Compilation of CHN notes

CHN History Act No. 157- Creation of Board of Health of the Philippine (BON) Act No. 1407- Abolish BOH

DILG

1919 Mrs. Carmen Del Rosario – 1 st Filipino Nurse Supervisor 1990-1992 – Local Revolutionary Code of 1991, RA 7160 Revolution Code National to local Definition Health – (WHO) state of complete physical, mental and social well being, not merely the absence of disease or infirmity Public health – (Dr. C.E. Winslow) the science and art of preventing disease, prolo prolongi nging ng life, life, promo promotin ting g heal health th and and eff effici icien ency cy thr throu ough gh orga organiz nized ed community effeort.

Community Health Nursing (Jacobson)- is a learned practice discipline with the ultimate goal of contributing as individual and in collaboration with others to the promotion of clients optimum level of function through teaching and delivery of care.

Factors affecting Optimum Level of Function (OLOF) 1. 2. 3. 4. 5. 6.

Political Behavio vioral heredit ditary ary Healt He alth h Care Care Deli Delive very ry Syst System em Envir En viron onme menta ntall Infl Influen uence cess Socio Socio econ econom omic ic Influe Influence ncess

Concepts 1. The The prim primar ary y focu focuss of comm commun unit ity y heal health th nu nurs rsin ing g prac practi tice ce is on heal health th promotion. 2. Community Community health health nurses nurses are generalist generalist in in term of of their practice through life but the whole community.

Compilation of CHN Notes | Karl Gerald C. Manalili, UASN 2010 |

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3. Commun Community ity health health nurses nurses are generalis generalistt in terms of their practic practicee through through life continuity in its full range of health problems and needs. 4. The nature of CHN practice requires that current knowledge derived from the biological, social science, ecology, clinical nursing and community health organizations be utilized 5. Contact with the client and and or family family may continue over a long long period period of time time which includes all ages and all types of health care. 6. The dynamic dynamic process process of assessing, assessing, planning planning,, implementi implementing ng and interveni intervening ng provide measurements of progress, evaluation and a continuum of the cycle until until the terminatio termination n of nursing nursing is implici implicitt in the practic practicee of commun community ity health nursing.

Principles 1. CHN CHN is based based on recogni recognize zed d nee needs ds of commu communit nities ies,, famili families, es, groups groups and and individuals. 2. Th Thee comm commun unit ity y heal health th nu nurs rsee must must un unde ders rsta tand nd full fully y the the obje object ctiv ives es and and policies of the agency she represents. 3. In CHN, CHN, the the family family is is the Unit of servic services. es. 4. CHN CHN must must be avail availabl ablee to all regar regardle dless ss of race race,, cree creed d and and socioe socioeco conom nomic ic status 5. Health Health teachi teaching ng is a primar primary y responsi responsibili bility ty of the CHN. CHN. 6. The communit community y health health nurse works as a member of the health team. 7. There must be a provision for period’s evaluation of community health team. 8. Op Oppo portu rtunit nities ies for for contin continuat uation ion staff staff educ educati ation on progr program amss nur nurses ses must must be provi provide ded d by the CHN CHN agenc agency. y. Th Thee comm communi unity ty health health nurse also has has a responsibility for his/her own professional growth. 9. Th Thee comm commun unit ity y heal health th nu nurs rsee make makess use use of avai availa labl blee comm commun unit ity y heal health th resources. 10. The community community health nurse nurse utilizes utilizes the already already existing existing active active organize organized d groups in the community. 11. There must be provision provision for educative educative supervision supervision CHN 12. There should should be accurate recording recording and reporting reporting in CHN.

Public Health Nurse 1. 2. 3. 4. 5. 6. 7. 8.

