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Health is the right of every human being. Healthy people is a prerequisite to national development. The DOH uses the life span approach to design program and assist in the delivery of health to specific age group. Specific Aims of Family Health: 1. Improve the survival, health and well being of mothers and the unborn through a package of services for the pre-pregnanacy, prenatal, natal and postnatal stages. 2. Reduce the mortality and morbidity rates for children 0-9 years 3. Reduce mortality from preventable causes among adolescents and young people. 4. Reduce morbidity and mortality among Filipino adults and improve their quality of life 5. Reduce the morbidity and mortality of older persons and improve their quality of life
The family Health Program includes: Maternal Health Program The Family Planning Program The Child Health Programs (Newborns, Infants and Children)
Infant and Young Child Feeding Newborn Screening Expanded Program on Immunization Management of Childhood Illnesses Micronutrients Supplementation Dental Health Early Childhood Development Child Health Injuries
The Adolescent Health Program The Adult Men The Adult Women The Older Person The Philippine Reproductive Health
30% to postpartum hemorrhage. What are the cause of maternal death? Delay in taking critical actions Delay in seeking care Delay in making referals Delay in providing appropriate medical management . 20.The Maternal Health Progman The Maternal Health Program The Philippines is tasked to reduce the MMR by three quaters by 2015 to achieve its millenium development goal. 9% pregnanacy abortive outvomes which are neither preventable and non predictable. The 2000 Philippine Health Statistics revealed that 25% of all maternal deaths are due to hypertension.
The Maternal Health Progman What are the other factors that contributes to maternal death? • Death including cosely spaced births • Frequent pregnanacy • Poor detection and management of high risk pregnanacies • Poor access to health facilities brought about by geographic distance • Lack of health staff and competence of the health staff What has the Government done to address this promblem? BEMOC strategy Improve the quality of prenatal and postnatal visit Reduce women’s exposure to health risk through institutionalization of responsible parenthood LGUs and NGOs and other stakeholder must advocate for health through resource generation .
D. E. Antenatal Registration Visit 1st Visit 2nd Visit 3rd Visit Every 2 weeks B.The Maternal Health Progman Essential Health Services Packages Available in Health Care Facilities A. C. Period of Pregnancy As early in pregnancy as possible before four months or during the first trimester During 2nd Trimester During 3rd Trimester After 8th month of pregnancy till term Tetanus Toxoid Immunization Micronutrients Supplementation Treatment of Disease and Other Condition Clean and Safe Delivery .
teach and counsel the women on important MCH message – – – – Birth registration Importnace of BF NBS Schedule of visit for postpartum visit .The Maternal Health Progman Clean and Safe Delivery Do a quick check upon admission for emergency signs: Unconcious/ convulsion Vaginal bleeding Severe abdominal pain Looks very ill Secere headache with visual disturbance Severe breathing difficulty Fever Severe vomiting Make the woman comfortbale Assess the woman in labor Determine the stage of labor Decide if the woman can deliver safely Give supportive care throughout labor Encourage to take a bath Encourage to drink Encourage to empty the bladder Encourage to do breathing techniques • • • • • Monitor and manage labor Monitor closely within one hour after delivery and give supportive care Continue care after one hour postpartum Educate and counsel on FP and provide FP method Inform .
What is a quality of ante – partum check up? A. 2nd. How many iron tablets does the pregnant woman will consume ? A. check – ups should be done every two weeks. Supplements given to the pregnant woman: 1. prenatal. it is ideal to have a monthly check – up and upon nearing the final term. delivery and monitoring of exclusive breastfeeding. What is the tool that is utilized to ensure a safe pregnancy? A. infant and young child mortality and morbidity. For the reduction in maternal. 3rd trimester.to be given on the 5 month of pregnancy up to 2 months after post partum. . For safe pregnancy. Q. HBMR – home based maternal record. 2. Q. DOH’s mission for creating the MCH program: 1. Q. 210 tablets.maternal and child health.Priority Program of DOH: • MCH . However. Iron with Folic Acid . At least one check – up on the 1st.
1 year after Tt3 TT3 – 5 years protection •TT5 . 2nd pregnancy) .reinstitution of the tetanus toxoid. However.after 4 weeks TT1 – no protection yet •TT3 .6 months after TT2 – 3 years protection •TT4 . Administration of Tetanus toxoid on pregnant women: •TT1 . an Administrative Order (AO 15) .1 year after Tt4 TT4 – 10 years protection TT5 – lifetime protection Update:(FIC) •TT3 – 5th ( month of pregnancy) •TT4 . but it should de given to women who are on there 5th month of pregnancy to avoid abortion.5th month of pregnancy TT – tetanus toxoid •TT2 . thus giving it to pregnant women was discouraged.2. Tetanus Toxoid and dental check-up controversial issue------has some abortive property.after 4 weeks •TT5 – 5th or 6th month of the new pregnancy (ex.
considered to be therapeutic if the patient is with iodine deficiency.also something to do with the first flow of milk. Clean delivery surface 3. pregnant. Iodized salt and iodized oil .10 000 IU (3 times a week up to term starting on the 4th or 5th month) •If taking multivitamins do not give vitamin A. Vitamin A enhances the absorption of iron towards the bone marrow. What TT will you give to the pregnant woman? Three cleans to be practiced in delivery: 1. Clean cutting and delivery and care of the umbilical cord. . 4.Situation: 21 year old woman. Vitamin A – for pregnant woman. dosage . Clean hands 2. *Syntocinon rather than Methergin After the baby has been born Syntocinon may be given to stimulate contractions that help push out the placenta and prevent heavy bleeding. fully immunized child. 3.iodized oil to be given once only.
•Bone resorption is the process by which osteoclasts break down bone and release the minerals resulting in a transfer of calcium from bone fluid to the blood. Can be given to women in endemic areas. Chloroquine .1 tablet a week for two (2) weeks . * Chloroquine . .1 tablet a week for two (2) weeks 6.1 tablet a week for four (4) weeks .although not routinely given to pregnant women. 500mg once a day.given anytime.When already in the place: * Chloroquine . Calcium .Before going to a place where malaria is prevalent. 2 tablets per week quickly up to the duration of the pregnancy. because the baby gets the calcium of the mother. it is used to treat malaria.When you arrived at your place: * Chloroquine . for bone resorption. Treatment: •Chloroquine (safe for pregnant women) .5.
traditional birth attendant (also known as “hilot”) •Under Presidential Decree 651.mandates that whoever performs the delivery must register the birth within 30 days. . . #651 . In addition the vertebrae overlying the open portion of the spinal cord do not fully and remain unfused and open. the neural tube is the embryos precursor to the central nervous system which comprises the brain and spinal cord. TBA . This allows the abnormal portion of the spinal cord to protrude through the opening in the bones.7. Folic Acid – dosage: 500mg once a day for iron absorption prevents neural tube defects (Defect in the spinal cord .Hilot are allowed to do delivery provided they will report the deliveries they performed to the nearest health care unit. •PD. *Spina bifida (Latin: “split spine”) is a developmental birth defect involving the neural tube incomplete closure of the embryonic neural tube results in an incompletely formed spinal cord. A quality ante natal check-up is where a pregnant woman gets to have at least one check-up every trimester.SPINA BIFIDA) * In the developing vertebrate.
emotional and psychological needs of mothers and infants are fulfilled through the practice of rooming-in and breastfeeding Breastfeeding has distinct advantages which benefit the infant and the mother including the hospital and the country that adopt its practice It is the first preventive health measures that can give to the child at birth It also enhances mother-infant relationship Furthermore the practice of Breastfeeding could save the country valuable foreign exchange that may otherwise be used for milk importation. SECTION 1. . It shall create an environment where the basic physical. SECTION 2 Declaration of Policy .The State adopts rooming-in as a national policy to encourage. 7600 .Republic Act No.This Act shall be known as ‗The Rooming-In and BreastFeeding Act of 1992‖. Title. . protect and support the practice of breastfeeding.AN ACT PROVIDING INCENTIVES TO ALL GOVERNMENT AND PRIVATE HEALTH INSTITUTIONS WITH ROOMING-IN AND BREAST-FEEDING PRACTICES AND FOR OTHER PURPOSES.
partum complications and to know if the mother is breastfeeding. *Latch-on .Breast milk is the best because it contains Fats. it contains growth factors that enhance the maturization of an infant‘s organ systems. enabling the infant to fight potential serious infection. Do the home visit within a month and advise the mother to take vitamin A. (Teratogenic . RA 7600 . Exclusive for 4 to 6 months 3.CHON. EMPHASIZES THE 3-ES 1. 2.provides bonding between mother and child and promotes uterine contraction. Colostrums is rich in immunoglobulin.ROOMING-IN AND BREASTFEEDING ACT. Extended up to 2 years to ensure adequate nutrition.CHO suitable for the infants needs. As Early as possible. Do home visit to know post .possible birth defects or malformations) . It also serve as first immunization.
ADVANTAGES OF BREASTFEEDING F B R E A S T Bonding Family planning (LAM) E Resistance in infection Energy giving Error free formula Digestible Inexhaustible supply E Economic D Allergy free I Safe N Time bounded No vitamins needed Guaranteed G .
brought by oxytocin. This makes her uterus contract more quickly and reduces bleeding Oxtocin is similar to pitacin a synthetic hormone used to make the uterus contract. Milk ejecting reflex . .What is LAM? By feeding a new baby only with breast milk. this pattern of exclusive breastfeeding is called the lactational amenorrhea method. These relax the mother and make her feel more nurturing toward her baby. Milk secreting reflex . or LAM. 3.oxytocin is release by the posterior pituitary gland.during pregnancy there is a decrease in prolactin because there is an increase in progesterone. Breastfeeding releases the hormones oxytocin and prolactin. a new mother can prevent pregnancy for up to six months if her period has not returned. Breastfeeding soar after giving birth increases oxytocin levels in the mother. 2. When used as a family planning method. Three (3) Maternal Reflexes in Breastfeeding: 1. Let-down .
low in fat and high in carbohydrates relative to the creamier hind milk which is released as the feed progresses. 2. * Calostrum (also known as beestings or first milk) is a form of milk produced by the mammary glands in late pregnancy and the few day after giving birth. 4.end feeding color is whitish because it is rich in fats.rich in vitamins. high in antibodies and low in fat. (blue watery in color) *Foremilk. proteins and minerals and has enough water. the milk released at the beginning of a feed is watery.Composition of breast milk s 1. Mature milk — blue watery in color. Colostrum is high in carbohydrates high in protein. 3. (Fat gives energy to the baby) . Hind milk . Fore milk . Colostrum — first milk after the delivery very rich in immunoglobulin A.
one cant be productive) Department of Health PD.EBM – expressed breast milk (for working mother) Storage Room temperature Full term baby 8 to 10 hours Pre – term baby 4 hours Refrigerator Freezer Deep freezer 2 days 3 months 6 months 24 hours 3 months Never Goal: Improvement of the nutritional status productivity and quality of life. . 491 . (Because if one is undernourished.declaring July as the nutritional month.
The baby must be screened again after 2 weeks for more accurate results. When is newborn screening done? Newborn screening is ideally done on the 48th hour or at least 24 hours from birth.NBS What is 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. One will never know that the baby has the disorder until the onset of signs and symptoms and more often ill effects are already irreversible. Why is it important to have newborn screening? Most babies with metabolic disorders look normal at birth. . Some disorders are not detected if the test is done earlier than 24 hours.
the NBS nurse coordinator will immediately inform the coordinator of the institution where the sample was collected for recall of patients for confirmatory testing. How much is the fee for newborn screening? P550. When are newborn screening results available? Newborn screening results are available within seven working days to three weeks after the NBS Lab receives and tests the samples sent by the institutions. Using the heel prick method. . Parents may seek the results from the institutions where samples are collected. The DOH Advisory Committee on Newborn Screening has approved a maximum allowable fee of P50 for the collection of the sample. In case of a positive screen. The blood is dried for 4 hours and sent to the Newborn Screening Laboratory (NBS Lab). a few drops of blood are taken from the baby's heel and blotted on a special absorbent filter card.NBS How is newborn screening done? Newborn screening is a simple procedure. A negative screen mean that the result of the test is normal and the baby is not suffering from any of the disorders being screened. Results are released by NBS Lab to the institutions and are released to your attending birth attendants or physicians.
brain damage and cataracts. babies may die within 7-14 days. If not detected and treated early. Congenital Hypothyroidism (CH) CH results from lack or absence of thyroid hormone. If the disorder is not detected and hormone replacement is not initiated within (4) weeks. foods and chemicals. the sugar present in milk. Babies with this deficiency may have hemolytic anemia resulting from exposure to certain drugs. dehydration and abnormally high levels of male sex hormones in both boys and girls. . Accumulation of excessive galactose in the body can cause many problems.1. Phenylketonuria (PKU) PKU is a metabolic disorder in which the body cannot properly use one of the building blocks of protein called phenylalanine. 5. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD Def) G6PD deficiency is a condition where the body lacks the enzyme called G6PD. including liver damage. 2. Congenital Adrenal Hyperplasia (CAH) CAH is an endocrine disorder that causes severe salt lose. the baby's physical growth will be stunted and she/he may suffer from mental retardation. Galactosemia (GAL) GAL is a condition in which the body is unable to process galactose. Excessive accumulation of phenylalanine in the body causes brain damage. which is essential to growth of the brain and the body. 4. 3.
the NBS secretariat office will assist its attending physician. Disorder Screened CH (Congenital Hypothyroidism CAH (Congenital Adrenal Hyperplasia) GAL (Galactosemia) PKU (Phenylketonuria G6PD Effects SCREENED Severe Mental Retardation Death Death of Cataracts Severe Mental Retardation Severe Anemia.NBS What should be done when a baby is tested a positive NBS result? Babies with positive results should be referred at once to the nearest hospital or specialist for confirmatory testing and further management. Kernicterus Effect if SCREENED and treated Normal Alive and Normal Alive and Normal Normal Normal . Should there be no specialist in the area.
deficiency in protein.Food Assistance Critical period in child‘s life is 6 months to 2 years old.Protein Energy Malnutrition •Marasmus. very irritable skin and bone. •Kwashiorkor . psychological and growth failure also have edema. . PEM . severe wasting. they are to be given food assistance because the child may acquire nutritional deficiency. as well as reddish discoloration of the hair and depigmented skin. •Best source of protein in the Philippines is fish.deficiency in carbohydrates Appearance of marasmic child .old man facie Characteristics of a Marasmic child. Nutritional Deficiency: I. Symptoms of kwashiorkor include a swollen abdomen known as a potbelly.
