NCM 107
PEDIA LECTURE
Scope of Practice
- Defines the boundaries of the
practitioner’s license
- Describes the “who”, “what”,
“where”, “when”, “why” and
“how” of nursing practice.
Standards
- Are authoritative statements of the
duties that all registered nurses,
regardless of role, population, or
specialty, are expected to perform
competently.
- Describe a competent level of
nursing care as demonstrated by the
critical thinking model known as the
nursing process.
Scope and Standards of Maternal and
Child Practice
● Health Care Technology
● Area of childbearing and childrearing
families
● As children grow, families need
continued health supervision and
support to ensure children remains
well
● As teenagers or young adults reach
maturity and begin to plan for their
own families, the cycle repeats and a
new generation of support becomes
necessary
● Although nursing has, in the past,
typically divided its concerns for
families during childbearing and
childrearing into two separate
entities, maternity care and child
health care are not two separate
entities, but a continuum
Examples of the Scope of Practice
⮚ Preconceptual Health Care – Care
of Women during three trimester of
pregnancy and the puerperium (the
6 weeks after childbirth, sometimes
termed the fourth trimester of
pregnancy)
⮚ Care of infants during the perinatal
period (the time span beginning at
20 weeks of pregnancy to 4 weeks [
28 days] after birth)
⮚ Care of children from birth through
young adulthood – care in settings
as diverse as a birthing room
Legal Considerations of Maternal-Child
Practice
1. New technologies
- Can lead to potential legal actions,
especially if clients are uninformed
about the reason or medical
necessity for these procedures.
2. Nurses are legally responsible for
protecting the right of their clients,
including confidentiality, and are
accountable for the quality of their
individual nursing care and that of
other health care team members.
New regulations on patient
confidentiality guarantee patients
can see their medical records if
they choose, but health information
must be kept confidential from
others.
NCM 107
PEDIA LECTURE
3. Understanding the scope of practice Resuscitation (for how long should it be
(the range of services and care that continued?)
may be provided by a nurse based
on state requirements) and
standards of care can help nurses Number of procedures or degree of pain
practice within appropriate legal a child should be asked to endure to
parameters. achieve a degree of better health.

4. Documentation is essential for

justifying actions. Balance between modern technology and
quality of life
5. Nurses need to be conscientious
about obtaining informed consent
for invasive procedures in children
and determining if pregnant women Difficulty maintaining confidentiality of
are aware of any risk to the fetus records when there are multiple caregiver
associated with a procedure or test.

PATIENT’S RIGHTS
6. If a nurse knows the care provided
1. Right to Appropriate Medical Care
by another practitioner was
and Humane treatment
inappropriate or insufficient, he or
2. Right to Informed Consent
she is legally responsible for
3. Right to Privacy and Confidentiality
reporting the incident. Failure to do
4. Right to Information
so can lead to a charge of
5. The Right to Choose Health Care
negligence or breach of duty.
Provider and Facility
6. Right to Self-Determination
7. Right to Religious Belief
ETHICO-MORAL Considerations of
8. Right to Medical Records
Maternal-Child Practice
9. Right to Leave
10. Right to Refuse Participation in
Conception issues, especially those
Medical Research
related to in vitro fertilization, embryo
11. Right to Correspondence
transfer, ownership of frozen oocytes or
and Receive Visitors
sperm, and surrogate motherhood
12. Right to Express Grievances
Abortion 13. Right to be Informed of His Rights
and Obligations as a Patient
Fetal rights versus rights of the mother
Stem cell research

-These stem cells are manipulated to

specialize into specific types of cells, such
as heart muscle cells, blood cells or nerve
cells. The specialized cells can then be
implanted into a person.
NCM 107
PEDIA LECTURE

COGNITIVE DEVELOPMENT .
Conservation Errors:
● PreSchool age is within 3-5 years old
Conservation refers to the ability to
recognize that moving or rearranging
matter does not change the quantity.

PHYSICAL GROWTH .
• Pulse rate decreases 85 beats/min EGOCENTRISM .
• Respiratory rate, 20 to 25 breaths/min
• Blood pressure 100/60 mmHg ● EGOCENTRISM refers to the child’s
inability to see a situation from another
• Levels of immune globulin (Ig) G and
person’s point of view.
IgA antibodies increase.