Plan Planne ner/ r/pr prog ogra ramm mmer er Provide Provide of Nursing Nursing Care/Ca Care/Careg regiver iver Mana Manage ger/ r/Su Supe perv rvis isor or Comm Commun unit ity y Organ Organiz izer er Coor Coordin dinato atorr of Ser Servi vice ce Trainer Trainer// Heal Health th Educa Educator/ tor/ Counselo Counselorr Healt ealth h mon monit itor or Role Model


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9. Change Ag Agent 10. Recorder/ Recorder/ Reporter/ Reporter/ Statistician Statistician 11. Researc Researcher her Community Health Process Assessment Collection of data, collected from family, groups and community. Examples: Demographic Data Vital Health Statistics Community Dynamics Health Status Education Methods: Community Survey Interview Statistics Epidemiological studies Common indicators of health status  

Morbidity Mortality

Categories of Health Problems

 

1. Health Deficit (HD)- instances of failure in health maintenance ( dse, disability, dev’tl lag) ö -ex. Dse/ illness- URTI, marasmus, scabies, edema disabilities- blindness, polio, colorblindness, deafness dev’tl problems like mental retardatx, gigantism, hormonal, dwarfism 

Health Treat (HT)- conditions conducive to dse, accidents or failure to realize one’s health potential ö healthy people ö ex. Family hx of illness- hereditary like DM, HPN  nutritional problems- eating salty foods  personal behavior- smoking, self-medication, sexual practices, drugs, excessive drinking  inherent personality char- short temperedness, short attn span  short cross infectx  poor home envi  lack/inadequate immunization  hazards- fire, falls, or accidents


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

     

family size beyond what resources can provide ö Foreseeable Crisis (FC)- anticipated periods of unusual demand on indiv or fam in terms of adjustment or family resources ( nature situatxs) ö ex. Entrance in school adolescents (circumcision, menarchs, pubarche courtship (falling in love, breaking up) marriage, pregnancy, abortion, puerperium death unemployment, transfer or relocation graduation, board exam Identify the ff: Ex: Active TB- HD 45 yr, old male smoke- HT Sedimentary health style- Ht Early pregnancy- FC Father of family losses his job FC Death in the family- FC Patient is sick due to pneumonia- HD Children who are not immunized- HT Lack of prenatal check – up- HT Eclampsia- HD Working hazard- HT Hypertensive- HD With measles “child”- HD Family members has liprosy (microbactria liporea)- HD Marriage- FC Community diagnosis A. B. C. D. E.

Physica Physicall Charac Characteri teristic sticss Populat Population ion Charact Characteris eristics tics Envir En vironm onment ental al factors factors Knowled Knowledge, ge, attitud attitude, e, practices practices of the people people Commun Community ity resour resources ces and and faciliti facilities es

Planning: Based on the actual and potential problems that were identified and prioritized Goal: Declaration of purpose or intent, gives essential direction to action Specific objectives: Made in terms of activities of daily living Implementation:  Carries Carries out nur nursing sing procedu procedures res which which are consiste consistent nt with nursing with nursing care plans.  Involve the patient with his/her family


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Utilized support system

Evaluation Frame works a. Stru Struct ctur ural al ele eleme ment ntss b. Proc Proces esss ele eleme ment ntss c. Outco utcome me ele eleme ment ntss Nursing Procedures Clinic Visit 1. 2. 3. 4.

Pre-c Pre-cons onsult ultati ation on confe confere rence nce Medi Medica call exam examin inat atio ion n Nurs Nursin ing g inter interve vent ntio ion n Post Post consu consult ltati ation on confe confere rence nce

Home Visit- face to face contact with the client Principles 1. A home home visit visit should should have have a purpos purposee or objec objective tive 2. Plannin Planning g for a home visit visit should should use every every available available inform informatio ation n about the the family, and individual 3. Planning Planning should revolve around the essential essential needs needs of of the individual individual 4. Plannin Planning g of a continuing continuing care care involve involve the the individu individual al or family family 5. Plannin Planning g should should be be flexibl flexiblee and practic practical al Bag technique- Tool Public health bag- is an indispensable equipment of the public health nurse Principles 1. 2. 3. 4.

