition Councils Membership shall come from both school and community This attend to the health related problems and concerns 12. Health counselling skills 3. school canteen. Attendance to emergency cases 9. DepEd <10 years old=weight for age and height for age >10 years old= BMI Appropriate school feeding programs with rice. ventilation. water supplies. Monitoring and evaluation of programs and projects. ball pen click.A. pupils and parents 11. parents and students Encourage the importance of immunization for prevention 13. Good oral and written communication skills 5. Rapid Classroom Inspection( after holidays and epidemics but not to exceed more than a month except for cases of epidemics) Procedure same as HA Purpose: Detect cases of CD Note the correction that have been made Note if the eyeglasses are correctly adjusted Note the general cleanliness of the students Note new ailments. Skills and competencies 1.for data and planning purposes Survey of the ff: current health situation and nutritional status Facilities Health education activities 2. Establishment of Data Bank on School Health and Nutrition Activities Treatment in the school clinic Record of the school visit Health assessment report of the school health personnel Health and nutritional status of pupils/students Form 86 of teaching and non teaching personnel Teachers health profile Records of attended emergency case Inventory of clinic and equipment supplies Health and nutrition activities in school Record of accomplishment of school health services Records of officers/ officials of the School-Community Health Council and their accomplishment Action plan 14. 15. teacher. Life skills 16 function of the school nurse Training programs. Student health counselling( for student who manifest the physical and emotional symptoms) (parents. Medical referrals 8. area. Social mobilization skills 4.) 6. Recording and reporting of accomplishments 9. Assessment and screening skills 2. Communicable disease control In participation of both the teachers. sanitation. conversation voice test. lighting. Ear examination Methods: Observation Examination by using penlight or otoscope Screening test (whisper test. School plant inspection for healthy environment Others concerns: school site. 16. conferences/workshops for teachers. Basic management skills 6. Standard vision testing for school children (20/20) a Purpose: Screen students with poor visual acuity and indentify other ocular problems Refer students with eye disease and errors of refraction for further examination and management. Health assessment (every year or with epidemics) Purpose: detect the signs of illness and physical defects for early correction. School health and nutritional survey (from 1st visit and Qyr). 8. Home visitation Indication: Pupils whose parents are afraid of some medical procedures Pupils who get re-infected because of home conditions Pupils suffering from CD Pupils who are absent frequently because of sickness 1. Putting up a school clinic (R. Health and nutrition education activities . milk or fortified noodles are given to children with below normal nutritional status for 120 feeding days Deworming is a pre requite prior to feeding Consent from parent is pre requisite prior to deworming 7. Height and weight measurement and nutritional status determination Height and weight measurement is a procedure for evaluating the tallness or the shortness and the heaviness of a pupil. 124) 3. Inspect for the size.

install and maintain in good condition all control facilities and protective barriers for potential and actual hazards. and treatment of workrelated diseases and injuries. C.study and describe the toxic properties of agents used in work application to which workers may be exposed. mission To ensure so far as possible every working man in the country is safe and in healthful working conditions Occupational Health Team 1.study and describe the natural history of occupational diseases and injuries in population groups. epidemiologists. Work with the occupational health team to lead the sanitary hygiene of all industrial establishment including hospitals to determine their compliance with the sanitation code and its implementing rules and regulations 2. safety engineer. ergonomist. pathology. the presence or absence of disability. 7. 3.design the tools. and machines used in manufacturing and other work applications 8. their tools. toxicologist. Participate to provide.Pupils who are malnourished. Provide control measures to reduce noise. sex. Attends to complaints of all establishment in the area of assignment related to industrial hygiene and recommends appropriate measures for immediate compliance. Ergonomists. Recommends to Local Health Authority the issuance of license/ business permits and suspensions or revocation of the same for any violations of the conditions upon which said licenses or permits had been issued. Community Assessment : Identify the demographic data on ▪ disease trends including morbidity and mortality statistics. occupational health therapist E. •Occupational health nursing By American Association of Occupational Health • The special practice that provides for and delivers health care services to workers and worker populations. protection. Occupational Health Nurses 2. medical technologist. Provide employees an occupational health services and facilities 11. 9. physician. Application: Primary prevention A program to ensure the health of prospective employees/ workers includes . pursuant to existing rules and regulation. toxicologists. equipment. 5. 7. 