July 2012 nle tips chn and cd


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  • @MarkFredderickAbejo sir bka naman pwedng humingi ng copies ng lahat ng majors.very simpilfied ang pagkagawa at madaling intindihin.
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  • @mitchpatricia downloadable already..... visit also my website www.allfornursing.com
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  • sir baka po pwede ko makahingi ng copy nito..it would be a great help for my dec.nle..thanks in advance and GoD BLESS!
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July 2012 nle tips chn and cd

  1. 1. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING    A.    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     Toothache  B.  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     diseases  C.  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     WOMEN  D.    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       Ø Individual  Treatment  Record  (ITR)    E.  Herbal  Plants   ü Fundamental  building  block  or  foundation     FHSIS.   Plant  Name   Scientific  Name   Indications   Ø Target  Client  List  (TCL)    Lagundi   Vitex  negundo   Asthma,  cough,   ü 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  as  Ulasimang  Bato   Peperonia   Gout   “targets”  or  “eligibles”  for  one  or  another   pellucida   Arthritis   program  of  the  Department   Rheumatism    POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  2. 2. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING     Ø Summary  Table     Maternal  Mortality  Rate  (MMR):   Reported   maternal   deaths   ü Composed  of  Health  Program  Accomplish   per  1000  registered  live  births  (RLB)   and  Morbidity  Diseases     Ø The  Monthly  Consolidation  Table  (MCT)      MMR=  #  of  maternal  deaths   x   1000       RLB   FHSIS  Reporting     Ø 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)     ü Prepare  by  Midwife   IMR=#  of  infant  deaths            x                                  1000   ü Every  2nd  week  of  the  month  is  the       RLB   submission     Ø 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)     ü Prepared  by  Nurse   NMR=#  of  neonatal  deaths   x   1000   ü Every  3rd  week  of  the  succeeding  quarter       RLB   month  is  the  submission     Ø Annual  Form   Swaroop’s   Index   (SI):   Reported   #   of   deaths   among   1. ABHS  report   individuals>  50  years  old  over  total  deaths   ü Contains  data  on  demographic,     environmental  and  natality.                    SI=#  of  deaths  (individual  >50  years  old)   x   100   ü Prepare  by  Midwife     Total  Deaths   ü 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   Ø 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)   ü Prepared  by  Nurse     ü Every  3rd  week  of  January  is  the   Ø Health  Threat  (HT):  any  condition  or  situation   submission   which  will  be  conducive  to  health  alteration,  health     interference  &  health  disturbance.  I.  Health  Indicators       Ø Foreseeable  Crisis  (FC):  stress  points,  anything  Crude   Birth   Rate   (CBR):   Overall   total   reported   births   per   which  is  anticipated/  expected  to  become  a  1000  population   problem.       CBR=overall  total  reported  births   x   1000   K.  Community  Organizing  (COPAR)                  Population       Preparatory  Phase  Incidence   Rate   (IR):   Reported   new   cases   of   disease   per   1. Area  of  Selection  percent  (100/population)  population   Ø 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     Ø The  1st  thing  to  do  upon  entering  the  community  is  Prevalence   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   Ø 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-­‐COPAR  1000  population   Ø Makes   use   of   the   Nursing   Process/Problem   Solving     Approach   CDR=overall  total  deaths   x   1000     Population  POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  3. 3. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING     Ø Prioritized   which   among   the   problems   identified   is   O.    