Prev Preven entt the spre spread ad of of infec infecti tion on Save Save time time and and eff effor ortt should should not not shado shadow w the concern concern for for the the patien patientt Can be perfo performe rmerr in a varie variety ty of ways ways

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Zippiram solution- disinfectant

Nursing Care in the House Principles 1. Nursing Nursing care care utilize utilizess a medical medical plan of care care and treatme treatment. nt.


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2. Perf Perfor orma manc ncee of nu nurs rsin ing g care care util utilit itie iess skil skills ls that that woul would d give give maxi maximu mum m comfort and security. 3. Nursing Nursing care care at home home should should be used used as a teaching teaching opportu opportunity nity.. 4. Performance Performance of nursing care should should recognize recognized d dangers dangers in the the patients’ patients’ overoverprolonged acceptance of support and comfort. 5. Nursing care is is an opportunity opportunity for detecting detecting abnormal abnormal signs signs and and symptoms. symptoms. Isolation Techniques     

All Articles used by the patient should not be mixed with the articles used by the rest of the members of the household. Frequent washing and airing of beddings and other articles and disinfectants of room are imperative The one caring for the sick member should be provided with a protective gown that should be use with in the room of the sick. All All disch discharg arges, es, espe especi ciall ally y from from the the nose nose and and thr throat oat of a commu communic nicabl ablee disease patient should be carefully discharged. Arti Articl cles es with with disc discha harg rges es shou should ld be firs firstt boil boiled ed for for 30 minu minute tess befo before re laundering. Thos could be burned, should be burned.

DOH Vision: Vision: HEALTH HEALTH FOR ALL BY 2000 & HEALTH HEALTH IN THE HANDS HANDS OF THE PEOPLE BY 2020 Mission: Ensure accessibility and quality of health care to improve the quality of life of all Filipinos, especially the Poor. National Objectives 1. 2. 3. 4. 5. 6. 7.

Impro Improve ve gene genera rall health health statu statuss Reduce Reduce morbid morbidity, ity, morta mortality lity and and disabil disability ity rates rates Elim Elimina inate te public public heal health th probl problem emss Erad Er adica icate te poliom poliomyel yeliti itiss Prom Promote ote healt healthy hy lifest lifestyle yle Prom Promote ote heal health th and and nut nutrit rition ion Prom Promote ote envi enviro ronm nment ental al healt health h

Basic Principles 1. 2. 3. 4.

Universa Universall access access to basic basic health health servic services es Health Health and and n nutri utrition tion of of vulner vulnerable able groups groups Epidemi Epidemiolog ologica icall shift from infec infectiou tiouss to degenerat degenerative ive Perfor Performanc mancee of the health health sect sector or must must be enhanc enhanced ed

Primary strategies to achieve health goals


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a. Increase Increase investme investment nt for for primar primary y health health care care b. Development Development of of national national standards standards and and objectives objectives for health

Herbal Medicine 1. aromatic- has volatile oil for tx of fever, cough, colds, itchiness and gas pain. Luya, bawang, sibuyas, yerba Buena, oregano, manzanilla, tanglad, sambong, lagundi, ___ or petals of sampaguita, jasmine & rosal Luya- shd not be taken on an empty stomach Elixir- ______ Shake week after week—tx for TB Bawang crush 1 ear & drink it Tincture of bawang 1:5 Add 5 tbsp. of gin; 1 tbsp chopped bawang Shake 10 mins for 1 week – good for superficial wounds Tanglad- lemon grass—for fever Sambong—stomachache Suha/kalamansi- for fever, TSB 2. astringent-tasting- bitter- has tannin & pectin for diarrhea & wound A vocado leaves B ayabas leaves K amilo leaves D uhat leaves S aging leaves (saba cut into chips, let dry, pulverize then add to _____) 3. bitter-tasting a. skin problems--Acapulco, kalachuchi, malunggay, kakawati, inakabuhay b. depressants- to put hyper people to sleep--dapdap, dita, makabuhay, makahiya c. anti-cancer drug-- tsitsirika d. aches & pains-- sambong, damong arya e. asthma- talampugay- can cause psychosis 4. seeds- fixed oils, anti-helmentics- niyug-niyogan (urine), patola, ipil-ipil, betel nut or bunga, balanyog, squash seeds, lanzones- do not throw peelings instead, burn it— good insect repellant 5. grass family- diuretics—kagon, tubo, tanglad, pandan, pugo-pugo, buto-butones, gatas-gatas, atajuo kahol, pansit-pansitan or ulasimang bato, stones- meis hairm, HPN- palay 10 Medicinal Plants: L agundi- asthma, cough, colds U lasimang bato- uric acid, HPN B awang- HPN


