COMMUNITY HEALTH CARE PROCESS Assessment Purpose : To identify the health needs of the people

Planning of nursing actions Purpose : To act on the determined needs of the community people

Implementation Purpose : To achieve the optimum level of health of the community people

Evaluation Purpose : To determine the effectiveness of health care programs

NURSING PROCEDURES CLINIC VISIT process of checking the clients health condition in a medical clinic

HOME VISIT a professional face to face contact made by the nurse with a patient or the family to provide necessary health care activities and to further attain the objectives of the agency

BAG TECHNIQUE a tool making of the public health bag through which the nurse during the home visit can perform nursing procedures with ease and deftness saving time and effort with the end in view of rendering effective nursing care

THERMOMETER TECHNIQUE to assess the clients health condition through body temperature reading

NURSING CARE IN THE HOME giving to the individual patient the nursing care required by his/her specific illness or trauma to help him/her reach a level of functioning at which he/she can maintain himself/herself or die peacefully in dignity

ISOLATION TECHNIQUE IN THE HOME -done by :

1. separating the articles used by a client with communicable disease to prevent the spread of infection: 2. frequent washing and airing of beddings and other articles and disinfections of room 3. wearing a protective gown , to be used only within the room of the sick member 4. discarding properly all nasal and throat discharges of any member sick with communicable disease 5. burning all soiled articles if could be or contaminated articles be boiled first in water 30 minutes before laundering PRINCIPLES OF HEALTH EDUCATION It considers the health status of the people, which is determined by the economic and social conscience of the country. It is a process whereby people learn to improve their personal habits and attitudes, to work responsibly for the improvement of health conditions of the family, community, and nation. It involves motivation, experience, and change in conduct and thinking, while stimulating active interest. It develops and provides experience for change in peoples attitudes, customs, and habits in relation to health and everyday living. It should be recognized as the basic function of all health workers. It takes place in the home, in the school, and in the community. It is a cooperative effort requiring all categories of health personnel to work together in close teamwork with families, groups, and the community. It meets the needs, interests, and problems of the people affected. It finds means and ways of carrying out plans by encouraging individual and community participation. It is a slow, continuous process that involves constant changes and revisions until objectives are achieved. Makes use of supplementary aids and devices to help with the verbal instructions.

THE COMMUNITY HEALTH NURSE Qualifications

1. Bachelor of Science in Nursing 2. Registered Nurse of the Philippines Planner/Programmer 1. Identifies needs, priorities, and problems of individuals, families, and communities 2. Formulates municipal health plan in the absence of a medical doctor 3. Interprets and implements nursing plan, program policies, memoranda, and circular for the concerned staff personnel 4. Provides technical assistance to rural health midwives in health matters Provider of Nursing Care 1. Provides direct nursing care to sick or disabled in the home, clinic, school, or workplace 2. Develops the familys capability to take care of the sick, disabled, or dependent member Manager/Supervisor 1. Formulates individual, family, group, and community-centered plan 2. Interprets and implements programs, policies, memoranda, and circulars 3. Organizes work force, resources, equipments, and supplies at local level 4. Provides technical and administrative support to Rural Health Midwives (RHM) 5. Conducts regular supervisory visits and meetings to different RHMs and gives feedback on accomplishments Community Organizer 1. Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services 2. Initiates and participates in community development activities Coordinator of Services 1. Coordinates with individuals, families, and groups for health related services provided by various members of the health team 2. Coordinates nursing program with other health programs like environmental sanitation, health education, dental health, and mental health

Trainer/Health Educator 1. Identifies and interprets training needs of the RHMs, Barangay Health Workers (BHW), and hilots 2. Conducts training for RHMs and hilots on promotion and disease prevention 3. Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and health-related services 4. Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education purposes 5. Conducts pre-marital counseling Health Monitor 1. Detects deviation from health of individuals, families, groups, and communities through contacts/visits with them Role Model 1. Provides good example of healthful living to the members of the community Change Agent 1. Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health Recorder/Reporter/Statistician 1. Prepares and submits required reports and records 2. Maintain adequate, accurate, and complete recording and reporting 3. Reviews, validates, consolidates, analyzes, and interprets all records and reports 4. Prepares statistical data/chart and other data presentation Researcher 1. Participates in the conduct of survey studies and researches on nursing and healthrelated subjects 2. Coordinates with government and non-government organization in the implementation of studies/research