Height and Weight:

o Average growth is 6-8 cm and 2 kg per
year during early childhood
o Girls are only slightly smaller and
lighter than boys
o Trunks and legs lengthen; heads
become more proportional
o Overall decline in body fat during
preschool years • Imitation: Preschoolers imitate the roles
o Future body type ectomorphic (slim of the people around them.
body build) or endomorphic (large • Role playing should be fun and does not
body build) becomes apparent. have to be accurate.

PSYCHOSEXUAL DEVELOPMENT .

PHALLIC STAGE (3 to 6 years)

• The phallic stage is the third stage of
psychosexual development,
spanning the ages of three to six
years, wherein the infant's libido
(desire) centers upon their genitalia
as the erogenous zone.

o Knock-knees (Genu valgus).

NCM 107
PEDIA LECTURE
PHALLIC STAGE (3 to 6 years)
• The child becomes aware of
anatomical sex differences, which
sets in motion the conflict between
erotic attraction, resentment, rivalry,
jealousy and fear which Freud called
the Oedipus complex (in boys) and
the Electra complex (in girls).
• This is resolved through the process of
identification, which involves the
child adopting the characteristics of
the same sex parent.
PSYCHOSEXUAL DEVELOPMENT .
MORAL DEVELOPMENT .
PRECONVETIONAL
• Stage 1. Obedience and Punishment
Orientation (2-3 years old)
The child/individual is good in order
to avoid being punished. If a person is
punished, they must have done wrong.
• Stage 2. Individualism and Exchange (4-7
years old)
At this stage, children recognize that
there is not just one right view that is
handed down by the authorities. Different
individuals have different viewpoints.

PHALLIC STAGE (3 to 6 years) COMMON FEARS OF PRESCHOOLER .

During the phallic stage what the boy loves
most is his penis. Hence the boy develops 1. Fear of the dark
castration anxiety. 2. Fear of mutilation
3. Fear of separation or abandonment
PHALLIC STAGE (3 to 6 years)
• Fixation at the phallic stage develops BEHAVIOR VARIATIONS .
a phallic character, who is
reckless, resolute, self assured, and 1. Telling tall tales
narcissistic--excessively vain and 2. Imaginary friends
proud. 3. Difficulty sharing
• The failure to resolve the conflict can 4. Regression
also cause a person to be afraid or 5. Sibling rivalry
incapable of close love; Freud also
postulated that fixation could be a root
cause of homosexuality.

PSYCHOSOCIAL DEVELOPMENT .

Initiative vs. Guilt

o During the preschool years, children
begin to assert their power and
control over the world through
directing play and other social
interaction.
o Children who are successful at this
stage feel capable and able to lead
others. o Those who fail to acquire
these skills are left with a sense of guilt,
self-doubt and lack of initiative.
NCM 107
PEDIA LECTURE
CONCERNS OF GIRLS
1. change in pelvic contour
2. breast development
3. menstruation
● Refers to children between the ages 0f 4. vaginal secretions
6-12 years
● School-age child development CONCERNS OF BOYS
describes the expected physical, 1. hypertrophy of breast tissue
emotional, and mental abilities of 2. increased seminal fluid
children ages 6-12. 3. nocturnal emissions
● The school-age years are a time of
steady growth and development. CONCERNS FOR TRANSGENDER
CHILDREN
GROWTH AND DEVELOPMENT OF A 1. psychosocial disorder
. SCHOOL AGE CHILD . 2. depression

PHYSICAL GROWTH TEETH

- deciduous teeth are lost and permanent
Weight teeth erupt
- Average annual weight gain • the average child gains 28 teeth
- approximately 3-5 lbs (1.3-2.2 kg) between 6-12 years
Height
- Increase in height is 1-2 inches
Pulse Rate
- 70-80 bpm
Blood Pressure
- 112/60 mmHg

SEXUAL MATURATION

Girls
- usually occurs between the years of 12
and 18
Boys
- between 14-20 years
NCM 107
PEDIA LECTURE
DEVELOPMENTAL MILESTONES . . CONSERVATION .
- the ability to appreciate that a
change in shape does not
COGNITIVE DEVELOPMENT necessarily mean a change in
size.
Concrete Operational Stage (7 to 11 Years)
● During this stage, children
begin to thinking logically
about concrete events o
They begin to understand
the concept of
conservation; that the
amount of liquid in a
short, wide cup is equal to
that in a tall, skinny glass, CLASS INCLUSION .
for example - the ability to understand that objects
can belong to more than one
● Their thinking becomes
classifications
more logical and
organized, but still very
concrete
● Children begin using
inductive logic, or
reasoning from specific
information to a general
principle