3. Environmental engineers. ergonomics D. epidemiologist. By PNA – ANSAP. Refers or elevate to higher authority all unresolved issues in relation to occupational and environmental. Safety Hazards engineers. Team Approach Collaboration with occupational health team for the development of comprehensive occupational health program Industrial hygienist. and reducing health hazards. and promote the healthy interface of humans. ▪ and social environmental conditions ▪ that will provide pertinent information for the establishment of priorities in planning and implementing occupational health programs B. Program Planning and Implementation Goal: promotion of wellness and prevention of illness and injury among workers. 5. Types of Classification: Age. and occupational health nurses make independent nursing judgments in providing occupational health services. The foundation of occupational health nursing practice is research-based with an emphasis on optimizing health. and restoration of workers’ health within the context of a safe and health work environment. Application of Epidemiology To determine relationship of work and injury or illness Methods use: Toxicology. preventing illness and injury. Worker Assessment: Assessment of the workforce to determine populations at risk for occupationally related injury or illness. Industrial engineers. 6. Coordinates with other governments agencies relative to the implementation of the implementing rules and regulations 4. and their work. The practice focuses on promotion. 4. health problems 12. Informs all affected workers regarding the nature hazards and the reasons for the control measures and protective equiptment. type of work. Prepare and submit yearly reports to the local and national Government Application of Public Health Principles to Occupational Health Nursing A.concentrate on environmental controls to limit environmental pollution and achieve a healthy environment. Industrial hygienists-recognize.focus on the prevention of occupational injuries and the maintenance or creation of safe workplaces and safe work practices. evaluate. and control toxic exposures and hazards in the work environment. It is primarily geared at helping workers attain and maintain optimum level of physical and psychological functioning. dust. Makes a periodic testing for physical examination of the workers and other health examination related to workers exposure to potential or actual hazards in the work place 8. health and other hazards.focus on the prevention. 9. 1982 •Is aimed at assisting workers in all occupations to cope with actual and potential stresses in relation to their work and work environment. Occupational physicians. 6.study design. Function of Public Health Nurse as an Occupational Health Nurse 1. detection. occupational health nurse. Ensure strict compliance on the regular use and proper maintenance of Personal Protective Equipment (PPE) 10. Occupational health nursing is autonomous. race.

ingestion. Mists. and vibration. insufficient training and education regarding job requirements. Radiation. Chronic: NIHL. racial inequality. V/S f. Maintenance of that level is provided through appropriate job placement. B. fungi. shift work. health care workers are exposed to chemical hazards such as anaesthetic gases. repeated awkward movements with hand-held tools. extreme temperature. microwaves. role conflict.is any injury. leadership and management styles. bacteria. Specifically. skin burns. substance abuse. IPPA e. or amputation that results from a single incident in the work environment. electric and magnetic field. metals. biological research and animal handling) have a high incidence of infectious diseases. lasers. Referral to Community Resources G. and visual. fatigue. mold. occupational asthma. eye injuries from infrared radiation. and absent or limited reward. hypersensitivity pneumonitis. skin rashes. sexual harassment. Chronic: Raynaud's syndrome from use of vibrating power tools. heat stress or stroke. gases.Occupational illness. poorly defines expectations and work instructions. solvents. birth defects and neurological disorders. Acute: acoustic trauma from excessive noise. or accidental injection. chemical burns. depression. fracture. caused by exposure to environmental factors associated with employment. noise. metal-fume fever. such as cut. mental illness.Occupational injury. or contaminated objects. aerosols. poisoning from accidental ingestion. Acute: respiratory irritation due to smoke. contaminated body fluids. surfaces Workers in certain occupations ( health care. increased BP. pesticides. local vibrations. g. frequent repetition of a limited movement. worksite violence. bronchogenic and GI carcinomas). Nutritional Assessment – height and weight measurements c. HIV and AIDS D.is any abnormal condition or disorder. disinfectant and detergents. pleural diseases. Secondary Prevention Applied once the health problems is not meet by primary prevention methods: Early detection and treatment of both work-and non-work related health problems Tertiary prevention: Rehabilitation toward workers disabled by occupational and non occupational problems Methods: Evaluation of current status Enhancement of employability. Vision Acuity Test/ Hearing Test d. Chronic: HPN. multiple myeloma and leukaemia's from exposure to ionizing radiation. skin and parasitic infections. Psychosocial Hazards: Often related to trauma to the nature of the job. and the physical condition in the work place. contact dermatitis and other dermatoses Chronic: cancers (mesothelioma. alcoholism. fatigue. Acute: increased HR. tissue fixative reagents. teratogenic or genetics effects induced by certain types of radiation. and appropriate job placement of employees Services: Physical occupational and speech therapy Vocational training Chronic pain clinics Remedial reading Mathematics program F. Appraisal of the General and Physical and Mental . sterilizing agents. Mechanical Hazards Mechanical agents may cause stress on the musculoskeletal or other body systems Hazards include inadequate work-station and tool design. chronic Hepa B. vapors. Physical Hazard Are agents within the work environment that