Public Health Programs

COMPREHENSIVE MATERNAL AND CHILD HEALTH PROGRAM 1. EPI (Expanded Program on Immunization) 2. CDD (Control of Diarrheal Diseases) 3. CARI (Control of Acute Respiratory Infections) 4. UFC (Under-Five Clinics) 5. MC (Maternal Care) 6. BF (Breastfeeding) 7. MRP (Malnutrition Rehabilitation Program) 8. VAD ( Vitamin A Deficiency) 9. IDD/IDA (Iodine Deficiency Disorders/ Iron Deficiency Anemia) 10. FP (Family Planning) EPI (EXPANDED PROGRAM ON IMMUNIZATION) TARGET SETTING: 1. INFANTS 0-12 MONTHS 2. PREGNANT AND POST PARTUM WOMEN 3. SCHOOL ENTRANTS/ GRADE 1 / 7 YEARS OLD

OBJECTIVES OF EPI:

TO REDUCE MORBIDITY AND MORTALITY RATES AMONG INFANTS AND CHILDREN from SIX CHILDHOOD IMMUNIZABLE DISEASE ELEMENTS OF EPI: 1. TARGET SETTING 2. COLDCHAIN LOGISTIC MANAGEMENT- Vaccine distribution through cold chain is designed to ensure that the vaccine were maintained under proper environmental condition until the time of administration.

3. Information, Education and Communication (IEC) 4. Assessment and evaluation of Over-all performance of the program 5. Surveillance and research studies EXPANDED PROGRAM ON IMMUNIZATION
Vaccine BCG (Bacillus Calmette Guerin) Minimum Afe of 1 Dose Birth or anytime after birth School entrant
st

Number of Doses 1

Minimum Interval Between Doses

Reason BCG is given at the earliest possible age protects against the possibility of TB infection from the other family members

DPT (Diphtheria Pertussis Tetanus)

6 weeks

4weeks

An early start with DPT reduces the chance of severe pertussis The extent of protection against polio is increased the earlier OPV is given. An early start of Hepatitis B reduces the chance of being infected and becoming a carrier. At least 85% of measles can be prevented by immunization at this age.

OPV (Oral Polio Vaccine)

6 weeks

4 weeks

Hepatitis B

6 weeks

4 weeks

Measles

9 months

CDD (CONTROL OF DIARRHEAL DISEASES) MANAGEMENT OF THE PATIENT WITH DIARRHEA

A. NO DEHYDRATION Condition well, alert Mouth and Tongue moist

Eyes normal Thirst drinks normally, not thirsty Tears present Skin pinch goes back quickly TREATMENT PLAN A- HOME Tx.

THREE RULES FOR HOME TREATMENT 1. Give the child more fluids than usual use home fluid such as cereal gruel give ORESOL, plain water

2. Give the child plenty of food to prevent undernutrition 1. continue to breastfeed frequently 2. if child is not breastfeed, give usual milk 3. if child is less than 6 months and not yet taking solid food, dilute milk for 2 days 4. if child is 6 months or older and already taking solid food, give cereal or other starchy food mixed with vegetables, meat or fish; give fresh fruit juice or mashed banana to provide potassium; feed child at least 6 times a day. After diarrhea stops, give an extra meal each day for two weeks. 3. Take the child to the health worker if the child does not get better in 3 days or develops any of the following: 1. many watery stools 2. repeated vomiting 3. marked thirst 4. eating or drinking poorly 5. fever 6. blood in the stool ORESOL TREATMENT Age Amount of ORS to give after Amount of ORS to provide for

each loose stool < 24 months 2 10 years 10 years up B. SOME DEHYDRATION 50-100 mL 100-200mL As much as wanted

use at home 500 mL/day 1000 mL/day 2000mL/day

Condition restless, irritable Mouth and Tongue dry Eyes sunken Thirst thirsty, drinks eagerly Tears absent Skin pinch goes back slowly WEIGH PT, Tx. PLAN B

APPROX. AMT. OF ORS- TO GIVE IN 1ST 4 HRS Age 4 mo 4-11 mo 12-23 mo 2-4 yrs 5-14 yrs 15 yrs + Weight kg 5 5-7.9 8-10.9 11-15.9 16-29.9 30 up ORS mL 200-400 400-600 600-800 800-1200 1200-2200 2200-4000

1. If the child wants more ORS than shown, give more 2. Continue breastfeeding 3. For infants below 6 mos. who are not breastfeed, give 100-200 ml clean water during the period 4. For a child less than 2 years give a teaspoonful every 1-2 min. 5. If the child vomits, wait for 10 min, then continue giving ORS, 1 tbsp/2-3 min 6. If the childs eyelids become puffy, stop ORS , give plain water or breast milk, Resume ORS when puffiness is gone 7. If ( -) signs of DHN- shift to Plan A 8. Use of Drugs during Diarrhea

