Community Health Nursing p.31-55

8/10/2019 Community Health Nursing p.31-55

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Far Eastern University-Institute of NursingIn-House Nursing Review

COMMUNITY HEALTH NURSING

I - Definition of Terms

Community- derived from a latin word comunicas which meansa group of people.

a group of people with common characteristics or interests

living together within a territory or geographical boundary

place where people under usual conditions are found

Healt- is the OLOF (Optimum Level of Functioning)Community Healt- part of paramedical and medical interventionapproach which is concerned

on the health of the whole populationAims!

!. health promotion". disease prevention#. management of factors affecting health

Nursin"- both profession $ a vocation. %ssisting sic& individuals to become healthy and healthyindividuals achieve optimum wellness

II - Community Healt Nursin"

'he utiliation of the nursing process in the different levels of clientele-individuals

families population groups and communities concerned with the promotion of healthprevention of disease and disability and rehabilitation.

Goal!'o raise the level of citienry by helping communities and families to cope with thediscontinuities in and threats to health in such a way as to ma*imie their potential forhigh-level wellness

MISSION O# CHN

+ealth ,romotion

+ealth ,rotection

+ealth alance

isease prevention

/ocial 0ustice

$HILOSO$HY O# CHN

'he philosophy of 1+2 is based on the worth and dignity on the worth and dignity of

man.

$rin%i&les of Community Healt!

!. 'he community is the patient in 1+2 the family is the unit of care and there are four levels ofclientele3 individual family population group (those who share common characteristicsdevelopmental stages and common e*posure to health problems 4 e.g. children elderly) andthe community.

". 5n 1+2 the client is considered as an %1'567 partner 2O' ,%//567 recipient of care#. 1+2 practice is affected by developments in health technology in particular changes in

society in general8. 'he goal of 1+2 is achieved through multi-sectoral efforts9. 1+2 is a part of health care system and the larger human services system.

Role of CH Nurse!

1linician - who is a health care provider ta&ing care of the sic& people at home or in

the :+;

+ealth %dvocator 4 spea&s on behalf of the client

%dvocator 4 act on behalf of the client

/upervisor - who monitors and supervises the performance of midwives

Facilitator - who establishes multi-sectoral lin&ages by referral system

1ollaborator 4 wor&ing with other health team member

COMMON $ROCEDURE IN CHN!

+O;7

CHN by Ms. Ma. Adelaida Morong 31


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/'7:5L5?%'5O2

/,715


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, Ty&es!

Com&reensi'e Community Dia"nosis $rolem-Oriente* Community Dia"nosis

- aims to obtain general information about thecommunity

- type of assessment responds to a particularneed

STE$S!

,reparatory ,hase

!. site selection". preparation of the community#. statement of the obDectives8. determine the data to be collected9. identify methods and instruments for data collectionB. finalie sampling design and methods

E. ma&e a timetable

5mplementation ,hase

!. data collection". data organiationcollation#. data presentation8. data analysis9. identification of health problemsB. priority ation of health problemsE. development of a health plan. validation and feedbac&

7valuation ,hase

.IOSTATISTICS

".! 7


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H ;rban-:ural - shows the proportion of people living in urban compared to the ruralareas

H 1rowding 5nde* - indicates the ease by which a communicable disease can betransmitted from ! host to another susceptible host.

H ,opulation ensity - determines congestion of the place

0ITAL STATISTICS

the application of statistical measures to vital events (births deaths and common

illnesses) that is utilied to gauge the levels of health illness and health services of acommunity.

TY$ES!

#ERTILITY RATE

A) CRUDE .IRTH RATE

total J of livebirths in a given calendar year K !CCC

estimated population as of 0uly ! of the same given year

.) GENERAL #ERTILITY RATE

total J of livebirths in a given calendar year K !CCC 'otal number of reproductive age

MORTALITY RATE

A) CRUDE DEATH RATE

'otal J of death in a given calendar year K !CCC7stimated population as of 0uly ! of the same calendar year

.) IN#ANT MORTALITY RATE

'otal J of death below ! yr in a given calendar year K !CCC 7stimated population as of 0uly ! of the same calendar year

C) MATERNAL MORTALITY RATE1

'otal J of death among all maternal cases in a given calendar year K !CCC 7stimated population as of 0uly ! of the same calendar year

MOR.IDITY RATE

A) $RE0ALENCE RATE

7 'otal J of new $ old cases in a given calendar year K !CC 7stimated population as of 0uly ! of the same calendar year

.) INCIDENCE RATEF

= 'otal J of new cases in a given calendar year K !CC 7stimated population as of 0uly ! of the same calendar year

C) ATTAC1 RATE

'otal J of person who are e*posed to the disease K !CC 7stimated population as of 0uly ! of the same calendar year

III - E&i*emiolo"y

the study of distribution of disease or physiologic condition among human population s

and the factors affecting such distribution



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the study of the occurrence and distribution of health conditions such as disease death

deformities or disabilities on human populations

a) ,atterns of disease occurrence

E&i*emi%

- a situation when there is a high incidence of new cases of a specific disease ine*cess of the e*pected.

