Environmental Concerns: relationships between human beings and our

social and natural communities.

Waste and Pollution  Human have both negative and positive
ENVIRONMENT – all the external conditions, impacts on the environment
circumstances, and influences surrounding and  Main reason for the negative impacts is the
affecting the growth and development of an organism human population is increasing. This place
or a community of organism. increasing demands on natural resources such
as food, water, energy and space.
THE STRUCTURE OF ENVIRONMENT
The pollution of environment (water pollution, air
ENVIRONMENT pollution, land pollution) has the bad influence to
human health. That is why nowadays a new branch of
SOCIAL ecological science begins to develop. It is HUMAN
NATURAL
ECOLOGY.
(Can have natural
the high level of industry, agriculture contributes
or changed
DIFFERENT human economic activities showing terrible situation
(anthropogenic
SUBSYSTEM that human life in many countries is ECONOMICALLY
condition)
OF DANGEROUS.
STRUCTURE
 As the human population increases in size, the
OF SOCIETY
space allotted to natural ecosystems is
Bio- Hydro- Atmos lithos
reduced its size.
sphere sphere phere phere
 Natural ecosystems are then no longer able to
process and rid the biosphere of wastes,
which accumulate are called POLLUTANTS.
 Human ecology views human communities
and human population as part of the
ecosystem of earth. It is the special ecology of
the species HOMO SAPIENS.

THE MAIN TASK IF HUMAN ECOLOGY

 The investigation of human health conditions.

