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Dec 2012  NLE TIPS CHD and CD
 

Dec 2012 NLE TIPS CHD and CD

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    Dec 2012  NLE TIPS CHD and CD Dec 2012 NLE TIPS CHD and CD Document Transcript

    • WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESSPART 3: COMMUNITY HEALTH NURSINGA. DOH Vision 2030 Bayabas Psidium quajava Diarrhea Toothache A Global Leader for attaining better health outcomes, Mouth and wound competitive and responsive health care systems, and wash equitable health financing. Bawang Allium sativum HPN ToothacheB. DOH Mission Yerta Buena Mentha cordifelia Same as Lagundi except asthma To guarantee EQUITABLE, SUSTAINABLE and QUALITY Sambong Blumea Edema health for all Filipinos, especially the poor and to lead the balsanifera Diuretic quest for excellence in health. Akapulko Cassia alata All forms of skin diseasesC. Levels of Prevention Niyog niyogan Quisqualis indica Intestinal Parasitism PRIMARY SECONDARY TERTIARY (Nematodes) LEVEL LEVEL LEVEL Tsaang Gubat Carmona resuta Diarrhea Health Prevention of Prevention of Infantile colic Promotion and Complications Disability, etc. (Kabag) Illness thru Early Dx Dental caries Prevention and Tx Ampalaya Mamordica Type II Diabetes charantia (NIDDM) Provided at – When When highly- hospitalization specialized F. Homemade Oresol Health is deemed medical care is care/RHU A volume or one liter Smaller volume or a glass necessary and necessary referral is referrals are homemade oresol homemade oresol Brgy. Health Stations made to made to Water 1000 ml. or 1 liter 250 ml. emergency hospitals and Sugar 8 teaspoon 2 teaspoon Main Health (now district), medical center Salt 1 teaspoon ¼ teaspoon or a pinch of Center provincial or such as PGH, salt=10-12 granules of rock regional or PHC, POC, salt: iodized salt=tips of thumb Community private National Center & index finger are penetrated Hospital and hospitals for Mental with salt Health Center Health, and other Private and gov’t private G. Millennium Goal Development (MDG) Semi-private hospitals at the agencies municipal level 1. ERADICATE EXTREME POVERTY AND HUNGER 2. ACHIEVE UNIVERSAL PRIMARY EDUCATION 3. PROMOTE GENDER EQUALITY AND EMPOWER WOMEND. 8 Common Generic Drugs (Botika sa Baranggay) 4. REDUCE CHILD MORTALITY (Phil. focus) 5. IMPROVE MATERNAL HEALTH (Phil. focus) 1. Co-Trimoxazole : GUT/GIT/URT Infection 6. COMBAT HIV/AIDS, MALARIA AND OTHER 2. Amoxicillin / Ampicillin DISEASES 3. Rifampicin 7. ENSURE ENVIRONMENTAL SUSTAINABILITY 4. Isoniazid 8. DEVELOP A GLOBAL PARTNERSHIP FOR 5. Pyrazinamide DEVELOPMENT 6. Paracetamol 7. Oresol H. Field Health Service Information System ( FHSIS) 8. Nifidipine: HPN  Individual Treatment Record (ITR)E. Herbal Plants  Fundamental building block or foundation FHSIS. Plant Name Scientific Name Indications  Target Client List (TCL)Lagundi Vitex negundo Asthma, cough,  Such lists will be of considerable value to colds & fever midwives/nurses in monitoring service Pain and delivery to clients in general and in inflammation particular to groups of patients identified asUlasimang Bato Peperonia Gout “targets” or “eligibles” for one or another pellucida Arthritis program of the Department RheumatismPOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSING  Summary Table Maternal Mortality Rate (MMR): Reported maternal deaths  Composed of Health Program Accomplish per 1000 registered live births (RLB) and Morbidity Diseases  The Monthly Consolidation Table (MCT) MMR= # of maternal deaths x 1000 RLB FHSIS Reporting  Monthly Form Infant Mortality Rate (IMR): Reported # of infant (0 to 12 1. Program report (M1) months of age) deaths per 1000 RLB 2. Morbidity report (M2)  Prepare by Midwife IMR=# of infant deaths x 1000  Every 2nd week of the month is the RLB submission  Quarterly Form Neonatal Mortality Rate (NMR): Reported # of neonatal (0 1. Program report (Q1) to 28 days or <1 month) deaths per 1000 RLB 2. Morbidity report (Q2)  Prepared by Nurse NMR=# of neonatal deaths x 1000  Every 3rd week of the succeeding quarter RLB month is the submission  Annual Form Swaroop’s Index (SI): Reported # of deaths among 1. ABHS report individuals> 50 years old over total deaths  Contains data on demographic, environmental and natality. SI=# of deaths (individual >50 years old) x 100  Prepare by Midwife Total Deaths  Every 2nd week of January is the submission 2. A1: Report on vital statistics: demographic, J. Nature of the Family Problem environmental, natality and mortality. 