August 7, 2020

FHC Lecture 1
(Sir Dennis)

FHC Exam -20% Rating

Study:
- Concepts
- Assessments
- Procedures

CONCEPTS OF MAN

MAN- is bio psychosocial and spiritual being

Bio- life
Psychological- capable of rational thinking
Social- man is able to establish relationship
- Man can’t live alone
- We need others to survive
Spiritual- man believes in one creator

NEEDS OF MAN (DR. ABRAHAM MASLOW)

HIERARCHY OF NEEDS

SELF- ACTUALIZATION

SELF-ESTEEM

LOVE AND BELONGINGNESS

SAFETY AND SECURITY

PHYSIOLOGIC NEEDS

NEEDS- essential for survival

WANTS- luho/ not essential

1. PHYSIOLOGIC NEEDS – Essential for survival EX: food, rest

(A-B-C-N-E-S)

A- AIRWAY
B- BREATHING
C- CIRCULATION
N- NUTRITION
E- ELIMINATION
S- SEX – PROCREATION- needed to the continuity of human race

2. SAFETY AND SECURITY – Freedom from psychological and physiological harm

Psychological- freedom from threat, anxieties, coercion with peace of mind
 Physiological- for the body’s physical safety and protection like shelter, clothing, medicine

3. LOVE AND BELONGINGNESS- acceptance, inclusion

Affection, the need to loved and be loved

4. SELF-ESTEEM- how you value yourself and others value you

How to increase: if you top board exam or other big achievements that will boost confidence
and honor and pride

5. SELF-ACTUALIZATION- maximizing our own potential

- Considers problems as a challenge
- Emotional maturity
- Being creative and flexible
- Consider needs of others (ALTRUISM- Selfless motive, give self for others Ex. Heroism)

STRESS- ACCDG. To HANS SELYE

- Nonspecific response of the body to any demand made upon it.

STRESSOR- Conditions that triggers stress

2 TYPES OF STRESSOR
1. Distress- negative stressors Ex: noise
2. Eustress- positive/normal, has positive effects

ACCDG. TO WALTER CANON – for the body to be healthy it needs to adapt

HOMEOSTASIS- dynamic equilibrium/balance

- Internal milieu must be balance

2 MODES/MECAHNISM/TYPES OF ADAPTATION

1. GAS- GENERAL ADAPTATION SYNDROME

- When we are stress, our entire body reacts to the stress
- Systematic reaction of nervous system
3 STAGES OF GAS
 STAGE OF ALARM- body is aware of the stress (FIGHT/FLIGHT)
 STAGE OF RESISTANCE- our body adapts to the stress to bring body back to homeostasis
 STAGE OF EXHAUSTION-worn-out/ when the stress is prolonged or intense our body
leads to exhaustion
-it can happen in any stages

2. LAS- LOCAL ADAPTATION SYNDROME

- Specific part of the body reacts

SPECIFIC LOCAL DEFENSES

1. 1st LINE OF DEFENSE

- Intact skin, hair, cilia, sweating, coughing, sneezing, mucus
2. 2nd LINE OF DEFENSE
- Inflammatory response/inflammation
- Body’s response/ defense against infection/ tissue injury
 WHAT HAPPENS IF THERE IS INJURY IN THE BODY?
- Vasodilation
- Increase body supply
- Redness (RUBOR)
- Heat (PALOR) CARDINAL SIGNS OF INFECTION
- Edema (TUMOR)
- Pain (DOLOR)

3. 3RD LINE OF DEFENSE

- Leukocytes (WBC) – soldiers of the body/ fights foreign objects in the body

2 groups

GRANULOCYTES
- Neutrophils – 1st to arrive
- Eosinophil- allergic reaction
- Basophils- blood clotting

AGRANULOCYTES
- Lymphocytes- synthesized immunoglobulins
- B-lymphocytes- antibodies
- Monocytes- scavenger cells (engulf foreign bodies /phagocytosis)

4. 4TH LINE OF DEFENSE

- Immunoglobulins (natural antibodies)
IgG- most dominant/ more exported via placental transfer
IgA- pass through externally via breast milk
IgM- increase/ present when there is viral/ bacterial infection
IgD- Beta cell maturation
IgE- increase/ present when there is allergies

CONCEPTS OF HEALTH

WHO- HEALTH- is the state of complete physical, mental, emotional and social well-being but
not merely the absence of disease or infirmity.