ECOLOGY – the study of how living things interact
with each other and their environment.
BIOSPHERE- the zone of earth where life is found.
ENVIRONMENTAL IMPACT
ENVIRONMENT
Human Activities Health of
Individual
HUMAN ECOLOGY – is an academic discipline that
deals with the association between humans and their
natural environment.
 It generates knowledge from all academic
disciplines and from personal experience to
investigate, and ultimately improve, the
 The research of dynamics of human health
condition in the process of historical and
socio-economical development.
 The forecast of the health condition of the
future generations.
 The investigation of the processes of human
health protections.
 The analysis of global and regional problems
of human ecology.
 The research of influence of environmental
factors to human health
 The composition of influence of
environmental factors to human health;
 The composition of medical-geographical
maps and environment pollution maps and
the determination f correlation dependence
between human disease and environmental
pollution.
 The determination if value of boundary
technologic load limit to human organism.
 THE MAIN TERMS OF HUMAN ECOLOGY Biological Hazards – examples include plague,
tuberculosis, malaria and human immunodeficiency
 Hygiene standard- is the define range of
virus (HIV)
values of the environmental factor which is
optimal or is not dangerous for human health, Examples of biological toxins (toxin produced by
activity and life; tetanus bacteria, poisons produced by certain
 Maximum permissible concentration – is mushrooms, and the poisoning of marine life by “red
maximum amount of toxic substances in unit tides”)
of volume or mass of water, air or oil which
Chemical hazards- nonbiological substances that are
does not have any influence to human health;
toxic enough to threaten human health.
 Maximum permissible level - is periodical or
permanent influence of the environment Are those that result from the mismanagement of
factor to human organism which can not chemicals.
cause any diseases or changes I human health
Not all people react to chemicals in the same ways;
condition.
some people are especially susceptible, whereas
 Maximum permissible dose – is the amount
others are not.
of toxic substance which penetrating in
human organism does not hurt it Psychological hazards – affect a person’s outlook on
life. Boredom, stress, fear, and depression.
NATURAL ENVIRONMENTAL HAZARDS
Sociological hazards – occurs when societies interact
HAZARD- a hazard is an agent which has the potential
in destructive ways or fail to interact in productive
to cause harm to a vulnerable target.
ways. Excessive population growth that results in
- The terms HAZARD and RISK are often used overcrowding and war.
interchangeably however, in terms of risk
RESIDUES AND WASTES FROM HUMAN
assessment, they are very distinct terms.
ACTIVITY
- A HAZARD is any agent that can cause harm or
damage to humans, property or the
environment.
NATURAL ENVIRONMENTAL HAZARDS Sources of waste
 Physical mining
 Biological agri-
culture
 Chemical
 Phycological
 Social
in-
A NATURAL ENVIRONMENTAL HAZRADS dus-
householdtry
utilities
Natural hazards -in the environment that damage or
destroy wildlife habitats, kill or harm humans, and
Biodiesel
damage property.
Agricultural production
May be physical, biological, chemical, psychological, crops & waste Forestry crops
or social in nature. residues & residues
Physical hazards – caused by forces either internal to Marine Biomass
the earth’s surface or on the surface itself. processing Municipal solid
Sources
waste & sewage waste
Internal forces include earthquakes and volcanoes.
Agro/food industrial
surfaces forces include winds, lighting, storms, floods, Animal
wastes
fires, and droughts. processing Fermentation
waste process waste
As people participate in their daily activities, they
continually produce residues and wastes. On any
typical day, a person might generate the following
types of residues and wastes:
 Human body wastes- urine and feces
(wastewater)
 Excess materials and foods- trash/garbage
 Yard wastes- grass clippings and tree
branches
 Construction and manufacturing wastes-
scrap wood and metal, contaminated water,
solvents, excess heat, and noise.
 Agricultural wastes- animal dung, run-off
from feedlot operations, crop residues, and
animal carcasses.
 Transportation waste- carbon monoxide,
gaseous pollutants, and used motor oil.
 Energy production wastes- mining wastes,
electrical power (combustion of coal) wastes,
and nuclear power(radioactive)
 Defense waste- weapons
production(radioactive) wastes.
FACTORS CONTRIBUTING TO
ENVIRONMENT HAZARD
 Urbanization
 Industrialization
 Human population growth
 The production and use of disposable
products and containers
TYPE OF WASTES AND POLLUTION
SOLID WASTE – household trash, grass clippings, tree
trimmings, manure, excess stone generated from
mining, and steel scraps from automobile plants.
United States produces 33% of the world’s solid
waste.
 Household trash
 Grass clippings
 Tree trimmings
 Excess stone generated from mining
 Steel craps
SOURCE OF SOLID WASTE
Four major sources:
 Mining and gas and oil production
 Agriculture
 Industry
 Municipalities (domestic sources)
Constitutes 9.5% of total. Example include paper,
wood chips, and highly complex chemicals.
Makes up 2.5% of all solid waste generated each year.
It includes waste generated by households,
businesses, and institution. This waste is known as
municipal solid waste (MSW)
Including crop residues, manure, and other vegetation
trimmings, make up 13%
Generate the greatest volume of solid waste, 75% of
total.
SOLID WASTE MANAGEMENT
Is the collection transportation, and disposal of solid
waste.
A broader definition of solid waste also includes
source reduction efforts that limit the production of
solid waste in the first place.
1. Collection – approximately 80% of the money
spent on waste management is spent on the
collection process.
2. Disposal – to meet the need for better
disposal of solid waste, communities have
adopted a variety of approaches, including:
a. Sanitary landfills- sites judged
suitable for inground disposal of solid
waste.
The passage of the Resource
Conservation and Recovery
Act of 1976 provide levitation
that phased out open dumps
and replaced with sanitary
landfills.
b. Combustion (incineration) the
burning of wastes, second major
method of refuse disposal.
The passage of Clean Air Act
of 1970 severely restricted
the right of individuals and
minimalities to burn refuse.
Republic Act No. 8749 otherwise
known as the Philippine Clean Air Act,
is a comprehensive air quality
management policy and program
which aims to achieve and maintain
healthy air for all Filipinos.
Ecological Solid waste Management
Act. No. 9003 of 2000. An act
providing for an ecological solid waste
 management program, creating the
necessary institutional mechanisms
and incentives, declaring certain acts
prohibited and providing penalties,
appropriating funds therefore, and for
other purposes.
c. Recycling is the collection and the
reprocessing of a resource so that it
ca e reused for the same or another
purpose. (Reduce, Reuse, Recycle,
Respond)
Composing – one form of recycling,
yard waste is recycled through a
natural process of aerobic
biodegrading into compost that can
be used as a much or fertilizer.
d. Sources Reduction – to limit solid
waste creation in the first place. This
can be achieved by avoiding the use
of non-reusable products.
HAZARDOUS WASTE – waste that are dangerous to
human health or the environment. It is the
responsibility of Environment Protection Agency
(EPA) to implement the legislation created by the
RCRA. (Resource Conservation and Recovery Act).
There are now more than 400 substances that are
considered hazardous wastes in the United States.
THE INFLUENCE OF PHYSICAL FACTORS TO
HUMAN ORGANISM
 Solar activity- there is the close connection
between death, birth and solar activity.
If there are spot on the sun
surface, people have bad
mood, their activity is
reducing, especially diseases
of cardiovascular and central
nervous systems.
 Weather- it can have different influence to
human organism. It influences to human
behavior and psychological condition.
 Temperature- high temperature can change
the immunological reactionary of human
organism, reduces the attention and causes
the system anemia. Low temperature can
change system of thermoregulation of human
organism and immunological reactions to
different infectious.
THE INFLUENCE OF ANTHROPOGENIC
FACTORS TO HUMAN ORGANISM
 Ozone hole- it can pass ultraviolet rays that
hurt human cells, cause mutations (e.g.,
cancer)
 Ozone depletion
Ozone is another form of
oxygen. You breath oxygen
(O2) but you don’t breath
ozone (O3)
Ozone decreases the amount
of solar radiation that reaches
the earth from the sun, also
known as UV
WHAT CAUSES OZONE DEPLETION?
 Use of CFC’s or chlorofluorocarbons lower
ozone by weak up O3
 CFCs are used in some aerosols can (not as
much any more)
 They are also released from some
refrigerators and air condition systems
 Consequences: skin cancer cataracts.
GREENHOUSE EFFECTS – it is the increase of
environmental temperature (global warming) that has
negative influence to human organism; Carbon
dioxide also known as greenhouse gas.
ACID RAIN – they can hurt human respiratory tracts
and skin attack fruits and vegetables. Is caused by
sulfur dioxide and nitrogen dioxide pollution from
burning fossils such as coal and oil.
SOME PROBLEMS ASSOCIATED WITH ACID
PRECIPITATION;
 Streams and lakes becoming more acidic,
killing fish, frogs and other life
 Damage forest and plants and deteriorates
buildings.
Photochemical fogs – it is the mixture if different
gases that are wastes from the plants if chemical
industry and transport. It hurts human respiratory
tracts and causes poisoning.
Heavy metals – lead, mercury, manganese, zinc,
chromium etc. they poisons that hurt all organs and
central nervous system, cause pathological changes in
them.
HAZARDOUS WASTE MANAGEMENT
 The office that has responsibility for
overseeing the correct management of our
hazardous waste is the EPA’s office of solid
waste/
  The total generation of Municipal Solid waste
