WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH

NURSING
A. DOH Vision 2030 A Global Leader for attaining better health outcomes, competitive and responsive health care systems, and equitable health financing. B. DOH Mission To guarantee EQUITABLE, SUSTAINABLE and QUALITY health for all Filipinos, especially the poor and to lead the quest for excellence in health. C. Levels of Prevention PRIMARY LEVEL Health Promotion and Illness Prevention SECONDARY LEVEL Prevention of Complications thru Early Dx and Tx TERTIARY LEVEL Prevention of Disability, etc. Ampalaya Mamordica charantia Bayabas Psidium quajava Diarrhea Toothache Mouth and wound wash HPN Toothache Same as Lagundi except asthma Edema Diuretic All forms of skin diseases Intestinal Parasitism (Nematodes) Diarrhea Infantile colic (Kabag) Dental caries Type II Diabetes (NIDDM)

Bawang Yerta Buena Sambong Akapulko Niyog niyogan Tsaang Gubat

Allium sativum Mentha cordifelia Blumea balsanifera Cassia alata Quisqualis indica Carmona resuta

Provided at Health care/RHU Brgy. Health Stations Main Health Center Community Hospital and Health Center Private and Semi-private agencies

When hospitalization is deemed necessary and referral is made to emergency (now district), provincial or regional or private hospitals

When highlyspecialized medical care is necessary referrals are made to hospitals and medical center such as PGH, PHC, POC, National Center for Mental Health, and other govt private hospitals at the municipal level

F. Homemade Oresol A volume or one liter homemade oresol Water 1000 ml. or 1 liter Sugar 8 teaspoon Salt 1 teaspoon Smaller volume or a glass homemade oresol 250 ml. 2 teaspoon teaspoon or a pinch of salt=10-12 granules of rock salt: iodized salt=tips of thumb & index finger are penetrated with salt

G. Millennium Goal Development (MDG) 1. 2. 3. 4. 5. 6. 7. 8. ERADICATE EXTREME POVERTY AND HUNGER ACHIEVE UNIVERSAL PRIMARY EDUCATION PROMOTE GENDER EQUALITY AND EMPOWER WOMEN REDUCE CHILD MORTALITY (Phil. focus) IMPROVE MATERNAL HEALTH (Phil. focus) COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES ENSURE ENVIRONMENTAL SUSTAINABILITY DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT

D. 8 Common Generic Drugs (Botika sa Baranggay) 1. 2. 3. 4. 5. 6. 7. 8. Co-Trimoxazole : GUT/GIT/URT Infection Amoxicillin / Ampicillin Rifampicin Isoniazid Pyrazinamide Paracetamol Oresol Nifidipine: HPN

H. Field Health Service Information System ( FHSIS) Individual Treatment Record (ITR) Fundamental building block or foundation FHSIS. Target Client List (TCL) Such lists will be of considerable value to midwives/nurses in monitoring service delivery to clients in general and in particular to groups of patients identified as targets or eligibles for one or another program of the Department

E. Herbal Plants Plant Name Lagundi Scientific Name Vitex negundo Indications Asthma, cough, colds & fever Pain and inflammation Gout Arthritis Rheumatism

Ulasimang Bato

Peperonia pellucida

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
Summary Table Composed of Health Program Accomplish and Morbidity Diseases The Monthly Consolidation Table (MCT) Maternal Mortality Rate (MMR): Reported maternal deaths per 1000 registered live births (RLB) MMR= # of maternal deaths RLB x 1000

FHSIS Reporting Monthly Form 1. Program report (M1) 2. Morbidity report (M2) Prepare by Midwife Every 2nd week of the month is the submission Quarterly Form 1. Program report (Q1) 2. Morbidity report (Q2) Prepared by Nurse Every 3rd week of the succeeding quarter month is the submission Annual Form 1. ABHS report Contains data on demographic, environmental and natality. Prepare by Midwife Every 2nd week of January is the submission 2. A1: Report on vital statistics: demographic, environmental, natality and mortality. 3. A2: Lists all diseases and their occurrence in the municipality/city. The report is broken down by age and sex. 4. A3: All deaths occurred in the municipality/city. The report is also broken down by age and sex Prepared by Nurse Every 3rd week of January is the submission I. Health Indicators

Infant Mortality Rate (IMR): Reported # of infant (0 to 12 months of age) deaths per 1000 RLB IMR=# of infant deaths RLB x 1000

Neonatal Mortality Rate (NMR): Reported # of neonatal (0 to 28 days or <1 month) deaths per 1000 RLB NMR=# of neonatal deaths RLB x 1000

Swaroops Index (SI): Reported # of deaths among individuals> 50 years old over total deaths SI=# of deaths (individual >50 years old) x Total Deaths J. Nature of the Family Problem Health Deficit (HD): if identified problem is an abnormality, illness or disease, theres a gap/difference between normal status (ideal, desirable, expected) & actual status (the outcome/result/problem encountered on that actual day) Health Threat (HT): any condition or situation which will be conducive to health alteration, health interference & health disturbance. Foreseeable Crisis (FC): stress points, anything which is anticipated/ expected to become a problem. 100