3. A2: Lists all diseases and their occurrence in  Health Deficit (HD): if identified problem is an the municipality/city. The report is broken abnormality, illness or disease, there’s a down by age and sex. gap/difference between normal status (ideal, 4. A3: All deaths occurred in the desirable, expected) & actual status (the municipality/city. The report is also broken outcome/result/problem encountered on that down by age and sex actual day)  Prepared by Nurse  Every 3rd week of January is the  Health Threat (HT): any condition or situation submission which will be conducive to health alteration, health interference & health disturbance.I. Health Indicators  Foreseeable Crisis (FC): stress points, anythingCrude Birth Rate (CBR): Overall total reported births per which is anticipated/ expected to become a1000 population problem. CBR=overall total reported births x 1000 K. Community Organizing (COPAR) Population Preparatory PhaseIncidence Rate (IR): Reported new cases of disease per 1. Area of Selectionpercent (100/population) population  It should be DOPE Community: Depressed, Oppressed, Poor & Exploited, a new criteria for IR=new cases of disease x 100 community organization Population 2. Entry Phase  The 1st thing to do upon entering the community isPrevalence rate (PR): Reported new cases of disease + old to have a courtesy call with the Barangay Captain,cases of disease per percent of population introduce self & group, purpose, present the project, activities, etc. PR=new cases + old cases x 100 3. Integration/Immersion (CIP) Population  Immersion is imbibing the life situation/condition of the community .Crude Death Rate (CDR): Overall total reported deaths per 4. Community Study: Diagnosis of Community-COPAR1000 population  Makes use of the Nursing Process/Problem Solving Approach CDR=overall total deaths x 1000  Prioritized which among the problems identified is Population to be attended 1st like in nature, magnitude, modifiability, preventive potential, saliencePOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSING O. Excreta DisposalL. Epidemiology Household Community  Epidemic: a situation when there is a high ○ Burial ○ Sanitary landfill or incidence of new cases of a specific disease in excess ► Deposited in 1m x controlled tipping of the expected. 1m deep pits covered ► Excavation of soil with soil, located 25 deposition of refuse and  Endemic : habitual presence of a disease in a given m. away from water compacting with a solid geographic location accounting for the low number supply cover of 2 feet of both immunes and susceptibles ○ Incineration  Sporadic : disease occurs every now and then affecting only a small number of people relative to ○ Open burning the total population Animal feeding Composting  Pandemic: global occurrence of a disease Grinding and disposal sewerM . Approve Water FacilitiesLevel I Level II Level IIIPoint Communal faucet Waterworks DOH PROGRAMSSource system or stand system or posts individual house EXPANDED PROGRAM ON IMMUNIZATION connections  Law: PD 996A protected A system composed A system with awell or a of a source, a source, a reservoir, Vaccine Dosage # of Doses todeveloped reservoir, a piped a piped distributor completespring with distribution network network and immunizationan outlet but and communal household taps BCGwithout a faucets, located at that is suited for 1. I .05 ml 1 dosedistribution not more than 25 densely populated 2. SE .1 ml 1 dosesystem for meters from the urban areas. DPT .5 ml 3 dosesrural areas farthest house in OPV 2-3 gtts 3 doseswhere rural areas where HBV <10 y/o: .5 3 doseshouses are houses are clustered >10 y/o: 1thinly densely. MV .5 ml 1 dosescattered.  It is safe and immunologically effective to administer all EPI vaccines on the same day at different sites of theN. Approved Toilet Facilities body.Level 1 Level 2 Level 3  The vaccination schedule should not be restarted fromNon-water On site toilet Water carriage the beginning even if the interval between dosescarriage toilet facilities of the types of toilet exceeded the recommended interval by months or year.facility: water carriage facilities  DPT2 or DPT3 is not given to a child who has- Pit latrines type with water connected to convulsions or shock within 3 days after DPT1. V- Reed Odorless sealed and septic tanks  Do not give live vaccines like BCG to a individuals whoEarth Closet flushed type with an/or to are immunosuppressed due to malignant disease (child- Bored-hole septic vault/tank sewerage with AIDS) , going therapy with immunosuppressive- Compost disposal system to agents or radiation.