(MSW) in 2018 was 292.4 million ton (U.S
short tons, unless specified) or 4.9piunds per
person per day. Of the MSW generated,
approximately 69 million tons were recycled
and 25 million tons were composted.
 Currently about 35,000 tons of municipal solid
waste are generated by the Philippines daily,
and more than 8,600 tons per day in metro
manila.
MANAGEMENT
 Out of this 68% was managed in water
treatment units.
 Deep well and underground injection
accounted for 11% of disposal.
 Less than 0.5% was accounted for by landfills
 2% was managed by combustion
(incineration)
 Majority of 17% remaining underwent other
type of treatment.
HAZARDOUS WASTE CLEANUP
 in 1980, the congress passed the
comprehensive environmental response,
compensation, and liability act (CERCLA) in
response to the public’s demand to clean up
leaking dump sites. CERCLA
1. created a national priority list (NPL)
of hazardous waste sites to be
cleaned up.
2. Stated that the government would
make responsible parties pay for
those cleanups whenever possible.
3. Provided funds to support the
identification and cleanup of the sites.
AIR POLLUTION
 Contamination of the air by substances in
amounts great enough to interface with the
comfort, safety, or health of living organisms.
 These contaminants occur as gases, liquid, or
solids.
The most prevalent sources if air pollution in United
States is:
1. Transportation, including privately owned
motor vehicles
2. Electric power plants fueled by oil and coal
3. Industry, primarily mills and refineries.
Air pollution
 The governments have labeled the air
pollutant or greatest concern in united states
as criteria pollutants.
 These are sulfur dioxide, carbon monoxide,
nitrogen oxie, respirable particulate matter
and lead.
 The EPA (Environmental Protection Agency)
has established national standards for
allowable concentration levels of each of
these six pollutants in the ambient air and
closely monitor their levels. These standards
are known as the National Ambient Air
Quality Standard (NAAQS)
OUTDOOR AIR POLLUTION
 Pollution of the outdoor air has resulted in a
number of specific problems for the US and
the world. They include:
1. Acid rain
2. Global warming
3. Destruction of ozone layer
4. Photochemical smog
 For the protection of outdoor, the Clean Air
Act (CAA) was amended again in 1990 to
include:
1. Mandates to reduce urban smog,
sulfur dioxide, and nitrogen oxide
2. Tighter controls on auto emissions
3. More efficient power plants
4. Total ban on the production of CFCs
for use in the US by year 1996
INDOOR AIR POLLUTION
 It was once believed that the comfortable
confines of the indoors wee protected form
the ills of air pollution.
 However, it is now known that indoor air
pollution can be greater threat to human
heath than outdoor air pollution.
 Indoor air pollutants can be trapped and
concentrated to dangerous levels. This
buildups of undesirable gases and airborne
particles inside a building is called indoor air
pollution.
 Indoor air pollution can arise from a number
of sources
1. Asbestos – naturally occurring
mineral fiber found in rock and soil
that was commonly used as an
insulation and fireproofing material.
2. Biogenic pollutants – are airborne
materials of biological origin such as
 living and non-living fungi and their
toxins, bacteria, viruses, pollens,
inspect parts and wastes, and animal
dander.
3. Combustion by-product- include
gases and particulates.
4. Radon – naturally occurring
radioactive gas that cannot be seen,
smelled, or tasted.
5. Environmental tobacco smoke (ETS) –
also known as secondhand smoke.
Includes both mainstream smoke and
side stream smoke. The inhalation of
ETS by nonsmokers is referred to as
passive smoking.
6. Volatile organic compounds –
compounds that exist as vapor over
the normal range of air pressures and
temperatures.
7. Formaldehyde – pungent water-
soluble gas, is one of the most
ubiquitous VOCs (Volatile Organic
Compounds)
 In the absence of any comprehensive policy,
individuals are encouraged to take steps to
reduce or eliminate sources of indoor air
pollution and improve air quality. These may
include:
1. Selecting safer household products,
such as “pump” dispensers instead of
spray dispensers.
2. Venting dryers outdoors instead of
indoors to keep indoor humidity low
and therefore discourage mold
growth.
3. Avoiding products containing
formaldehyde
4. Having loose asbestos fibers removed,
it founds
5. Limiting or prohibiting indoor smoking
6. Maintaining heating, air conditioning,
and ventilation systems in good
working condition
7. Testing buildups for radon
WATER AND ITS POLLUTION
 Water in streams, rivers, lakes, and reservoirs
is called surface water.
 The water that sinks into soil is referred to as
subsurface or groundwater.
Groundwater is the water found underground in the
cracks and spaces in soil, sand and rock. It is stored in
moves slowly through geologic formations of soil,
sand and rocks.
That is not absorbed by the roots of vegetation moves
slowly downward until it reaches the underground
reservoirs referred to as aquifers.
Aquifers are porous, water-saturated layers of
underground bedrock, sand, and gravel that can yield
an economically significant amount of water.
It is possible to remove salt from this water by
desalinization.
Hydrosphere – is polluted with human help, industrial
waste can include heavy metal and organic chlorides,
such as pesticides. These materials are not destroyed
under natural conditions. So, they accumulate in the
bottom mud of deltas of highly polluted rivers and
cause environmental problems.
Every year 5 million people die in the result of
poisoning by polluted eater. Nowadays new diseases
appear that are connected with chemical water
pollution.
 Itay-itay- is the disease caused by water with
high concentration of cadmium.
 Minomata – it is the disease caused by water
with high concentration of mercury;
 Molybdenum podagral – it is the disease
caused by water with high concentration of
molybdenum;
 Fluorosis – it is the disease caused by water
with high concentration of fluor.
TREATMENT OF WATER FOR DOMESTIC USE
 The greatest use of water is for agricultural
(41%), utilities (38%) and industrial
manufacturing (10%). Only 10 % is used
directly by the public
 Steps in surface water treatment:
1. Coagulation and flocculation
 2. Sedimentation
3. Filtration
4. Disinfection
SOURCES OF WATER POLLUTION
 Water pollution includes any physical or
chemical change in water that can harm living
organisms or make it unfit for the others.
1. Point source pollution – refers to a
single identifiable source that
discharges pollutants into the water,
such as pipe, ditch, or culvert
2. Nonpoint source pollution – includes
all pollution that occurs through the
runoff, seepage, or falling of
pollutants into water.
TYPES OF WATER POLLUTANTS
1. Biological pollutants- include pathogens such
as parasites, bacteria, viruses and other
undesirable living microorganisms.
2. Nonbiological pollutants – include inorganic
chemicals such as lead, copper, and arsenic:
organic chemical: and radioactive pollutants
STRATEGIES TO ENSURE SAFE WATER
1. PUBLIC POLICY
Clean Water Act (CWA)
 Ensuring water quality in such a way as to
make all rivers swimmable and fishable
 Reducing the discharge of pollutants in US
waters to zero.
Other that helped to ensure safe water:
Safe drinking water act of 1974 and the safe drinking
water act amendments of 1996. These laws deal with
public drinking water in a comprehensive manner by
instructing the EPA to set maximum contaminant
levels for specific pollutants in drinking water.
2. WASTEWATER TREATMENT
 Wastewater is the substance that remains
after have used water for domestic or
commercial purposes.
 The primary purpose of wastewater
treatment is to improve the quality of
wastewater. This is accomplished in two ways:
1. By converting organic wastes to
simple inorganic wastes
2. By disinfecting the treated
wastewater before releasing it back
into the environment.
 There are three stages of wastewater
treatment
1. Primary treatment- a physical or
mechanical process that results in the
separation of liquids and solids.
2. Secondary treatment – aerobic
bacteria are added to the wastewater
to break down the organic materials
into inorganic carbon dioxide, water,
and minerals.
3. Tertiary treatment – involves sand
charcoal filters, or extended settling
tanks that can remove 90% of the
remaining dissolved pollutants left
behind after the first two treatment
levels.
LAND POLLUTION – the geosphere and biosphere are
intimately connected through soils, which consists of
a mixture of air, mineral matters, organic matters, and
water. Soils can accumulate almost all toxic
substances.
 In agriculture people use pesticides and
nitrates. These substances are very dangerous
and toxic. They can cause mutations, cancers,
pathological processes in central nervous
system, respiratory and alimentary tracts,
skin.
RADIATION
 Is the energy released when atoms are split or
naturally decay from a less stable to more
stable form.
 Naturally occurring radiation comes from
three sources:
1. Cosmic radiation – comes to the earth
from the outer space and the sun
2. Terrestrial radiation – comes from
radioactive minerals that are within
the earth solid and rock. (Uranium,
radon)
 3. Internal radiation- radiation internal
to the human body. Exposure to such
radiation occurs as a result of
ingesting food or drugs and inhaling
air that contains radioactive atoms.
NOISE POLLUTION
 Of all environmental pollution, the types that
receives the least attention is noise pollution,
or excessive or unwanted sound.
 Sound is heard when energy from vibrations,
travelling through air, liquid, or solid media as
pressure waves, is received by the ear.
Unwanted, unpleasant sound is referred to as
NOISE.
Amplitude – refers to the sound volume, that
is, its loudness or intensity. It is measured and
expressed as decibels (db).
APPROACHES TO NOISE ABATEMENT
1. Policy- in 1972, congress passed the noise
control act (NCA). This act was aimed at
regulating noise emissions from new
consumer products.
2. Educational program- the goal in this
approach is to alter the behavior of those
generating the noise, thereby reducing noise
at the source.