CLAUDE BERNARD- HEALTH- is the ability of the body to maintain homeostasis / maintain
internal milieu or balance

ECOLOGICAL MODEL- health and illness depends upon the interaction of epidemiologic TRIAD

- Agent
- Host
- Environment

HEALTH BELIEF MODEL- person’s perception in the health seeking behavior that affects his/her
complaint behavior.
CLINICAL MODEL- based on signs and symptoms
STAGES OF ILLNESS BEHAVIOR

1. SYMPTOMS EXPERIENCE
– person’s experiencing symptoms
- Usually ignores the symptoms
2. ASSUMPTIONS OF THE SICK ROLE
- Person’s acknowledges that he/she is sick
- Tries home remedies
3. MEDICAL CARE CONTACT
- If the symptoms persist, the client seeks/ consult medical advice
4. DEPENDENT CLIENT ROLE
- The client depends on the professional to relieve the signs and symptoms
5. CONVALESCENCE/ RECOVERY
- The signs and symptoms are gradually disappearing

CONCEPT OF HEALTH PROMOTION AND DISEASE PREVENTION

HEALTH PROMOTION
- enhance well-being
- Activities that enhances well-being
- No disease
- Approaches/ actions that will do
Ex: eating balance diet, exercise, adequate sleep, fogging, mental well-being

LEVELS OF PREVENTION

1. PRIMARY PREVENTION
- Iiwas
- Synonymous to prevention
- No disease/ avoidance behavior
- Avoid factors that may trigger/ cause the disease
- All actions/ activities directing towards avoidance probability of getting disease
Ex: vaccination, immunization, avoidance to stress, vices, over-fatigue

2. SECONDARY PREVENTION
- Actions directing towards identification of disease and early treatment and prompt treatment
- Early management to stop the progress
Ex: all diagnostic/ laboratory examinations, assessment, 1 st aid treatment and symptomatic
management

3. TERTIARY PREVENTION
- Phase is disorder/ disability
- Maximize the remaining potential/ ability despite/ amidst disability
- rehabilitation
 INFECTION CONTROL
CYCLE/PROCESS OF INFECTION

CAUSATIVE AGENT/
ETIOLOGIC AGENT

SUSCEPTIBLE HOST RESERVOIR

PORTAL OF ENTRY PORTAL OF EXIT

MODE OF TRANSMISSION

1. CAUSATIVE AGENT- agents/ organisms that cause diseases

Ex. Parasite organisms that can’t live/ survive without a host
Viruses, bacteria

2. RESERVOIR- area where the organisms can be found

Ex. Soil, GIT, Respiratory tract

3. PORTAL OF EXIT—corresponds to the portal of entry

Ex. Anus, mouth

4. MODE OF TRANSMISSION- vehicle/ channel of transmission

Ex. Sneezing, coughing
Droplet- large particles
Airborne- small particles, suspend in the air
Contact transmission-
Direct
Indirect- inanimate objects, may pinagdaanan bago makuha
Fomites- objects or materials which are likely to carry infection
Vector-borne- arthropods (lamok)

5. PORTAL OF ENTRY- GIT/Respiratory tract

6. SUSCEPTIBLE HOST- not immune host

*TO PREVENT THE INFECTION- BREAK THE CHAIN. STOP THE GROWTH!

SEPSIS- presence of organism

ASEPSIS- absence of organism/pathogens/ disease causing organisms/ infections
2 TYPES OF ASEPSIS

MEDICAL-clean technique
-to inhibit the growth and transmission of the pathogens

SURGICAL- sterile technique

-to maintain/render the area free from any/all organisms

HOW CAN W EPREVENT/CONTROL INFECTION?

ISOLATION- separating the infected individual based upon largest incubation

QUARANTINE- limiting the freedom of movement of exposed/suspected/contact
-has no disease but with history

TYPES OF ISOLATION

1. STANDARD ISOLATION- universal precaution

-blood and body fluids
-intended to all types of pt. regardless of diagnosis
-ex. Hand washing, gloving

2. TRANSMISSION BASED PRECAUTION- focus on mode of transmission

-ex. Airborne- small particles
Droplet- large particles
Contact- direct/indirect
Enteric- disease transmitted in GIT
Ex. Diarrheal diseases (cholera, typhoid, amoebiasis)
Vector-borne- dengue, filariasis, , malaria, encephalitis, ziga virus

3. REVERSE/PROTECTIVE ISOLATION- protecting the client which is

immunosuppressed/compromised.
Ex. AIDS pt., Burned pt., very young/old pt., pt. undergoing chemotherapy, leukemia
pt.