9. Antibiotics should only be used for dysentery and suspected cholera 10. Antiparasitic drugs should only be used for amoebiasis and giardiasis C. SEVERE DEHYDRATION Condition lethargic or unconscious; floppy Eyes very sunken and dry Tears absent Mouth and tongue very dry Thirst- drinks poorly or not able to drink Skin pinch goes back very slowly Tx PLAN C- Tx. quickly 1. Bring pt. to hospital 2. IVF Lactated Ringers Solution or Normal Saline 3. Re-assess pt. Every 1-2 hrs 4. Give ORS as soon as the pt. can drink Two problems in CDD 1. High child mortality due to diarrhea 2. High diarrhea incidence among under fives Highest incidence in age 6 23 months Highest mortality in the first 2 years of life Main causes of death in diarrhea : 1. DEHYDRATION 2. MALNUTRITION To prevent dehydration, give home fluids am as soon as diarrhea starts and if dehydration is present, rehydrate early, correctly and effectively by giving ORS For undernutrition, continue feeding during diarrhea especially breastfeeding.

5 Interventions to prevent diarrhea

1. Breastfeeding 2. improved weaning practices 3. use of plenty of clean water 4. hand washing 5. proper disposal of stools of small children Risk of severe diarrhea 10-30x higher in bottle fed infants than in breastfed infants. Advantages of breastfeeding in relation to CDD -Breast milk is sterile -Presence of antibodies protection against diarrhea -Intestinal Flora in BF infants prevents growth of diarrhea causing bacteria. Breastfeeding decreases incidence rate by 8-20% and mortality by 24-27% in infants under 6 months of age. When to wean? 4-6 months soft mashed foods 2x a day 6 months variety of foods 4x a day Summary of WHO-CDD recommended strategies to prevent diarrhea Improved Nutrition exclusive breastfeeding for the first 4-6 months of life and partially for at least one year. Improved weaning practices Use of safe water collecting plenty of water from the cleanest source protecting water from contamination at the source and in the home Good personal and domestic hygiene handwashing proper disposal of stools of young children

CARI (CONTROL OF ACUTE RESPIRATORY INFECTIONS) CLASSIFICATION: A. NO PNEUMONIA: COUGH OR COLD 1. No chest in drawing 2. No fast breathing ( <2 mos- <60/min, 2-12 mos. less than 50 per minute; 12 mos. 5 years less than 40 per minute) TREATMENT: 1. If coughing more than 30 days, refer for assessment 2. Assess and treat ear problems/sore throat if present 3. Advise mother to give home care 4. Treat fever/wheezing if present HOME CARE: 1. FEED THE CHILD Feed the child during illness Increase feeding after illness Clear the nose if it interferes with feeding

2. INCREASE FLUIDS offer the child extra to drink Increase breastfeeding

3. SOOTHE THE THROAT AND RELIEVE THE COUGH WITH A SAFE REMEDY 4. WATCH FOR THE FOLLOWING SIGNS AND SYMPTOMS AND RETURN QUICKLY IF THEY OCCUR Breathing becomes difficult Breathing becomes fast Child is not able to drink Child becomes sicker

B. PNEUMONIA 1. No chest in drawing 2. Fast breathing ( less than 2 mos- 60/min or more ; 2-12 mos. 50/min or more; 12 mos. 5 years 40/min or more)

TREATMENT 1. Advise mother to give home care 2. Give an antibiotic 3. Treat fever/wheezing if present 4. If the childs condition gets worst, refer urgently to hospital; if improving, finish 5 days of antibiotic. C. Severe Pneumonia Chest indrawing Nasal flaring Grunting ( short sounds made with the voice) Cyanosis Tx. 1. Refer urgently to hospital 2. Treat fever ( paracetamol), wheezing (salbutamol) D. Very Severe Disease Not able to drink Convulsions Abnormally sleepy or difficult to wake Stridor in calm child Severe undernutrition

ASSESSMENT OF RESPIRATORY INFECTION ASK THE MOTHER: 1. How old is the child? 2. Is the child coughing? For how long? 3. Age 2 months up to 5 years: Is the child able to drink? Age less than 2 months: Has the young infant stopped feeding well? 4. Has the child had fever? For how long? 5. Has the child had convulsions? LOOK, LISTEN:

1. Count the breaths in one minute. 2. Look for chest in drawing. 3. Look and listen for stridor. Stridor occurs when there is a narrowing of the larynx, trachea or epiglottis which interferes with air entering the lungs. 4. Look and listen for wheeze Wheeze is a soft musical noise which shows signs that breathing out (exhale) is difficult.