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B ayabas- Diarrhea Y erba Buena- arthritis, toothache, swollen gums, cough & colds S ambong- cough and colds, renal stones A mpalaya- DM N iyug-nyogan- ascariasis T saang gubat- diarrhea A capulco- fungal infection, scabies RA 8423- utilization of medicinal plants as alternative for high cost medications.

Epidemiology- study of distribution and dynamic of disease occurrence in human population Endemic- constant presence of disease or infection agent with in a given geographic area Epidemic- occurrence in a community or region of cases of an illness clearly in excess of expectancy Pandemic- epidemic so widely spread that vast numbers of people in different countries are affected Sporadic- disease that occurs only occasionally or in a few isolated places Surveillance- a continuing scrutiny of all aspects of occurrence and spread of a disease that is pertinent to effective control ( promotion, preventive patient and rehabilitative) Sentinel sites- are health facilities which are selective as representatives of what is happening in areas whose reports are accurate, complete and prompt (health center) Statistics- that science involved in the collection, organization, analysis and interpretation of numerical data Biostatistics- the scientific discipline concerned with the application of statistical methods to problems in biological and medicine.

Fertility Rate 1. CBR (Crude birth rate)- relative pop due to births Total number of births in a calendar year CBR= Birth x 1000 Pop ex. 25.8= CBR There are 26 births in every 1000 pop


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2. General Fertility Rate (GFR) - true fertility rate – specific segments of pop that is fertile GFR= ________Birth__________ ________Birth___________ _ x 1000 Pop of women (15 to 44 yo) Ex. GRF=32 There are 32 births in every woman in 15-44 Mortality Rates 1.Crude Death Rate ____ x 1000 Decrease in pop due to death CDR= death x 1000 Pop Ex. CDR= 6 there are 6 in every 1000 pop 2. Specific Mortality Rate- can apply to any pop grp SMR = death from or particulare grp x 1000 Pop of that grp a. SMR SMR (males) (males) = death (males) x 1000 pop of males b. SMR (females) = death of females 15-44 pop of females 15-44  Infant Mortality Rate: IMR= Death 0 -1 year x 1000 Births  Neonatal Mortality Rate: NMR= deaths 0-28 days x 1000 Births  Post Neonatal Mortality Rate: PNMR = deaths 28 days to 1 year x 1000 Births NMR + PNMR = IMR Neonatal deaths + Post neonatal deaths= Infant deaths Ex. Birth 200 NMR= 20 Death – 28 to 1 NMR + PNMR = IMR 20 + 10 = 30 (ANS) 2_ x 1000 10 00 = 100 1 000 0 = 10 200 100 

Maternal Mortality Rate (MMR) MMR= death of women r/t pregnancy, delivery, & puerperium x 1000 Births Ex. IMR = 30 There are 30 infant deaths in every 1000 births NMR = 20 There are 20 neonatal deaths in every 1000 births PNMR = 10


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MMR = .92 

Proportionate Mortality Rate = PMR ( for any grp) PMR= death from a particular grp x 100 total death Ex. 52% PMR of males = deaths of males x 100 total deaths In every 100 death, 52 are males

PMR = deaths 0-1 x 100 0.1 total total deaths deaths PROPORTIONATE MORTALITY INDICATOR A. Swaro Swaroop op’s ’s Inde Index x = SI SI SI = death of 50 yrs & up x 100 total deaths The SI, the better the situation is! B. Relative Relative importance importance of of a killer killer ( TB, heart heart dse, diarrhea) diarrhea) Death due to TB x 100 total deaths PMR = 30% TB --In every 100 deaths, 30 are due to TB 

