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WHAT YOU SHOULD KNOW BEFORE THE PNLE
                                    DECEMBER 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
                                                                           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 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 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                                          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, 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                                  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 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                                  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                                                      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, salience
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
                                                                         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 sewer

M . Approve Water Facilities
Level I           Level II                 Level III
Point             Communal faucet          Waterworks                                    DOH PROGRAMS
Source            system or stand          system or
                  posts                    individual house        EXPANDED PROGRAM ON IMMUNIZATION
                                           connections              Law: PD 996
A protected       A system composed        A system with a
well or a         of a source, a           source, a reservoir,          Vaccine       Dosage             # of Doses to
developed         reservoir, a piped       a piped distributor                                            complete
spring with       distribution network     network and                                                    immunization
an outlet but     and communal             household taps                BCG
without a         faucets, located at      that is suited for            1. I          .05 ml             1 dose
distribution      not more than 25         densely populated             2. SE         .1 ml              1 dose
system for        meters from the          urban areas.                  DPT           .5 ml              3 doses
rural areas       farthest house in                                      OPV           2-3 gtts           3 doses
where             rural areas where                                      HBV           <10 y/o: .5        3 doses
houses are        houses are clustered                                                 >10 y/o: 1
thinly            densely.                                               MV            .5 ml              1 dose
scattered.
                                                                      It is safe and immunologically effective to administer all
                                                                       EPI vaccines on the same day at different sites of the
N. Approved Toilet Facilities                                          body.
Level 1                Level 2              Level 3                   The vaccination schedule should not be restarted from
Non-water              On site toilet       Water carriage             the beginning even if the interval between doses
carriage 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 who
Earth 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 a
improved pit                                plant.                     scar after first injection

Toilets requiring
small amount of                                                    Type of Vaccine    Storage Temp.         Hours of Life after
water to wash                                                                                               opening
waste into                                                         OPV                -15 to -25 C
receiving space                                                    Measles            At the freezer
- Pour flush                                                       Hepa B                                   8 hours
- Aqua privies                                                     DPT                2 to 8 C
                                                                   Tetox              Body of
                                                                   BCG                refrigerator          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            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 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)                                        MAIN SYMPTOM: Diarrhea

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




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




                                                                Ear Problem Classifications
Low Malaria Risk Classification




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

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Dec 2012 NLE TIPS CHD and CD

  • 1. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 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  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 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 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
  • 2. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 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, 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  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 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  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  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, salience 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
  • 3. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING O. Excreta Disposal L. 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 sewer M . Approve Water Facilities Level I Level II Level III Point Communal faucet Waterworks DOH PROGRAMS Source system or stand system or posts individual house EXPANDED PROGRAM ON IMMUNIZATION connections  Law: PD 996 A protected A system composed A system with a well or a of a source, a source, a reservoir, Vaccine Dosage # of Doses to developed reservoir, a piped a piped distributor complete spring with distribution network network and immunization an outlet but and communal household taps BCG without a faucets, located at that is suited for 1. I .05 ml 1 dose distribution not more than 25 densely populated 2. SE .1 ml 1 dose system for meters from the urban areas. DPT .5 ml 3 doses rural areas farthest house in OPV 2-3 gtts 3 doses where rural areas where HBV <10 y/o: .5 3 doses houses are houses are clustered >10 y/o: 1 thinly densely. MV .5 ml 1 dose scattered.  It is safe and immunologically effective to administer all EPI vaccines on the same day at different sites of the N. Approved Toilet Facilities body. Level 1 Level 2 Level 3  The vaccination schedule should not be restarted from Non-water On site toilet Water carriage the beginning even if the interval between doses carriage 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 who Earth 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 a improved pit plant. scar after first injection Toilets requiring small amount of Type of Vaccine Storage Temp. Hours of Life after water to wash opening waste into OPV -15 to -25 C receiving space Measles At the freezer - Pour flush Hepa B 8 hours - Aqua privies DPT 2 to 8 C Tetox Body of BCG refrigerator 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
  • 4. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING NATIONAL TB PROGRAM 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 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
  • 5. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) MAIN SYMPTOM: Diarrhea 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 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
  • 6. 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 Ear Problem Classifications Low Malaria Risk Classification 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
  • 7. WHAT YOU SHOULD KNOW BEFORE THE PNLE DECEMBER 2012 PNLE PEARLS OF SUCCESS PART 3: COMMUNITY HEALTH NURSING Enlargement of abdomen Splenomegaly MAIN 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 very Malnutrition 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 students on the possible topics that might be part of the upcoming Dec. 2012 PNLE