- Ventilated facilities. treatment  Repeat BCG vaccination if the child does not develop aimproved pit plant. scar after first injectionToilets requiringsmall amount of Type of Vaccine Storage Temp. Hours of Life afterwater to wash openingwaste into OPV -15 to -25 Creceiving space Measles At the freezer- Pour flush Hepa B 8 hours- Aqua privies DPT 2 to 8 C Tetox Body of BCG refrigerator 4 hoursPOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSINGNATIONAL TB PROGRAM Disease Causative Agent Mode of Clinical Reservoir Diagnostic Treatment Nursing Transmission Manifestation Exam ImplicationTuberculosis Mycobacterium Droplet Infection General Man Sputum DOTS Pointers for“Primary Tuberculosis ( inhalation of weakness And Exam - patient is teaching onComplex” is bacilli from patient Loss of Diseased 3 sample required to take Anti-TB drugs:less than 3 who coughs and weight, Cattle are taken the Ant-Tb drugsyears old sneeze) cough and (Bovine with 24 hrs: in the presence of Rifampicin: wheeze TB) - spot a health care taken befor- any child which does sample (1st provider to meals, causeswho does not not respond visit) ensure red urine urinereturn to to antibiotic - early compliance to Isoniazide:normal health therapy. morning treatment causesafter measles Fever and specimen regimen peripheralor whooping night sweat - spot neuritis, givencough. Abdominal sample Anti-TB drugs: with Vit.B6 swelling (2nd visit) (RIPES) Pyrazinamide: Most with a hard Note: at Rifampicin cause hazardous painless least 2 Isoniazid hyperurucemia period: mass and sample are Pyrazinamide Ethambutol: first 6-12 free fluid positive Ethambutol causes optic months Hemoptysis Streptomycin neuritis/ after and chest Chest blurring of infection pain Xray vision Highest in Painful firm Mantoux Streptomycin: risk of or soft Test cause tinnitus, developin swelling in a - .1 cc loss of hearing g: under 3 group of injection of balance, damage years old superficial PDD and to 8th cranial lymph 48-72 hours nerve nodes. reading * 10 mm + Note: After 2-4 5 mm + weeks of (HIV pt.) treatment, patient is no longer contagiousRECOMMENDED CATEGORY OF TREATMENT REGIMEN Category Type of TB Patient Treatment Regimen Intensive Phase Continuation Total Period Phase New smear positive PTB New smear positive PTB I with extensive 2 RIPE 4 RI 6 mos. parenchymal lesion EPTB and Severe concomitant HIV disease Treatment Failure II Relapse 2 RIPES /1 RIPE 5 RIE 8 mos. Return after default New smear-negative PTB III With minimal parenchymal 2 RIP 4 RI 6 lession mos. Chronic ( still smear- Refer to Specialized facility IV positive after supervised or DOTS Plus Center refer re-treatment ) to City Provincial NTP CoordinatorPOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSING INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) MAIN SYMPTOM: DiarrheaDanger SignMAIN SYMPTOM: Cough and Difficulty Breathing Dehydration Classification A child who has had diarrhea for 14 days or more and who has no signs of dehydration is classified as having PERSISTENT DIARRHOEAPneumonia Classification Classify a child with diarrhea and blood in the stool as having DYSENTERY. A child with dysentery should be treated for dehydrationPOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSINGMAIN SYMPTOM: Fever No Malaria Risk Classification MAIN SYMPTOM: Ear ProblemHigh Malaria Risk Classification Ear Problem ClassificationsLow Malaria Risk ClassificationPOSSIBLE 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 studentson 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 SUCCESSPART 3: COMMUNITY HEALTH NURSING Enlargement of abdomen SplenomegalyMAIN SYMPTOM: Malnutrition and Anemia 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  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 veryMalnutrition and Anemia Classification 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) COMMUNICABLE DISEASES *On Stream Clearing – cutting of vegetation overhanging along stream banks *Avoid outdoor night activities (9pm – 3am) Cholera *Wearing of clothing that covers arms and legs in the  Other names:El tor evening*Use mosquito repellents  Fecal-oral route 5 Fs *Zooprophylaxis – typing of domestic animals like the  Incubation Period: Few hours to 5 days; Usually 3 carabao, cow, etc near human dwellings to deviate days mosquito bites from man to these animals Intensive  Pathognomonic Sign: Rice watery stool IEC campaign  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)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 studentson the possible topics that might be part of the upcoming Dec. 2012 PNLE