. DECENTERING .
- also known as decentration
- refers to the ability to consider
multiple aspects of a situation
- is the ability to project one’s self into
other people’s situations and see the
world from their viewpoint rather than
focusing only on their own view.
PSYCHOSEXUAL DEVELOPMENT .
. ACCOMODATION .
- the ability to adapt thought The Latent Period (6 years to Puberty)
processes to fit what is Erogenous Zone: Sexual Feelings Are Inactive
perceived such as understanding - The latent period is a time of
that there can be more than one exploration in which the sexual
reason for other people’s action energy repressed or dormant.
This energy is still present, but
it is sublimated into other areas
such as intellectual pursuits and
social interactions. This stage is
important in the development of
NCM 107
PEDIA LECTURE
social and communication skills down by the authorities.
and self-confidence. Different individuals have
- As with the other psychosexual different viewpoints.
stages, Freud believed that it
CONVENTIONAL
was possible for children to
become fixated or "stuck" in Stage 3. Orientation to
interpersonal relations of
this phase.
mutuality (7-10 years)
- Fixation at this stage can result
in immaturity and an inability to - the child follows rulesbecause
form fulfilling relationships as of a need to be a good person
an adult. in own eyes and eyes of
others.

PSYCHOSOCIAL DEVELOPMENT . Stage 4. Maintenance of Social

Order, Fixed Rules, and Authority
Psychosocial Conflict: Industry vs. Inferiority ( 10- 12 years old)
- Major Question: "How can I be good?" - childs find following rules
- Basic Virtue: Competence satisfying.
- Important Event(s): School - follow rules of authority
- Through social interactions, children
figures as well as parents in
begin to develop a sense of pride in
an effort to keep the system
their accomplishments and abilities.
working
- Children need to cope with new social
and academic demands. Success leads
to a sense of competence, while
failure results in feelings of inferiority. . COMMON HEALTH PROBLEMS OF .
. SCHOOL AGE PERIOD .
MORAL DEVELOPMENT .
1. DENTAL CARIES
- caries or cavities
- School age children begin to mature in
2. MALOCCLUSION
terms of moral development as they
- a deviation of tooth position
enter a stage of
from the normal
PRECONVENTIONAL
- congenital
REASONING, sometimes as early as 5
- familial traits
years old (Kohlberg, 1984)
- During this stage, if asked, “why it is
wrong to steal from your neighbor?” . COMMON FEAR AND ANXIETIES OF .
they will answer “the police says it’s . SCHOOL AGE PERIOD .
wrong or “because if you do, your go
to jail.” 1. Anxiety related to beginning school
2. School refusal or phobia
3. Homeschooling .
PRECONVENTIONAL 4. Children who spend time
independently
Stage 2. Individualism and Exchange (4-7
5. Sex education
years old)
6. Stealing
- At this stage, children 7. Bullying
recognize that there is not just
one right view that is handed
NCM 107
PEDIA LECTURE
ADOLESCENT . and scrotum grow as early as age 9.
● the period between the ages 13 and up
to 20 years
● A time that serves as a transition
between childhood and becoming a
late adolescent.
- early period (13-14 years)
- middle period (15-16 years)
- late period (17- 20 years)
GROWTH AND DEVELOPMENT OF AN
. ADOLESCENT .
● Most girls are 1-2 inches taller than
boys coming into adolescence but
generally stop growing within 3 years
from menarche and so are shorter than
boys by the end of adolescence.
● Boys typically grow about 4-12 inches
in height and gain about 7-30 kg
during their teenage years.
● Girls grow 2-8 inches in height and
gain 7-25 kg.
● Growth stops with closure of the
epiphyseal lines of the long bones
which occurs at about 16-17 years of
age in females and about 18-20 years
of age in males
TEETH
- gain their second molars about 13
years of age and third molars (wisdom
teeth) between 18-21 years of age
PUBERTY
- is the time at which an individual first
becomes capable of sexual
reproduction
- a girl has entered puberty when she
begins to menstruate
- a boy enters puberty when he begins to
produce spermatozoa
BOYS
- the first puberty change is the
enlargement of the scrotum and testes.
- may begin to notice that their testicles
Soon, the penis begins to lengthen.
- by age 17 or 18, their genitals are
usually at their adult size and shape.
GIRLS
- the first puberty change is the
development of breast buds.
- may begin to develop breast buds as
early as 8 years old. Breasts develop
fully between ages 12 and 18.
DEVELOPMENTAL MILESTONE .
PLAY OR RECREATION
- social games and play
- recreation and leisure activities
involving the opposite sex (by middle
adolescent): outing, swimming, picnics
and parties
- dating activities, movies
- daydreaming activities