- when the proportion of the susceptibles are high compared to the proportion ofthe immunes

E&i*emi% &otential- an area becomes vulnerable to a disease upsurge due to causal factors such as

climatic changes ecologic changes or socio-economic changesEn*emi%

- habitual presence of a disease in a given geographic location accounting for thelow number of both immunes and susceptibles

e.g. Malaria is a disease ende"i! at #alawan.- the causative factor of the disease is constantly available or present to the area.

S&ora*i%

- disease occurs every now and then affecting only a small number of peoplerelative to the total population

- intermittent$an*emi%

- global occurrence of a disease

/teps in 7,57


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,neumonia ,' and diarrheal diseases consistently remain the !C leading causes of

deaths.

0) Healt Care Deli'ery System

the totality of all policies facilities euipments products human resources and services

which address the health needs problems and concerns of the people. 5t is largecomple* multi-level and multi-disciplinary.

HEALTH SECTORS

=O67:2


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promote active and sustained peopleNs participation in health care

MA6OR HEALTH $LANS TO/ARDS 7HEALTH IN THE HANDS O# THE$EO$LE IN THE YEAR ,2,28

A) MA6OR HEALTH $LAN

"# 52 A# +ealth for more in A8

'hin& health +ealth Lin&

9 in A9

.) $RIORITY $ROGRAM IN YEAR ,222

,lan 9C

,lan 9CC

PomenNs health

1hildrenNs health

+ealthy Lifestyle

,revention $ 1ontrol of 5nfectious isease

C) $RIORITY $ROGRAM IN THE YEAR ,223

Ligtas untis 1ampaign


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,rostate 1ancer %wareness


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,neumonia /evere anemia ,. falciparum malaria

1erebral malaria meningitis severe dehydration

,neumonia iarrhea 7ar infection

,neumonia


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IMCI COLOR CODING

$IN1

:URGENT RE#ERRAL;

YELLO/

:Treatment at out&atientealt fa%ility;

GREEN

:Home mana"ement;

O;',%'572' +7%L'+F%15L5'G

,re-referral treatments

%dvise parents

:efer child

O;',%'572' +7%L'+F%15L5'G

'reat local infection

=ive oral drugs

%dvise and teach

careta&erFollow-up

+O


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R 2o signs ofpneumonia or very severedisease

Assess an* %lassify DIARRHEA

A %il* =it *iarroea is assesse* for!

how long the child has had diarrhoea

blood in the stool to determine if the child has dysentery

signs of dehydration.

Classify DYSENTERY

child with diarrhea and blood in the stool

'wo of the following signs T

%bnormally sleepy ordifficult to awa&en

/un&en eyes

2ot able to drin& ordrin&ing poorly /&in pinch goes bac& very slowly

/767:77+G:%'5O2

5f child has no other severeclassification3 - =ive fluid for severedehydration ( ,lan 1 ) O: 5f child has anothersevere classification 3 - :efer ;:=72'LG to hospitalwith mother giving freuent sips ofO:/ on the way - %dvise the mother tocontinue breastfeeding 5f child is " years or olderand there is cholera in your areagive antibiotic for cholera

'wo of the following signs 3

:estless irritable

/un&en eyes

rin&s eagerly thirsty /&in pinch goes bac& slowly

/O


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improving

ehydration present /767:7 ,7:/5/'72'5%::+7%

R 'reat dehydration beforereferral unless the child hasanother severe classification

R =ive 6itamin a

R :efer to hospital

2o dehydration ,7:/5/'72'5%::+7%

R %dvise the mother onfeeding a child who has persistentdiarrhea

R =ive 6itamin %R Follow up in 9 days

lood in the stool G/72'7:G R 'reat for 9 days with anoral antibiotic recommended for

/higella in your area

R Follow up in " days =ive also referral treatment

Does te %il* a'e fe'er>

**Decide :

-


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lood smear ( - ) or

:unny nose or


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the last # months

Den"ue #e'er

leeding from nose orgums or leeding in stools orvomitus or lac& stools orvomitus or /&in petechiae or 1old clammye*tremities or 1apillary refill morethan # seconds or %bdominal pain or 6omiting 'ourniuet test ( U )

SE0ERE DENGUEHEMORRHAGIC #E0ER

5f s&in petechiae or'ourniuet testare the onlypositive signs give O:/

5f any other signs arepositive give fluids rapidly asin ,lan 1

'reat the child toprevent low blood sugar

O 2O' =567%/,5:52

:efer all children;rgently to hospital

2o signs of severe denguehemorrhagic fever

F767:3 72=;7+7

'ender swelling

behind the ear


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,us seen draining

from the ear and discharge isreported for less than !8 daysor

7ar pain

%1;'7 7%: 52F71'5O2 =ive antibiotic for 9

days

=ive paracetamol for

pain

ry the ear by

wic&ing

Follow up in 9 days

,us seen draining

from the ear and discharge isreported for less than !8 days

1+:O251 7%: 52F71'5O2 ry the ear by wic&ing

Follow up in 9 days

2o ear pain and no

pus seen draining from the ear2O 7%: 52F71'5O2

2o additional

treatment



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Ce%? for Malnutrition an* Anemia

Gi'e an A&&ro&riate Antiioti%!