Decreased consumption of oil. Low percentage of breastfeeding. Wrong beliefs and practices.Vitamin A Deficiency Factors that affects VAD (Vitamin A Deficiency) 1. Decreased percentage of breastfeeding. Intercurrent infection. pneumonia and diarrhea. 2. . 4. 2. II. 3. 5. Poverty . VAD .Factors that affects PEM (Protein Energy Malnutrition): 1. 3. Low consumption of oil in the diet.poor harvest of food. High incidents of measles.
cheesy.Q. Bitot‘s spot . 3.dryness of the cornea and conjunctiva can also cause thickening and wrinkles. Keratomalacia .softening of the cornea (If the cornea is soft it is prone to infection which then may lead to blindness). Signs and symptoms of Vitamin A deficiency 1. Night blindness characterized by frequent blinking of the eyes or when a child frequently falls. foamy grayish spot forms on the surface of dry patches of the conjunctiva at the side of the eyes. . Xeropthalmia . 2. What is the sign that you will notice that a child is Vitamin A deficient? A.
How to treat a Vitamin A deficiency Age: over 1 year to adult Age: 6 to 12 months old Dosage: 200. 000 IU Therapeutic treatment: – To be given on day 1 – Day 2 – After 2 weeks Dosage: 100. 000 IU Therapeutic treatment: – To be given on day 1 – Day 2 – After 2 weeks For high-risk group – To be given on day 1 – Day 2 – After 2 weeks – After 6 months For high-risk group – To be given on day 1 – Day 2 – After 2 weeks – After 6 months .
comes from animal source it is best to cook in oil in order to be absorbed by the body. Poor absorption in the diet 3.orange juice) . Non-heme iron .plant source green leafy vegetable Needs vitamin C to be absorbed by the body. Chronic illness • • Heme-iron .III. C . High demand in lactation 2. IDA . (good source of vit.Iron Deficiency Anemia Factors that affects IDA (Iron Deficiency Anemia) 1.
lD . use of iodized oil 3. Iodized Oil(200mgs cap/year) Q. because of soil erosion. Growth retardation or growth failure. thru health education Q. What is the tool to know if there is growth retardation? A. Q. use of iodized salt 2. What is the first sign that the child is suffering from iodine deficiency? A. .IV. What is the treatment for iodine deficiency? A. How to prevent iodine deficiency: 1.Iodine Deficiency Iodine deficiency is endemic in highly mountainous area. Growth monitoring chart.
Indicators of Nutritional Anthropometric Measurement: 1. *EPI is based on epidemiological approach.universal goal in child immunization. 46 . Wednesday . arm circumference or triceps fold Expanded Program on Immunization (EPI) Goal:To reduce the morbidity and mortality of immunizable disease. 6 . What day is the polio patch day? A. height for age 3. 7846 . •R A. weight for height (assess if there is wasting. •Proclamation No. •Proclamation No.polio-eradication program.compulsory immunization for all children below 8 years old. weight for age (weight is compatible with age) 2. Laws on Expanded Immunization Program (EPI) •P. org term use for nutritional assessment) 4.D 996 .compulsory immunization of hepatitis B. Q.
REPUBLIC ACT NO. . (a) Oral poliomyelitis immunization.Basic immunization or services shall include: (a) BCG Vaccination against tuberculosis (b) Inoculation against diphtheria. .AN ACT REQUIRING COMPULSORY IMMUNIZATION AGAINST HEPATITIS-B FOR INFANTS AND CHILDREN BELOW EIGHT (8) YEARS OLD. AMENDING FOR THE PURPOSE PRESIDENTIAL DECREE NO. (g) such other basic immunization services for infants and children below eight years of age as determined by the Secretary of Health in a department circular: provided that newborn infants of women with Hepatitis-B shall be given immunization against Hepatitis B w thin twenty four (24) hours after birth. Scope. (d) Protection against measles (e) Immunization against rubella. 996. (f) Immunization against HepatitisB. 2. AND APPROPRIATING FUNDS THEREFORE SECTION 1. 7846 . Section 2 of President of Decree No 996 s hereby amended to read us follows ―Sec. tetanus and pertussis.
Three priority groups in target setting: 1.comprise of 3.mass approach rather than individual approach.Elements of Expanded Program on Immunization (EPI) A. pregnant women . Infant – comprise of 3% of the total population 2. equipment element . TARGET SETTING .maintains the potency of the vaccine 2. people element . school aged group – 20% of the total population B. COLD-CHAIN LOGISTIC MANAGEMENT Two essential elements of the cold-chain logistic management: 1.main storage temperature or the storage ref (15 C to -25 C) .5% of the total population 3.
is used to maintain the potency of the vaccine.*cold chain monitoring chart .all vaccine received after 1 year old *Most stable vaccine is the BCG *Freeze dried presentation= BCG and AMV needs diluent * Live attenuated bacterial vaccine is BCG * Live attenuated viral vaccine is AMV *After the reconstituted BCG & AMV the life span of the vaccine is only 6 hours freezer +2 to +8 degrees centigrade (ref) .all vaccine received before 1 year old * CIC (complete immunized child) . * FIC (fully immunized child) .
Coordinate . Who acts as the team leader in EPI? A. Q.C. Advocate .the nurse gives proper scheduling 3. Monitoring . IEC . education and communication D.monitor the target group to be immunized *all the legal mandates are not included in the essential element of the EPI but serves as a guide in the implementation of the EPI. surveillance and research Roles of nurse in Expanded program on Immunization (EPI) 1. Assessment and evaluation E.information. PHN (Public Health Nurse) .the nurse motivates 2. Studies.
Also helps the child not to be infected by leprosy (extra pulmonary tb) BCG .Q. When the child has received the following vaccines before the age of 1.05ml . • 1 dose of BCG • 3 dose of DPT • 3 dose of HEPA B • 3 dose of OPV • 1 dose of AMV Types of Vaccines Vaccine Complete name Bacillus Calmette Guerin When to given After delivery Number of times to be given Once Route of administration ID – intradermal (Rt deltoid) Wheal – indicator that administration is successful Protection from Tuberculosis. When do you say that a child is fully immunized? A.
DPT 0. 4 weeks interval IM .5 ml Anti Measles Vaccine 9 months SQ – subcutaneous (fats) – 45 degree Measles.intramuscular .5 ml Diphtheria pertussis tetanus toxoid 6 weeks after birth 3 times. protects from acquiring severed diarrhea and pneumonia Hepatitis Hepa B Hepatitis B Vaccine After delivery 3 times.intramuscular Diphtheria pertussis (whooping cough) tetanus OPV Oral Polio Vaccine 6 weeks after birth 3 times. 4 weeks interval Once Oral – 2 drops Polio AMV 0. 4 weeks interval IM .
to be given in school-aged child (.BCG .10ml)=not done anymore-----no change in titer * Normal side effect of BCG is Kochs phenomenon Bad side effect of BCG: 1.isoniazid) How to treat indolent ulceration? •Put INH powder (INH . indolent ulceration What causes the deep abscess? •Wrong technique •Unsterile needle •Wrong route (IM rather than ID) How to treat deep abscess and glandular enlargement? •Incision and drainage •Put INH powder (INH .isoniazid) *Isoniazid is used in the treatment of mycobacterial infection. . deep abscess 2. glandular enlargement 3.Bacillus Calmette Guerin *Booster of BCG .
Pertussis (Don‘t give DPT if the child is 3 years over only DT) Q.Diphtheria Pertussis Tetanus *Booster is given 3 years old above but DT only. so advise the mother to give the child antipyretic & to do TSB (tepid sponge bath).DPT. What is the pathognomonic sign of diphtheria? A. Pseudo – membrane . *Normal side effect of this vaccine is that the child can develop fever. What component of your DPT will give your client a seizure or convulsion? A. Q.
What should the nurse do if the child vomits or spit out OPV? HEPA B Hepatitis B * If the pregnant mother is infected with the Hepa B virus. give the baby HEPA B vaccine within 24 . first tested in 1952.OPV Oral Polio Vaccine *No known side effect *Nursing consideration: do not feed the child 30 minutes before and after the giving the vaccine. Sabin (per orem) ** Two polio vaccines are used throughout the world to combat polio. It consist of an injected dose of inactivated (dead) poliovirus . and announced to the world by Salk on April 12. Q. Two Types of Oral Polio Vaccine 1.The first was developed by Jonas Salk. The second was an oral vaccine developed by Albert Sabin using attenuated poliovirus. 1955. Salk (route is subcutaneous) 2.
*Vitamin A should be given at 100 000 IU to enhance the effect of AMV. thru early detection and antibiotic treatment. Look and Listen Earliest sign of pneumonia 1. Control of Acute Respiratory Infection (CARI) Goal: : To reduce mortality case of pneumonia among children 0 to 5 years old.AMV Anti Measles Vaccine * Nobody can die because of measles alone. fast breathing 2. chest indrawing . the child may die because of complications like developing bronchopneumonia. Do an assessment: Ask.
Laws Affecting Community Health .
Presidential Decree: PD. 568 - totality of all policies in infrastructure, facilities, equipment, human resources and services that address the health need problems and concerns of all people. RESTRUCTURED HEALTH CARE DELIVERY SYSTEM REPUBLIC ACT NO. 1082 - STRENGTHENING HEALTH AND DENTAL SERVICES IN THE RURAL AREAS, AND PROVIDING FUNDS THEREFOR (rural Health Act) REPUBLIC ACT NO 7160 – AN ACT PROVIDING FOR A LOCAL GOVERNMENT CODE OF 1991 Administrative Order (AO 15) - reinstitution of the tetanus toxoid. Administrative Order (AO 3) - Vitamin A. Presidential Decree; P.D. 651. - Hilot are allowed to do delivery provided they will report the deliveries they performed to the nearest health care unit.
Republic Act No. 7600 - AN ACT PROVIDING INCENTIVES TO ALL GOVERNMENT AND PRIVATE HEALTH IN5TITUTION5 WITH ROOMING-IN AND BREAST-FEEDING PRACTICES AND FOR OTHER PURPOSES. Presidential Decree: PD. 491 - Department of Health declaring July as the nutritional month. REPUBLIC ACT NO. 8172 - ASIN LAW REPUBLIC ACT NO. 8972 - AN ACT PROMOTING SALT IODIZATION NATIONWIDE AND FOR RELATED PURPOSES. (Under Senator Juan Flavier)
REPUBLIC ACT NO. 8976 - AN ACT ESTABLISHING THE PHILIPPINE FOOD FORTIFICATION PROGRAM AND FOR OTHER PURPOSES.
Laws on Expanded Immunization Program (EPI)
•PD. 996 - compulsory immunization for all children below 8 years old. •Proclamation No. 6 — universal goal in child immunization. •Proclamation No. 46 - polio-eradication program
REPUBLIC ACT NO. 7846 - AN ACT REQUIRING COMPULSORY IMMUNIZATION AGAINST HEPATITIS-B FOR INFANTS AND CHILDREN BELOW EIGHT (8) YEARS OLD, AMENDING FOR THE PURPOSE PRESIDENTIAL DECREE NO. 996 AND APPROPRIATING FUNDS THEREFORE
Look if lips are dry.comes back easily) Look .CDD — CONTROL OF DIARRHEAL DISEASES TKO — TOILET. tongue Feel . .9 grams >NaCI .3 5 grams >Trisodium Citrate dehydrate .2. Glucose enhances the absorption of sodium.9 grams >Glucose .Assess for skin turgor (pinch in abdominal area: normal .20 grams (helps absorb sodium) Q. Why glucose is important? A.chemical composition: 27. scaly. ORESOL Assess . Give Oresol (Oral Rehydration Solution) •In depressed area make homemade oresol Home made Oresol: • 1 liter of water • 1 tsp of salt • 8 tsp of sugar •Oresol. KUBETA.―Ilang beses na po dumumi ang bata?‖ .Feel if the fontanel is sunken Treatment.