3. Environmental changes- noise abatement can
be achieved through environmental
modification. This modification can be made
at the source of the noise, to the path it
travels, or to the exposed parties.
Structure of the Philippine
Health Care Delivery System
HEALTH RESOURES
 Rural Health Unit (RHU) and their sub-centers
 Chest clinics, Malaria Eradication Units and
Schistosomiasis Control Unit
 Tuberculosis clinics and hospitals of the PTBs
 Private Clinics
 Clinics run by PMA
 Community Hospitals and Health Services
 Centers run by Philippine Medical Care
Commission (PMCC)
 Voluntary Health Facilities run by religious and
civic groups
THREE DIVISIONS OF HEALTH CARE
DELIVERY SYSTEM
1. Government Sectors
2. Mixed Sectors
3. Private Sectors
GOVERNMENT
 The primary government agency in the field of
health runs the bulk of the government health
facilities is the Department of Health.
DEPARTMENT OF HEALTH
 The Philippines Department of Health (DOH)
(Filipino: Kagawaran ng kalusugan) is the
principal health agency in the Philippines. It is
the executive department of the Philippine
Government responsible for ensuring access
to basic public health services to all Filipinos
through the supervision of quality health care
and the regulation of providers of health
goods and services.
 Mandated as the lead Agency in Health
 It has a regional field office in every region
and maintains specialty hospitals, regionals
hospitals and medical centers.
 RA 7160 – The Local Government Code of
1991 which resulted in devolution, which
transferred the power and authority from the
national to the local government units, aimed
to build their capabilities for self-government
and develop them fully as self-reliant
communities.
ROLE AND FUNCTIONS OF DOH
 Leadership
 Enabler and Capacity Builder
 Administrator of Specific Services
MISSION
 Ensure accessibility and quality care to
improve the quality of life all Filipinos,
especially the poor.
PRINCIPLES
 Universal access to basic health services must
be ensure
 The health and nutrition of vulnerable groups
must be prioritized
 The epidemiologic shift from infectious to
degenerative disease must be managed
 The performance of the health sector must be
enhanced.
GOALS AND OBJECTIVES:
1. Improve the general health status of the
population
2. Reduce morbidity, mortality, disability and
complications from the following diseases and
disorders
3. Eliminate certain diseases as public health
problems
4. Eradicate poliomyelitis
5. Promote healthy lifestyle
6. Promote the health and nutrition of families
and special populations
7. Promote environmental health and
sustainable development
8. Strengthen national and local health systems
to ensure better health service delivery.
9. Reduce the cost and ensure the quality of
essential drugs
10. Institute health regulatory reforms to ensure
quality and safety of health goods and
services
11. Strengthen health governance and
management support system
12. Expand the coverage of social health
insurance.
13. Mobilize more resources for health improve
efficiency in the allocation, production and
utilization of resources for health
14. Improve efficiency in the allocation
production and utilization of resource for
health
THE DOH OFFICES
 The DOH is composed of about 17 central
offices, 16 Centers for Health Development
located in various regions, 70 hospitals and 4
attached agencies.
CENTRAL OFFICE
 The central office is composed of the Office of
the Secretary and five major functions clusters
RESPONSIBILITIES OF DOH
1. Ensuring access to basic health services to all
Filipinos through the provision of quality
health care
2. Formulation and development of national
health policies, guidelines, standard and
manual operation for health services and
programs
3. Issuance of rules and regulations, licenses and
accreditation
4. Promulgation of the national standards, goals,
priorities and indicators
5. Development of special health programs and
projects
MIXED SECTORS
 PTS – Philippine Tuberculosis Society
 PCS – Philippine Cancer Society
 PNPC – Philippine National Red Cross
 PMHA – Philippine Mental Health Association
 PHA – Philippine Heart Association
PRIVATE SECTORS
1. Socialized Medicine – funded by general
taxation, emphasis on prevention.
2. Compulsory Health Insurance – law requires
people to subscribe to health insurance plan,
usually government sponsored; covers only
curative and rehabilitative medicine;
preventive services provided by government
agencies.
3. Voluntary Health Insurance – government
only encourages people to subscribe to health
insurance.
4. Free Enterprise – people have to take care of
their medical needs.
HEALTH PROGRAMS (DOH)
1. Adolescent and Youth Health and
Development Program (AYHDP)
2. Botika ng Bayan
3. Promotion of Breast-feeding program/
Mother and Baby Friendly Hospital Initiative
(MBFHI)
4. Cancer Control Program
5. Diabetes Control Program
6. Dengue Control Program
7. Dental Health Program
8. Emerging Health Disease Control
9. Environmental Health
10. Expanded program on Immunization
11. Family Planning
12. Food and Waterborne Diseases Prevention
and Control Program
13. Knock out Tigdas
14. Leprosy Control program
15. Malarial Control Program
16. National Filariasis Elimination Program
HEALTH PROGRAMS
1. Adolescent and youth health and
development program (AYHDP)
Reproductive health sexuality, reproductive
tract infection (STD, HIV/AIDS)
 Responsible parenthood, maternal and child
health
Communicable diseases, diarrhea, DHF,
measles, malaria
Mental health substance uses and abuse
2. Botika ng Barangay
Refers to a drug outlet manage by a legitimate
community organization (CO/non-government
Organization (NGO) and/or local government
unit (LGU), with a trained operator and a
supervising pharmacist specifically established
I accordance with administrative order no.
144 s. 2004.
3. Promotion of breast-feeding program/
mother and baby friendly hospital initiative
(MBFHI)
The mother and baby friendly hospital
initiative is the main strategy to transform all
hospitals with maternity and new born
services into facilities which fully protect,
promote, support breast feeding and
rooming-in practices
4. Cancer control program
The Philippines cancer control program,
begun I 1988, is an integrated approach
utilizing primary, secondary and tertiary
prevention in different regions of the country
at both hospital and community levels.
Six lead cancers (lung, breast, live, cervix, oral
cavity, colon and rectum) are discussed.
5. Diabetes Control Program
Diabetes is a serious chronic metabolic
disease characterized by an increase in blood
sugar levels associated with long term
damage and failure or organs functions,
especially the eyes, the kidneys, the nerves,
the heart and blood vessels.
In diabetic, blood sugar reaches a dangerously
high level which leads to complications.
 Blindness
 Kidney failure
 Stroke
 Heart attack
 Wounds that would not heal
 Impotence
What can you do to control your blood sugar?
 Diet therapy
 Exercise
 Control your weight
 Quit smoking
6. Dengue Control Program
The thrust if the dengue control program is
directed towards community-based
prevention and control in endemic areas
Major strategy is advocacy and promotion,
particularly the four O’clock habit which was
adopted by most LGUs. This is a nationwide,
continues and concerted effort to eliminate
the bleeding paces of aedes aegypti
7. Dental Health Program
Comprehensive dental health program aims
to improve the quality of life of the people
through the attainment of the highest
possible oral health. Its objective is to prevent
and control dental diseases and conditions
like dental carries and periodontal diseases
thus reducing their prevalence.
8. Emerging Disease Control Program
Emerging infectious disease are newly
identified and previously unknown infection
which cause public health problems either
locally or internationally
these include diseases whose incidence in
human have increased within the past two
decades or threaten to increase in the near
future.
9. Environmental Health
Environmental health is concerned with
preventing illness through managing the
environment and by changing people’s
behavior to reduce exposure to biological and
non-biological agents of disease and injury.
It is concerned primarily with effects of the
environment to the health if the people.
10. Expanded program on Immunization
The expanded program on immunization is
one of the DOH programs that has already
been institutionalized and adopted by all LGUs
in the region.
Its objective is to educe infant mortality and
morbidity through decreasing the prevalence
of six (6) immunizable disease (TB, diphtheria,
pertussis, tetanus, polio and measles).
11. Family Planning
Responsible parenthood which means that
each family has the right and duty to
determine the desired number of children
they might have and when they might have
them.
Respect for life.
Birth spacing refers to interval between
pregnancies (which is ideally 3-5 years).
12. Food and waterborne disease prevention and
control program (FWBDPCP)
 Established in 1977 but become fully
operational in 1977 but became fully
operational in year 2000 with the provision of
a budget amounting to PHP 551,000.00the
program focuses on cholera, typhoid fever,
hepatitis A and other food borne emerging
diseases (e.g., paragonimus)
13. Knock out tigdas
The knock out tigdas is strategy to reduce the
number or pool of children at risk of getting
measles, or being susceptible to measles and
achieve 95% measles circulator in all
communities in 2008.
14. Leprosy control program
Leprosy control program envisions eliminating
leprosy as a public health program by
attaining a national prevalence rate (PR) of
less than 1 per 10,000 populations by year
2000.
15. Malaria control program
58of 80 provinces: malaria endemic
Population at risk: 12M
22 provinces: maintain malaria-free* status
2-4 outbreaks per malaria-free: absence of
indigenous malaria case.
16. National filariasis elimination program
General objectives:
 To reduce the prevalence Rate
to<1/1000 population.
17. National mental health program
 It aims at integrating mental health within the
total health system, initially within the DOH
system, and local health system.