A) #or $neumonia@ A%ute ear infe%tion or 0ery Se'ere *isease

COTRIMOABOLE5 FO: 9 %G/

AMOYCILLIN5 FO: 9 %G/

A"e or /ei"t A*ulttalet

Syru& Talet Syru&

" months up to !" months ( 8- V A &g )

! " 9 ml ! " 9 ml

!" months up to 9 years ( !C4 !A&g )

! E.9 ml ! !C ml

.) #or Dysentery

COTRIMOABOLE5 FO: 9 %G/

AMOYCILLIN5 FO: 9 %G/

AGE OR /EIGHT TA.LET SYRU$ SYRU$ ,32MG


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C) #or Colera

TETRACYCLINE>5 FO: # %G/

COTRIMOABOLE5 FO: # %G/

AGE OR /EIGHT Ca&sule ,32m" Talet Syru&

" 4 8 months( 8 - V B&g )

! " 9ml

8 4 !" months

( B - V !C &g )

! " 9 ml

! 4 9 years old( !C 4 !A &g

! ! E.9ml

Gi'e an Oral Antimalarial

1+OLO:O>;527=ive for # days

,rimauine=ive single dose inhealth center for ,.

Falciparum

,rimauine=ive daily for !8 days for ,.

6iva*

/ulfado*ine U,yrimethamine

=ive single dose

%=7 '%L7' ( !9C


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%=7 65'%


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0III - DOH $ROGRAMS

DENTAL HEALTH $ROGRAM

'o improve the uality of life of the people through the attainment of the highest possible oral

health.

O4e%ti'e!'o prevent and control dental diseases and conditions li&e dental caries and

periodontal diseases thus reducing their prevalence.

OSTEO$OROSIS $ROGRAM

5t is characteried by a decrease in bone mass and density that progresses without a symptomor pain until a fracture occurs generally in the hip spine or wrist.

ObDectives3

'o increase awareness on the prevention and control of osteoporosis as a chronic debilitatingconditionM

'o increase awareness by physicians and other health professionals on the screening treatmentand rehabilitation of osteoporosisM

'o empower people with &nowledge and s&ills to adopt healthy lifestyle in preventing theoccurrence of osteoporosis.

HEALTH EDUCATION CO

%ccepted activity at all levels of public health used as a means of improving the health of the

people through techniues which may influence peoples thought motivation Dudgment and action.

Tree as&e%ts of ealt e*u%ation!

5nformation

1ommunication

7ducation

Seuen%e of ste&s in ealt e*u%ation!

1reating awareness

1reating motivation

ecision ma&ing action

RE$RODUCTI0E HEALTH

!. Family ,lanning".


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2ational Focus3 2ational


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%mpalaya (


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% combination of education research and action.

'he purpose is the 7


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Re"imen I

":5,7 8:5

2ew pulmonary smear (U) cases

2ew seriously ill pulmonary smear (-) cases

w e*tensive lung lesions

2ew severely ill e*tra-pulmo '

Re"imen II

":5,7/!:5,7 9:57

2ew pulmonary smear (U) case

2ew seriously ill pulmonary smear (-) casesw e*tensive lung lesions

2ew severely ill e*tra-pulmo '

Re"imen III

":5, 8:5

2ew smear(-) but with minimal pulmonary '

on radiography as confirmed by a medicalofficer

2ew e*tra-pulmo ' (not serious)

II - LE$ROSY

/ometimes &nown as Hansens *isease is an infectious disease caused by an aerobic acid fast rod-shaped mycobacterium

=erhard %rmauer +ansen

+istorically leprosy was an incurable and disfiguring disease

'oday leprosy is easily curable by multi-drug antibiotic therapy

Si"ns Sym&toms

Early sta"e:CLUM$; Late Sta"e:GMISC;

Change in s&in color GynocomastiaLoss in sensation Madarosis(loss of eyebrows)Ulcers that do not heal Inability to close eyelids (Lagopthalmos)

Muscle wea&ness Sin&ing nosebridge$ainful nerves Clawingcontractures of fingers $ nose

$re'alen%e Rate


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Causati'e A"ent!%nopheles female mosuitoSi"ns Sym&toms!

Chills to convulsionHepatomegalyAnemiaSweats profuselyElevated temperature

Treatment!1hemoprophyla*is 4 chlorouine ta&en at wee&ly interval starting from !-" wee&s before

entering the endemic area.

$re'enti'e Measures! :CLEAN;Chemically treated mosuito netsLarvae eating fishEnvironmental clean upAnti mosuito soaplotionNeem treeseucalyptus tree

III - #ILIARIASIS

name for a group of tropical diseases caused by various thread-li&e parasitic round worms

(nematodes) and their larvae

larvae transmit the disease to humans through a mosuito bite can progress to include gross enlargement of the limbs and genitalia in a condition called

ele$&antiasis

S


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DEN1UEis a mosuito-borne infection which in recent years has become a maDor international

public health concern..

5t is found in tropical and sub-tropical regions around the world predominantly in urban and semi-

urban areas.

S

Community Health Nursing p.31-55

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