Case Fatality Rate (CFR) ö How is survival rate, how strong is killing power, prognosis CFR= death due to part cause x 100 total cases Ex. CFR = 98 HIV ___death HIV___ x 100 Total cases of TB In every 100 cases of HIV, there are 98 deaths

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Cause-of-death Rate (mortality rate)


ö

Rank as a killer

C of DR= death due to particular cause x 100,000 total pop Ex. C of DR =320 TB In every 100,000 pop there are 320 deaths due to TB 

Prevalence Rate = (Morbidity rate) ö Rank as a common dise PR = old and new case of TB x 100,000 TB total pop Ex. PR = old & new case of TB x 100,000 TB Ex. PR = 326 TB There are 326 cases of TB out of 100,000 population.

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Incidence Rate IR= ___new cases___ x 100,000 pop at risk

Swaroff’s Index Total death of a person aging above 50 Total number of deaths of all ages

X 100

Situation: Barangay X has a total population of 1362 for the year 1999-2000 bases on the following date, solve for the swaroff’s index, infant mortality rate, crude death rate and the maternal mortality rate

Swarrof’s index= 7/57 x 100= 12.8 IMR= 17/1294 x 1,000 = 13

IR= 6/1362 x 1,000= 4090

CBR= 1294/1362 x 1,000 = 950

3 CDR= 57/1362 x 1,000= 42 MMR= 3/1294 x 1,000 = 2.33


Essential Health Services (ELEMENTS) of PHC E- Education on methods of preventing and controlling health problems L- Local endemic disease prevention and control M- Maternal and child care including family planning E- Essential drugs N- Nutrition T. Treatment S- Sanitation and H2O supply Four Corner stone/ Pillar in PHC 1. 2. 3. 4.

Acti Active ve com communi munity ty part partic icip ipat atio ion n Intr Intra a an and int inter er sect sector oral al link linkag ages es Use Use of appr approp opri riat atee tech techno nolo logy gy Supp Su ppor ortt mec mecha hani nism sm made made ava avail ilab able le

Levels Health Care Primary- Brangay “ district midwife/ trained health workers” Secondary- Regional/District “NURSE” Tertiary- Hearth Center, Lung Center etc. - doctor

Reproductive Health (RH) Vision: reproductive health practices as a way of life for ever man and woman throughout life Concept: a. b. c. d. e. f. g.

married married coupl couples es has has the capa capabili bility ty to repro reproduce duce reproductive health is exercise of reproductive right purpose of enhancement of life and personal relation safe safe pregna pregnanc ncy, y, safe safe delive delivery ry protecti protection on from from unwante unwanted d pre pregnan gnancy cy protecti protection on from from harmful harmful repro reproduct ductive ive pract practice ice and and violenc violencee assures assures access access to inform informatio ation n on sexualit sexuality y to achieve achieve sexual sexual environment

Determinants of RH: 1. soci socioo- eco econo nom mic 2. stat statu us of of wom women en 3. socia sociall and and gende genderr issu issues es 4. biologic biological, al, cultur cultural al and and psychopsycho-soci social al factors factors


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GOALS: MCH AND NUTRITION > every pregnancy should be intended > every birth should be healthy > every sex act should be free of co erection and infection > achieve desired family size Ten Elements of RH 1. 2. 3. 4.