In case the child has continuous LBM the nurse should also assess the child‘s immunization record.Continuous LBM can cause severe diarrhea. The nurse must give the patient Oresol before transporting him / her.3 or more LBM per day for more than a month •Acute . 3Fs in diarrhea: •Fluid . What is your nursing consideration when transporting the patient? A.3 LBM per day in less than two weeks . Difference between chronic and acute diarrhea: •Chronic .increase fluid intake •Feeding — continuous feeding •Fast referral Q. **If the child has diarrhea DO NOT STOP FEEDING.
rice soup (am) to replace lost body fluid. If unsure. boil water for 5 minutes or do water chlorination. Prevention and Control: •Drink water only from safe sources.Diarrhea Mode of Transmission •Ingestion of contaminated food and water. •Eat only foods that ore well cooked and properly prepared. •Sunken eyeballs and fontanel. •Avoid eating ―street vended food. . •Excess thirst. •Continue feeding. Signs and Symptoms •Passage of watery stool‘s at least 3x a day. Immediate Treatment: •Give Oral Rehydration Solution (ORESOL).
nearly every child in the world has been infected with rotavirus at least once. By the age of five. However. with each infection. •Use toilet when defecating. •Consult the nearest health center. is a genus of double-stranded RNA virus in the family Reoviridae. •Wash fruits and vegetables with clean water before eating or cooking. MACRA . immunity develops and subsequent infections are less severe. Those below 20 years old and above 35 years old (because this age group is considered high risk) . *Rotavirus the leading cause of severe diarrhea among infants and young children.•Keep the food away from insects and rats by covering them using food cover. If diarrhea does not stop. Those who have had pregnancy for the past 15 months 3. Family Planning: (target group .MACRA) 1. •Wash your hands before eating and after using the toilet.marriageable couple of reproductive age (15 to 44/49 years old) 2.
Reproductive Health •Ultimate goal: It is geared toward the quality of life. 5. Characteristic of responsible parenting: •Sincerity (sincere because it comes from the heart) •Accountability (accountable for whatever happens) .requiring every couple before getting married to undergo marital counseling.safe pregnancy safe motherhood and responsible parenting. Those with medical complication that do not necessitate pregnancy.reproductive health agenda PD965 . •Ligtas Buntis . •Objective: Take care of the baby and the mother (from womb to tomb) DOH LAW: House Bill 4110 . (Like patient with congestive heart failure should be given advise regarding family planning method) RH .4. Those who have more than four (4) children.
Pneumonia .Role of a nurse in family planning. Malnutrition (Kwashiorkor & Marasmus. Act as a facilitator How to give child care: B I N G O Breastfeed Immunization Nutrition Growth Monitoring Oresol IMCI: 6 Childhood Diseases: 1. Look Listen 3 Diarrhea — Assess Look Feel . where the later is more severe because there is wasting. 2. Anemia is also another form of malnutrition because you can easily get iron from food).Ask.
Malaria causative agent: Anopheles mosquito (high flying) One important aspect in public health: SANITATION •PD 856 . 9263 . 8504 . .semen & blood to be infected. 6-8AM and 4-6PM biting time) 6. Dengue .violence against women and children act.causative agent: Aedes aegypti (low flying mosquito.prevention and control of HIV and AIDS.check or monitor every six weeks (RPR/TPPA) Rapid Plasma Reagin (RPR) / treponema pallidum particle agglutination (TPPA). •HIV / AIDS .4. *Window period is the time between initial infection and the development of detectable antibodies against the infection.window period maybe 6 days/weeks/months/year for the infection to become full blown. •R. AIDS can‘t survive in outside environment) •R. Measles 5.A. •Close monitoring is done to prevent HIV and AID5 (HIV .sanitation & sex worker act or law •If patient is positive with gonorrhea .check or monitor every two weeks (gram staining) •If patient is positive with syphilis .A.
untie against AIDS. • Slogan: unite the children.Health Education: • Strategy in health education is peer education.screening test. • ―Elisa‖ . • Western blot — confirmatory test. ** The ELISA test or the enzyme immunoassay (EIA) was the first screening test commonly employed for HIV It has a high sensitivity In an ELISA test a person‘s serum is diluted 400-fold and applied to a plate to which HIV antigens have been attached ** In the Western blot procedure cells that may be HI V-infected are opened and the proteins within are placed into a slab of gel to which an electrical current is applied .
COMMUNICABLE DISEASES 1.TB control program Mycobacterium tuberculosis is the bacterium that causes most cases of tuberculosis It was first described on March 24 1882 by Robert Koch who subsequently received the Nobel Prize in physiology or medicine for this discovery in 1905 the bacterium is also known as Koch's bacillus. Passive case finding – the patient is the one who goes to the health center and subject himself for sputum testing. 1136 . . Tuberculosis • • • Active case finding the health worker is the one going out looking for symptomatic and possible TB suspect.A. R.
also known as Koch’s disease .Directly Observed Treatment Short-course chemotherapy .RA 1136 .elements of DOTS . . low grade fever especially in the afternoon or at night.DOTS – ―tutok gamutan‖ . .the law that mandates the treatment of TB. night sweat. DOH aims to eradicate tuberculosis.Causative agent Koch's bacilli .Mycobacterium tuberculosis .Symptoms: age 10 years and above with chronic cough (more than 2 weeks).6-8 months treatment .Mode of transmission: airborne or droplets . loss of appetite (anorexia) with progressive weight loss. chest and back pain.DOTS .
No induration should be recorded as ―0 mm‖ Erythema (redness) should not be measured. A person who has been exposed to the bacteria is expected to mount an immune response on the skin containing the bacterial proteins.sputum microscopy done 3 times for 3 consecutive days .Acid fast stain (acid fast bacilli) Children . The reaction is read by measuring the diameter of induration (palpable raised hardened area) across the forearm (perpendicular to the long axis) in millimeters.To test for TB: Adult .PPD Purified Protein Derivatives or Mantoux Test Procedure: A standard dose of Tuberculin units (0.Inhale-exhale then coughs to get the sputum .1 mL) is injected intradermally (into the skin) and read 72 hours later. .
5 mm or more ( immuno comprise) is positive in . The results of this test must be interpreted carefully.. 10mm. The person‘s medical risk factors determine at which increment (5 mm.Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB -Patients with organ transplant and other immuno-suppressed patients 10 mm or more (high risk) is positive in .HIV positive person . 15mm) of induration the result is considered positive. A positive result indicates TB exposure.Injection drug users .Residents and employees of high-risk congregate settings (e. etc. nursing homes hospitals homeless shelters.Classification of tuberculin reaction.) . prisons.g.Recent contacts of TB case .Recent arrivals (less than 5 years) from high-prevalence countries .Microbacteriology lab personnel .
Government commitment. *TB can not be eradicated because of poverty. . Regular uninterrupted drug supply to the rural health unit in order to avoid treatment failure or relapse 5. Case detection by sputum microscopy 3. low body weight. etc) -Children less than 4 years of age or children and adolescents exposed to adults in high-risk categories.. Elements of DOTS: 1. Standardized surveillance monitoring. 4. 2. Standardized 6 to 8 months treatment regimen.g diabetes prolonged corticosteroid therapy leukemia end stage renal disease chronic malabsorption syndromes. 15 mm or more (low risk) is positive in -Persons with known risk factors for TB. Because needs training and financial support.Persons with clinical conditions that place them at high risk (e.
.Treatment Drugs TB Drugs R ifampicin (450 mg) I soniazid (400 mg) INH Side Effects Reddish discoloration of urine Peripheral Neuritis . What is the anti – Tb drug that can‘t be given to children below 6 years old? A. What is the comprehensive strategy to detect and cure TB? A. Hyper Uricemia . DOTS Q.increase fluid intake Optic Neuritis P yrazinamide (500 mg) PZA E thambutol (500 mg) S treptomycin Ototoxicity (nabibingi) Q. Ethambutol.inflammation of the nerves (pamanmanhid) Give Vit.high uric acid To counteract . B6 pyradoxine to prevent peripheral neuropathy.
3. New TB patient negative on smear with extensive lung involvement. Relapse 3. Defaulters Intensive phase Maintenance phase Give RIPES for 2 months Give RIPE for 1 month (total of 3 months) Give RIE for 5 months . New TB patient positive on smear 2. Treatment failure 2. Extra pulmonary TB (millary TB) Intensive phase Maintenance phase Give RIPE for 2 months Give RI for 4 months CAT II 1.Treatment of TB Cases: CAT I 1.
CAT III 1. ofloxacine. . New TB patient negative on smear for three (3) consecutive times with minimal lung lesion or PTB minimal Intensive phase Maintenance phase Give RIPE for 2 months Give RI for 4 months CAT IV 1. inoflux * TB patients – after two weeks of taking the drug is no longer contagious. MDRTB multiple drug resistant TB Quinolone.
. It is most commonly localized in the thoracic portion of the spine. a kind of tuberculous arthritis of the intervertebral joints. Miliary TB may infect any number of organs including the liver and spleen. More precisely it is called tuberculous spondylitis and the original name was formed after Percivall Pott (1714-1788) a London surgeon. It is a complication of 1-3% of all TB cases.** Miliary tuberculosis (or disseminated TB) is a form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1-5 mm). Its name comes from a distinctive pattern seen on a chest X ray of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds thus the term ―miliary‖ tuberculosis. ** Pott‘s disease is a presentation of extra pulmonary tuberculosis that affects the spine.
Tuberculosis: (from National Center for Disease Prevention and Control) A BACTERIAL DISEASE An ill child with: •A history of contact with a suspect or confirmed case of pulmonary tuberculosis •Any child who does not return to normal health after measles or whooping cough •Losses weight.1. cough and wheeze which does not respond to antibiotic therapy for acute respiratory diseases •Abdominal swelling with a hard painless mass and free fluid •Painful. firm or soft swelling in a group of superficial lymph nodes •Any bone or joint lesion of slow onset •Signs suggesting meningitis or disease in the central nervous system Occurrence: •Worldwide •Morbidity and mortality rates are higher in developing countries Infectious Agent: Myobacterium tuberculosis .
that is through inhalation of bacilli from patients • dust inhalation of bacilli which have dried on the surface of the ground or floor and become suspended in the air Incubation Period: •About 4 to 12 weeks from infection •A year or two after infection of pulmonary or extrapulmonary tuberculosis Period at Communicability: •A person who excretes tubercle bacilli is communicable.Reservoir: •Man •Diseased cattle Mode of transmission: • droplets infection. •Degree of communicability depends upon: >The number of excreted bacilli in the air >Virulence of the bacilli >Environmental conditions like overcrowding .
When patient is asked to jog in place no sweat can be seen at the lesion. when pricked.Susceptibility/Resistance: •Susceptibility to infection is general. intimate skin to skin contact.Incubation period: 1 to 5 years (variable) .Symptoms are: whitish skin lesion.thru direct contact. •The risk of developing the disease is highest in the children under 3 years. .Mode of transmission . . the patient will not feel anything.also known as Hansen's bacillus. Leprosy Mycobacterium leprae . 2. it is numb since leprosy involves the nerves. .
more than 5 lesions.less than 5 lesions.generic name) 300 mg Day 2 to 28: Dapsone 100 mg Lamprene (Clofazimine) 50 mg Note: Lamprene causes skin discoloration (skin will become darker) .Day 1 Day 2 to 28: Dapsone only 2.generic name) 300 mg Initial dose ay 1: Rifampicine 600 mg Dapsone 100 mg Lamprene (Clofazimine . Multi bacillary (MB) or Lepromatous . Pauci bacillary (PB) or Tuberculoid type . Treatment: Rifampicine 600 mg Dapsone 100 mg Lamprene (Clofazimine .Two (2) types OF Leprosy 1. Treatment: Rifampicine 600 mg given once a month Dapsone 100 mg given daily Initial dose: Rifampicine & Dapsone .
C L U M P Change in color in the skin (red or white) Lesion is hypostatic (state of physical weakness) Ulcers that don't heal Muscle weakness Painful nerve .Early signs and symptoms.
.Late signs and symptoms: C L I Clawing of the fingers and toes Leonine appearance Inability to close the eye S M Sinking of the nose bridge Madarosis (loss of eyebrow) Diagnosis: 3 Ps 1. 3. Presence of localized area of anesthesia. 2. Presence of the Hansen's bacilli. Peripheral nerve enlargement.
Leprosy: (from National Center for Disease Prevention and Control) Cause • Mycobacterium leprae Mode of Transmission • Airborne: inhalation of droplet/spray from coughing and sneezing of untreated leprosy patient Signs and Symptoms • • • • Long standing skin lesions that do not disappear with ordinary treatment Loss of feeling numbness on the skin Loss of sweating and hair growth over the skin lesions Thickened and/or painful nerves in the neck. forearm. near elbow joint and the back of knees .
Rabies RHABDO VIRUS – rabies virus (commonly infects humans) causes rabies. 3.an acute central nervous system (CNS) infection caused by the direct invasion of the brain by the Rhabdo virus. Practice personal hygiene. We should avoid direct contact with untreated patients. Clean environment Immediate treatment. 1 to 19 years. • Rabies . Maintain body resistance by healthful living. lick . • Mode of transmission: bite. Rhabdo virus are said to be heat stable. • Incubation period is to 1-2 weeks.Prevention and Control • • • • • • • • Treat all leprosy cases to prevent spread of infection. Good nutrition Enough rest and exercises. scratch.