- lengthy telephone conversations with
friends of the opposite sex
PSYCHOSOCIAL DEVELOPMENT .
- In EARLY TO MIDDLE
ADOLESCENCE (ages 12–18),
children face the task of identity vs.
role confusion.
- According to Erikson, an adolescent’s
main task is developing a sense of self.
Adolescents struggle with questions
NCM 107
PEDIA LECTURE
such as “Who am I?” and “What do I
want to do with my life?”
- Along the way, most adolescents try on
many different selves to see which
ones fit; they explore various roles and
ideas, set goals, and attempt to
discover their “adult” selves.
- Adolescents who are successful at this
stage have a strong sense of identity
and are able to remain true to their
beliefs and values in the face of
problems and other people’s
perspectives.
FOUR MAIN AREAS
-in which they must make gains to achieve a
sense of identity
1. accepting their change body image
2. establishing a value system or what
kind of person they want to be
3. making a career decision
4. becoming emancipated from parents
-IF young people do not achieve a sense of
identity, they can have little idea what kind of
person they are or may develop ROLE
CONFUSION
LATE ADOLESCENT
- In LATE ADOLESCENCE (ages
18-20-40), adolescent face the task of
intimacy vs. isolation.
- from late adolescence to early middle
age, 18 to 40.
- A strong sense of self must be
developed in adolescencein order to
create intimate relationships with
others during this stage.
- Adults who lack a positive self-concept
may experience emotional isolation or
loneliness.
- developing sense of intimacy means a
late adolescent is able to form
long-term, meaningful relationships
with persons of the opposite as well as
their same sex.
- those who do not develop sense of
intimacy are left feeling isolated
- a sense of intimacy is closely related to
the sense of trust learned in the first
year of life because, without the
feeling that one can trust others,
building a sense of intimacy is difficult
COGNITIVE DEVELOPMENT .
● FORMAL OPERATIONAL
THOUGHT
- the final stage of cognitive
development
- begins at age 12 or 13 years
and grows in depth over the
adolescent years, although it
may not be complete until
about age 25 years.
- this step involves the ability to
use scientific method
(deductive reasoning) to arrive
at conclusions
MORAL DEVELOPMENT .
POSTCONVENTIONAL (12 years and older)
Stage 5: Social-Contract, Utilitarian
Law-Making Perspective
- follows standard for the good of all people
Stage 6: Universal-Ethical-Principal
Orientation
- follow internalized standards of conduct
(many adult do not reach this level of moral
development)
PSYCHOSEXUAL DEVELOPMENT .
Genital Stage
Age Range: Puberty to Death
Erogenous Zone: Maturing Sexual Interests
- The onset of puberty causes the libido
to become active once again.
- During the final stage of psychosexual
development, the individual develops a
strong sexual interest in the opposite
NCM 107
PEDIA LECTURE
sex. This stage begins during puberty SAFETY .
but last throughout the rest of a
person's life. A. leading cause of death: ACCIDENTS
- Where in earlier stages the focus was - motor vehicular accident
solely on individual needs, interest in - sports injuries
the welfare of others grows during this - firearms accidents
stage. The goal of this stage is to
establish a balance between the various REGULAR SCREENING .
life areas.
A. hemoglobin/and hematocrit
SLEEP . - to determine iron deficiency
- requires 8-10 hours of night sleep to anemia, especially in girls
prevent fatigue and susceptibility to having the first menses
infection (menarche)
- may experience a change in sleep
patterns B. urinalysis
- occasional afternoon naps/ daytime - to identify urinary tract
sleeping: infection (UTI), especially in
*possibly due to physical maturity, girls who are predisposed to it
reduced nocturnal sleep and fatigue because of the shortness of the
- “wet dreams” in boys: orgasm and female urethra
release of semen during sleep known
as nocturnal emission a normal C. physical assessment (and X-ray, as
phenomenon needed)
- for detection of scoliosis, a
FEARS . condition common in pre-
adolescent to adolescent
- fear of threat to body image: body females
odor, acne and obesity
- fear of injury or death...death is viewed D. gynecologic care for females
as unfulfilled dreams
- fear of the unknown E. breast examination
- for detection of breast cancer
COMMON HEALTH PROBLEMS OF AN .
ADOLESCENT . F. testicular examination
- For detection of testicular
1. Hypertension cancer
2. Poor posture
3. Body piercing and tattoos
4. Fatigue
5. Menstrual irregularities
6. Acne
7. Obesity
NCM 107
PEDIA LECTURE
1.RIGHT TO APPROPRIATE MEDICAL
CARE
-Every person has a right to health and
medical care corresponding to his state of
health, without any discrimination and within