Materna Maternall and and child child health health nutr nutritio ition n Fam Family ily plan planni ning ng Preven Prevention tion and and managem management ent of abortio abortion n complica complication tion Prevention Prevention and and treatment treatment of reproduct reproductive ive tract tract infection, infection, respiratory respiratory infection and STD, HIV/ AIDS 5. Edu Educati cation on and coun counseli seling ng on sexual sexuality ity and and sex health health 6. Bre Breast ast and repr reproduc oductive tive tract tract cance cancerr 7. Ot Othe herr gyneco gynecolog logic ical al condit conditio ion n 8. Men’s RH 9. Adol Adoles esce cent nt RH 10. Prevention Prevention and treatment treatment of infertility infertility Tetanus Toxiod T1- anytime during pregnancy T2- 4 weeks of pregnancy T3- 6months/ 244 weeks of pregnancy T4- 1 year old T5- above 1 year *PPD 996 immunization program

Vaccine BCG half life 4hours

Route R dorsal Deltoid

Live attenuated bacteria “stored @ 2-8degree Celsius DPT half life 8 hours Weakened toxin killed bacteria stored @2 Weakened toxin to 8 degree Celsius

L Deltoid IM Right/ Left/ Right

Dosage 0.05/ml

Frequency At birth

0.1/ml

School entrance

0.5/ml

DPT 1- 6th weeks DPT 2- 10 weeks DPT 3- 3 ½ months


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OPV Hepa B

Oral IM anterior thigh left/right/ left SQ outer part of the arm

Measles

2-3 gtts .05/ml

6 weeks@ 3 doses 6 weeks2 3 doses

0.5ml

9 months

4th weeks interval

Side effects 1. Koch’s Koch’s phen phenome omenonnon- 2-4 days days after after vaccine vacciness - acute inflammation •

deep abscess- deeper injection tx: incession / drainage/ INH powder

2. Feve Feverr- aft after er and and last last for for 1 day day - Tx: antipyretics - more that 24 hours after dose “ local soreness at the site”

*Abscess- wrong injection technique Tx: incision and and drainage *Convulsion- rare and occurs 3 months due to pirtosis of vaccine(don’t continue) 3. Salk – IM NO SIDE EFFECTS Sabin – Oral

4. FEVER FEVER and and Rash Rash – 5 – 7 days days “vac “vaccina cination tion” ” - last 1-3 days - Management: antipyretic

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Leprosy Control Program

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Multi Drug therapy 1988 RA 4073 Chronic disease of the skin and and peripheral nerves caused by Mycobacterium Leprea or Han’s Bacillus

Early s/s: Change in skin color- reddish or white Loss of sensation Decrease hair growth- dermis Loss of sweating- exocrine Muscle weakness- nerves Thickened/ painful nerves Ulcer that do not heal Late s/s Madiacrosis Lagophthalmos- inability to close the eye lids Clawing of fingers and toes Contractures Sinking of nose bridge Gynecomastia Chronic ulcers Pneumonia Signs Fast breathing Chest in drawing Convulsion Abnormally sleepy Severe under nutrition Not able to drink Stridor upon inhalation- auscultation Wheezing- upon exhalation Fever or low body temp. Management of pneumonia: most pneumonia deaths are preventable if treated early Tx is based :  early recognition of pneumonia  prompt treatment of non severe cases at home with standard antibiotics and good supportive care


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quick identification if severe cases and quick referral to the hospitals- prevent death

Treatent may include antibiotics • advising mothers to give home care • treating fever and wheezing • Home Care: (child with cough and colds) • • • • •

no antibiotics needed feed the child increase fluid intake clear nose keep child warm and comfortable

S/S that the child must be brought to health care facility: • • • •

fast breathing difficulty breathing unable to drink feeding problem Role of Drugs in control of infection  children with cough and colds with no pneumonia must not be given antibiotics  antibiotics should only be given to cases pneumonia, severe pneumonia and very severe disease  COTRIMOXAZOLE

Availabity of Drugs 1. Cotr Cotrim imox oxaz azol olee 2. inje inject ctab able le penic penicil illi lin n 3. others: others: O2 O2 may be delive delivered red as as a life life saving saving measure cough suppressant- antitussive antihistamine- bronchodilator Prevention of Pneumonia 1. Timely Timely immuni immunizati zation on against against measle measless and pertussi pertussiss st 2. Exclusive BF for the 1 4-6 months of life 3. Good ood nu nutr trit itio ion n 4. Vit. Vit. A suppl supplem emen entat tatio ion n 5. Reduce exposure to house smoke from cooking/tobacco 6. Kee Keeping ping youn young g infants infants warmwarm- prevent prevent O2 loss loss