(ID) 0. * E.paralysis. ―manyakal‖ behavior (nauulol) 3. (ID) 0. Invasive stage .1 cc on one side.• Manifestations 1. aerophobia. restlessness 2. numbness.subject the dog to brain biopsy= NEGRIBODIES.1 cc on one side. Paralytic stage. unresponsiveness • Diagnosis.O 84. deltoid Day 90. headache. intradermal (ID) 0.national rabies prevention and control program • Immunization. Excitement stage . Active (single bite/scratch) 2. deltoid .1ml on both deltoid muscles (muscle on the shoulder) Day 3 (ID) 0.hydrophobia.1 cc each on both deltoid Day 30.fever. (ID) 0. 1. Passive -ERIG/ HRIG= neck up Both should be administered for multiple bite or scratch or if bite is at the bock or from neck up Active: Day 0.1 cc each on both deltoid Day 7.
one side one dose 3 years onwards .equine rabies immuno globulin (do skin test) • HRIG .1 ml booster dose= day 0 and day 3. after 7 days. day 0 – 90 *rabies . *Vaccines: • ERIG .purified verocell rabies vaccine (verorab) • PCEC .human rabies immuno globulin • PVRV . it can still be continued within 7 days.* after day 0. re-start treatment.purified chick embryo cultured (rabipur) . develops antibodies immediately. but the patient should be given antibiotic and anti-tetanus 6 months – 3 years= .6 months .no lifetime immunity Passive: administered once only.repeat immunization. *good for 3 years of being immunized * Immunity: 0 . if day 3 is not administered.no booster needed.
*Rhabdo virus .con travel 3mm per hour and can go to the blood vessel or nerves. If animal has been immunized Takes 5 to 14 days before it can develop . ACTIVE For single bite on the extremities PASSIVE If you want to immediately protect the patient within 24 hours To give within 7 days Give active immunization first before giving the passive.
• • • • Headache and fever Pain or numbness of bite site Delirium and paralysis Muscle spasms Hydrophobia and aerophobia .Rabies: (from National Center for Disease Prevention and Control) Cause • Rabies Virus Mode of Transmission • Through bite of a rabid animal or contamination of any wound/scratch with saliva containing rabies virus Signs and Symptoms 1.
and provide clean sleeping quarters. Observe the dog for 14 days and consult your physician if any of the following occurs: >dog becomes wild and runs aimlessly >drooling of saliva >bites any moving or non-moving object >does not eat or drink >the dog dies within observation period If dog cannot be observed (stray dog) or if suspected to be rabid. When Bitten by a Dog • • Wash the wound immediately with soap and running water. Take care of your pet dog: bathe. consult your physician immediately or go to the nearest Animal bite Treatment Center in your area. give clean food. • .Prevention and Control • • • • Be a Responsible Pet Owner Have your pet dog immunized against rabies at 3 months old and every year thereafter. Never allow your pet dog to roam the streets.
It is most commonly found in Asia. although the first doctor who described entirely the disease cycle was Piraja da Silva in 1908. . schistosomiasis can be very debilitating. after Theodor Eilharz. An often chronic illness that results from infection of the blood with parasitic flatworm (schistosome). The acute form of schistosomiasis is sometimes commonly called swimmer‘s itch. The disease affects many people in developing countries. Schistosomiasis is known as Bilharzia or bilharziosis in many countries. Schistosomiasis Schistosomiasis or bilharzia is a parasitic disease caused by several species of flatworm. and in certain African communities and east Asia.4. especially in areas with water that is contaminated with fresh water snails. who first described the cause of urinary schistosomiasis in 1851. Although it has a low rate. it can cause liver and internal damage. and South America. which may carry the parasite. Africa.
• • • Schistosoma mansoni and Schistosoma intercalatum cause intestinal schistosomiasis Schistosoma haematobium causes urinary schistosomiasis Schistosoma japonicum causes Asian intestinal schistosomiasis Mode of Transmission. which are the larvae capable of infecting mammals. Schistosomiasis may localize in different parts of the body and its localization determines its particular clinical profile. Each causes a different clinical presentation of the disease. Intermediate Host: • Tiny fresh water snail (Oncomelania quadrasi). • Penetration of the skin with infected cercaria. .Schistosomiasis • Commonly called swimmers itch. (endemic in Samar and Leyte) There are five species of flatworms that cause schistosomiasis.
Diagnostic Method: • Stool examination through Kato Katz method Drug of choice: • Praziquantel Prevention and Control: • Avoid infected area • Wear rubber boots • Wash with soap and water & 70% alcohol • Eradication of the snail .
Signs and Symptoms: a.Schistosomiasis: (from National Center for Disease Prevention and Control) The Disease: • It is caused by a blood fIuke (parasite) called Schistosoma japonicum. • It is closely related to personal habits and livelihood requiring contact with water. transmitted through a tiny fresh water snail (Oncomelania quadrasi) • It is transmitted to man or animal through skin penetration when they get in contact with schisto infested water. Early Stage • Abdominal pain • Low grade fever • Loose bowel movement • Bloody stool .
•Consult SCT or Health Centers for additional information. Late Advance Stage •Inflammation of the liver •Bulging of the Abdomen •Enlargement of the Spleen •Sometimes the brain is affected that caused epilepsy Diagnostic Method: Stool examination through Kato Katz method Prognosis: Curable at the early stage but fatal in the advanced stage Drug of Choice: Praziquantel tablets Prevention and Control: •Submit stool for examination to the Schistosomiasis Control Team (SCT) or Health Centers. •Avoid contact or exposing oneself to schisto infested waters. •Construct and use sanitary toilets. . •Fencing or tying of stray animals •Keep environment clean and participate in community efforts of controlling the disease.b.
Wuchereria bancrofti. and Brugia timori Treatment: • Diethylcarbamazine citrate or hetragan • Amputation . Brugia malayi. all transmitted by mosquitoes.5. Loa loa is another filarial parasite of humans transmitted by deer fly. It is extremely rare in Western countries. Bruqia timori. caused by three threadlike parasitic filarial worms called nematode worms. Filariasis Lymphatic Filiariasis is a parasitic and infectious tropical disease. Mode of Transmission: • Thru the bite of an infected female mosquito (aedes poecilius) Intermediate Host: • Wuchereria bancrofti.
vagina.Diagnosis: • Nocturnal blood smear taken at patients residence or hospital at around 8pm. Health teaching: • Proper hygiene • If there is swelling. scrotum legs and arms • Fever • Cough • Chills • Wheezing . elevate the affected are to promote circulation Filiariasis: (from National Center for Disease Prevention and Control) • Commonly known as ―elephantiasis‖ is a disease caused by a parasite transmitted by mosquito Signs and Symptoms • Pain and swelling of the breast.
Prevention • Wear long sleeve shirt and long pants when working in farms or areas endemic of filariasis. . Corynebacterium pseudodiptheriticum . Corynebacterium diptheriae . Corynebacterium xerosis normal inhabitant of the human conjunctiva. Treatment • Selective treatment with DEC (Diethylcarbamazine Citrate) is given to people with clinical manifestations of the disease. • Mass treatment of the people living in established endemic areas. c. b. • Sleep under a mosquito net. Genus corynebacterium a. 6.normal inhabitant of the pharynx. Diptheria 1. • Medicines (DEC and albendazole) are given once a year for 5 years.causes diphtheria and produces a potent toxin.
is the pathgnomonic sign of Diptheria it is characterized by a whitish grey color in the throat doctors may order a Tracheostomy= surgical procedure performed on the neck to open a direct airway through an incision in the trachea (the windpipe).the disease s spread through direct contact with a carrier or by contaminated milk. weakness. -after incubation period of 2 to 6 days. .bacteria multiply at the site of the infection and release the toxin into the blood stream which damages the heart and the nerves and result in heart failure and general collapse within four (4) days.* Diptheria . sore throat.soft grey membrane called Pseudomembrane. . But administration of antibiotic (PCN) and anti-toxin arrest the disease.acute highly contagious infection generally affecting the throat but occasionally other mucous membrane and the skin. Later a soft grey membrane forms across the throat constricting the air passage and can cause difficulty in breathing (DYSPNEA) and swallowing (DYSPHAGIA). . mild fever develops. .
What is the susceptability test for diphtheria? A. What is the sensitivity test for diphtheria? • 2 to 5 days or maybe longer A. Incubation Period: Q. MALONEY’S test. acute naso pharyngitis or acute laryngitis with a pseudomembrane formation in the throat. Infectious Agent: • Q. Mode of Transmission: • By droplets spread through sneezing coughing and close personal contact. Reservoir: • Man Q. .Diptheria: (from National Center for Disease Prevention and Control) A BACTERIAL (Toxin-Related) DISEASE • It is an acute pharyngitis. SHICK’S test.What instrument is used in cleaning a patient who underwent a Tracheonomy Forceps Corynebocterium diphtheria A.
hospitals.Period of Communicability: • May last for 2 to 3 weeks • May be shortened in patients with antibiotic treatment. . Diphtheria transmission is increased in schools. Prevention: • Immunization of infants with 3 doses of DPT. households and in crowded areas.
Pertussis Whooping cough – is an infection of the respiratory system characterized by severe coughing spells that end in a ―whooping‖ sound when the person breathes in. Causative agent: • Bordetella pertussis Incubation Period: • 7 to 10 days but not exceeding 21 days Mode of Transmission: • airborne or droplet .7.
7 to 14 days in which the patient will have fever. Invasive or Catarrhal Stage . Spasmodic Stage • patient develops forceful cough with whoop. Convalescence Stage • Recovery Stage Q. swollen face and neck.Stages of Pertusis: 1. protruding eyes. Which stage is the most infectious or contagious? A. Invasive stage or catarrhal stage. Treatment: • Penicillin G or Erythromycin . watery eyes and nasal discharge • sometimes patient becomes restless 2. because of the discharge or secretion. the patient may sometimes develop epistaxis (nose bleeding) 3.
Occurrence: • Worldwide • Morbidity higher in developing countries . Pertusis: (from National Center for Disease Prevention and Control) A BACTERIAL (Toxin-Related) Disease • History of severe cough and history of any of the following: Cough persisting 2 or more weeks. fits of coughing.Nursing Intervention: • Oxygenation (to lessen the paroxysm of cough) • Give small frequent feeding to avoid aspiration pneumonia (sometimes can he fatal) • Ask the patient to have a solid bed rest to avoid coughing • Give abdominal support to patient especially children when coughing to avoid umbilical hernia. and cough followed by vomiting.
Infectious Agent: • Bordetella pertussis Reservoir: • Man Mode of Transmission: • Primarily by direct contact with discharges from respiratory mucus membranes of infected persons • Airborne route probably by droplets • Indirect contact with articles freshly soiled with the discharges of infected persons Incubation Period: • Usually 7 days but ranges from 5 to 15 days Period of Communicability: • Highly communicable in early catarrhal stage before paroxysmal cough • Antibiotics may shorten the period of communicability from 7 days after exposure to 3 weeks after onset of typical paroxysms to only 5 to 7 days after onset therapy .
Susceptibility/Resistance: • Susceptibility is general. • . This is followed by difficulty swallowing and general muscle stiffness and spasms in other parts of the body. • One attack confers a prolonged immunity although exposed adults may have another attack. 8. As the infection progresses. Tetanus • • • • • Characterized by a prolonged contraction of skeletal muscle fibers The primary symptoms are caused by tetonospasmin. • Three doses of DPT confers immunity to pertussis. a neurotoxin produced by the Gram-positive. Infection can be prevented by proper immunization and by postexposure prophylaxis. Infection generally occurs through wound contamination and often involves a cut or deep puncture wound. lockjaw. obligate anaerobic bacterium tetani. muscles spasms in the jaw develop hence the common name.
farmer tiling the soil with open wound can be infected with Tetanus because Clostridium tetani stays in the soil) . Mode of Transmission: • through an open wound (important in the mode of transmission is the presence of open wound) • stays in the soil (ex.tetanus serum (nursing consideration ANST because it is a serum) or Tetanus toxoid.Causative Agent: • Clostridium tetani • Preventive medicine: anti.
Clinical Manifestation: T I TRISMUS or lock jaw Incontinence (inability to control) R D R O Rigidity of muscles abdomen and extremities Dyspnea Resus Sardonicus (sarcastic face or look) OPITOTONUS (arching of the back) P Pain First Sign of Tetanus: • Rigidity of abdomen. muscles and extremity Pathognomonic Sign: • Resus Sardonicus Diagnosis: • Based on wound history and wound culture .
5.give antibiotic (bactericidal) that will act on the cell wall • Patient suffering from spasm control the spasm by sedating the patient • Give Valium (Diazepam)/downers 2.10 mg .Management: • Neutralize the toxins or bacteria • Give ATS (Anti-Tetanus serum 1 500 IU to 3 000 IU ANST) • Kill the bacteria .
9. Meningococcemia Meningococcemia is the presence of Neisseria meningitis (also known as meningococcus). There can be meningitis or septicemia. because there is rapid deterioration of the patient within 24 hours. The disease is hard to identify as it can appear in several different forms.) •An acute fatal disease. •. (SEPTICEMIA – is the presence and multiplication of pathogens in blood. It is demonstrated by blood culture. • Like meningitis but with rashes Causative Agent: •Neisseria Meningitidis . depending on which part of the body the bacteria invade. or a combination of both.Common in cold in congested area. a sever bacterial infection in the blood stream.
Neisseria Meningitidis . It is the only form of bacterial meningitis known to cause epidemics. is a gramnegative bacterium best known for its role in meningitis. . ** Neisseria meningitidis. Incubation Period: •2 to 10 days Mode of Transmission: •droplet and direct contact .can go to the blood and can cause blood invasion in the spinal column (CSF (cerebra spinal fluid – clear fluid found inside the spinal column) then the brain covering and will cause meningitis.first colonizes in the nasapharyngeal mucous membrane. also simply known as meningococcus. It only infects human. there is no animal reservoir.
if flexion of the neck is painful but full range of motion is present nuchal rigidity is absent) Characteristic Rash: • Petechiae. Ecchymosis usually in the wrist and ankle **A petechiae is a small red or purple spot on the body. .Manifestation: • Sign of meningeal irritation like meningitis • Usually accompanied by a rash • There is nuchal rigidity (Nuchal rigidity is the inability to flex the head forward due to rigidity of the neck muscles. **A bruise also called contusion or ecchymosis. is an injury to biological tissue in which the capillaries are damaged allowing blood to sip into the surrounding tissue. caused by a minor hemorrhage (broken capillary blood vessels).