may cause tissue damage or other physical harm. Program Evaluation Assessment of program to determine benefits in terms of decreasing loss of productivity related to employee health problems is carried out. oil synthetic textiles. overtime. unsafe working conditions. cuts or contusions. other than one resulting from a occupational injury. the job content. GI f. Acute: neck strain and other muscular fatigue from forceful exertion or awkward positioning. School Nursing Health assessment METHODS USED: a. Interpersonal conflict. Interview b. chemotherapeutic and antineoplastic agents. solvents. skin absorption. particulate matters (dusts and fumes). Chemical Hazards: Various forms of either synthetic or naturally occurring chemicals in the work environment may be potentially toxic or irritating to the body system through inhalation. mesothelioma C.a history and physical examination to assess level of wellness. latex and mercury. sleep disturbances. carpal tunnel syndrome Raynaud's syndrome E. Biological Hazards: Biological agents such as viruses. medications. explosives. sprain. Acute: self limiting infections such as colds and influenzas. Chronic: TB. limited autonomy. and pharmaceuticals. Issues In Occupational Health Nursing A. the organizational structure and culture. measles. CAD. or parasites may cause infection disease via direct contact with infected individuals/ animals.

Waste basket d. If 4. o Take note of political development. People. Recording PREPARATION: a. o Her appearance. Wash hand by the start of health assessment 4. Criteria for Initial Site Selection o Must have a population of 100-200 families. Site Selection o Initial networking with local government. o Neighbours are not hesitant to enter the house. COPAR prepares people/clients to eventually take over the management of a development program(s) in the future. Identifying Potential Barangay o Do the same process as in selecting municipality. ventilated. HANDS. o Formulate plans for institutionalizing COPAR. o Develop community profiles for secondary data. Refer cases that cannot be handle stat 5. 2. Stet should be use across the heart/ lung assessment e. o Coordinate with local government and NGOs for future activities. o No strong resistance from the community.. Nx conduct a classroom lecture to educate the pupils on what to do during the Health Assessment. Tongue dep. From head to foot b. Step/ sphygmo g. o Choose foster families based on guidelines. o Should not belong to the rich segment. o Pay courtesy call to community leaders. especially the most oppressed. exploited and deprived sectors are open to change. o Respected by both formal and informal leaders. screened room or a corner of the classroom b. ARMS. o Determine the need of the program in the community. have the capacity to change. o No similar group or organization holding the same program. TEETH Ask the child to open is mouth and say ―ah‖ to show his throat d. o No serious peace and order problem. 2 or 3 chairs according to need c. HAIR Ask the pupil to run his fingers through his hair several times Ask to show the nape by the pulling the hair up.Condition g. 2. speech. If the health personnel is of the opposite sex. lighted. AND FINGER NAILS: Ask the child to roll their sleeves Extend their arms Show hands one side first. Well. Assess the children one by one 5. o Consult key informants and residents. then the other Spread their finger b. Pre-Entry Phase Preparation of the Institution o Train faculty and students in COPAR. FEET/LEG Ask the girl to pull up her dress The boy his trousers to their knees Or you can observe while they performed marching i. EYES Ask the child to pull his lower lid using his index finger and ask him to look up c. Skin diseases c. Forms/ records PROCEDURES OF HEALTH ASSESSMENT 1. Inspection: a. performed the procedure in the presence of the same sex. o Make long/short list of potential communities. Entry Phase Guidelines for Entry o Recognize the role of local authorities by paying them visits to inform their presence and activities. COPAR should be based on the interest of the poorest sector of society. Phases of the COPAR Process 1. The result should be discuss to the teacher 3. NECK and CHEST Examine the neck Chest/ back should be auscultated g. 2. behavior and lifestyle should be in keeping with those of . community resources are mobilized for community services. and are able to bring about change. Hand washing facilities e. o No member of the host family should be moving out in the community. h. Signs of abnormal condition d. o Coordinate participants of other departments. EARS Ask the child to push back his hair behind his ear and pull the outer ear up. f. o Develop survey tools. Principles of COPAR 1. COPAR maximizes community participation and involvement. Identifying Host Family o House is strategically located in the community. o Do ocular survey of listed communities. penlight f. o Conduct preliminary special investigation. 2. Findings should be recorded during the assessment STEPS a. Choosing Final Barangay o Conduct informal interviews with community residents and key informants. GENERAL APPEARANCE IMPORTANT REMINDERS IN HA: 1. 3. NOSE Ask the child to place his 2nd finger on the tip of the nose and pull up his nose and extend his head backward e. 3-5 children at a time should be waiting for the assessment 3. o Revise/enrich curriculum and immersion program. Identifying Potential Municipalities o Make long/short list. slightly backward/ and then forward. o Economically depressed. Inform parents if the findings COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH (COPAR) Importance of COPAR COPAR is an important tool for community development and people empowerment as this helps the community workers to generate community participation in development activities. COPAR should lead to a self-reliant community and society.