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7. Prac Practic ticing ing good good hygie hygiene ne Control of Diarrhea Disease Management of patient with diarrhea: use this chart for patients with a. loos loosee wat water ery y sto stool olss b. loose loose stool stoolss with with blood blood Step 1- Asses your patient for dehydration Step 2- Asses for other problems 1. Look Look at at condi conditio tion: n: well well aler alertt Eye: normal Tears: present Mouth and tongue: moist Thirst: drinks normally, not thirsty 2. FeelFeel- Skin Skin Pinch: Pinch: goes goes back quickly quickly 3. Decid Decide: e: No deh dehydr ydrat ation ion 4. Tr Treat eatme ment: nt: treat treatme ment nt A Treatment Plan A > to treat diarrhea at home > use this plan to teach the mother to 1. Continue to treat at home her child’s current episode of diarrhea 2. give early treatment for future episode of diarrhea

Treatment Plan C (Sever dehydration) Can you give IVF ------------Yes-------Start IVF immediately “PNSS and 0.9 % NaCl NO Is IV next available-----------Yes-------Send patient within 30 minutes NO Are you trained To------------Yes------Start with ORS Use NGT for Rehydration NO Can the patient-----------------Yes------Start with ORS per orem Drink Rehydration


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URGENT! Send the patient for IV or NGT Water Decontamination  Boiling 2-3 minutes  Chlorine • 1 drop of 5% Na Hypo chloride in 10 L H2O Stat for 20-30 minutes • Aerate •

MDT PB non infectious Tuberculoid Indetermidiate

MB- infectious LEpramatous/ Borderline

6-9 months Day 1/ 2-8 Rifampicin/Dapsone

24-30 months Day 1/ 2-28 Rifampicin Clofazimine Dapsone

ROM- Rifampicin. Ofloxacin, Minocyclinc Prevention- BCG

Pneumonia Very Severe Unable to drink Convulsion Difficult to wake stridor

Severe Fast breath Chest indrawing

Pneumonia Fast breathing No chest indrawing

No Pneumonia No fast breathing No chest indrawing

Tb Network: Nurse Physician Midwives Early case Med Tech Findings

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Category 1 New (+) cases PTB Seriously ILL a. Intensive Phase Advance pulmonary TB b. Extra pulmonary TB 2 months R ifampicin I soniazid P yrazinamide E thambutol “should not used 6 years old below because of visual disturbance

Category 2 2-8 months maintenance Treatment replaces Failure 2 months 3 months R R I I P P E E S- streptomycin “IM”

Category 3 PTB minimal(-) 3x sputum smear x-ray PTB minimal Extra TPB (not serious) 2months R I P

2 months R I

5 months R I E

4 months R ifampicin I soniazid

 ENVIRONMENTAL SANITATION

is defined as the study of all factors in man’s physical environment, which may exercise a deleterious effect on his health, well-being and survival. Environmental Sanitation

Goal: to eradicate and control environmental factors in dse transmission through the provision of basic services and facilities to all households. 1. Water Water Supply Supply Sanita Sanitatio tion n Prog Program ram 1 types types of Appro Approved ved Water Water Supply Supply Facil Faciliti ities es Level 1 Level II Point Source Communal Faucet system or stand posts

Level III Waterworks system or individual house connections A protected well of a A system composed of a source, a A system with a source, a developed sprung with an reservoir, a piped distribution reservoir, a piped distributor outlet but without a network and communal faucets, network and household distribution system for rural located at not more than 25 meters taps that is suited for areas where houses are from the farthest house in rural areas densely populated urban thinly scattered. where houses are clustered densely. areas. Water must pass the National Standards for Drinking Water set by the DOH.