5. See if the child is abnormally sleepy or difficult to wake. (Suspect meningitis) 6. Feel for fever or low body temperature. 7. Check for severe under nutrition MANAGEMENT OF A CHILD WITH AN EAR PROBLEM Classification of Ear Infection A. MASTOIDITIS tender swelling behind the ear (in infants, swelling may be above the ear) TREATMENT 1. Antibiotics 2.Surgical intervention

B. ACUTE EAR INFECTION pus draining from the ear for less than 2 weeks, ear pain, red, immobile ear drum (Acute Otitis Media) TREATMENT 1.Cotrimoxazole,Amoxycillin,or Ampicillin 2.Dry the ear by wicking C. CHRONIC EAR INFECTION pus draining from the ear for more than 2 weeks (Chronic Otitis Media) TREATMENT Most important & effective treatment: Keep the ear dry by wicking. Paracetamol maybe given for pain or high fever. Precautions for a child with a draining ear: 1. Do not leave anything in the ear such as cotton, wool between wicking treatments. 2. Do not put oil or any other fluid into the ear. 3. Do not let the child go swimming or get water in the ear.

Maternal Care
Philosophy Pregnancy, labor and delivery and puerperium are part of the continuum of the total life cycle Personal, cultural and religious attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique MCN is FAMILY CENTERED- the father is as important as the mother

Classification of pregnant women Normal healthy pregnancy With mild complications- frequent home visits With serious or potentially serious cx referred to most skilled source of medical and hospital care

Home Based Mothers Record (HBMR ) Tool used when rendering prenatal care containing risk factors and danger signs

*Risk Factors 145 cm tall (4 ft & 9 inches) Below 18 yrs old, above 35 yrs old Have had 4 pregnancies With TB, goiter, heart disease, DM, bronchial asthma, severe anemia Last baby born was less than 2 years ago Previous cesarean section delivery History of 2 or more abortions, difficult delivery, given birth to twins , 2 or more babies born before EDD, stillbirth Weighs less than 45 kgs. or more than 80 kgs.

*Danger Signs 1. any type of vaginal bleeding 2. headache, dizziness, blurred vision 3. puffiness of face and hands 4. pallor

Prenatal Care Schedule of Visits

1st as early as pregnancy, 1st trimester 2nd - 2nd trimester 3rd & subsequent visits - 3rd trimester

More frequent visits for those at risk with cx

TT1 administered anytime during pregnancy TT2 1 month after TT1 (3 years protection) TT3 6 months after TT2 (5 years protection) TT4 1 year after TT3 (10 years protection) TT5 1 year after TT4 (Lifetime protection)

Components of Prenatal Visits History taking Determination of obstetrical score- G, P, TPAL, AOG, EDD U/A for Proteinuria, glycosuria and infection Dental exam Wt. Ht. BP taking Exam of conjunctiva and palms for pallor Abdominal exam - fundic ht, Leopolds maneuver and FHT Exam of breasts, face, hands and feet for edema and neck for thyroid enlargement Health teachings- nutrition, personal hygiene, common complaints Tetanus toxoid immunization Iron supplementation from 5th mo. of pregnancy - 2 mos. Postpartum In goiter endemic areas iodized capsule once a year In malaria infested areas- prophylactic Chloroquine ( 150 mg/tab ) 2 tabs/ wk for the whole duration of pregnancy

UNDER FIVE CLINIC

The first five years of life form the foundations of the childs physical and mental growth and development. Studies have shown the mortality and morbidity are high among this age group. The Department of Health established the Under Five Clinic Program to address this problem. PROGRAM OBJECTIVES AND GOALS: Monitor growth and development of the child until 5 years of age. Identify factors that may hinder the growth and development of the child. ACTIVITIES AND STRATEGIES: 1. Regular height and weight determination/ monitoring until 5 years old. 0-1 year old=monthly 1 year old and above =quarterly

2. Recording of immunization, vitamins supplementation, deworming and feeding. 3. Provision of IEC materials (ex. Posters, charts, toys) that promote and enhance childs proper growth and development. 4. Provision of a safe and learning oriented environment for the child. 5. Monitoring and Evaluation. BREASTFEEDING/ LACTATION MANAGEMENT EDUCATION TRAINING Breastfeeding practices has been proved to be very beneficial to both mother and baby thus the creation of the following laws support the full implementation of this program: Executive Order 51 Republic Act 7600 The Rooming-In and Breastfeeding Act of 1992