Crude Birth Rate (CBR): Overall total reported births per 1000 population CBR=overall total reported births Population x 1000

K. Community Organizing (COPAR) Preparatory Phase 1. Area of Selection It should be DOPE Community: Depressed, Oppressed, Poor & Exploited, a new criteria for community organization 2. Entry Phase The 1st thing to do upon entering the community is to have a courtesy call with the Barangay Captain, introduce self & group, purpose, present the project, activities, etc. 3. Integration/Immersion (CIP) Immersion is imbibing the life situation/condition of the community . 4. Community Study: Diagnosis of Community-COPAR Makes use of the Nursing Process/Problem Solving Approach Prioritized which among the problems identified is to be attended 1st like in nature, magnitude, modifiability, preventive potential, salience

Incidence Rate (IR): Reported new cases of disease per percent (100/population) population IR=new cases of disease Population x 100

Prevalence rate (PR): Reported new cases of disease + old cases of disease per percent of population PR=new cases + old cases Population x 100

Crude Death Rate (CDR): Overall total reported deaths per 1000 population CDR=overall total deaths Population x 1000

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
O. Excreta Disposal L. Epidemiology Epidemic: a situation when there is a high incidence of new cases of a specific disease in excess of the expected. Endemic : habitual presence of a disease in a given geographic location accounting for the low number of both immunes and susceptibles Sporadic : disease occurs every now and then affecting only a small number of people relative to the total population Pandemic: global occurrence of a disease Household Burial Deposited in 1m x 1m deep pits covered with soil, located 25 m. away from water supply Community Sanitary landfill or controlled tipping Excavation of soil deposition of refuse and compacting with a solid cover of 2 feet Incineration Open burning Animal feeding Composting Grinding and disposal sewer

M . Approve Water Facilities Level I Point Source A protected well or a developed spring with an outlet but without a distribution system for rural areas where houses are thinly scattered. Level II Communal faucet system or stand posts A system composed of a source, a reservoir, a piped distribution network and communal faucets, located at not more than 25 meters from the farthest house in rural areas where houses are clustered densely. Level III Waterworks system or individual house connections A system with a source, a reservoir, a piped distributor network and household taps that is suited for densely populated urban areas. DOH PROGRAMS EXPANDED PROGRAM ON IMMUNIZATION Law: PD 996 Vaccine BCG 1. I 2. SE DPT OPV HBV MV Dosage # of Doses to complete immunization 1 dose 1 dose 3 doses 3 doses 3 doses 1 dose

.05 ml .1 ml .5 ml 2-3 gtts <10 y/o: .5 >10 y/o: 1 .5 ml

N. Approved Toilet Facilities Level 1 Non-water carriage toilet facility: - Pit latrines - Reed Odorless Earth Closet - Bored-hole - Compost - Ventilated improved pit Toilets requiring small amount of water to wash waste into receiving space - Pour flush - Aqua privies Level 2 On site toilet facilities of the water carriage type with water sealed and flushed type with septic vault/tank disposal facilities. Level 3 Water carriage types of toilet facilities connected to septic tanks an/or to sewerage system to treatment plant.

It is safe and immunologically effective to administer all EPI vaccines on the same day at different sites of the body. The vaccination schedule should not be restarted from the beginning even if the interval between doses exceeded the recommended interval by months or year. DPT2 or DPT3 is not given to a child who has convulsions or shock within 3 days after DPT1. V Do not give live vaccines like BCG to a individuals who are immunosuppressed due to malignant disease (child with AIDS) , going therapy with immunosuppressive agents or radiation. Repeat BCG vaccination if the child does not develop a scar after first injection Storage Temp. -15 to -25 C At the freezer 8 hours 2 to 8 C Body of refrigerator Hours of Life after opening

Type of Vaccine OPV Measles Hepa B DPT Tetox BCG

4 hours

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
NATIONAL TB PROGRAM
Disease Tuberculosis Primary Complex is less than 3 years old - any child who does not return to normal health after measles or whooping cough. Most hazardous period: first 6-12 months after infection Highest in risk of developin g: under 3 years old Causative Agent Mycobacterium Tuberculosis Mode of Transmission Droplet Infection ( inhalation of bacilli from patient who coughs and sneeze) Clinical Manifestation General weakness Loss of weight, cough and wheeze which does not respond to antibiotic therapy. Fever and night sweat Abdominal swelling with a hard painless mass and free fluid Hemoptysis and chest pain Painful firm or soft swelling in a group of superficial lymph nodes. Reservoir Man And Diseased Cattle (Bovine TB) Diagnostic Exam Sputum Exam 3 sample are taken with 24 hrs: - spot sample (1st visit) - early morning specimen - spot sample (2nd visit) Note: at least 2 sample are positive Chest Xray Mantoux Test - .1 cc injection of PDD and 48-72 hours reading * 10 mm + 5 mm + (HIV pt.) Treatment DOTS - patient is required to take the Ant-Tb drugs in the presence of a health care provider to ensure compliance to treatment regimen Anti-TB drugs: (RIPES) Rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin Nursing Implication Pointers for teaching on Anti-TB drugs: Rifampicin: taken befor meals, causes red urine urine Isoniazide: causes peripheral neuritis, given with Vit.B6 Pyrazinamide: cause hyperurucemia Ethambutol: causes optic neuritis/ blurring of vision Streptomycin: cause tinnitus, loss of hearing balance, damage to 8th cranial nerve Note: After 2-4 weeks of treatment, patient is no longer contagious