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2. Proper Proper Excr Excreta eta and and Sewa Sewage ge Dispo Disposal sal Syst System em 3 types of Approved Toilet Facilities Level 1 Non- water carriage toilet facility:

Level 2 On site toilet faci acilities of

Level 3 Water carriage types


Pit Latrines the water carriage type of toilet facilities with water sealed and connected to septic Reed Odorless Earth Closet flushed type with septic tanks and/or to Bored-Hole vault/tank disposal sewerage system to Compost facilities. treatment plant. Ventilated improved pit Toilets requiring small amount of water to wash waste into receiving space -pour flush -aqua privies Rural Areas- “blind drainage” type of wastewater collection and disposal facilities shall be emphasized until such time that sewer facilities and off-site treatment facilities are available.

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3. Proper Proper Solid Solid Waste Waste Managem Management ent - refers to satisfactory methods of storage, collection and final disposal of solid wastes. Refuse Garbage Rubbish

2 ways to Refuse Disposal Household -Burial > deposited in 1m x 1m deep pits covered with soil, located 25m away from water supply - open burning - animal feeding - composting - grinding and disposal sewer

Community -Sanitary landfill or controlled tipping > excavation of soil deposition of refuse and compacting with a solid cover of 2 feet - Incineration

4. Food Food Sani Sanita tati tion on Prog Progra ram m Policies:  Food establishment are subject to inspection (approved of all food sources containers and transport vehicles)  Comply with sanitary permit requirement  Comply with updated health certificates for food handlers, helpers, cooks  All ambulant vendors must submit a health cert to det presence of intestinal parasite and bacterial infection. 3 points of contamination  Place of production processing and source of supply  Transportation and storage  Retail and distribution points

5. Hosp Hospit ital al Was Waste te Man Manag agem emen entt Goal: To prevent the risk of contraction contracting nosocomial infection from type disposal of infectious, pathological and other wastes from hospital 6. Programs Programs related related to health-risk health-risk minimi minimizatio zation n secondary secondary to environmental environmental polluti pollution on These include the following:  Anti-smoke Belching campaign and Air Pollution Campaign


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    

Zero Solid Waste Management Toxic, chemical and Hazardous Waste Management Red tide Control and Monitoring Integrated Pest Management and Sustainable Agriculture Pasig River Rehabilitation Management

7. Educat Education ion of of prevai prevaili ling ng healt health h probl problems ems Accepted activitiy at all levels of public health used as a means of improving the health of the people through techniques which may influence people’s thought motivation, judgement and action. Three aspects of Health education:  Information- provision of knowledge  Communication- exchange of information  Education- change in knowledge, attitudes, and skills Sequence of Steps in Health Education  Creating awareness  Creating motivation  Decision making action

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HIV/ STI PREVENTION AND CONTROL

Operational Strategies:  Promotion of health/ health education  Disease detection  Treatment program  Contact tracing  Clinical services Program components:  Case-finding  Case management  Training  Monitoring  Reporting system  Operations research

MENTAL HEALTH

A state of well-being where a person can realize his or her own abilities, to cope with the normal stresses of life and work productively - The emotional adjustment the person achieve in which he can live with reasonable comfort, functioning, acceptably in the community where he/she lives - Involves the promotion of a healthy state of mind amont the whole pop through ♥ Developing positive outlook in life Strengthening coping mechanisms ♥

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Vulnerable group to the dev of Mental Illness: ♥ Women Street children ♥ ♥ Victims of torture or violence Internal refugees ♥ ♥ Victims of armed conflicts ♥ Victims of natural and man-made disasters Components of Mental Health Program A. Stress B. Drugs Drugs and Alco Alcohol hol Abuse Abuse Rehab Rehabil ilita itati tion on C. Treatment Treatment and and Rehabilita Rehabilitation tion of Mental Mentally-i ly-illll Patients Patients D. Special Special Project Project for Vulnerabl Vulnerable e Groups Groups Stresses in the environment of children such as times of disasters and natural calamities, disintegration of the values, structure and functions of the family and urbanization, migration, drugs, and physical and sexual abuse and poverty have direct effects on physical and mental health.

GOOD LUCK!

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Compilation of CHN notes

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