TOP

TEN COMMUNITYS
DISEASE
Fajar Ari Nugroho

ISPA: PNEUMONIA

Deni=on
acute inamma=on of the alveolar
spaces with exudate, aLer a cold or u

Classica=on
Hospital
acquired
Community
acquired

Atypical

Sign & Symptom

1.
2.
3.
4.
5.
6.
7.
8.

Dicult & painful respiratory

Shortness of breath
Rales, rhonchi
Fever
Anorexia
Malaise
Abdominal disten=on
A produc=ve cough painful &
incessant (green/yellow sputum)

High Risk
1. Elderly
2. Very young

Interven=on:
Objec=ve
1. Prevent or correc=on dehydra=on
2. Relieve breathing diculty &
discomfort
3. Prevent weight loss from hyper
metabolic state

4. Support diet with adequate

an=oxidant & nutrient-dense food

5. Avoid addi=onal infec=on

6. In convalescent stage, avoid
cons=pa=on

Interven=on:
Food & Nutri=on
1. If not contraindicated, oer 3 L or

more of daily uid secre=on &

lower temperature
2. Progress, as tolerated, to a high
calorie-diet overweight : normal
diet
3. Early enteral nutri=on prevent
worse condi=on
4. Frequent, small meal & soL diet
befer

5. A mul=ple vitamin mineral

supplement

6. Fiber & juice

Interven=on: Nutri=on
Educa=on, Counseling,
Care Management
1. Discuss the role of diet and uid
intake in recovery

2. Careful food handling will be

important

3. Hand washing is key as well,

especially aLer sneezing & coughing

& before ea=ng

ISPA: TUBERCULLOSIS

Deni=on
cause by a tubercle bacillus invading the
lungs & seing up an inammatory
process

Sign & Symptom

1.
2.
3.
4.
5.

Loss of appe=te
Constant fa=gue
Tissue was=ng
Exhaus=on

Cough las=ng 3 weeks or longer with

occasional blood-=nged sputum
6. Profuse night sweat

7. Weight loss

High Risk
all immunocompromised person

Interven=on:
Objec=ve
1.
2.
3.
4.
5.

Maintain weight
Normalize calcium levels in serum
Replace nutrient losses
Promote healing of cavity

Counteract neuri=s from isoniazid

(INH) therapy
6. S=mulate appe=te

7. Prevent dehydra=on
8. Prevent lung infec=on, inamma=on
& complica=on

Interven=on:
Food & Nutri=on
1. Use a well-balanced diet containing

liberal amounts of protein &

adequate calories 35-45 Kcal/kg if
weight loss

2. Use adequate uids 35 cc/kg or 2 L

3. Add more omega-3 fafy acids
4. Ensure that the diet provides
sucient calcium
5. No alcohol

Interven=on :
Educa=on, Counseling,
Care Management
1. Add protein powder or nonfat dry
milk

2. Encourage the prepara=on of

appe=zing meals

3. Plan rest periods before & aLer meals

4. Promote as much quality of life as
possible

5. Careful food handling

communicable disease

GASTRITIS & GASTROENTERITIS

Deni=on
inamma=on of the stomach

an inamma=on stomach & intes=nal
leaning

Interven=on :
Objec=ves
1. Prevent or correct dehydra=on,

shock, hypokalemia & hyponatremia

2. Allow the stomach & GI tract to rest,

but relieve thirst with water &
tolerated uids

3. Empty stomach to permit mucous

lining to heal

4. Omit lactose if not tolerated

Interven=on:
Food & Nutri=on
1. Gastri=s = omit foods that are poorly
tolerated, provide adequate
hydra=on
2. Acute gastroenteri=s = NPO or PPN

3. Chronic gastroenteri=s = small,

frequent feeding, progress with

larger, restrict fat intake, add ber
containing ber as tolerated
4. Ginger or ginger ale may alluviate
some nausea

Interven=on: Nutri=on
Educa=on, Counseling,
Care Management
1. Pa=ent with chronic gastri=s should
be assessed for folate & vit B12

2. ORT is recommended as rst line

therapy

3. Careful food handling will be

important

HYPERTENSION

Deni=on
as having a sustained systolic & diastolic
blood pressure greater than 140 & 90
mm Hg respec=vely

JNC 7 Report
1. Age >50, systolic BP >140 mmHg is

more important CVD risk factor than

diastolic BP
2. Beginning at 115/75 mmHg, CVD risk
doubles for each increment of 20/10
mmHg
3. Prehypertension individual (systolic
BP of 120-139 mmHg or diastolic BP
80-89 mmHg required health-
promo=ng lifestyle modica=ons to
prevent to progressive rise in BP &
CVD

Interven=on:
Objec=ve
1. Control BP to lessen the likelihood of
heart failure or stroke online
20-24% of pa=ent with hypertension
= sodium sensi=ve

2. Assess medical risk factors,

comorbidi=es, and causes
3. A high-potassium intake

4. If diet does not help within 2 weeks

medica=on may needed

5. Calcium supplementa=on
6. Encourage adequate intake of uids
7. Increase physical ac=vity to 30

minutes daily most days of the weeks

Interven=on:
Food & Nutri=on
1. DASH diet rich in fruits, vegetables,
2.
3.
4.
5.
6.
7.
8.
9.

low saturated fafy acid (SFA) & total

fat
Tips on ea=ng the DASH way start
small, make gradual changes in ea=ng
habits
Increase fruits & vegetables for their
avonoids & phytochemical
Limit sodium 2-4 g daily
Use an energy-controlled diet if
weight loss is needed
Fat intake should be moderate
Increase calcium intake by 400-500
mg/day
Increase intake folic acid, B12 & b6
Control caeine intake from colas,
habitual coe intake is less
problema=c

Interven=on: Nutri=on
Educa=on, Consul=ng,
Care Management
1. Encourage pa=ence, trust &
mo=va=on

2. Encourage the adequate intake of

fruits & vegetables

3. Remove salt from table, processed &

canned food
4. Interes=ng food avors are oLen
hidden by salt
5. Read label carefully

6. Obesity lead hypertension

7. Increase physical ac=vity

Thanks