 Within the DOH, it is initiated and sustained
the integration process within the hospital
and public health systems, both at the central
and regional level.
 Furthermore, it aims at ensuring equity in the
availability, accessibility, appropriateness and
affordability of mental health and psychiatric
services in the country.
18. Newborn screening
 Newborn screening (NBS) is a simple
procedure to find out if your baby has a
congenital metabolic disorder that may lead
to mental retardation and even death if left
untreated.
19. Occupational health program
 Vision and mission statement
 Health for all occupations in
partnership with the workers,
employers, local government
authorities and other sectors in
promoting self-sustaining programs
and improvement of workers’ health
and working environment.
 Program objective and targets:
 To promote and protect the health
and well being of the working
population thru improved health,
better working conditions and
workers’ environment.
20. Health development program for older
persons
 The program intends to promote and improve
the quality of life of older persons through the
establishments and provision of basic health
services for older persons, formulation of
policies and guidelines pertaining to older
persons, provision of information and health
education to the public, dedicated to older
person and, the conduct of basic and applied
researches.
21. Pinoy MD program “gusto ko maging doctor”
 A medical scholarship grant for indigenous
people, local health workers, barangay health
workers, department of health employees or
their children.
 This is a joint program of the Department of
Health (DOH), Philippine charity Sweepstakes
Office (PCSO), and several state universities
and medical schools.
22. Prevention of blindness program
 To eliminate all avoidable blindness by
preventing and controlling diseases through
the development of human resource,
infrastructure, and appropriate technology.
23. Schistosomiasis control program
 Goal of the national schistosomiasis control
program is to eliminate schistosomiasis as a
public health problem (prevalence of 1% and
below)
24. National Tb control program
 In 1196, WHO introduced the directly
observed treatment short course (DOTS) to
ensure completion of treatment.
 The DOTs strategy depends on five elements
for its success:
 Microscope, medicines, monitors, DOT and
political commitment.
 If any of these elements are missing, our
ability to consistency cure TB patients slips
through our fingers.
 25. Republic Act 7719 is otherwise known as
“blood services act of 1994”
 The main objectives are:
 To promote and encourage voluntary
blood donation by the citizenry and to
instill public consciousness of the
principle that blood donation is a
humanitarian act.
 To provide, adequate, safe, affordable
and equitable distribution of supply of
blood and blood products.
COMMUNITY ASSESSMENT,
COMMUNITY HEALTH
PROJECT PLANNING,
IMPLEMENTATION,
MONITORING AND
EVALUATION
Learning Objectives: At the end of the session, the
students should be able
To conduct their own community assessment based
on a case and they must be able to conceptualize and
plan a health project on. The hypothetical community
assigned to them. The students will be taught on how
to do a community assessment, prioritization of a
specific health problem, designing a community
health program as well as its implementation,
monitoring and evaluation.
COMMUNITY ASSESSMENT
A community assessment is an exercise by which a
collaborative partnership gathers information on the
current strengths, concerns, and conditions of
children, families, and the community.
The information comes from many sources- especially
parents and family members- and is elicited by many
techniques, including interviews, focus groups, and
scanning demographic data collected by local
agencies. Because many types of partners participate
in a community assessment- strategic planners,
program staff, administrators, teachers, parents, and
other community members- the resulting information
is broad, accurate, and useful.
Community assessments focus on:
a. local assets,
b. resources, and
c. activities as well as gaps, barriers, or emerging
needs
The process of identifying and appraising this
information will help your collaborative partnership.
Clearly understand the context in which families live
and the issues families want to address; locate hidden
strengths or underutilized resources that could be
developed. Determine which resources could
contribute to comprehensive strategies, and in what
way; Design effective, collaborative strategies that
engage children and families because they respond to
real and important conditions; and Empower families
and community members by giving them a role in
designing and implementing the strategies.
Process of conducting a community
assessment involves
1. Scanning the community to locate existing
information,
2. Developing a family focus
3. Identifying community assets and the degree
to which they are accessible to the people
who can benefit from them
4. Analyzing the information obtained through
the first three steps.
HEALTH PROJECT PLANNING
a. Planning requires a critical analysis of the
problem to be addressed.
b. Problem analysis is important for developing a
goal and objectives for the project that are
realistic and achievable.
Once the goal and objectives are set, strategies for
achieving them can be determined. Resources needed
in the project, and ways to obtain them, are then
identified. The planning process also includes deciding
how the project will be managed, sustained and
evaluated.
Major steps in planning, sustaining and evaluating a
health promotion project
Step 1: Identify the issues or health
problems in the community
Needs assessment
 Clarifying need is an essential part of deciding
what issue or problem the project will
address.
 The term ‘needs assessment’ is used to
describe a process of collecting information
that will give a good indication of the priority
needs of a community.
  It provides an opportunity for the community
to become involved in the planning from the
beginning.
 It helps with allocating resources and making
decisions about where to start with health
promotion work.
Classifying Needs
When undertaking a needs assessment, it is important
to consider that needs will be thought of differently,
depending on whom you consult.
 Needs are sometimes classified as:
 Normative needs
 Felt needs
 Expressed needs
 Comparative needs
Normative Needs
 A discrepancy between an individual/s or
group/s present state and a given norm or
standard
Felt Need
 A felt need is an individual desire or want that
an individual has to improve either his or her
performance.  have a list of major issues and potential target
 Asking people what they want is frequently
used in identifying felt needs that attribute
may influence what people say they want.
 When searching for felt needs, designers must
be aware of needs that are motivated by a
desire other than performance improvement.
Expressed Need or Demand
 A felt need becomes an expressed need when
people put what they want into actions. For
example, if more students sign up for an
online course than the seat limit, then there
may be an expressed need for more sections
of the course. Expressed needs are often
identified in suggestion boxes and in-house
publications with a question-and-answer or
suggestion column.
Comparative Need
 A discrepancy between what one group has
and what another group, with similar
characteristics, has. A comparative need is
present when two groups with similar
characteristics do not receive a similar service.
Sharing the results of the needs assessment with the
community is a key part of the planning process.
This process will:
 Raise community awareness about the issues
and possible underlying causes
 Stimulate discussion about ways to address
the issues
 Allows the community to be involved in
planning and decision-making about the
project
Consider baseline data
 Some of the information gathered during the
needs assessment may be able to be uses as
‘baseline data’.
 Baseline data describe the situation or
condition at the time the project or
intervention starts.
 Data collected later during the evaluation is
then compared against the baseline data to
see the effect of the project.
Step 2: Prioritize the Issues or Health
Problems
 At the end of Step 1, the project team will
groups for the project.
 There are always competing needs or issues in
any community.
 Limitations such as time and resources mean
that not everything can get addressed.
 Issues will need to be prioritized.
 Needs and priorities vary from individual to
individual, family to family, group to group.
 It is important to work out criteria to sort out
which issue the project will address
Step 3. Identify risk factors and set the
goal for the project
 Risk factors- are any aspect of behavior,
society or the environment that are directly
linked to the health problem.
 Risk factors lead to or directly cause the
problem.
 Note that some risk factors can be changed,
while others are not able to be modified, for
example, family history of a condition.
Example of risk factors:
 Eating high fat food (behavioral) and having a
family history of heart disease (biological) are
 both risk factors for heart disease, People can
change their food choices (modifiable) but not
their genetics (non-modifiable)
 Direct exposure to bacteria to bacteria and
germs (environmental) may be a risk factor
for diarrhea.
 Addressing a problem successfully will require
the project to focus on the underlying causes
or issues that led to the problem in the first
place.
 In other words, the goal and objectives of a
project need to relate to the underlying
causes or issues.
 Developing a clear and organized goal and
objectives that relate to each other requires
some critical analysis of the problem.
Step 4: Determine contributing factors
and state objectives for the project
Contributing factors- are any aspects of behavior,
society or the environment that leads to the risk
factors developing. Contributing factors enable or
reinforce the risk factors. They can relate to
individual, financial, political, educational,
environmental, or other issues.