Why do patients with meningo die? A. Because it leads to DIC Disseminated Intravascular Coagulation-> Hypovolomia (decreased in blood volume) -> Hypotension (heart is failing/no pressure) -> Hypovolemic shock (cause of death) Diagnosis: • Blood culture of the CSF (cerebrospinal fluid) Management: • Early administration of Penicillin G or Ceftriaxone • (in case you are or duty in the hospital with meningo case) do prophylaxis: Rifampicin or Ceftriaxone or Ciprofloxacin .Q.
Transmission • Direct contact with discharges from the nose and throat of an infected person. sneezing. . • Severe skin lesions may lead to gangrene. drinks and utensils.Meningococcemia: (from National Center for Disease Prevention and Control) Is a disease brought about by spread of the bacteria (Neisseria Meningitides) to blood stream causing severe signs and symptoms that may lead to death. sore throat and other respiratory symptoms • Pinpoint rashes which become wider and appear like bruises starting from the legs and arms. sharing of foods. • Unstable vital signs. • It can be spread by coughing. Signs and Symptoms • Fever • Cough. kissing.
adequate rest/ sleep. Avoid close contacts with meningococcemia patients. no alcohol and cigarette smoking. . regular exercise. Treatment Early recognition of meningococcal infection and prompt treatment with penicillin greatly improves chances of survival. Wash hands frequently with soap and water. Increased resistance by having healthy diet. Maintain clean environment/surroundings.• May or may not have signs of meningitis such as: stiff neck convulsion (in some cases) delirium altered mental vomiting Prevention and Control Avoid crowded places. Don‘t share utensils or anything that has been in the mouth of an infected person.
chills. Meningitis Common Causative Agent: • Neisseria meningitis Mode of Transmission: • droplet and direct contact Clinical Manifestations: • fever. vomiting • signs of increase intracranial pressure (headache. projectile vomiting.10. bulging of the anterior and posterior fontanels) • babies with high pitch cry Signs of meningeal irritation • Kernig‘s sign • Brudzinski • Nuchal rigidity .
• Hydrate the patient Treatment: • Give Penicillin G and Cephalosporin • Mannitol drip .to decrease intracranial pressure .clear) Nursing Intervention: • Do lumbar tap only with the consent of the patient or family member. • Let the patient lie flat on bed for 6-8 hours to prevent spinal headache.bloody due to trauma 2nd and 3rd . • Position the patient in fetal position.Diagnosis: • Lumbar tap (getting CSF in the lumbar area) • Needs 3 vials ( 1st .
is an acute viral infectious disease spread from person to person.11. • Legio depilitans Incubation Period • 7 to 12 days Mode of Transmission • Direct contact or fecal oral route . primarily via the fecal – oral route. Poliomyelitis was first recognized as a distinct condition by Jacob Heine in 1840. The polio vaccines developed by Jonas Salk and Albert Sabin in 1962. Its causative agent. was identified in 1908 by Karl Landsteiner. often called polio or infant paralysis. poliovirus. Causative Agent. Poliomyelitis Poliomyelitis.
Treatment: • Prevention of contracture and deformities can be achieved by rehabilitation . diarrhea • Non-paralytic signs & symptoms: signs of meningeal irritation and spasm • Paralytic. AFP (Acute Flaccid Paralysis) Diagnosis: • Do muscle testing= Range of Motion. vomiting.Signs and Symptoms: • Abortive type of poliomyelitis: minimal illness like fever. EMG (Electromyogram) to know what muscle is paralyzed. lumbar tap. stool exam.
oral route • Oral route through pharyngeal secretion • Contact with infected persons .Poliomyelitis: (from National Center for Disease Prevention and Control) • • A VIRAL DISEASE A suspect case of polio is defined as any patient below 15 years of age with acute flaccid paralysis including those diagnosed to have Guillain . Signs and Symptoms: • fever • severe muscle pain and paralysis • difficulty of breathing • Inability to move affected arm/leg Mode of Transmission: • Fecal .Barre Syndrome for which no other cause can be immediately identified.
It is widespread in tropical and subtropical regions including parts of America. . but other related species (Plasmodiurn ovale. This group of human-pathogenic Plasmodium species is usually referred to as malarial parasites. * The disease is caused by protozoan parasites of the genus Plasmodium. Asia and Africa.borne infectious disease caused by protozoan parasites.Complications: • death may occur if respiratory muscles are affected • paralyzed limb Treatment: • there is no treatment for polio but only supportive treatment based on the symptoms presented/manifested by the patient 12. Malaria * Malaria is a vector . Plasmodium malariae can also infect humans. The most serious form of the disease are caused by Plasmodium falciparum and Plasmodium vivax.
vivax. Infection of the red blood cells. • Endemic area: Palawan . • Spread thru blood transfusion if blood is contaminated. ovale. Vector: • Anopheles mosquito (high flying) • Blood meal/Biting Time: 9AM to 3PM • Plasmodium species: falciparum. malariae Specie that is common in the Philippines and can be fatal: • Plasmodium falciparum: because it causes cerebral malaria. • Previously used needle with infection. Malarial parasites are transmitted by female Anopheles mosquitoes. (high-flying mosquitoes) Mode of transmission: • Spread by the bite of an infected mosquito.• • • The disease is caused by protozoan parasites of the genus Plasmodium.
• Then goes to the red blood cell (RBC) and multiplies and as it multiplies the red blood cells will rapture thus causes anemia.Incubation Period: • 10 to 12 days Life cycle: • Begins when female mosquito bites a person with malaria. . it moves to the mosquito‘s salivary glands. * The life span of the RBC is 120 days but when infected with the malarial parasite the life span of RBC is shortened. the mosquito ingests blood containing malaria parasite and once inside the body of the mosquito.the parasite is injected along with the mosquito‘s saliva. Then the malaria parasite goes to the liver and will stay in the liver and mature for almost one (1) month or 2 to 4 weeks. • When the infected mosquito bites another person .
chills 2.causes cerebral malaria. Plasmodium ovale 3. most fatal (incubation period 10-12 days) 2. hot stage – fever. nose bleeding 3. temperature and decreased respiratory rate.Types of malaria: 1.excessive sweating. Plasmodium falciparum . nausea & vomiting. diaphoretic . Plasmodium malariae Clinical manifestations of malaria 1. cold stage . Plasmodium vivax 4. decreased blood pressure. general body weakness (malaise). .
TWO (2) TYPES OF SMEAR 1. Thin blood smears helps doctors discover what species of malaria is causing the infection. preferred. Thin smear – a drop of blood that is spread across a large area of the slide. but the appearance of the parasite is much more distorted and therefore distinguishing between the different species can be much more difficult. and reliable diagnosis of malaria is microscopic examination of blood films because each of the four major parasite species has distinguishing characteristics. With the pros and cons of both thick and thin smears taken into consideration.Diagnosis: • The most economical. it is imperative to utilize both smears while attempting to make a diagnosis. so picking up low levels of infection is easier on the thick film. . Two sorts of blood film are traditionally used. Thin films are similar to usual blood films and allow species identification because the parasite‘s appearance is best preserved in this preparation. Thick films allow the microscopist to screen a larger volume of blood and are about eleven times more sensitive than the thin film.
Thick blood smears are most useful for detecting the presence of parasites because they examine a larger sample of blood.When one has left the place: *Chloroquine or Doxycycline .1 tablet a week for four (4) weeks . When is the right time to do malarial smear? A.a drop of blood on a glass slide.When already in the place.) Q. Height of fever accompanied by chills.1 tablet a week for two (2) weeks Mefloquine .2. *Chloroquine or DoxycycIine . (Often there are few parasites in the blood at the time the test is done.1 tablet a week for two (2) weeks .Before going to a place where malaria is prevalent: *Chloroquine or Doxycycline . Thick smear . Treatment: • Chloraquine or Doxycycline (safe far pregnant women) .chloroquine resistant malaria medicine .
blood transfusion .Nursing interventions: • TSB . .tepid sponge bath • High caloric diet • Correct anemia • If hemoglobin level is low .
Dengue is transmitted to humans by the Aedes aegypti (rarely Aedes albopictus) mosquito. • • • one of the most important vector-borne diseases acute febrile infection of sudden onset with clinical manifestation Caused by one of four closely related virus serotypes of the genus Flavivirus. with a geographical spread similar to malaria. . Caused by one of four closely related virus serotypes of the genus Flavivirus. DENGUE Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases. found in the tropics and Africa. including Singapore. which feeds during the day. family Flaviviridae each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur. is that malaria is often eradicated in major cities. Indonesia and Brazil. Taiwan.13. whereas dengue is often found in urban areas of developed tropical nations. One major difference. however.
increase of 20 % because of hemo concentration • Prothrombin Time (ProTime) • Partial Thromboplastin Time . headache. gum bleeding. bleeding manifestation (epistaxis.Vector: • • • • Aedes aegypti (low flying mosquito) Biting Time: 6AM to 8AM and 4PM to 6PM Abnormal clotting mechanism Decrease in intravascular volume -> Hypovolemia Clinical Manifestations: • fever. joint pain. petechiae) • Do tourniquet Test = test for capillary fragility. retrobulbar pain . look/count the petechiae per square inch (Positive: more than 20 in 1 square inch) Diagnosis: • Platelet Count (Normal: 150 000 to 400 000) • Request for Hematocrit (Hct) .
generalized rash.only IV fluid allowed with BT Stages/Grade of Manifestation: • Grade I – Fever. hypotension (heart will compensate by tachycardia). weak pulse • Grade IV .Grade I + bleeding manifestation (epistaxis) • Grade III .Grade II + sign of circulatory collapse (cold clammy skin.Nursing Intervention: • Need to rehydrate the patient • If there‘s loss of blood. positive Herman sign (there is flash extremities with pale center) • Grade II . do Blood Transfusion • NSS .Grade III + shock .
Nursing Intervention: • watch out for bleeding • avoid dark colored food Prevention: C L Chemically Treated Mosquito Net Larva eating fish (ex. oregano. gold fish) E A N Environmental sanitation Anti mosquito soap made of Lanzones Natural mosquito repellant (neem tree. eucalyptus) .
etc. Signs and Symptoms • Sudden onset of high fever which may last 2 to 7 days • Joint & muscle pain and pain behind the eyes.Dengue hemorrhagic fever • • (from National Center for Disease Prevention and Control) is an acute infectious disease manifested initially with fever. The adult mosquitoes rest in dark places of the house. old rubber tires. cans. rain barrels. Transmission Aedes aegypti the transmitter of the disease is a day biting mosquito which lays eggs in clear and stagnant water found in flower vases. • Weakness • Skin rashes .maculopapular rash or red tiny spots on the skin called petechiae • Nose b!eeding when fever starts to subside • Abdominal pain • Vomiting of coffee-colored matter • Dark-colored stools .
• Clean gutters of leaves and debris so that rain water will not collect as breeding places of mosquitoes • Old tires used as roof support should be punctured or cut to avoid accumulation of water • Collect and dispose all unusable tin cans. .Prevention and Control • Cover water drums and water pales at any times to prevent mosquitoes from breeding • Replace water in flower vases once a week • Clean all water containers once a week. jars bottles and other items that can collect and hold water. Scrub the sides well to remove eggs of mosquitoes sticking to the sides.
• Can cause trachoma (involves the eyes) and inclusion conjunctivitis. Sexually Transmitted Disease Clamydias • • Tiny spherical bacteria that invades the host cells where they are protected from immune defense mechanism. they are pathogenic because it involves many organs.lesions that surround the ears • Can go to the urinary system of both male and female and can cause NGU (non .Doxycycline. scientist considered it as a virus.gonococcal urethritis) Treatment . A. .14.otitis media (luga) • Otitis externa . Like the Rickettsias. • Can cause infection of the middle ear . Chlamydia trachormatis • Varies their pathogenicity.
difficulty) When it becomes severe the urine has unusual discharge (yellow.difficulty in urinating (dys . greenish or greenish yellow) • • Causative Agent: • Neisserta gonorrhea Signs and Symptoms: • Painful Urination (Dysuria) • Purulent Urethral Discharge • Burning sensation Specimen: • Urethral and Cervical Smear Culture .Neisseria Gonorrhea • • • Constitutes a large group of medically important gram negative aerobic cocci. Most neisseria are found or thrives in the mucous membranes of the human urogenital tract and causes venereal disease. The only cocci that are gram negative. Initial symptoms is Dysuria .
Diagnosis: • Gram staining • Coffee bean shape Treatment: GN= Cefixime 100mg(200mgs SD) or Ceftriaxone 500mg(female).1gm(male) SD IM Uncomplicated anogenital infection = NGU (non-gonococcal urethritis) =Doxycycline (DOXIN) 100mg BID (twice a day) for 1 week or 10 to 14 days .
Causative Agent: • Treponema pallidum
Mode of Transmission: • Direct contact Signs and Symptoms: • Primary lesion: Painful (chancre) • Secondary lesion: presence or rashes > Condyloma - rashes at the palm and sole, copper or reddish in color > Alopecia - patchy hair loss • Tertiary lesion: Gumma - necrosis with cardiac involvement and neurological complications.