the community residents without disregard of their being role model. adopt a low-key profile. Improve quality of prenatal and postnatal care Pregnant women should have at least four (4) prenatal visit 3. Recommended Schedule for Post Partum Care Visits G. delivery and puerperium Strategic thrusts for 2005-2010 1. OJT) to develop their style in managing their own concerns/programs. Micronutrient Supplementation D. childbirth and puerperium (25%) 2. Antenatal Registration 2. Tetanus Toxoid Immunization C.establishing rapport with the people in continuing effort to imbibe community life. Launch and implement Basic Emergency and Obstetric Care (BEMOC) strategy in coordination with DOH Entails establishment of facilities that provide emergency obstetric care for every 125. o Identification of secondary leaders. Antenatal Registration B. 3. implementing. Key Activities o Training of CHO for monitoring and implementing of community health program. the different committee’s setup in the organization-building phase is already expected to be functioning by way of planning. Sustenance and Strengthening Phase Occurs when the community organization has already been established and the community members are already actively participating in community-wide undertakings. MATERNAL HEALTH PROGRAM Tasked: to reduce MMR by three quarters by 2015 to achieve ( millennium Development Goal) MDG Maternal Mortality Rate (2003) CAUSE Other Complications related to pregnancy occurring in the course of labor. Monitor UO Do not give: ORS for both unconscious or with convulsions IVF if not trained to do so.never or hardly consulted 3. At this point. Clean and Safe delivery F.5ml Route: Intramuscularly Site: Right or Left Deltoid/Buttocks 3. Give IVF to prevent or correct shock. Postpartum hemorrhage (20. Treatment of Diseases and Other Conditions E.000 population and which are located strategically 2. Do not give anything PO 2. and evaluating community-wise activities. Key persons .approached by most people Opinion leader . Tilt head backwards (unless trauma is suspected) Lift chin to open airway Clear secretions from throat. Unconsciousness What to do? Keep on her back arms at the side. Unconsciousness 3. informal. Tetanus Toxoid Immunization Dose:0. Activities in the Entry Phase o Integration . If DOB and puffiness develops. o Implementation of livelihood projects. Hemorrhage related to pregnancy . Hypertension complicating pregnancy. Post partum bleeding 4.Difficulty of breathing/ obstruction of airway What to do? Clear the airway Place in her best position Refer woman to hospital with EmOC capabilities. results relayed through community assembly Leader Spotting Through Sociogram. Intestinal parasite infection 5. Pregnancy with abortive outcome (9%) 4. Post partum bleeding What to do?: Massage uterine and expel clots. o Conduct of mobilization on health and development concerns.3%) 3. stop the infusion. malaria 1. Importance of BF 1. Monitor BP and SOB every 15‘ Monitor fluid given. Difficulty of breathing/ obstruction of airway 2.approach by key persons Isolates . o Avoid raising the consciousness of the community residents. It is at this phase where the organized leaders or groups are being given training (formal. living with the community seek out to converse with people where they usually congregate lend a hand in household chores avoid gambling and drinking o Deepening social investigation/community study verification and enrichment of data collected from initial survey conduct baseline survey by students. If bleeding persist: 1. with the overall guidance from the community-wide organization. Reduce women‘s exposure to health risks Institutionalization of responsible parenthood 4. Treatment of Diseases and Other Conditions Types: 1. o Linkaging and networking. Stakeholders must advocate for health Resource generation and allocation for health services Essential Health Service Packages A. Micronutrient Supplementation 4. Organization-building Phase Entails the formation of more formal structure and the inclusion of more formal procedure of planning. Key Activities o Community Health Organization (CHO) preparation of legal requirements guidelines in the organization of the CHO by the core group election of officers o Research Team Committee o Planning Committee o Health Committee Organization o Others o Formation of by-laws by the CHO 4. implementing and evaluating their own programs.