Examples of contributing factors:
 Lack of knowledge about low fat diets
(educational) and high cost of low-fat foods in
the store (financial) are both contributing
factors to the risk factor ‘eating a high fat diet’
 Poor housing condition (environmental) and
lack of home hygiene (behavioral) are both
contributing factors to the risk factor’
exposure to bacteria and germs’
Developing the project goal and objectives
The Goal and Objectives:
 Make plan clear and focus those energies of
the project team
 Let people know what they can expect to
happen as a result of the project
 Are the basis for planning the evaluation of
the project
Goal
 The goal is about making changes to the risk
factors addressed by project
 The goal indicates what the planned, longer-
term outcome of the project is
 It is also intended to inspire, motivate and
focus people and encourage team
cooperation.
Objectives
 Objectives state what changes the project will
make to the contributing factors.
 The objectives indicate what the impact will
be on the contributing factors during the time
frame of the project.
 The objectives are about what has to change
in the short term to get closer to achieving the
project goal.
A well written ‘goal and objectives’ state who will
achieve how much of what by when. Developing a
clear, achievable goal and objectives requires good
baseline data
Step 5: Determine what strategies will be
 After the objectives are developed, the
strategies are determined.
 Strategies describe what it is that the project
team will do to try and make the changes
required to achieve the objectives.
 Relationship between the goal, objectives and
strategies
The process for planning a project begins with the big
picture (issue of problem). It is an analysis of the big
picture issue that gives the framework for developing
the plan- from the longer-term goal, to more specific
objectives, down to the actual strategies, and finally
the detail of individual actions.
Step 6: Develop the Action Plan
Once the strategies of the project are determined, the
project team can write the action plan. The action
plan includes all the specific activities, large and small,
that will need to be done to implement each of these
activities, when they will be completed and how they
will be evaluated. The more detail that is worked out
for strategies, the easier it will be to accurately
identify all the activities to be done. If the project is
large, with many stages, it may not be possible to
detail all the specific activities at the beginning of the
project. Detailed documentation is also important for
maintaining accountability within the team and
between the team and the community or funding
agency. The action plan will also list the resources
required to do the project successfully. Resources will
be required throughout the whole project, from needs
assessment through putting strategies into action to
final report writing. Resources can include human
resources, financial resources, materials, equipment
and venues, dates.
Step 7: Sustain the Project
Planning for sustainability means thinking of ways to
keep the project (or important parts of it) going after
its official end. It then becomes an ongoing part of
community activity. Many factors can threaten
sustainability of the project. Project teams need to be
on the lookout for these factors and have a plan for
dealing with them. Sustainability needs to be
considered from the initial planning stages of a
project.
Step 8: Evaluate the project
 Evaluating a project is about looking critically
at what is happening in the project and
making a judgment about its value, worth or
benefit (see the word value in evaluate).
Evaluation is important because it can tell us:
 How the project is going
 What effect it is having
 What changes we need to make to improve it
Major steps in planning, sustaining and evaluating a
health promotion project
1. Identify the issues or health problems in the
community.
2. Prioritize the issues or health problems to
identify the one that the project will address.
3. Identify risk factors and set the goal for the
project
4. Determine contributing factors and state
objectives for the project
5. Determine what strategies will be
6. Develop the action plan for the project. DO IT!
7. Sustain the project or keep the project (or
some parts of it) going
8. Evaluate the project
Community Organization Participatory Action
Research (COPAR) COPAR is a vital part of public
health nursing. COPAR aims to transform the
apathetic, individualistic and voiceless poor into
dynamic, participatory and politically responsive
community.
 A collective, participatory, transformative,
liberative, sustained and systematic process of
building people’s organization by mobilizing
and enhancing the capabilities and resources
of the people for the resolution of their issues
and concerns towards effecting change in
their existing oppressive and exploitative
conditions (1994 national Rural Conference).
 A process by which a community identifies its
needs and objectives cooperative and
collaborative attitudes and practices in the
community (Ross 1967).
 A continuous and sustained process of
educating the people to understand and
develop their critical awareness of their
existing condition, working with the people
collectively and efficiently on their immediate
and long-term problems, and mobilizing the
people to develop their capability and
readiness to respond and take action on their
immediate needs towards solving their long-
term problems (CO: A Manual of experience,
PCPD- Philippine Center for Population and
Development)
 COPAR is an important tool for community
development and people empowerment as
this helps the community works to generate
community participation in development
activities.
 Prepares people/client to eventually take over
the management of a development programs
in the future.
 COPAR maximizes community participation
and involvement; community resources are
mobilized for community services.
Process
The sequence of step whereby members of a
community come together to critically assess to
evaluate community conditions and work together to
improve those conditions.
Structure
Refers to a particular group of community members
that work together for a common health and health
related goals.
Emphasis
1. Community working to solve its own problem.
2. Direction is established internally and
externally.
3. Development and implementation of a
specific project less important than the
development of the capacity of the
community to established the project.
 4. Consciousness raising involves perceiving
health and medical care within the total
structure of society.
Principles
 People especially the most oppressed,
exploited and deprived sectors are open to
change, have the capacity to change and are
able to bring about change.
 COOPAR should be based on the interest of
the poorest sector of the community.
 COPAR should lead to a self-reliant
community and society.
Phases of COPAR
1. Pre-entry Phase
2. Entry Phase
3. Organization-building Phase
4. Sustenance and Strengthening Phase
Pre-entry Phase
Is the initial phase of the organizing, where the
community organizer looks for communities to serve
and help. Activities include:
Preparation of the Institution
 Train faculty and students in COPAR
 Formulate plans for institutionalizing COPAR.
 Revise/enrich curriculum and immersion
programs
 Coordinate participants of other departments.
Site Selection
 Initial networking with local government
 Conduct preliminary special investigation
 Make long/short of potential communities
 Do ocular survey of listed communities
Criteria for Initial Site Selection
 Must have a population of 100-200 families
 Economically depressed. No strong resistance
from the community
 No serious peace and order problem.
 No similar group or organization holding the
same program.
Identifying Potential Municipalities
 Make long. short list of personnel
municipalities
Identifying Potential Community
 Do the same process as in selecting
municipality
 Consult key informants and residents.
 Coordinate with local government and NGOs
for future activities
Choosing Final Community
 Conduct informal interviews with community
residents and key informants
 Determine the need of the program in the
community
 Take note of political development
 Develop community profiles for secondary
data
 Develop survey tools
 Pay courtesy call to community leaders
Identifying Host Family
 House is strategically located in the
community
 Should not belong to the rich segment
 Respected by both formal and informal
leaders
 Neighbors are not hesitant to enter the house
 No member of the host family should be
moving out
Entry Phase
Sometimes called the social preparation phase, it is
crucial in determining which strategies for organizing
would suit the chosen community. Success of the
activities depend on how much the community
organizers has integrated with the community.
Guidelines for entry
 Recognize the role of local authorities by
paying them visits to inform their presence a
d activity
 His/her appearance, speech, behavior and
lifestyle should be in keeping with those of
the community residents without disregard of
their being a role model.
 Avoid raising the consciousness of the
community residents; adopt a low-key profile.
Activities in the entry phase
 Integration. Establishing rapport with the
people in continuing effort to imbibe
community life. Living with the community,
seek out to converse with people where they
usually congregate, lend a hand I household
chores and avoid gambling and drinking.
  Deepening social investigation/community  Implementation of live hood projects.
study. Verification and enrichment of data
Critical Steps
collected from initial survey, conduct baseline
survey by students, results relayed through 1. Integration
community assembly. 2. Social Investigation
3. Tentative Program Planning
Core group Formation
4. Groundwork
 Leader spotting through sociogram 5. Meeting
 Key Persons – approached by most people 6. Role play
 Opinion Leader – approached by the key 7. Mobilization or action
persons 8. Evaluation
 Isolates – Never or hardly consulted. 9. Reflection
10. Organization
Organization-building Phase