RECOMMENDED CATEGORY OF TREATMENT REGIMEN

Category Type of TB Patient Treatment Intensive Phase Regimen Continuation Phase 4 RI Total Period

II

New smear positive PTB New smear positive PTB with extensive parenchymal lesion EPTB and Severe concomitant HIV disease Treatment Failure Relapse Return after default New smear-negative PTB With minimal parenchymal lession Chronic ( still smearpositive after supervised re-treatment )

2 RIPE

6 mos.

2 RIPES /1 RIPE

5 RIE

8 mos.

III

2 RIP Refer to or DOTS to City

4 RI Specialized Plus Center Provincial Coordinator facility refer NTP

6 mos.

IV

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) Danger Sign MAIN SYMPTOM: Diarrhea

MAIN SYMPTOM: Cough and Difficulty Breathing Dehydration Classification

Pneumonia Classification

A child who has had diarrhea for 14 days or more and who has no signs of dehydration is classified as having PERSISTENT DIARRHOEA

Classify a child with diarrhea and blood in the stool as having DYSENTERY. A child with dysentery should be treated for dehydration

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
MAIN SYMPTOM: Fever No Malaria Risk Classification

MAIN SYMPTOM: Ear Problem

High Malaria Risk Classification

Low Malaria Risk Classification

Ear Problem Classifications

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE

WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING
MAIN SYMPTOM: Malnutrition and Anemia Enlargement of abdomen Splenomegaly Hepatomegaly Anemia / pallor weakness Diagnostic Test: COPT or cercum ova precipitin test (stool exam) Drug-of-Choice: PRAZIQUANTEL (Biltracide) Oxamniquine for S. mansoni Metrifonate for S. haematobium *Death is often due to hepatic complication Dispose the feces properly not reaching body of water Use molluscides Prevent exposure to contaminated water (e.g. use rubber boots) Apply 70% alcohol immediately to skin to kill surface cercariae Allow water to stand 48-72 hours before use

Malnutrition and Anemia Classification

COMMUNICABLE DISEASES Cholera Other names:El tor Fecal-oral route 5 Fs Incubation Period: Few hours to 5 days; Usually 3 days Pathognomonic Sign: Rice watery stool Diagnostic Test: Stool culture Treatment:Oral rehydration solution (ORESOL) IVF Drug-of-Choice: tetracycline (use straw; can cause staining of teeth). Oral tetracycline should be administered with meals or after milk. Shistosomiasis Other Names: Snail Fever Bilharziasis Endemic in 10 regions and 24 provinces High prevalence: Regions 5, 8, 11 Contact with the infected freshwater with cercaria and penetrates the skin Diarrhea Bloody stools (on and off dysentery)

Malaria Plasmodium Parasites: Vivax Falciparum (most fatal; most common in the Philippines) Bite of infected anopheles mosquito Night time biting High-flying Rural areas Clear running water Malarial Smear best time to get the specimen is at height of fever because the microorganisms are very active and easily identified Chemoprophylaxis: only chloroquine should be given (taken at weekly intervals starting from 1-2 weeks before entering the endemic area). In pregnant women, it is given throughout the duration of pregnancy. Treatment: 1. QUININE oldest drug used to treat malaria; from the bark of Cinchona tree; ALERT: Cinchonism quinine toxicity 2. CHLOROQUINE 3. PRIMAQUINE sometimes can also be given as chemoprophylaxis 4. FANSIDAR combination of pyrimethamine and sulfadoxine CLEAN Technique *Insecticide treatment of mosquito net *House Spraying (night time fumigation) *On Stream Seeding construction of bio-ponds for fish propagation (2-4 fishes/m2 for immediate impact; 200-400/ha. for a delayed effect) *On Stream Clearing cutting of vegetation overhanging along stream banks *Avoid outdoor night activities (9pm 3am) *Wearing of clothing that covers arms and legs in the evening*Use mosquito repellents *Zooprophylaxis typing of domestic animals like the carabao, cow, etc near human dwellings to deviate mosquito bites from man to these animals Intensive IEC campaign

POSSIBLE TOPICS ON COMMUNITY HEALTH NURSING FOR THE UPCOMING DECEMBER 2012 PNLE

*Patterned on the previous board exams from December 2006 December 2011 the purpose of this note is to GUIDE students on the possible topics that might be part of the upcoming Dec. 2012 PNLE