TECHNIQUE IN PREVENTING INFECTION IS TO MAKE A BARRIER

BARRIER/PROTECTIVE BARRIER- physical, chemical

1. Hand washing
2. Wearing gloves
3. Use of antiseptic solution
4. Processing of equipment/instrument

HANDWASHING
BEFORE AFTER
The days of work Any situation if the hands are contaminated
Examining the pt Examining pt
Doing procedure Removing gloves
Putting on sterile gloves Coughing/ sneezing
Handling clean/disinfected instrument Personal use of toilets
Going home
CONSIDERATIONS TO HELP FORM BARRIER

1. Consider every person/client/staff as potentially contagious/ infectious/susceptible

infectious.
2. Wash hands- is the single most important procedure to prevent infection
3. Wear gloves- both hands to prevent cross contamination whether direct/ indirect.
4. Use of physical barrier- face mask, face shield, googles, aprons- (PPE)
5. Use of antiseptic agents/ solution- cleaning skin and mucus membranes before and after
procedure/ cleaning of wounds
6. Safety work practices- no recapping of used needles- put in sharp collector or puncture
instrument collector. Use of hook technique/ one-hand technique.
7. Dispose the infectious materials appropriately/proper disposal
COLOR CODING
BLACK- general waste/ dry like paper, plastic
GREEN- wet but not infectious/ biodegradable
YELLOW- pathogenic/ infectious
RED- hazardous/ chemical wastes like medicine bottle/vials
8. Processing of used instrument

MATERIALS NEEDED FOR HANDWASHING

1. Clean, running water/ flowing
2. Soap- liquid/bar/ disinfectant
3. Clean, dry towel
4. Faucet- foot-controlled, if not use tissue to close

WHAT ARE THE IMPORTANT REQUIREMENTS FOR HANDWASHING?

1. Clean running water

2. Soap/ disinfecting agent
3. Friction

PROCESS OF HANDWASHING

1. Remove jewelries
2. Wet hands
3. Soap
4. Lather palm to palm
5. Scrub in between fingers
6. Pal, and back (VV)
7. Fingernails
8. Thumb
9. Wrist
10. Rinse thoroughly (off the fingers going down) (SURGICAL-fingers up down to elbow)
11. 12. Dry with clean towel

*BE CAREFUL NOT TO TOUCH THE INSIDE OF THE SINK*

GLOVING-wearing of gloves to protect the health workers when handling pt. / specimen

3 KINDS OF GLOVES
1. SURGICAL- in contact with mucus membrane/ blood supply or stream/ tissue that is not
contaminated
 2. CLEAN/ EXAMIONING GLOVES- single use, every contact with mucus membranes to
reducethe provider the risk of exposure
Ex. Pelvic examination/ IE

3. HOUSEHOLD/ UTILITY/HEAVY DUTY GLOVES-contaminated/ waste/chemical

Ex. When cleaning CR

OUTER PART- most sterile

Double gloving- nagpapaanak with HIV/AIDS

USE OF ANTISEPTICS

ANTISEPTIC- used in living thins/ on the part of the body

Ex. Betadine

DISINFECTANT- non-living things/ objects

Ex. Chlorine/ cidex

PROCESSING OF USED INSTRUMENTS

- Critical, to reduce transmission

4 STEPS IN PROCESSING INSTRUMENTS

1. DECONTAMINATION- to protect the one who will wash the instruments

How: make 0.5% Chlorine solution, soak the instrument for 10min.
Chlorine / Bleach solution- kills organisms that cause hepo-B and HIV

2. WASHING-thoroughly with water, use sterile gloves, brush

3. RINSE
4. DRY

DISINFECTION- killing the microorganisms but not including the spores

STERILIZATION- complete destruction of all microorganism/living microorganisms including spores
(Good /bad)

RIGHT ACCEPTABLE METHODS PREFFERED METHODS

-minimum standards - standard, mas ok
-disinfection - sterilization
-HLD-high level disinfection Ex.
Ex. 1. Autoclave- high pressure
1. BOILING- submerge, soak for 20min -106kPa/15lbs pressure
after boiling point (used for metals) -121◦C wrapped-30min
2. STEAM- not submerged, out in the Unwrapped-20min
streamer, 20mins from the boiling pt., 2. Dry heat- oven/microwave
lid on -170◦C, 60min/1hr
-less damaging effects on plastics and 3. CHEMICAL CIDEX- Soaked for 8hrs, air
less formation of calcium salts dry
3. CHEMICAL CIDEX- solution, soaking for -Wrapped in sterile cloth
20min. (for sharps)

Pick-up forceps- downward not less than 6inches, to prevent contaminating instrument