the limits of the resources, manpowerand
competence available for health and medical
care at the relevant time. The patient has the
right to appropriate health and medical care of
good quality. In the course of such, his human
dignity, convictions, integrity, individual
needs and culture shall be respected. If any
person cannot immediately be given treatment
that is medically necessary he shall,
depending on his state of health, either be
directed to wait for care, or be referred or sent
for treatment elsewhere, where the appropriate
care can be provided. If the patient has to wait
for care, he shall be informed of the reason
for the delay. Patients in emergency shall be
extended immediate medical care and
treatment without any deposit, pledge,
mortgage or any form of advance payment for
treatment.
2. RIGHT TO INFORMED CONSENT
-The patient has a right to a clear, truthful and
substantial explanation, in a manner and
language understandabl e to the patient, of all
proposed procedures, whether diagnostic,
preventive, curative, rehabilitative or
therapeutic, wherein the person who will
perform the said procedure shall provide his
name and credentials to the patient,
possibilities of any risk of mortality or serious
side effects, problems related to recuperation,
and probability of success and reasonable
risks involved: Provided, That the patient will
not be subjected to any procedure without his
written informed consent, except in the
following cases:
a) in emergency cases, when the patient
is at imminent risk of physical injury,
decline Of death if treatment is withheld
or postponed. In such cases, the
physician can perform any diagnostic or
treatment procedure as good practice of
medicine dictates without such consent;
b) when the health of the population is
dependent on the adoption of a mass
health program to control epidemic;
c) when the law makes it compulsory for
everyone to submit a procedure; d) When
the patient is either a minor, or legally
incompetent, in which case. A third party
consent Is required;
e) when disclosure of material information to
patient will jeopardize th e success of
treatment, in which case, third party
disclosure and consent shall be in order;
f) When the patient waives his right in writing.
Informed consent shall be obtained
from a patient concerned if he is of
legal age and of sound mind. In case the
patient is incapable of giving consent
and a third
party consent is required. the following
persons, in the order of priority stated
hereunder, may give consent:
i. spouse;
ii. son or daughter of legal age;
iii. either parent;
iv. brother or sister of legal age, or
v. guardian
If a patient is a minor, consent shall be
obtained from his parents or legal guardian. If
next of kin, parents or legal guardians refuse
to give consent to a medical or surgical
procedure necessary to save the life or limb of
a minor or a patient incapable of giving
consent, courts, upon the petition of the
physician or any person interested in the
welfare of the patient, in a summary
proceeding, may issue an order giving
consent.
NCM 107
PEDIA LECTURE
3. RIGHT TO PRIVACY AND
CONFIDENTIALITY.
- The privacy of the patients must be assured
at all stages of his treatment. The patient has
the right to be free from unwarranted public
exposure, except in the following cases: a)
when his mental or physical condition is in
controversy and the appropriate court, in its
discretion, order him to submit to a physical or
mental examination by a physician; b) when
the public health and safety so demand; and c)
when the patient waives this right in writing.
-The patient has the right to demand that all
information, communication and records
pertaining to his care be treated as
confidential. Any health care provider or
practitioner involved in the treatment of a
patient and all those who have legitimate
access to the patient's record is not authorized
to divulge any information to a third party
who has no concern with the care and welfare
of the patient without his consent, except: a)
when such disclosure will benefit public
health and safety; b) when it is in the interest
of justice and upon the order of a competent
court;
and c) when the patients waives in writing the
confidential nature of such information; d)
when it is needed for continued medical
treatment or advancement of medical science
subject to de-identification of patient and
shared medical confidentiality for those who
have access to the information.
-Informing the spouse or the family to the first
degree of the patient's medical condition may
be allowed; Provided That the patient of legal
age shall have the right to choose on whom to
inform. In case the patient is not of legal age
or is mentally incapacitated, such information