Entails the formation of more formal structure and

the inclusion of more formal procedure of planning,
implementing, and evaluating community-wise
activities. It is at the phase where the organized
leaders or groups are being given training (formal,
informal, OJT) to develop their style in managing their
own concerns/programs.

Key activities

 Community Health Organization (CHO)

 Preparation of legal requirements
 Guidelines in the organization of the CHO by
the core group
 Election of Officers
 Research Team Committee
 Planning Committee
 Health Committee Organization
 Formation of by-laws by the CHO
 Others

Sustenance and Strengthening Phase

Occurs when the community organization has already

established and the community members ar already
actively participating in community-wide
undertakings. At this point, the different community’s
setup in the organization-building phase is already
expected to be functioning by way of planning,
implementing and evaluating their own programs,
with the overall guidance from the community-wide
organization.

Key activities

 Training of CHO for monitoring and

implementing of community health program
 Identification of secondary leaders
 Link aging and networking
 Conduct of mobilization on health and
development concerns
CPHM LAB
VITAL SIGNS
 Is the baseline procedure. It reflects the
body’s physiological status and ability to
regulate temperature, maintain local and
systematic blood flow and oxygenated tissues.
 Changes in vital signs can indicate sudden or
gradual changes in clients’ status. Significant
changes should be reported immediately to
the charges nurse and physician.
VITAL SIGNS are physical signs that indicate and
individual is alive, such as heart beat, breathing rate,
temperature, blood pressures and recently oxygen
saturation.
 This signs may be observed, measured, and
monitored to assess and individual’s level of
physical functioning.
 Normal vital signs change with age, sex,
weight, exercise tolerance, and condition.
THE 4 CARDINAL SIGNS OF VITAL SIGNS
1. Body temperature
2. Pulse rate
3. Respiratory rate
4. Blood pressure
VITAL SIGNS MUST BE MEASURED, REPORTED, AND
RECORDED ACCURATELY IF YOU ARE NOT SURE OF A
MEASUREMENT, RECHECK IT.
WHEN TO TAKE VITAL SIGNS
1. On the client’s admission to hospital or
extended care facility
2. In a hospital on a routine frequency according
to a physician order.
3. During a client visit to a clinic or to a
physician’s office
4. Before and after a surgical procedure
5. Before and after and invasive diagnostic
procedure
6. Before and after administration of medication
that affects cardiovascular and respiratory
functions
7. Whenever the client’s general condition
suddenly worsens.
8. Before nursing interventions that may
influence any one of the vital signs.
(Ambulating after a week of bed rest).
9. Whenever the client reports to the nurse any
none specific symptoms of physical stress.
10. Whenever clients present symptoms of
confusion and disorientation.
A. Body Temperature
 Normal body temperature is
maintained through a balance
between heat production and heat
loss is affected largely by the central
nervous system control by center
located in the HYPOTHALAMUS.
(Located below the thalamus of the
midbrain nearest to the pituitary
gland)
 Rise and fall of the body temperature.
 Temperature old people, people with
diabetes, babies and young children
typically feel more comfortable at
higher temperatures.
PURPOSE OF THE BODY
TEMPERATURE
1. To obtain baseline date on admission to the
hospital
2. To guard against hyperthermia or
hypothermia
3. To monitor the client’s response to a
procedure or therapy
4. To detect and follow the cause of febrile
illness.
5 PRIMARY FACTORS THAT AFFECTS
HEAT PRODUCTION IN THE BODY
1. Basal metabolic rate
 Amount of energy release in the body
requires to maintain essential activity.
 BMS vary with age and sex (the younger the
person, the higher is the BSM. Male has
higher BMS than female)
2. Muscular activities
 Muscles exercises increases heat production.
3. Thyroxin
 A hormone secreted by the thyroid gland,
essential for normal growth and metabolism.
Increase in thyroxin output increases the rate
of cellular metabolism. Increases heat
production.
4. Epinephrine, nor-epinephrine and
sympathetic activity
 Epinephrine and norepinephrine – chief
hormone of normal adrenal medulla. Increase
in these hormones immediately increases the
rate of cellular metabolism in many body
tissue. (e.g., liver and muscles tissues)
 Sympathetic stimulation of brown fats cells
stimulated they produce a large amount of
heat.
5. Body temperature
 Fever increases metabolic rate. The presence
of fever increases the body’s temperature
further.
4 PHYSICAL PROCESS OF HEAT LOSS
1. Radiation
 Is the transfer of heat from the surface of one
object to the surface of another without
contact with two objects. Example. UV rays of
the sun, 60% heat loss by a nude person
standing in a room at a normal room
temperature.
2. Evaporation
 Or vaporation Is the process by which water is
converted into steam.
3. Convection
 Is the movement of heat from one another by
current of heat of fluids. Transfer of heat from
the hotter to the colder part. Ex electric fan
4. Conduction
 Is the transfer of heat from any substance like
air, water and clothing which comes in
contact with the body. Ex. Sponge bath.
FACTORS AFFECTING TEMPERATURE
MAINTENANCE AND REGULATION
1. Environmental temperature
 Brief exposure to extreme cold stimulates the
body to produce more heat.
 Too much exposure to the sun by the use of
warm clothing heat regulates.
2. Diurnal variations
 The body temperature generally lowest in the
early morning and highest in the afternoon
and early evening following the day’s activity.
3. Exercise
 Heat production is increase by exercise dur to
increases call activity.
4. Specific dynamics action of food
 The oxidation and combustion of food
released heat producing energy covertly in
starvation.
5. Hormonal activity
 Any factors that increase activities
consequently raises heat production. Ex.
Progesterone secretion at the tome of
ovulation raises the body temperature.
6. Age
 New born and children normally have higher
body temperature than adult’s period.
Normally ranges from 97.7 to 99.9F to 36.5
to 37.5 C
 75 years are at risk for hypothermia due to
inadequate diet, less activity and loss of
subcutaneous fats.
7. Stress
 Highly stresses or anxious client could have an
elevated body temperature. Stress can
stimulate sympathetic nervous system leading
to the increase in production of epinephrine
and norepinephrine.
8. Food, fluid and smoking
TWO SCALES OF MEASURING BODY
TEMPERATURE
 Fahrenheit scales (F) – is named after
Gabriel Daniel Fahrenheit, a German physicist
who invented the mercury thermometer in
1714. In these scale water freezes at 32 F and
boils at F
 Celsius scale or a centigrade(C) – is named
after Swedish scientist Andres Celsius who
proposed the scale at which the freezing point
of water is C and the boiling is 100C.
Temperature is measured in either Celsius or
Fahrenheit, with a fever defined as greater then 38-
38.5 C or 101-101.5 F.
TWO TYPES OF BODY TEMPERATURE
Core temperature
 Temperature of the deep tissues of the body
 Remains relatively constant unless exposed to
sever extremes in environmental temperature
 Assessed by using a thermometer
Surface temperature
 Temperature of the skin
 May vary a great deal in response to the
environment
 Assessed by touching the skin
COMMON SITES FOR BODY TEMPERATURE
 Mouth (oral)
 Place in the posterior sublingual
pocket of the tongue
 Contraindicated in infant and children
below 6 years old, unconscious
patient and those receiving oxygen
 therapy, confused and with convulsive  The ventricular contraction
disorder. approximately 60-100 ml of blood
 Taken 5 to 7 minutes. enters the aorta, distending the aortic
 Rectum (rectal or anal) walls and creating the pulse wave.
 Most accurate but inconvenient and  Pulse wave of blood created by the
unpleasant contraction by the left ventricle of the
 Taken 3 minutes heart.
 Axilla (armpit)
AGE HEART RATE
 Preferred in children and fastest. (beats/min)
 Ear INFANTS 120-160
TODDLERS 90-140
SITE NORMAL RANGE
ORAL PRESCHOOLERS 80-110
98.6 97.6 TO 99.6
RECTAL SCHOOL AGERS 75-100
99.6 98.6 TO
ADOLESCENT 60-90
100.6
AXILLARY ADULTH 60-100
97.6 96.6 TO 98.6
TYMPANIC 98.6 98.6
TEMPORAL 98.6 98.6 PURPOSE OF PULSE ASSESSMENT

1. To obtain a baseline measure of the client’s

3 TYPES OF THERMOMETER heart rate and rhythm.
a. Mercury fluid 2. To monitor changes in the client’s
b. Electronic cardiovascular status.
 Battery operated unit 3. To monitor the hearts response to a disease,
c. Disposable chemical / digital thermometer procedure or therapy.
 Thermometer is inserted in the client’s tongue 4. To assess blood flow to a specific body part.
and left in place for the time recommended  Infant rates range from 100-160 beats
by the manufacture. Ex. 45 sec per minutes.
 4 years of age ranges from 80-120
Tympanic thermometer – measures the temperature beats per minutes.
in the tympanic membrane (Eardrum) fast and  Adolescent and adults ranges from
accurate-1 to 3 seconds 60-100 beats per minutes.
Infants- pull the ear straight back PULSE SITE
Adults and children over 1 year – pull ear up and 1. Apical – apex of the heart (central pulse)
back. 2. Temporal pulse – temporal bond (superior
PARTS OF THE TEMPERATURE and lateral to the eye)
3. Carotid pulse – site of the neck, below the
 Bulb or mercury bulb lobe of the ear.
 Stem of the body 4. Radial – palpated at the thumb side of the
 Mercury inner aspect of the wrist.
5. Femoral pulse – palpated between the
TERMINOLOGIES
anterior iliac spines.
1. Pyrexia – in a lay term “FEVER” an elevated 6. Brachial pulse – antecubital space (medially)
body temperature result is higher than the 7. Popliteal pulse – palpated in the popliteal
normal value of 39.5  forsa (knee crease)
2. Hypothermia – an abnormally low body 8. Dorsalis pulse – palpated along the top of the
temperature. Body temperature falls below foot pedal.
34.5 and could lead to death. 9. Posterior pulse – palpated on the inner side
3. Hyperthermia – an abnormally high body of each ankle.
temperature. A very high fever about 41. COUNTING A PULSE
B. Pulse
Usually count a pulse for 30 secs and multiply the
number times 2 to get the pulse rate for 1 minute.
 Note the rhythm (pattern) of the heart beat –
if is irregular we count the pulse for a full
minute
 Also observe the force (strength) of the
heartbeat.
 Most common site used for taking a pulse
 Can be taken without disturbing or exposing
the person
 Place the first two or three fingers of one
hand against the radial artery
 The radial artery is on the thumbs side of the
wrist
 Do not use your thumb to take a person’s
pulse
 Use gently pressure
 Count the pulse for 30 seconds and multiply
by two
Wrist pulse - The pulse rate may fluctuate and
increase with exercise, illness, injury, and emotions.
Girls ages 12 and older and women, in general, tend
to have faster heart rates than do boys and men.
Neck pulse - If the rate is particularly slow or fast, it is
probably best to measure for a full 60 seconds in
order to minimize the error.
DEFINITION OF TERMS
1. Tachycardia – increase beats about 100
2. Bradycardia – beats lower than 60
3. Bouncing pulse – a pulse that reaches higher
level than normal then disappears quickly
4. Feeble, weak, thread pulse – terms use for a
pulse whose volume is small and can blew
readily liberated. Very weak but rapid.
5. Running pulse – a pulse rate that is too fast to
counted sometimes difficult to count.
C. Respiration
 Act of breathing which include the intake of
oxygen and output of carbon dioxide.
 Process of oxygen intake and carbon dioxide
output by the lungs
 Normal respiration rate 12-20 breaths per
minutes
 Respiratory center located at the medulla or
brain stem
PURPOSE OF RESPIRATION ASSESSMENT
1. To obtain baseline data on respiratory rate
and characteristics
2. To monitor effect by pathologic condition
such as infection on the client respiration.
3. To monitor the client’s response to a specific
therapy.
4 INTERRELATED PROCESSES OF
RESPIRATION
1. Ventilation – the movement of air into and
out of the lungs
2. Conduction – the movement of air through
lung airways
3. Diffusion – the movement of oxygen and
carbon dioxide between the alveoli and red
blood cells.
4. Perfusion – the distribution of blood flow
though pulmonary capillaries.
DEFINITION OF TERMS
1. Eupnea – normal breathing. Inspiration is
1.5sec, expiration 2-3 sec.
2. Apnea – absence of breathing
3. Bradypnea – decrease respiratory rate.
4. Dyspnea – difficult and painful breathing
5. Tachypnea – fast shallow breathing there is
an increase of respiratory rate.
6. Kassmaul respiration – air hunger. A rapid or
intense respiration.
7. Orthopnea – breathing easier when person sit
or stand.
8. Biot’s respiration – irregular in rate and depth
without emerging patterns.
9. Hyperventilation- refers to very deep, rapid
respiration
10. Hypoventilation – refers to shallow
respiration.
PARTS OF THE STETHOSCOPE
1. DIAPHRAGM
2. EARPIECE
3. TUBE OR STEM
Always clean the earpieces of the stethoscope
with alcohol before and after use.
Warm the diaphragm in your hand before
placing it on the person.
Hold the diaphragm in place over the artery
Do not let the tubing strike against anything
while the stethoscope is being used.
Respiration rates may increase with fever,
illness. When checking respiration, also note
whether a person has any difficulty breathing.
  Instruct your patients to avoid coffee, using a stethoscope, the nurse identities FIVE
smoking or any other unprescribed PHASES in the series of sounds called KOROTKOFF.
drug with sympathomimetic activity
1st systolic – pressure of blood as a result of
on the of the measurement.
contraction of the ventricle. Faint, clear and
D. BLOOD PRESSURE tapping sounds are hears. (Identify at least two
 Is force exerted by the blood against consecutive tapping sounds.
the arterial walls.
 Consists of systolic and diastolic 2nd murmuring sounds or swishing, soft blowing
pressure. SYSTOLIC is the pressure of sound.
the blood as a result of the
3rd more crisper
contraction of the ventricles.
DIASTOLIC is the pressure when the 4th maffled
ventricles are at rest.
5th disappearing sounds.
 120/80 mmHg normal for adult
 105/65 mmHg for children Instrument used – SPHYGMOMANOMETER
 Pulse pressure – the difference
2 TYPES OF SPHYGMOMANOMETER
between the systolic and diastolic
pressure. 1. Aneroid
 Reflect to the output of blood volume, 2. Mercury
peripheral blood viscosity, arterial
(effect the blood pressure)
 Viscosity – the sticky of the blood.