Excreta  Disposal   to   be   attended   1st   like   in   nature,   magnitude,   modifiability,  preventive  potential,  salience   Household   Community     ○      Burial   ○   Sanitary   landfill   or  L.  Epidemiology   ►  Deposited  in  1m  x   controlled  tipping     1m  deep  pits  covered   ►   Excavation   of   soil   Ø Epidemic:  a  situation  when  there  is  a  high   with  soil,  located  25   deposition   of   refuse   and   incidence  of  new  cases  of  a  specific  disease  in  excess   m.  away  from  water   compacting   with   a   solid   of  the  expected.     supply   cover  of  2  feet     Ø Endemic  :  habitual  presence  of  a  disease  in  a  given     ○  Incineration       geographic  location  accounting  for  the  low  number   ○      Open  burning   of  both  immunes  and  susceptibles   • Animal  feeding   Ø Sporadic  :  disease  occurs  every  now  and  then   • Composting   affecting  only  a  small  number  of  people  relative  to   • Grinding   and   the  total  population   disposal  sewer     Ø Pandemic:  global  occurrence  of  a  disease       DOH  PROGRAMS  M  .    Approve  Water  Facilities    Level  I     Level  II   Level  III   EXPANDED  PROGRAM  ON  IMMUNIZATION  Point   Communal   faucet   Waterworks   v Law:  PD  996  Source     system   or   stand   system  or     posts   individual  house   Vaccine   Dosage   #   of   Doses   to   connections   complete  A  protected   A  system  composed   A  system  with  a   immunization  well  or  a   of  a  source,  a   source,  a  reservoir,   BCG      developed   reservoir,  a  piped   a  piped  distributor   1.  I   .05  ml   1  dose  spring  with   distribution  network   network  and   2.  SE   .1  ml   1  dose  an  outlet  but   and  communal   household  taps   DPT   .5  ml   3  doses  without  a   faucets,  located  at   that  is  suited  for   OPV     2-­‐3  gtts   3  doses  distribution   not  more  than  25   densely  populated   HBV   <10  y/o:  .5   3  doses  system  for   meters  from  the   urban  areas.   >10  y/o:  1  rural  areas   farthest  house  in   MV   .5  ml   1  dose  where   rural  areas  where    houses  are   houses  are  clustered   v It  is  safe  and  immunologically  effective  to  administer  all  thinly   densely.   EPI  vaccines  on  the  same  day  at  different  sites  of  the  scattered.   body.     v The  vaccination  schedule  should  not  be  restarted  from   the  beginning  even  if  the  interval  between  doses  N.    Approved  Toilet  Facilities   exceeded  the  recommended  interval  by  months  or  year.  Level  1   Level  2   Level  3   v DPT2  or  DPT3  is  not  given  to  a  child  who  has    Non-­‐water   On  site  toilet   Water  carriage   convulsions  or  shock  within  3  days  after  DPT1.  V  carriage  toilet   facilities  of  the   types  of  toilet   v Do  not  give  live  vaccines  like  BCG  to  a  individuals  who  facility:     water  carriage   facilities   are  immunosuppressed  due  to  malignant  disease  (child  -­‐  Pit  latrines   type  with  water   connected  to   with  AIDS)  ,  going  therapy  with  immunosuppressive  -­‐  Reed  Odorless   sealed  and   septic  tanks   agents  or  radiation.  Earth  Closet         flushed  type  with   an/or  to   v Repeat   BCG   vaccination   if   the   child   does   not   develop   a  -­‐  Bored-­‐hole   septic  vault/tank   sewerage   scar  after  first  injection  -­‐  Compost   disposal   system  to    -­‐  Ventilated   facilities.   treatment    improved  pit   plant.     Type  of  Vaccine   Storage  Temp.   Hours  of  Life  after     opening  Toilets  requiring   OPV   -­‐15  to  -­‐25  C    small  amount  of   Measles   At  the  freezer    water  to  wash   Hepa  B     8  hours    waste  into   DPT   2  to  8  C    receiving  space   Tetox   Body  of    -­‐  Pour  flush   BCG   refrigerator   4  hours  -­‐  Aqua  privies       NATIONAL  TB  PROGRAM  POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  4. 4. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING         Disease   Causative  Agent   Mode  of   Clinical   Reservoir   Diagnostic   Treatment   Nursing   Transmission   Manifestation   Exam   Implication                  Tuberculosis   Mycobacterium   Droplet  Infection   • General   Man   • Sputum   DOTS   Pointers  for  “Primary   Tuberculosis   (  inhalation  of   weakness   And   Exam   -­‐  patient  is   teaching  on  Complex”  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  drugs    years  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,  causes  who  does  not   not  respond   visit)   ensure   red  urine  urine  return  to   to  antibiotic   -­‐  early   compliance  to   Isoniazide:  normal  health   therapy.   morning   treatment   causes  after  measles   • Fever  and   specimen   regimen   peripheral  or  whooping   night  sweat   -­‐  spot     neuritis,  given  cough.   • 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   contagious    RECOMMENDED  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     Coordinator          POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  5. 5. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING    INTEGRATED  MANAGEMENT  OF  CHILDHOOD  ILLNESS   MAIN  SYMPTOM:  Diarrhea  (IMCI)      Danger  Sign          MAIN  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  DIARRHOEA      Pneumonia  Classification         Classify  a  child  with  diarrhea  and  blood  in  the  stool  as   having  DYSENTERY.  A  child  with  dysentery  should  be   treated  for  dehydration                         MAIN  SYMPTOM:  Fever  POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  6. 6. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING               MAIN  SYMPTOM:  Ear  Problem        High  Malaria  Risk  Classification           Ear  Problem  Classifications      Low  Malaria  Risk  Classification                    No  Malaria  Risk  Classification    POSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE  
  7. 7. WHAT YOU SHOULD KNOW BEFORE THE PNLE JULY  2012  PNLE  PEARLS  OF  SUCCESS    PART  3:  COMMUNITY  HEALTH  NURSING    MAIN  SYMPTOM:  Malnutrition  and  Anemia   ü Diarrhea Bloody stools (on and off dysentery)   Enlargement of abdomen Splenomegaly Hepatomegaly Anemia / pallor weakness ü Diagnostic Test: COPT or cercum ova precipitin test (stool exam) ü Drug-of-Choice: PRAZIQUANTEL (Biltracide) Oxamniquine for S. mansoni Metrifonate for S. haematobium *Death is often due to hepatic complication ü Dispose the feces properly not reaching body of water Use molluscides Prevent exposure to contaminated water (e.g. use rubber boots) ü Apply 70% alcohol immediately to skin to kill surface cercariae ü Allow water to stand 48-72 hours before use Ø Malaria ü Plasmodium Parasites: Vivax Falciparum (most fatal; most common in the Philippines)     ü Bite of infected anopheles mosquito Night time biting   High-flyingMalnutrition  and  Anemia  Classification   ü Rural areas Clear running water   ü Malarial Smear – best time to get the specimen is at height of fever because the microorganisms are very active and easily identified ü 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. ü 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 ü 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; COMMUNICABLE  DISEASES   200-400/ha. for a delayed effect)   *On Stream Clearing – cutting of vegetationØ Cholera overhanging along stream banks ü Other names:El tor *Avoid outdoor night activities (9pm – 3am) ü Fecal-oral route 5 Fs *Wearing of clothing that covers arms and legs in the ü Incubation Period: Few hours to 5 days; Usually 3 evening*Use mosquito repellents days *Zooprophylaxis – typing of domestic animals like the ü Pathognomonic Sign: Rice watery stool carabao, cow, etc near human dwellings to deviate ü Diagnostic Test: Stool culture mosquito bites from man to these animals Intensive ü Treatment:Oral rehydration solution (ORESOL) IVF IEC campaign ü Drug-of-Choice: tetracycline (use straw; can cause staining of teeth). Oral tetracycline should be administered with meals or after milk.  Ø Shistosomiasis ü Other Names: Snail Fever Bilharziasis ü Endemic in 10 regions and 24 provinces High prevalence: Regions 5, 8, 11 ü Contact with the infected freshwater with cercaria and penetrates the skinPOSSIBLE  TOPICS  ON  COMMUNITY  HEALTH  NURSING  FOR  THE  UPCOMING  JULY  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  July  2012  PNLE