shall be given to the parents, legal guardian or
his next of kin.
4. RIGHT TO INFORMATION.
- In the course of his/her treatment and
hospital care, the patient or his/her legal
guardian has a right to be informed of the
result of the evaluation of the nature and
extent of his/her disease, any other additional
or further contemplated medical treatment on
surgical procedure or procedures, including
any other additional medicines to be
administered and their generic counterpart
including the possible complications and
other pertinent facts, statistics or studies,
regarding his/her illness, any change in the
plan of care before the change is made, the
person's participation in the plan of care and
necessary changes before its implementation,
the extent to which payment maybe expected
from Philhealth or any payor and any charges
for which the patient maybe liable, the
disciplines of health care practitioners who
will fumish the care and the frequency of
services that are proposed to be furnished.
-The patient or his legal guardian has the right
to examine and be given an itemized bill of
the hospital and medical services rendered in
the facility or by his/her physician and other
health care providers, regardless of the
manner and source of payment.He is entitled
to a thorough explanation of such bill.
-The patient or hislher legal guardian has the
right to be informed by the physician or
his/her delegate of hisJher continuing health
care requirements following discharge,
including instructions about home
medications, diet, physical activity and all
other pertinent information to promote health
and well-being.
-At the end of his/her confinement, the patient
is entitled to a brief, written summary of the
course of his/her illness which shall include at
least the history, physical examination,
diagnosis, medications, surgical procedure,
ancillary and laboratory procedures, and the
plan of further treatment, and which shall be
provided by the attending physician. He/she is
NCM 107
PEDIA LECTURE
likewise entitled to the explanation of, and to
view, the contents of medical record of his/her
confinement but with the presence of his/her
attending physician or in the absence of the
attending physician, the hospital's
representative. Notwithstanding that he/she
may not be able to settle his accounts by
reason of financial incapacity, he/she is
entitled to reproduction, at his/her expense, the
pertinent part or parts of the medical record
the purpose or purposes of which he shall
indicate in his/her written request for
reproduction. The patient shall likewise be
entitled to medical certifICate, free of charge,
with respect to his/her previous confinement.
5. THE RIGHT TO CHOOSE HEALTH
CARE PROVIDER AND FACILITY.
- The patient is free to choose the health care
provider to serve him as well as the facility
except when he is under the care of a service
facility or when public health and safety so
demands or when the patient expressly waives
this right in writing.
- The patient has the right to discuss his
condition with a consultant specialist, at the
patient's request and expense. He also has the
right to seek for a second opinion and
subsequent opinions, if appropriate, from
another health care provider/practitioner.
6. RIGHT TO SELF-DETERMINATION.
- The patient has the right to avail
himself/herself of any recommended
diagnostic and treatment procedures.Any
person of legal age and of sound mind may
make an advance written directive for
physicians to administer terminal care when
he/she suffers from the terminal phase of a
terminal illness: Provided That
A. he is informed of the medical
consequences of his choice;
B. he releases those involved in his care
from any obligation relative to the
consequences of his decision;
C. his decision will not prejudice public
health and safety.
7. RIGHT TO RELIGIOUS BELIEF.
- The patient has the right to refuse medical
treatment or procedures which may be
contrary to his religious beliefs, subject to the
limitations described in the preceding
subsection: Provided, That such a right shall
not be imposed by parents upon their children
who have not reached the legal age in a life
threatening situation as determined by the
attending physician or the medical director of
the facility.
8. Right to Medical Records.
- The patient is entitled to a summary of his
medical history and condition.He has the right
to view the contents of his medical records,
except psychiatric notes and other
incriminatory information obtained about
third parties, with the attending physician
explaining contents thereof. At his expense
and upon discharge of the patient, he may
obtain from the health care institution a
reproduction of the same record whether or
not he has fully settled his financial obligation