**Pregnant women can transmit the disease to the unborn child (congenital syphilis/Hutchington Disease) Diagnosis: • RPR -Rapid Plasma Reagin • If positive (agglutination), have to confirm via TPPA (Treponema Pallidum Particles AggIutination) ** Rapid Plasma Reagin (RPR) refers to a type of test that looks far specific antibodies in the blood of the patient that indicate that the organism (Treponema pallidum) that causes syphilis is present. The term reagin means that this test does not look for antibodies against the actual bacterium but rather for antibodies against substances released by cells when they are damaged by T. pallidum. Another test after used to screen for syphilis is the Venereal Disease Research Laboratory VDRL slide test, however, the RPR test is generally preferred due to its ease of use. In addition to screening for syphilis, an RPR level (also called a ―titer‖ ) can be used to track the progress of the disease over time and its response to therapy.
The RPR test is an effective screening test, meaning it is very good in detecting people who are affected by syphilis, however, this comes with the drawback that this test is also known to show that people have syphilis who in reality do not (in other words it will produce false positives). When the RPR test produces a positive result, this result is confirmed with a test that is more specific, This test is called the treporema pallidum particle agglutination (TPPA), and it confirms the diagnosis of syphilis. Treatment: • Penicillin Nursing Consideration: • ANST (after negative skin test)
window period • 6 days. leading to life – threatening opportunistic infections.HIV/AIDS (Human Immunodeficiency Virus Infection/Acquired Immune Deficiency Syndrome) Human immunodeficiency virus (HIV) is a retrovirus that can lead to acquired immunodeficiency syndrome (AIDS). 6 years • Patient with AIDS/HIV have low immune system Signs and Symptoms: • Kaposi's sarcoma (skin cancer) • PCP (Pneumocystic Carinii Pneumonia) . a condition in humans in which the immune system begins to fail. 6 weeks. • • Blood and sperm (body fluids such as tears. saliva) The HIV virus cannot survive the outside environment Incubation Period: • Variable . 6 months.
request weekly blood count because AZT causes Anemia and Agranulocytosis • Check for RBC count and Hematocrit and Hemoglobin **Hematocrit / 3 = Hemoglobin Hemoglobin x 3.screening test • Western blot .confirmatory test • Polymerase Chain Reaction (PCR) • For Kids: request for P24 Antigen Treatment: • AZT (Zidovudine) Nursing Consideration: • If patient is taking AZT.Initial Manifestation: • Oral Thrush (singaw) Diagnosis: • ELISA Test (Enzyme Linked Immuno-Sorbent Assay) .5 = RBC count .
TB (tuberculosis) Transition Period from HIV to AIDS: • 2 years to 20 years Development of Detectable Antibodies: • 1 to 3 months . In the Philippines.Q. what is the most common opportunistic infection in patients with AIDS? A.
Cholera • acute enterotoxin gastrointestinal infection Causative Agent: • Vibrio El Tor • Vibrio cholerae Signs and Symptoms: • Voluminous diarrhea • Rice watery fishy odor • Severe Dehydration • Suffer from muscle cramps • Hypokalemia (lack of Potassium). eat Banana (Latundan 2OmEq) • Replace fluid by giving IV (fast drip) to avoid hypovolemic shock Acid Base Balance: • • Metabolic acidosis (rectum) Respiratory acidosis (mouth) Q.15. Best parameter in your patient to know if dehydrated A. give Kalium Durule. Weight the patient .
Cholera: (from National Center for Disease Prevention and Control) Causative agent • Vibrio cholerae bacteria Mode of Transmission • Eating of food or drinking of water contaminated with human waste Signs & Symptoms • sudden onset of frequent painless watery stools • vomiting • rapid dehydration (e.g. sunken eyeballs.. • If diarrhea persists. consult your health workers or bring the patient to the nearest hospital . wrinkled and dry skin) Immediate Treatment • Replace lost body fluid by giving Oral Rehydration Solution (ORESOL) or homemade solution composed of 1 teaspoon of salt 4 teaspoons of sugar mix to Liter of water.
Prevention and Control • In extreme cases cholera is a rapidly fatal disease A healthy individual may die within 2-3 hours if no treatment is provided. boil drinking water (Upon reaching boiling point extend boiling for two or more minutes) or Do water chlorination Keep food away from insects and rats by covering it. Sanitary disposal of human waste. If unsure. Use toilet properly and clear toilet everyday. Wash hands with soap after using toilet and before eating. .• • • • • • Drink only safe and clean water. Keep surroundings clean to prevent flies and other insects and rodents from breeding. Wash and cook food properly.
Mumps / Parotitis Causative Agent: . viral pneumonia and bronchitis in children and URTI in young adults.Paramyxo virus PARAMYXO VIRUS – medium size envelope virus that has the affinity for mucous. • • • URTI – upper respiratory tract infection MUMPS -parotitis (inflammation of the parotid glands) can cause sterility especially with the male since it affect the testicles (orchitis) All viral infection are self .they cause mumps. croup. . measles.16. .limiting meaning they can be cured by itself.
direct or indirect contact Treatment: • Symptomatic • Cold compress • Diet: Soft bland Complication: • Orchitis .an often very painful condition of the testicles involving inflammation. swelling and frequently infection • For younger children: Meningoencephalitis Nursing Responsibility: • Young kids: Advise mother to put supporter or sling and cold compress .Incubation Period: • 9 days or 1 to 2 weeks Mode of Transmission: • Droplet.
non-A and non-B Hepatitis Hepa D – co .infection Hepatitis / co-exists with Hepatitis B Hepa E . AND APPROPRIATING FUNDS THEREFORE Incubation Period: • 45 to 180 days Types: • • • • • Hepa A . AMENDING FOR THE PURPOSE PRESIDENTIAL DECREE NO 996.AN ACT REQUIRING COMPULSORY IMMUNIZATION AGAINST HEPATITIS-B FOR INFANTS AND CHILDREN BELOW EIGHT (8) YEARS OLD.Infectious Hepatitis Hepa B .Serum Hepatitis / Post Transfusion Hepatitis Hepa C . Hepatitis RA 7846 .17.transmitted by infected food or drink and can cause acute hepatitis .Compulsory Immunization of Hepa B REPUBLIC ACT NO 7846 .
Icteric phase .ALT • heart . C.blood blood contact. semen Phases: 1.symptoms during this stage includes. SGPT . Pre-icterus . pain in right upper quadrant (Pre . jaundice hepatomegaly . pruritus.liver • liver . D .SGOT or AST • request for Hepatitis B Surface Antigen (HBSAg) • anti .Fecal .Mode of Transmission: • Hepa A .icterus is two (2) weeks before icterus phase) 2. Post-icteric phase or resolution phase .symptoms during this stage includes: jaundice and flu like symptoms such as body malaise. cholic.Oral Route • Hepa B. anorexia.HBSAg . dark colored urine 3.symptoms: fatigue Laboratory Diagnosis: • marked increase in Serum Glutamic Pyruvic Transaminase (SGPT).
Treatment: • Diet: High Caloric Diet (high sugar) Advise patient for bed rest • Rationale: to rest the liver
**Liver damage / pathology. Low protein diet
Hepatitis A (from National Center for Disease Prevention and Control)
It is caused by the Hepatitis A virus (HAV)
Mode of Transmission • ingestion of food contaminated with human waste and urine of persons who are sick of Hepatitis A
Signs and Symptoms • fever • Flu - Like symptoms: weakness, muscle and joint aches, loss of appetite, dizziness • with or without abdominal discomfort • after few days, jaundice may follow
Immediate Treatment • No specific medicine to cure the patient or shorten the course of illness. • Sick persons should be isolated advised to rest take plenty of fluids and avoid fatty foods. • Patient who fail to take fluids or are too weak to eat are sometimes brought for intravenous administration of fluids and vitamins. Prevention and Control • Wash hands after using the toilet before preparing food and before eating • Dispose human waste properly. • Thoroughly cook oysters, clams, and other shellfish for 4 minutes or steamed for 1 minute & 30 seconds. • Practice safe handling and storage of food and water. **The disease is self – limiting and may last for 1 to 2 weeks. Patient often recovers even without treatment.
Hepatitis B (from National Center for Disease Prevention and Control)
A VIRAL DISEASE. Hepatitis B is liver infection caused by the B type of Hepatitis virus. It attacks the liver often resulting to inflammation.
Signs and Symptoms • weakness • stomach upset • dark urine or very pale stools • Jaundice
Mode of transmission - Hepatitis B spreads through the following: • from child to child • from mother to child during birth through blood transfusion • through sharing of unsterilized needles, knives or razors • through sexual intercourse Complications • chronic hepatitis • cirrhosis • liver failure • liver cancer
Prevention • Immunization of infants with 3 doses of Hepatitis B vaccine at ages 6 weeks old. l. Most people who are infected with hepatitis C don‘t have any symptoms for years The virus Stays in the liver and causes chronic liver inflammation cirrhosis or liver cancer. 10 weeks old and 14 weeks old. • use of safe/clean injection and equipment/supplies Treatment: NONE Hepatitis C (from National Center for Disease Prevention and Control) • • • Hepatitis C is usually spread through contact with blood products. .
Signs and Symptoms • Headache, nausea and vomiting, abdominal pain, jaundice, weakness and fatigue. • Some people have dark yellow urine, light-colored stools and yellowish eyes.
Treatment • Medicines such as interferon and rebavirin don‘t cure hepatitis C, but they do make people feel better and may prevent future liver problems.
Prevention • There is no vaccine for hepatitis C. • Use condom during sexual activity to protect yourself and your partner from hepatitis C • Don‘t share needles with anyone. • Wear gloves if you have to touch anyone‘s blood. • Don‘t use an infected person‘s toothbrush, razor, or anything that could have blood on it. • Make sure any tattooing or body piercing is done with clean tools.
18. Chicken Pox
Causative Agent: • Varicella - zoster virus (VZV) - causes chicken pox, shingles (herpes) • Varicella zoster virus (VZV) is one of the eight herpes viruses known to affect humans (and other vertebrates) Incubation Period: • 14 to 21 days Mode of Transmission: • Droplet and airborne (within 3 feet)
Period of Communicability: • 1 to 2 days before the appearance of the rash, up to 6 days after, or when all the lesions had dried or crusted
Signs and Symptoms: • Initially: Maculopapular rash (typical chicken pox lesion vesicle) • Lesion is said to be CENTRIFUGAL (starts from the center then spreads outward) Diagnosis: • Isolation of the virus in 3 to 4 days after the rash • Stain with Giemsa stain ** Giemsa stain, named after Gustav Giemsa, an early malariologist, is used for the histopathological diagnosis of malaria and other parasites. It is a mixture of methylene blue and eosin. The stain is usually prepared from commercially available Giemsa powder. **Giemsa stain is also a differential stain. It can be used to study the adherence of pathogenic bacteria to human cells. It differentially stains human and bacterial cells purple and pink respectively. It can be used for histopathotogicol diagnosis of malaria and some other spirochete and protozoan blood parasites.
speeds skin healing and controls systemic spread ** Reye‘s syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs. but if the patient has fever or body pain. Jaundice is not usually present. give antihistamine (caladryl or baking soda solution) • Acyclovir . and severe encephalopathy (with swelling of the brain). especially the brain and liver. **Early diagnosis is vital otherwise death or severe brain damage may follow. ** The disease causes fatty liver with minimal inflammation. and there is a change in the appearance of the kidneys. The liver may became slightly enlarged and firm.Treatment: • Symptomatic. It is associated with aspirin consumption by children with viral diseases such as chicken pox. DO NOT GIVE ASPIRIN (might cause or lead to Reye‘s Syndrome) • For Pruritus (itch). Nursing Consideration: • Advise patient not to scratch trim the nails .
4th day of fever • weakness • muscle and joint pains • sudden onset of fever Immediate treatment • chickenpox rashes will disappear in 1-2 weeks time even without treatment .Chicken Pox (from National Center for Disease Prevention and Control) Causative agent: • Varicella zoster virus Mode of transmission • person to person‘s direct contact droplet or air borne spread of fluid or secretions from persons with chicken pox • contagion / fore and 5 days after the appearance of blisters Signs and symptom • appearance of reddish skin lesions which later become blisters on the 3rd .
becomes dormant but can be reactivated and produce shingles) • Affects the severely immuno-compromised patients (patients with organic diseases such as HIV. 19.Prevention and control • Avoid crowded areas during epidemics • Isolate known cases • Vaccine is available as precautionary measure and as per doctor‘s advise. Herpes Zoster also known as Shingles Causative Agent: • Varicella zoster • Reactivation of previous chicken pox infection • Universal property of latency (virus hides on the neurons. Diabetes) . Cancer.
Is it possible that the patient will still have pain after treating the infection? A. If the virus caused permanent nerve damage (Post – Herpetic neuropathy).Signs and Symptoms: • Vesicular but appear in cluster • Lesion is unilateral (limited to one side) • Usually follows the nerve pathway • Very painful Q. Treatment: • Pain .first priority in the treatment • Acyclovir .for pain • To dry the lesion give Potassium Manganese (KMnO4) Compress . YES.
commonly known as shingles. After a chickenpox infection the virus can lodge permanently in ganglionic neurons. often referred to as shingles. the virus may break out of nerve cell bodies and travel down nerve axons to cause viral infection of the skin in the region of the nerve. and less frequently in nonneuronal satellite cells. a condition called postherpetic neuralgia. The nerve cell bodies of dorsal root. In an immunocompromised individual perhaps years or decades after a chickenpox infection. and the virus may spread from one or more ganglia along nerves of an affected segment and infect the corresponding dermatome causing a rash. is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body. which is also the virus that causes chickenpox. although the mechanism is not understood. without causing any symptoms. Although the rash usually heals within two to four weeks some sufferers experience residual nerve pain for months or years. cranial nerve or autonomic ganglion may contain the latent virus.Herpes zoster (or zoster). It is caused by Varicella Zoster Virus (VZV). .