Systolic blood pressure is the pressure at which you

can first hear the pulse.

 In systolic 140 or below is a normal

systolic reading.

Diastolic blood pressure is the last pressure at which

you can still hear the pulse.

 In diastolic 90 or below is a normal

diastolic reading.

Avoid moving your hands or the head of the

stethoscope while you are taking readings as this may
produce noise that can obscure the sounds of
karatkoff.
PURPOSE OF THE BLOOD PRESSURE  sitting position
ASSESSMENT  arm and back are supported
 feet should be resting firmly on the floor
1. To obtain baseline blood pressure
 feet not dangling.
measurements.
2. To assess the client’s cardiovascular status -raise patient arm so that the branchial artery is
3. To assess thew client’s response to blood or roughly at the same height as the heart. If the arm is
fluid volume loss after surgery, childbirth, held too high, the reading will be artifactually lowered
trauma or burns. and vice versa.
4. To evaluate the client’s response to charges in
-listen for auditory vibrations from artery ”
his condition after treatment with fluids,
bump,bump,bump” (Korotkoff).
medication, or other therapies.
PARTS OF SPHYMOMANOMETER
KOROTKOFF’S SOUNDS – the sound that can hear.
Gradually lowered. When taking a blood pressure 1. Cuff
2. Scale
 3. Pump/ Bulb ELEVATED 120- And Less
4. Regulator / Valve 129 than 80
HIGHBLOOD 130- Or 80-89
DEFINITION OF TERMS
PRESSURE(HYPERTEN 139
1. Hypertension – abnormally high BP over SION) STAGE 1
140mmHg systolic and/or 90 mmHg diastolic HIGH BLOOD 140 or Or 90 or
confirmed by minimum of 2 consecutive visits. PRESSURE higher higher
(HYPERTENSIO)
2. Hypotension – abnormally low BP with
STAGE 2
systolic below 100 mmHg.
HYPERTENSIVE CRISIS Higher And/ Higher
FACTORS INFLUENCING BLOOD PRESSURE (consult your doctor than or than
immediately) 180 120
 Age
 Stress
 Ethnicity CAUSES OF HYPERTENSION
 Gender  Stress
 Daily variation  Anxiety
 Medications  Obesity
 Activity, weight  High salt intake
 Smoking  Aging
Female Age SBP DBP  Kidney disease
21-25 115.5 70.5  Vascular conditions
26-30 113.5 71.5  Hypertension is often called the “silent killer”
31-35 110.5 72.5
-physician will want to see multiple blood pressure
36-40 112.5 74.5
measurements over several days or weeks before
41-45 116.5 73.5
making a diagnosis of hypertension and imitating
46-50 124 78.5
treatment.
51-55 122.5 74.5
56-50 132.5 78.5 10 HERBAL PLANTS APPROVED
61-65 130.5 77.5
BY DOH
Age Group Female Male 1. AKAPULKO / ACAPULKO
15 to 18 117/77 mmHg 120/85 mmHg Scientific name: Cassia Alata
19 to 24 120/79 mmHg 120/79 mmHg
25 to 29 120/80mmHg 121/80 mmHg Common name: Ring Worm Bush
30 to 35 122/81mmHg 123/82 mmHg
Mode of action:
36 to 39 123/82mmHg 124/83 mmHg
40 to 45 124/83mmHg 125/83 mmHg  It contains chrysophanic acid, a fungicide used
46 to 50 126/84mmHg 127/84 mmHg to treat fungal infections, like; ringworms,
51 to 55 129/85mmHg 128/85 mmHg scabies and eczema.
56 to 60 130/86mmHg 131/87 mmHg
60 and above 134/87mmHg 135/88 mmHg Indication:

 Treatment of skin disease

BLOOD PRESSURE CATEGORIES  Tinea infections, insect bites, ringworms.
BLOOD PRESSURE SYSTOL DIASTOL Eczema, scabies and itchiness.
CATEGORY IC IC 2. AMPALAYA
mmHg mmHg
Scientific name: Momordica Charantia
(upper (lower
numbe number Common name: Bitter Gourd
r) )
NORMAL Less And Less Mode of action:
than than 80
120
  It increases the production of beta cells by the  Helps lower bad cholesterol level
pancreas, thus improving the body’s ability to  Aids in lowering blood pressure
produce insulin, which controls the blood  Relieves toothache
sugar for diabetes.  With anticoagulant properties
6. LAGUNDI
Indication:
Scientific name: Vitex Negundo
 Lower blood sugar levels.
3. Bayabas Indication:
Scientific name: Psidium guajava  Asthma, cough and fever
 Skin diseases (dermatitis, scabies, ulcer,
Common name: Guyabas
eczema) and wounds
Mode of action:  Headache
 Rheumatism, sprain, contusion and insect
 Has antidiarrheal effect, antibacterial
bites.
antiamebic and antispasmodic activity. It has
7. Niyog-niyugan
shown to have a tranquilizing effect on
intestinal smooth muscle, inhibit chemical Scientific name: Quisqualis indica
processes found in diarrhea and aid in the re-
Common name: Chines Honey Suckle
absorption of water in the intestines.
Indication:
Indication:
 Anti-helmenthic
 Antiseptic and astringent
8. Ulansimang Bato
 Kills bacteria, fungi and amoeba
 Used to treat diarrhea Scientific name: Peperomia Pellucida
4. YERBA BUENA
Common name: Pansit-Pasitan
Scientific name: Mentha Cordifelia
Indication:
Common name: Pepper Mint
 Lower uric acid
Indication:  Helps prevent rheumatism and gout
9. Sambong
 Arthritis
 Toothaches Scientific name: Camphor
 Relief of intestinal gas
Indication:
 Stomach aches
 Headaches  Diuretic agent
 Mouthwash  Effective in dissolving kidney stones
 Indigestion  Relieves stomach pains
5. BAWANG 10. Tsang gubat
Scientific name: Allium Sativum Scientific name: Carmona Retusa
Common name: Ajos Common name: Tsa
Mode of action: Mode of action:
 It contains antibacterial compound known as  Has high fluoride content, it is used as a
allicin. Garlic juice inhibits the growth of fungi mouth gargle for preventing tooth decay
and a virus thus prevents viral, yeast and
fungal infections. Garlic was said to have Indication:
positive result in lowering cholesterol and  Stomach pains gastroenteritis
blood pressure.  Intestinal motility dysentery
Indication:  Diarrhea
 Mouth gargle