with the physician or institution concerned.
- The health care institution shall safeguard the
confidentiality of the medical records and to
likewise ensure the integrity and authenticity
of the medical records and shall keep the
same within a reasonable time as may be
determined by the Department of Health.
- The health care institution shall issue a
medical certificate to the patient upon
request.Any other document that the patient
may require for insurance claims shall also be
made available to him within forty-fIVe (45)
days from request.
9. RIGHT TO LEAVE.
- The patient has the right to leave hospital or
any other health care institution regardless of
his physical condition: Provided. That
NCM 107
PEDIA LECTURE
A. he/she is informed of the medical
consequences of his/her decisionl
B. helshe releases those involved in
his/her care from any obligation
relative to the consequences of his
decision;
C. hislher decision will not prejudice
public health and safety.
- No patient shall be detained against hi$/her
will in any health care institution on the sole
basis of his failure to fully settle his financial
obligations. However, he/she shall only be
allowed to leave the hospital provided
appropriate arrangements have been made to
settle the unpaid bills: Provided. further, That
unpaid bills of patients shall be considered as
loss income by the hospital and health care
provider/practitioner and shall be deducted
from gross income as income loss only on
that particular year.
10. RIGHT TO REFUSE PARTICIPATION
IN MEDICAL RESEARCH.
- The patient has the right to be advised if the
health care provider plans to involve him in
medical research, including but not limited to
human experimentation which may be
performed only with the written informed
consent of the patient: Provided, That, an
institutional review board or ethical review
board in accordance with the guidelines set in
the Declaration of Helsinki be established for
research involving human experimentation:
Provided, further, That the Department of
Health shall safeguard the continuing training
and education of fUture health care
provider/practitioner to ensure the
development of the health care delivery in the
country: Provided, furthermore, That the
patient involved in the human experimentation
shall be made aware of the provisions of the
Declaration of Helsinki and its respective
guidelines.
11. RIGHT TO CORRESPONDENCE
AND TO RECEIVE VISITORS.
- The patient has the right to communicate
with relatives and other persons and to receive
visitors subject to reasonable limits prescribed
by the rules and regulations of the health care
institution.
12. RIGHT TO EXPRESS GRIEVANCES.
- The patient has the right to express
complaints and grievances about the care and
services received without fear of
discrimination or reprisal and to know about
the disposition of such complaints.Such a
system shall afford all parties concerned with
the opportunity to settle amicably all
grievances.
13. RIGHT TO BE INFORMED OF HIS
RIGHTS AND OBLIGATIONS AS A
PATIENT.
- Every person has the right to be informed of
his rights and obligations as a patient.The
Department of Health,in coordination with
heath care providers, professional and civic
groups, the media, health insurance
corporations, people's organizations,local
government organizations, shall launch and
sustain a nationwide information and
education campaign to make known to people
their rights as patients, as declared in this Act
Such rights and obligations of patients shall
be posted in a bulletin board conspicuously
placed in a health care institution.
-It shall be the duty of health care institutions
to inform of their rights as well as of the
institution's rules and regulations that apply to
the conduct of the patient while in the care of
such institution.
NCM 107
PEDIA LECTURE
QUEER .
- A political statement which advocates
binary think in and seeing both sexual
orientation and gender identity as
SEX (biological) . potentially fluid
- is simply the marker recorded in our - The term is a simple label to explain a
birth certificates. complex set of sexual behaviors and
- This is normally defined as the desires.
genitalia and body that you were born - For example, a person who is attracted
into. to multiple genders may identify as
- does not define your gender or how queer.
you identify
- QUESTIONING .
SEXUAL ORIENTATION . - An individual who is unsure of and/or
- “Who am I attracted to?” exploring their gender identity and/or
★ HETEROSEXUAL ( hetero ➔ sexual orientation
opposite) aka CISGENDER - Still in the transition of
★ HOMOSEXUAL ( homo ➔ self-identification
same)
★ BISEXUAL ( bi ➔ both) INTERSEX .
★ ASEXUAL ( a ➔ little/none) - is a person is born with a combination
★ PANSEXUAL (all genders) of male and female biological traits.