Encourage to empty bladder and bowels to facilitate delivery of the baby. Intestinal parasite infection What to do? Give mebendazole 500mg tab. Encourage to drink but not eat as this may interfere surgery in case needed 3. for emergency signs. Provide non-traumatic delivery recognize complications Referred those complicated deliveries to high level of care Steps to follow during labor. frequency and duration of contractions and FHT. Monitor and manage the different stage of labour -watch out for any danger signs 1. Malaria What to do? Give sulfadoxin-pyrimethamine to woman from malaria endemic areas who are in 1st or 2nd pregnancy 500mg-25mg tab. Purpose: To deliver clean.. Clean and Safe delivery Presence of skilled birth attendant Purpose to ensure hygiene during labor and delivery.2mg IM and another dose after 15‘ Do not give: Mem to woman with eclampsia.▪ Place cupped palmed on uterine fundus and feel for state of contraction ▪ Massage fundus in a circular motion ▪ Apply bimanual uterine compression if mem treatment done and postpartum bleeding still persist. E. Of pregnancy ▪ This might cause congenital problem in the baby 5. Assess the woman in labor . Determine the stage of labor Uterine contractions Bulging vulva Leaking amniotic fluid Vaginal bleeding IE 5. Not to do: IE more frequently than Q 4hrs. First stage: active labor 4cms cervical dilatation What to do? Check Q30‘ for emergency signs Check Q4hrs. 3 tabs. Single dose anytime from 4-9mos. Panting can be done by breathing with open mouth with 2 short breaths followed by long breaths. membranes are not ruptured and no progress in cervical dilatation. safe and free from fatigue 1. BP and cervical dilatation. Of pregnancy if none was given in the past 6 mos. Make the woman comfortable Establish rapport with the client by greeting and interviewing to make her comfortable 3. preeclampsia or HPN 4. For fever. contractions are stronger and more frequent but not progress in cervical dilatation. Do a quick check upon admission for emergency signs: Unconscious/convulsion Vaginal bleeding Severe abdominal pain Looks very ill Severe headache with visual disturbance Severe breathing difficulty Fever Sever vomiting 2. 4. BP and . Give supportive care throughout labor. This prevent pushing at the end of the 1st stage 7. childbirth and immediate postpartum Please refer accordingly 1. ▪ Give ergometrine 0. Decide if the woman can safely deliver By assessing the condition of the client and not finding any indication that could harm the delivery of the baby 6. For fever. Record time of ROM and color of amniotic fluid Assess progress of labor ▪ Refer STAT to hospital with complete facilities for the ff condition: ▪ If after 8hrs. Encourage to take a bath at the onset of labor 2. First stage: not in active labor Cervix: 3cms Contraction: weak Frequency: < 2 to 10‘ What to do? Check Q 1hr. with or without membranes ruptured It is false labor if after 8hrs there is no increase in contractions.to determine the status during labor LMP Number of pregnancy Start of labor pains Age/height Danger signs of pregnancy Taking the history through interview will help determine the client‘s condition during delivery of baby 4. pulse. Remind to empty the bladder every 2 hours. Do not give: Mebendazole in the 1st 1-3mos. pulse. At the beginning of 2nd to 3rd tri semesters not less than one month interval. Check Q 4hrs. Encourage to do breathing technique to help energy in pushing out the vagina.