Scabies Also known as Itch Mite Causative Agent: • Sarcoptes scabiei Site: • Interdigitals Clinical Manifestation: • Intense Pruritus Pathognomonic Sign: • Silvery-White linear streak Mode of Transmission: • Direct or Indirect contact Treatment: • Kwell Lotion or Lindane .20.
into a ―nymphal‖ stage. The larvae. itchy skin rashes when the impregnated female tunnels into the stratum corneum of the skin and deposits eggs in the burrow. intense pruritus (itching) and secondary infection. which hatch in 3-10 days. The adult mites live 3-4 weeks in the host‘s skin.Nursing Intervention: • Wash the infected area first then pat dry before applying Lindane (thin application only because it is neurotoxic)) once a meek Nursing Consideration: • Apply treatment only once a week • Treat the entire household at the same time • Kwell lotion is contraindicated to pregnant women and children below 2 years old Scabies is a transmissible ectoparasite skin infection characterized by superficial burrows. move about on the skin molt. The word scabies comes from the Latin word for ―scratch‖ (scabere). as shown by the Italian biologist Diacinto Cestoni in the 18th century produces intense. and then mature into adult mites. Scabies is caused by the mite Sarcoptes scabiei. variety hominis. .
Scabies is transmitted readily often throughout an entire household.g bed partners school mates daycare) and thus is sometimes classed as a sexually transmitted disease. The presence of the eggs produces a massive allergic response which in turn produces more itching.The action of the mites moving within the skin and on the skin itself produces an intense itch which may resemble an allergic reaction in appearance. Pendiculosis (lice) Causative Agent: • Pediculus humanus capitis (head lice) • Pediculosis corporis (body lice) • Pthirus pubis (pubic lice) **Pediculosis corporis is caused by the louse Pediculus humanus humanus. 21. . by skinto-skin contact with an infected person (e. Unlike the head louse. the body louse deposits eggs on clothing. Spread by clothing bedding or towels is a less significant risk though possible.
Body lice are spread through direct contact with the body. and infestation in blacks is rare. Head lice are spread through direct head-to-head contact with an infested person. Pubic lice are most often spread by intimate contact with an infested person. . body lice on the clothing. The condition is more commonly known as head lice body lice or pubic lice.on the bodies of humans.Treatment: • Kwell Shampoo ( cave it for 5 to 10 minutes and dry it with white towel then comb using a fine-tooth comb (‗suyod‖) **Pediculosis is an infestation of lice -. Head lice occur on the head hair.which are parasitic insects -. Head lice (Pediculus humanus capitis) infestation is most frequent on children aged 3-10 and their families. Lice do not have wings and cannot jump. and pubic lice mainly on the hair near the groin. clothing or other personal items of a person already carrying lice. Human lice do not occur on pets or other animals. Females get head lice more often than males.
In addition. body lice can be a vector for louse-borne typhus.From each egg or ―nit‖ may hatch one nymph that will grow and develop to the adult louse. They have shorter bodies and pincer-like claws making them look like crabs (hence. Excessive scratching of the infested areas can cause sores. although the head louse is often smaller. Lice feed on blood once or more often each day by piercing the skin with their tiny needle like mouthparts. Lice cannot burrow into the skin. Symptoms The most common symptom of lice infestation is itching. which may become infected. louseborne relapsing fever or trench fever. Head lice and body lice (Pediculus humanus) are similar in appearance. the nickname for pubic lice: ―crabs‖). . are quite distinctive. Full .grown lice are about the size of a sesame seed. Pubic lice (Pthirus pubis) on the other hand.
Pruritus especially at night (the worm goes down to the anus at night) Mode of Transmission • Direct or indirect contact Diagnosis: • put a scotch tape on a tongue depressor and swab it on the anus • nocturnal perianal pruritus Treatment • Anti . Vermox (mebendazole).X (pyrantel pamoate) are commonly used to treat pinworms. and Pin .pinworm drugs such as Albenza (albendazole).Enterobiasis (pinworm) Causative Agent: • Enterobius vermicularis (parasite) Manifestation: • Itchy.22. .
liver. and peritoneum but the worms cannot survive long in these places. It is found worldwide and causes the common infection enterobiasis humans. Habitat The pinworm lives in the lower part of the small intestine and the upper part of the colon. the pinworm does not usually enter the bloodstream or any other organs besides the intestines. to deposit about 10. She then secretes a substance which causes a very strong itching sensation. inciting the host to scratch the area and thus transfer some of the eggs to the fingers. The human pinworm is commonly found in children. Only in rare cases disoriented pinworms are found in the vagina and even more rarely in the uterus. 000 eggs in the perianal area (around the anus). fallopian tubes. 000 to 20.** The best known is the human pinworm also known as the threadworms Enterobius vermicularis and the more recently discovered Enterobius gregorii. The female migrates to the anus and emerges. Reproduction Pinworm eggs are easily seen under the microscope. usually during the night. . Unlike many other intestinal parasites.4 mm in length which the adult female is 8 . The adult pinworm male is 1 . After mating the male dies. pin – shaped posterior for which the worm is named.13 mm and possesses the long.
up the rectum. Once ingested orally the larvae hatch and migrate back to the intestine. pinworm infestation does not usually cause any damage to the body. There s also some evidence of or association between enterobiasis and diminished zinc levels. In some cases. growing to maturity in 30-45 days. The eggs can survive for 2 to 3 weeks on their own outside of the human body.32 um. in which the sticky side of a strip of cellophane tape is pressed against the peri. but can also be made using the ―scotch. the larvae will hatch in the peri . Sleep disturbance may arise from the itching or crawling sensations. Effects Except for itching.anal area and travel back inside the anus. toys and the bathtub.Eggs can also be transferred to cloth. Diagnosis Diagnosis is often made clinically by observing the female worm (or many worms) in the pen anal region.anal skin. with one convex side and one flattered side and colorless shell. and back inside to the intestines where they mature. then examined under a microscope for pinworm eggs.tape‖ test. . The diagnostic characteristics are: size 50-60 um by 20 . typical elongated shape. Some case reports suggest that severe infestation on may be associated with an increased risk far appendicitis.
ask a pharmacist for medicines to treat pinworms (or threadworms as they are known in the UK).Treatment Anti-pinworm drugs such as Albenza (albendazole). It is not a necessity to visit a doctor to get these drugs.treated. . Vermox (mebendazole). Another precaution is to wash the hands before eating (to prevent any pinworm eggs under finger nails from being ingested) and to wash any area or clothes which have touched or been in the vicinity of the infected areas. These medicines kill the pinworms 95% of the time. The person being treated may have to return after a time of two weeks to be re . and Pin-X (pyrantel pamote) are commonly used to treat pinworms. as Pin-X is available as an over-the-counter medication (Albenza and Vermox are prescription in the US). but do not kill the eggs. Treating the entire family is after necessary for cure.
Treatment: • Pyrantel Pamoate (Combantrin) • Mebendazole ..000 ova per day for 1 year after 3 weeks.) .contraindicated to pregnant women Nursing Intervention: • Give anti-histamine (ex. Ascariasis Causative Agent: • Ascaris lumbricoides • Size: 6 inches up to 20 inches long Mode of Transmission: • food contaminated with the parasitic ova will go to the small intestine —> lymphatic system -> blood stream -> lungs (s i s for weeks) — respiratory tract (where it will be then coughed off) or if swallowed back . the eggs/ova are infectious and can stay in the soil for 3 years. Benadryl) for 3 days first before giving Combantrin to prevent erraticity of the worms (might go out through the nose.23.. mouth.goes back to the intestine and copulate -> lays 200.
When the larva hatches it migrates to the small intestines then it is carried by the lymphatic vessels and bloodstream then into the lungs. then it ascends to the respiratory tract and it is swallowed.Nursing Contraindication: • do not give to children 2 years and below Ascariasis • • • • • Intestinal roundworm (round .worms are collectively known as nemotoides) An intestinal worm common in warm areas with poor sanitation where it persists largely by indiscriminate defecation of children. The larva matures in the small intestines where it remains as an adult warm ranging from 6 inches to 20 inches. . The life cycle resemble Trichuris trichiura except that the larvas also migrate to the lungs. where it passes into the air sac.
it can cause intestinal obstruction (too crowded n the intestines) and abdominal bleeding and forms BOLUS ASCARIASIS. Diagnosis: • fecalysis (stool exam) look for ova (egg) golden yellow egg to adult worm in stool vomiting larva in the sputum. • if it migrates in the small intestines and there is heavy infection.Symptoms: • if it migrates in the lungs . • CBC test . cough.for pregnant women . • sign of migration to the lungs can be seen through the x-ray Treatment: • Mebendazole • Pyrantel Pamoate .it can cause fever. constriction of the alveoli thus produces a wheezing sound.if the eosinophils is high it can mean there‘s a parasitic infection or allergic reaction.
where they mature to adult male and female worms. they can persist n soil for 3 years or more. In 3 weeks. or ―roundworm‖. it is carried to the liver and heart. These fertilized eggs become infectious after 2 weeks in soil. the larvae pass from the respiratory system to be coughed up. infections in humans occurs when an ingested infective egg releases a worm that penetrates the wall of the duodenum and enters the bloodstream. and enters pulmonary circulation to break free in the alveoli.000 eggs per day for a year.* Ascaris lumbricoides. From here. Fertilization can now occur and the female produces as many as 200. . and thus returned to the small intestine. where it grows and molts. swallowed.
may also cause bleeding in the intestines and can cause anemia. Symptoms: • Only heavy infection causes severe abdominal pain and diarrhea. the life cycle begins from the time the parasite is swallowed. the larva hatchc5 a small intestines. weight loss and appendicitis. Trichuris trichiura • • • • • • causes trichuriasis when it infects a human large intestine. • Occasionally the rectum will pass by the anus and will cause rectal prolapse. the infection results when a person swallows food that contains egg that has been incubated in the soil for 2 .24. the parasite occurs mainly in the subtropics and tropics where poor sanitation and a warm.3 weeks. each larva grow to about 4 –1/2 inches and then the mature female produces 5. moist climate provide the conditions needed for the eggs to incubate in the soil. then migrate to the large intestines and embeds their heads in the intestinal lining. . an intestinal worm.000 eggs per day which are passed in the stool.
should not be given to pregnant women because it can cause harmful effect to the fetus). The appendix is rich in infection-fighting lymphoid cells. Maintaining good personal hygiene Treatment: Mebendazole (however. Avoid unclean vegetables. 2.Prevention: 1. which causes trichuriasis when it infects a human large intestine. Use of sanitary toilet facilities. is a roundworm. . The name whipworm refers to the shape of the worm. **Medical literature shows that the appendix is not generally credited with significant function. it is routinely removed without any notable ill effects or side effects. they look like whips with wider ―handles‖ at the posterior end. The human whipworm (Trichuris trichiura or Trichocephalus trichiuris). suggesting that it might play a role in the immune system. Whether or not the appendix has a function. 3.
The females can grow to 50 mm (2 inches) long. which can detect eggs and charcot-leyden crystals. Rectal prolapse is possible in severe cases. Infection occurs through accidental ingestion of eggs and is more common in warmer areas. and albendazole may also be offered as on anti-parasitic agent. On reaching adulthood. Neither the male nor the female has much of a visible tail past the anus. Mebendozole is 90% effective in the first dose. . and then move into the wall of the small intestine and develop. Whipworm infestation is detectable by stool examination. The eggs hatch in the small intestine. . the thinner end (the front of the worm) burrows into the large intestine and the thicker end hangs into the lumen and mates with nearby worms.Light infestations are frequently asymptomatic. Heavy infestations may have bloody diarrhea Long-standing blood loss may lead to iron-deficiency anemia. Adding iron to the bloodstream helps solve the iron deficiency and rectal prolapse.
and nasal cavity Strawberry tongue New bilateral Exophthalmos .Pathognomic signs DISEASE Duchenne's Muscular Dystrophy Hypocalcaemia Gower‘s Sign Trousseau sign and Chvostek sign SIGN Tetanus Liver cirrhosis Systemic Lupus Erythematosus Bulimia Nervosa Leprosy Measles Diphtheria Kawasaki Disease Grave‘s disease Risus sardonicus Spider angioma Butterfly rash Chipmunk facies (parotid gland swelling) Leonine facies (thickened lion-like facial skin) Koplik‘s spots Pseudomembrane on tonsils. pharynx.
Pancreatitis Chronic hemorrhagic pancreatitis Cholera Typhoid fever Meningitis Cholecystitis Cullen‘s sign (bluish discoloration of umbilicus) Grey-Turner‘s Sign (ecchymosis in flank area) Rice-watery stool Rose spots in abdomen Kernig‘s sign and Brudzinski‘s sign Murphy‘s sign (pain on deep inspiration when inflamed gallbladder is palpated) Levine‘s sign (hand clutching of chest) Angina pectoris Patent ductus arteriosus Parkinson‘s disease Whipple‘s disease Machine-like murmur Pill-rolling tremors Oculo-Masticatory Myorhythmia .