***Labels and terms vary based on the GENDER IDENTITY .

country, culture, and generation.
CISGENDER WOMAN . genders, all, or neither.
- A gender identity that society
considers to match the biological sex
assigned at birth.
- Prefix cis- means “on the side of”
SEX AND GENDER . identity
- Sex is assigned at birth while
GENDER IDENTITY is determined
by oneself.
- SEX is usually categorized as
•MALE, FEMALE, or INTERSEX
(atypical combinations of indicators)
- Gender Identity is an internal or
psychological sense of oneself as
•MAN, WOMAN, or QUEER (some
other genders)
- refers to one’s inner sense of self of
being a girl/woman, boy/man, other
- Gender identity is the way that you
identify up here, in your head.
GENDER EXPRESSION .
● External manifestation of one’s gender
● This is usually manifested through
one’s clothing, haircut, mannerisms,
tone of voice, or body characteristics.
● How one expresses gender might not
necessarily reflect one’s actual gender
identity.
● refers to how an individual expresses
his or her sense of self.
● it is how one embodies gender
attributes, presentations & roles–
● Which is the way you choose to
express your gender.
● MASCULINE, FEMININE,
ANDROGYNOUS, GENDER
NEUTRAL
NCM 107
PEDIA LECTURE
HETEROSEXISM . -
- Discrimination or prejudice against
people of diverse SOGIE on the
assumption that...
...heterosexuality is the normal
sexual orientation
GENDER BASED PHOBIA . at them.
•HOMOPHOBIA
•BIPHOBIA
•TRANSPHOBIA
TRANSGENDER . other personal details that are not
- umbrella term for persons whose
gender identity and/or expression is/are
not aligned to assigned sex at birth
(false or incomplete description of
gender identity)
SEXUAL REASSIGNMENT/ SURGERY
R. TRANSITION .
- This is sometimes referred to as either
sex change or gender reassignment
surgery and is a surgical procedure to
change the genitals and secondary sex
characteristics from one gender to
another.
THING TO REMEMBER:
These are guidelines, not rules.
- While these are the common
definitions of being LGBT, these are
not set in stone and can change from
person to person.
- If a person does not fit these
parameters/definitions, it does not
mean that they are any less of a
person of diverse SOGIE who is
vulnerable to GENDER-BASED
VIOLENCE and DISCRIMINATION
based on their SOGIE.
- DO NOT ASSUME. You can not tell
that someone is LGBT just by looking
- BE RESPECTFUL.
- DO NOT ask about a person’s genitals,
surgical status, how they have sex, and
relevant to you or their business with
the establishment.
- If you are not sure about the names or
pronouns they prefer to use, ASK:
❖ How do you wantme to address
you?
- Stick to the names or pronouns they
prefer.
- Be careful with confidentiality,
disclosure, and “outing.”
- NEVER “OUT” people, without
consent.
- It takes incredible trust for a person of
diverse SOGIE to disclose their status
to you. Do not casually share this
information or “gossip” about a
person’s SOGIE.
. - LGBT Children: Often overlooked are
cases of children who are at a young
age, are “perceived” to be LGBTs.
They are entitled to protection as
children under the Convention on the
Rights of the Child, as to their status,
expression, and even, their sexuality.
- AVOID insincere compliments or
“helpful” tips:
NCM 107
PEDIA LECTURE
- Understand that a person’s identity,
labels, and decisions for their bodies
are their own and should be respected.
- There are many terms and labels that
persons of diverse SOGIE use to
describe their experiences.
- If the person comes to you and is
unsure of the label that fits them best,
give them the time and space to figure
it out for themselves. Don’t tell them
what term you think they should use.
You wouldn’t want your identity to be
defined by others, so please allow
others to define themselves.
POPE FRANCIS ONCE SAID: .
“IF SOMEONE IS GAY HE SEARCHED
FOR THE LORD AND HAS GOOD WILL,
WHO AM I TO JUDGE? WE SHOULDN’T
MARGINALIZE PEOPLE FOR THIS.
THEY MUST BE INTEGRATED INTO
SOCIETY.”
- The Catholic Bishops Conference of
the Philippines note that the Church
won’t tolerate same sex marriage/union
but the Church’s position is to FULLY
EMBRACE persons with diverse
SOGIE

- These terms and labels may change in

the course of your interaction with
them.

LGBTQQI2SAA .
- Lesbian
- Gay
- Bisexual
- Transgender
- Queer
- Questioning
- Intersex
- 2-Spirited
- Asexual
- ally

STOP PERPETUATING LGBT MYTHS .

- There are only a few industries where
LGBTs thrive.
- Being LGBT is a disease.
- Being LGBT is contagious.
- Exclusive schools breed being LGBT.
- All gay men are paedophiles.
- All lesbians are violent.
- All bisexuals are automatically
sexually promiscuous.
- Being LGBT is something that a
person can turn on or off, at will.
- ALL relationships within the LGBT
community don’t last.