Side Lying Position BEST FOR BABIES REDUCE INCIDENCE OF ALLERGENS ECONOMICAL ANTIBODIES PRESENT STOOL INOFFENSIVE (GOLDEN YELLOW) EMPERATURE ALWAYS IDEAL FRESH MILK NEVER GOES OFF EMOTIONALLY BONDING EASY ONCE ESTABLISHED DIGESTED EASILY IMMEDIATELY AVAILABLE NUTRITIONALLY OPTIMAL GASTROENTERITIS GREATLY REDUCED Environmental Health Program Environmental Sanitation and Promotion of Safe Water Supply Environmental Sanitation is defined as the study of all factors in the man‘s environment. c. =Provision for human milk bank. Cradle Hold = head and neck are supported 2. give carefully selected nutritious foods as supplements. RA 7600 THE ROOMING –IN and BREASTFEEDING ACT of 1992 =An act providing incentives to government and private health institutions promoting and practicing rooming-in and breast-feeding. d. Scheduled when to return for consultation for postpartum visit suffering from diarrheal diseases. emergency signs. The Rooming-In and Breastfeeding Act of 1992 A. Strengthens the infant‘s immune system. POSITIONS IN BF THE BABY: 1. education and re-education drive =Sanction and Regulation BABY Provides Antibodies Contains Lactoferin (binds with Iron) Leukocytes Contains Bifidus factor-promotes growth of the Lactobacillus-inhibits the growth of pathogenic bacilli For the Mother e. Saves medical costs to families and governments by preventing illnesses and by providing immediate postpartum contraception. Reduces the risk of ovarian and breast cancers and osteoporosis. Football Hold 3. visible descend of the had during contraction. teach and counsel the woman on important MCH messages: Birth registration Importance of BF Newborn Screening for babies delivered in RHU or at home within 48hrs up to 2 weeks after birth. preventing many infections. Breastfeeding provides physical and psychological benefits for children and mothers as well as economic benefits for families and societies. Monitor closely within 1hr. breast milk substitutes. Informs. 11. Recommended Schedule for Post Partum Care Visits G. Postpartum. BENEFITS : For infants a. especially to those . It will just exhaust the woman Do not give medication to speed of labor. supplies and fuel to prepare them. b. Reduces a woman‘s risk of excessive blood loss after birth f. =Information. Keep watch closely for at least 2hrs. infant formulas. Not to do: Do not apply fundal pressure to help deliver the baby Third stage: Between birth of the baby and delivery of the placenta What to do: Deliver the placenta Check the completeness of placenta and membranes Not to do: Do not squeeze or massage the abdomen to deliver the placenta 8. Exclusive breastfeeding is recommended for the first six months of life. Provides a nutritional complete food for the young infant. EO 51 THE MILK CODE – protection and promotion of breastfeeding to ensure the safe and adequate nutrition of infants through regulation of marketing of infant foods and related products. Conserves funds that otherwise would be spent on breast milk substitute. 9. Not to do: Do not allow woman to push unless delivery is imminent. At about six months. i. Provides a natural method of delaying pregnancies.g. g. After delivery and give supportive care. Educate and counsel on FP and provide FP method if available and decision was made by a woman. ) B. (e. feeding bottles. 10. FHR and mood and behavior Continue recording in the partograph. Importance of BF BREASTFEEDING Breast milk is best for babies up to 2 years old. Executive Order 51 B.cervical dilatation Record time of ROM and color of amniotic fluid Record finding in partographs/patient record. For the Family and Community h. Republic Act 7600 C. which exercise or may exercise deleterious effect on his well-being and F. Safely rehydrates and provides essential nutrients to a sick child. or bulging thin perineum and head visible What to do: Check Q 5‘ for perineum thinning and bulging. It may cause trauma to mother and the baby Second stage: Cervix: 10 cms. Continue care after 1hr. BREASTFEEDING/ LACTATION MANAGEMENT EDUCATION TRAINING Breastfeeding practices has been proved to be very beneficial to both mother and baby thus the creation of the following laws support the full implementation of this program: A. Reduces the infant‘s exposure to infection. teats etc.