The characteristic symptoms: • excessive urine production (polyuria) • excessive thirst and increased flu d intake (polydipsia). .NON COMMUNICABLE DISEASES 1. ** These symptoms are likely to be absent if the blood sugar is only mildly elevated. is a syndrome characterized by disordered metabolism and inappropriately high blood sugar (hyperglycaemia) resulting from either low levels of the hormone insulin or from abnormal resistance to insulin‘s effects cuopled with inadequate levels of secretion to compensate. Diabetes Diabetes mellitus often simply diabetes. and blurred vision.
type 2. which have different causes and population distributions. While. however types 1 and 2 diabetes are chronic conditions. the hormones of pregnancy can cause insulin resistance in women genetically predisposed to developing this condition. ultimately. and gestational diabetes (occurring during pregnancy). the causes are different. Type 2 diabetes is characterized by insulin resistance in target tissues. all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia. • • Type 1 diabetes is usually due to autoimmune destruction of the pancreatic beta cells. • • . Gestational diabetes typically resolves with delivery of the child. This causes a need for abnormally high amounts of insulin and diabetes develops when the beta cells cannot meet this demand Gestational diabetes is similar to type 2 diabetes in that it involves insulin resistance.The World Health Organization recognize three main forms of diabetes mellitus: type 1.
• . in which insulin is not secreted by the pancreas.All types have been treatable since insulin became medically available in 1921. Type 2 may be managed with a combination of dietary treatment. most insulin used today is produced through genetic engineering. or human insulin with modified molecules that provide different onset and duration of action. frequently. although dietary and other lifestyle adjustments are part of management. Insulin can also be delivered continuously by a specialized pump which subcutaneously provides insulin through a changeable catheter. tablets and injections and. While insulin was originally produced from natural sources such as porcine pancreas. either as a direct copy of human insulin. is directly treatable only with injected or inhaled insulin. • Type 1 diabetes. insulin supplementation.
Poor healing of wounds. can lead to gangrene.Diabetes can cause many complications: • Acute complications (hypoglycemia. ketoacidosis coma) may occur if the disease is not adequately controlled. which may require amputation. • • . Adequate treatment of diabetes. particularly of the feet. • Serious long-term complications include cardiovascular disease (doubled risk). and microvascular damage which may cause impotence and poor healing. chronic renal failure. as well as increased emphasis on blood pressure control and lifestyle factors (such as not smoking and keeping a healthy body weight) may improve the risk profile of most aforementioned complications. retinal damage (which can lead to blindness) nerve damage (of several kinds).
2. Hypertension • • • • A SILENT KILLER Most common among the diseases of the heart Most common cause of stroke Highly preventable MOSTLY AFFECTED BY HIGH BLOOD PRESSURE • • • • Smokers Overweight Older age group above 40 years old for males menopausal age for female With family history like. diabetes and kidney disease Under chronic stress Heavy alcohol drinker With high serum cholesterol level • • • . heart diseases.
85% of all primary high blood pressure are mild and thus can be managed by lifestyle modification . 9 Filipinos die of CVD 1 out of 4 deaths in the country is due to CVD 1 out of 10 Filipinos aged 15 years old and above has hypertension/high blood pressure 80% . continuous & 3x a week) Avoid fatty and salty foods Have adequate relaxation Drink moderately Have a regular blood pressure check-up Cardio Vascular Disease (CVD) • • • • • • no.Prevention • • • • • • • Don‘t smoke Maintain ideal body weight Exercise regularly (at least 20 minutes. 1 killer in the country Every hour.
. clicking. tunes. buzzing. or whistling sound or as ticking. have a healthy lifestyle Pathology of hypertensive • Left ventricle atrophy Hypertension in isolation usually produces no symptoms although some people report headaches. or beeping. roaring. It has also been described as a ―whooshing‖ sound as of wind or waves. dizziness. It is usually described as a ringing noise. ―crickets or tree frogs‖ or ―locusts‖. facial flushing or tinnitus. blurred vision. but in some patients it takes the form of a high pitched whining.Facts • Take good care of your heart. fatigue. ** Tinnitus can be perceived in one or both ears or the head. humming. songs. hissing.
depending on the organ system that is being treated. In practice.3. and treatments. vascular surgeons. • . its usually used to refer to those related to atherosclerosis (arterial disease). Cardiovascular Disease • • • Cardiovascular disease refers to the class of diseases that involve the heart or blood vessels (arteries and veins) While the term technically refers to any disease that affects the cardiovascular system. neurologists and interventional radiologists. thoracic surgeons. cardiovascular disease is treated by cardiologists. These conditions have similar causes. mechanisms.
Most cancers can be treated and some cured. depending on the specific type. but risk for the more common varieties tends to increase with age. location. cancer is usually treated with a combination of surgery. which are self-limited in their growth and don‘t invade or metastasize (although some benign tumor types are capable of becoming malignant). forms of cancer may affect other animals and plants. Cancer may affect people at all ages even fetuses. chemotherapy and radiotherapy. and stage. and sometimes metastatic (spread to other locations in the body). • • • • • • . Cancer causes about 13% of all deaths Apart from humans.4. Once diagnosed.) invasive (invade and destroy adjacent tissues). Cancer • Cancer is a group of diseases in which cells are aggressive (grow and divide without respect to normal limits. These three malignant properties of cancers differentiate them from benign tumors.
and competing professional theories all affect how ―mental health‖ is defined. The World Health Organization states that there is no one ―official‖ definition of mental health. Cultural differences. • • • . subjective assessments. From perspectives of the discipline of positive psychology or holism mental health may include an individual‘s ability to enjoy life and procure a balance between life activities and efforts to achieve psychological resilience. Mental Health • Mental health is a term used to describe either a level of cognitive or emotional wellbeing or an absence of a mental disorder.5.
6425 OTHERWISE KNOWN AS THE DANGEROUS DRUGS ACT OF 1972. the welfare of the family and solidarity and responsible parenthood to prevent drug addiction. diabetes and chronic obstructive pulmonary diseases.THE COMPREHENSIVE DANGEROUS DRUGS ACT OF 2002 AN ACT INSTITUTING THE COMPREHENSIVE DANGEROUS DRUGS ACT OF 2002. • As nurses we have to continue educating the family. REPEALING REPUBLIC ACT NO. cancers. AND FOR OTHER PURPOSES. AS AMENDED. 9165 . • Maximize the health potential of the individual.Healthy Lifestyle Program ―Health and Wealth is a way of life‖ The goal of the Healthy lifestyle program of the DOH: • Reduce prevalence of lifestyle diseases particularly cardiovascular diseases. PROVIDING FUNDS THEREFOR. . REPUBLIC ACT NO.
Section 1.It is the policy of the State to safeguard the integrity of its territory and the well being of its citizenry particularly the youth from the harmful effects of dangerous drugs on their physical and mental well being and to defend the same against acts or omissions detrimental to their development and preservation.This Act shall be known and cited as the ―Comprehensive Dangerous Drugs Act of 2002. it being one of today's more serious social ills chanrobles virtual law library. programs and projects. . implementation and enforcement of anti-drug abuse policies. Toward this end the government shall pursue an intensive and unrelenting campaign against the trafficking and use of dangerous drugs and other similar or substances through or integrated system of planning. The government shall however aim to achieve a balance in the national drug control program so that people with legitimate medical needs are not prevented from being treated with adequate amounts of appropriate medication. which include the use of dangerous drug.‖ chanrobles virtual law library. In view of the foregoing the State needs to enhance further the efficacy of the law against dangerous drugs. Declaration of Policy . Sec 2. Short Title .
Declaration of Principles and Policies — Sect or 11 Art c e XIII of the 1987 Constitution of the Republic of the Philippines declares that the Stare shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goads health and other social services available to all the people at affordable cost.‖ SECTION 2. REPUBLIC ACT NO. Short Title This Act shall be known as the National Health Insurance Act of 1995.PHILIPPINE HEALTH INSURANCE ACT AN ACT INSTITUTING A NATIONAL HEALTH INSURANCE PROGRAM FOR ALL FILIPINOS AND ESTABLISHING THE PHILIPPINE HEALTH INSURANCE CORPORATION FOR THE PURPOSE SECTION 1. Likewise it shall be the policy of the State to provide free medical care to paupers. Priority for the needs of the underprivileged sick elderly disabled women and children shall be recognized.It is further declared the policy of the State to provide effective mechanisms or measures to re integrate into society individuals who have fallen victims to drug abuse or dangerous drug dependence through sustainable programs of treatment and rehabilitation. 7875 . .
manufacture. REPUBLIC ACT NO 6675 . encourage and require the use of generic terminology in the importation. USE AND ACCEPTANCE OF DRUGS AND MEDICINES IDENTIFIED BY THEIR GENERIC NAMES.GENERIC ACT LAW AN ACT TO PROMOTE. Section 1. marketing.This Act shall be known Serer as the ―Generic Act of 1988.‖ (September 1988) Sec. DISTRIBUTION. Title .―gamot na mabisa at abot kayang halaga‖ Objective: to lower the price of medicine and make good quality health service affordable. . REQUIRE AND ENSURE THE PRODUCTION OF AN ADEQUATE SUPPLY. advertising and promotion prescription and dispensing of drugs. To ensure the adequate supply of drugs with generic names at the lowest possible cast and endeavor to make them available free for indigent patients. 2.GMA 50 . distribution. Statement of Policy – It hereby declared the policy of the State: To promote.
Short Title — This Act shall be known as the ―Traditional and Alternative Medicine Act (TAMA) of 1997‖. . REPUBLIC ACT NO. 8423 . and To promote drug safety by minimizing duplication in medications and/or use of drugs with potentially adverse drug interactions. PROVIDING FOR A TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND AND FOR OTHER PURPOSES Section 1. REPUBLIC ACT NO 8423 – ―Traditional and Alternative Medicine Act (TAMA) of 1997‖.AN ACT CREATING THE PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE (PITAHC) TO ACCELERATE THE DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN THE PHILIPPINES.To encourage the extensive use of drugs with generic names through a national system of procurement and distribution. To emphasize the scientific basis for the use of drugs in order that health professionals may became more aware and cognisant of the therapeutic effectiveness.
Declaration of Policy — It is hereby declared the policy of the State to improve the quality and delivery of health care services to the Filipino people through the development of traditional and alternative health care and its integration into the national health care delivery system. • If there is a reaction to the herbal medicine. It shall also be the policy of the State to seek a legally workable basis by which indigenous societies would own their knowledge of traditional medicine. advice client to go to the nearest health center. advise the client never to use insecticides or pesticides • Use one herbal medicine at a time • When cooking the herb. use clay pat and remove the cover to prevent ―over cook‖. the indigenous societies can require the permitted users to acknowledge its source and can demand a share of any financial return that may come from its authorized commercial use. When such knowledge is used by outsiders.Section 2. • When using herbal medicines. In promoting herbal medicines: • Encourage client to backyard gardening. .
elite old .A.elder population • 75-85 .old old 101 above .aged population • 86 over .R.older population • 65-74 .middle old 85.extremely age population • • • • 60-74 .young old 75-84 . 7432 .senior citizen‘s act (20% discount) Range of Aging: • 55-64 .―isang milyong sipilyo‖ Elderly care .DOH‘s program oral and dental hygiene .100 .
Two major function of the family 1. socialization Sub – specialty Nursing 1. 3. Occupational Health Nursing (RA 1054) To Elements: a.Family The Family is the unit of care in public health core (PHC) During home visitation. reproduction 2. the distance of the PHN bag to the patient should be at least 6 feet. Health promotion b.free dental and medical services for all the employees . When you do your hand washing Get all the things inside the bag When returning all the things after the nursing procedure. Three times 1. How many times you should open your PHN bag? A. Q. 2. Health protection *RA 1054 .
It can be a very general science that can be applied to any kind of dynamic population. one that changes over time or space.give health education to the student (ex. School and community coordination Demography Demography is the statistical study of all populations. structure and distribution of populations. migration and aging. Health service .give booster dose of antigen (ex. Proper hygiene) b. School Health Nursing Four (4) Phases in School Nurse: a. DT.by education them to proper nutrition (ex. BCG. Health Instruction . . and spatial and/or temporal changes in them response to birth death. Health promotion .2. It encompasses the study of the size. don't eat junk food) c. deworming) d. that is.
Serves as a basis for evaluation (ex. Population size number of people given at a certain place and time.A.Nature and scope of demography a. Morbidity . survey) Q. female. Population distribution . Anticipate health problem 2.leading cause of death in elderly is CV (cardio vascular disease) R. Population dynamic .new born screening (should be taken 24 hours after birth) . Population composition . d. Determine availability and needs for resources 3. Decrease the breath sound and chuckle.this pertains to the allocation of resources.pertains how congested the community is. how many male. What are the signs and symptoms when an elderly has infection? A.leading cause of death in elderly is pneumonia Mortality . elder in a certain area) c. (Population size may vary between daytime and night time) b. Three significance of demography 1. 9288 .arrangement of people according to group (ex. infant.
Three Levels of Toilet Facility: 1.communal faucet or stand past stand post must not be near the septic tank. Deep well: 1 tsp.non-water carriage toilet (PIT-LATRIN) 2.water carriage facility connected to a septic tank. Of chlorine for every one liter of water (stock solution) Stock solution is good for only a week. Level 1 . when it starts to boil. *distance from the rubbish pr toilet facilities must be 25 meters away. 3. Level 2 . connected to a sewerage system to final treatment plant. Boil water for at least 5 mins. Level 3 .source (protected well or spring) should only serve 15 to 25 households and not more than 250 meters away from the farthest user. .individual house connection of water work system pipe distribution and serving densely populated areas. 2. Level 3 .Level of Water Supply: 1.on site toilet facility (with water seal and septic tank) 3. Level 1 . Level 2 .
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