Malnutrition is one of the problems that we have in the country.10 Institutional sanitation 1. Effectively and efficiently coordinate programs/projects/activities with other government and non-government agencies. HEALTH AND SANITATION -Environmental Sanitation is still a health problem in the country. malaria. its outreach is not more than 250 m from the farthest user yields 40-140 L/ min Level II ( Communal Faucet or Stand Posts) With a source. climate change and other conditions) NURSING RESPONSIBILITIES AND ACTIVITIES Health Education – IEC by conducting community assemblies and bench conferences. The man still tried to get the scorpion out of the water but the scorpion stung him again.5 Insect vector and rodent control 1. The Occupational Health Nurse.2 Food sanitation 1. School Health Nurse and other Nursing staff shall impart the need for an effective and efficient environmental sanitation in their places of work and in school. filariasis and dengue hemorrhagic fever DOH thru’ Environmental Health Services (EHS)unit is authorized to act on all issues and concernsin environment and health including the verycomprehensive Sanitation Code of the Philippines (PD 856. piped distributor network and household taps Fit for densely populated urban communities Requires minimum treatment or disinfection ENVIRONMENTAL SANITATION .11 Stream pollution PROPER EXCRETA AND SEWAGE DISPOSAL PROGRAM EHS sets policies on: Approved types of toilet facilities : LEVEL II – on site toilet facilities of the water carriage type with water-sealed and flush type with septic vault/tank disposal. -Water is a basic need for life and one factor in man‘s environment.the study of all factors in man‘s physical environment. schistossomiasis. well-being and survival.7 Air pollution 1. infectious hepatitis. Hospitals shall dispose their hazardous wastes thru incinerators or disinfectants to prevent transmission of nosocomial diseases PROGRAM ON HEALTH RISK MINIMIZATION DUE TO ENVIRONMENTAL POLLUTION Foci: 1. WATER SUPPLY SANITATION PROGRAM EHS sets policies on: Approved types of water facilities Unapproved type of water facility Access to safe and potable drinking water Water quality and monitoring surveillance Waterworks/Water system and well construction Approved type of water facilities Level 1 (Point Source). pathological and other wastes from hospital which combine them with the municipal or domestic wastes pose health hazards to the people. serves 15-25 households. policies on health protection measures 3.6 Housing 1. LEVEL III – water carriage types of toilet facilities connected to septic tanks and/or to sewerage system to treatment plant. Safe Water and Sanitation is necessary for basic promotion of health. Assist in the deworming activities for the school children and targeted groups. There was a man who saw a scorpion floundering around in the water. Water is necessary for the maintenance of healthy lifestyle.3 Refuse and garbage disposal 1. reservoir. Actively participate in environmental sanitation campaigns and projects in the community.8 Noise 1. intestinal parasitism. reservoir. -Other sanitation related diseases : tuberculosis.1 Water sanitation 1. Sanitary toilet campaign drive for proper garbage disposal. -One basic need of the family is food. Actively participate in the training component of the service like in Food Handler‘s Class. which may exercise a deleterious effect on his health. There are many food resources found in the communities but because of faulty preparation and lack of knowledge regarding proper food planning. researches on effects of GLOBAL WARMING to health (depletion of the stratosphere ozone layer which increases ultraviolet radiation.a protected well or a developed spring with an outlet but without a distribution system indicated for rural areas. 1978). parks drainage and other projects. And if food is properly prepared then one may be assured healthy family. Act as an advocate or facilitator to families in the community in matters of program/projects/activities on environmental health in coordination with other members of Rural Health Unit (RHU) especially the Rural Sanitary Inspectors. He decided to save it by stretching out his finger but the scorpion stung him. Be a role model for others in the community to emulate terms of cleanliness in the home and surrounding. -Diarrheal diseases ranked second in the leading causes of morbidity among the general population. beautification of home garden.4 Excreta disposal 1.9 Radiological Protection 1. Prevention of serious environmental hazards resulting from urban growth and industrialization 2. piped distribution network and communal faucets Located at not more than 25 m from the farthest house Delivers 40-80 L of water per capital per day to an average of 100 households Fit for rural areas where houses are densely clustered Level III ( Individual House Connections or Waterworks System) With a source. FOOD SANITATION PROGRAM -sets policy and practical programs to prevent and control food-borne diseases to alleviate the living conditions of the population HOSPITAL WASTE MANAGEMENT PROGRAM Disposal of infectious. Another man nearby told him to stop saving the . Ex. Includes: 1.survival. and attend training/workshops related to environmental health.

It‘s my nature to love. don‘t give up your goodness even if people around you sting… THE END See u next sem. why should I give up my nature to love just because it‘s the nature of the scorpion to sting?‖ Don‘t give up loving.scorpion but the man said. ―It‘s the nature of the scorpion to sting. .

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