PROGRAM OBJECTIVES AND GOALS: Protection and promotion of breastfeeding and lactation management education training ACTIVITIES AND STRATEGIES: 1.FULL IMPLEMENTATION OF LAWS SUPPORTING THE PROGRAM A. EO 51 THE MILK CODE protection and promotion of breastfeeding to ensure the safe and adequate nutrition of infants through regulation of marketing of infant foods and related products. (e.g. breast milk substitutes, infant formulas, feeding bottles, teats etc. ) B. RA 7600 THE ROOMING IN and BREASTFEEDING ACT of 1992 An act providing incentives to government and private health institutions promoting and practicing rooming-in and breast-feeding. Provision for human milk bank. Information, education and re-education drive Sanction and Regulation

2. CONDUCT ORIENTATION/ADVOCACY MEETINGS TO HOSPITAL/ COMMUNITY. ADVANTAGES OF BREASTFEEDING:

MOTHER Oxytocin help the uterus contracts Uterine involution Reduce incidence of Breast Cancer Promote Maternal-Infant Bonding Form of Family planning Method (Lactational Amenorrhea)

BABY Provides Antibodies Contains Lactoferin (binds with Iron) Leukocytes Contains Bifidus factor-promotes growth of the Lactobacillus-inhibits the growth of pathogenic bacilli

POSITIONS IN BF THE BABY: Cradle Hold = head and neck are supported Football Hold Side Lying Position

B.R.E.A.S.T.F.E.E.D.I.N.G BEST FOR BABIES REDUCE INCIDENCE OF ALLERGENS ECONOMICAL ANTIBODIES PRESENT STOOL INOFFENSIVE (GOLDEN YELLOW) EMPERATURE ALWAYS IDEAL FRESH MILK NEVER GOES OFF EMOTIONALLY BONDING EASY ONCE ESTABLISHED

DIGESTED EASILY IMMEDIATELY AVAILABLE NUTRITIONALLY OPTIMAL GASTROENTERITIS GREATLY REDUCED

GARANTISADONG PAMBATA (GP) Garantisadong Pambata is a biannual week long delivery of a package of health services to children between the ages of 0-59 months old with the purpose of reducing morbidity and mortality among under fives through the promotion of positive Filipino values for proper child growth and development.

HEALTH SERVICES OFFERED IN GP AND WHO ARE THE TARGETS Health Service Vitamin A capsule Dosage 200,000 IU or 1 capsule 100,000 IU or cap or 3 drops Route of Administration Orally by drops Target Population 12-59 months old, nationwide 9-12 month old infants receiving AMV nationwide

Ferrous Sulfate (25 mg. Elemental Iron per ml; 30 ml. Bottle as taken home medicine with instructions) Routine Immunization -BCG* -DPT* -OPV* -AMV* -Hepa B (if available)

0.3ml(2-6 mos) once a day 0.6ml(6-11mos) once a day

Orally by drops

2-11 months old infants in Mindanao area, including evacuation centers in armed conflict areas.

0.05ml 0.5ml 2 drops 0.5ml 0.5ml

Deworming drug (if available)

1 tablet as single dose

-Intradermal R deltoid -Intramuscularly anterior thigh -Orally -Subcutaneously deltoid -Intramuscularly Orally

Nationwide 0-11 mos 0-11 mos 0-11 mos 9-11 mos 0-11 mos

36-59 mos, nationwide

Weighing

0-59 mos, nationwide

GARANTISADONG PAMBATA Sangkap Pinoy Vitamin A, Iron and Iodine -Sources: green leafy and yellow vegetables, fruits, liver, seafoods, iodized salt, pan de bida and other fortified foods. These micronutrients are not produced by the body, and must be taken in the food we eat; essential in the normal process of growth and development: a) Helps the body to regulate itself b) Necessary in energy metabolism c) Vital in brain cell formation and mental development d) Necessary in the body immune system to protect the body from severe infection. e) Eating Sangkap Pinoy-rich foods can prevent and control: 1. Protein Energy Malnutrition 2. Vitamin A Deficiency 3. Iron Deficiency Anemia 4. Iodine Deficiency Disorder

BREASTFEEDING Breast milk is best for babies up to 2 years old. Exclusive breastfeeding is recommended for the first six months of life. At about six months, give carefully selected nutritious foods as supplements. Breastfeeding provides physical and psychological benefits for children and mothers as well as economic benefits for families and societies.

BENEFITS :

For infants a. Provides a nutritional complete food for the young infant. b. Strengthens the infants immune system, preventing many infections. c. Safely rehydrates and provides essential nutrients to a sick child, especially to those suffering from diarrheal diseases. d. Reduces the infants exposure to infection. COMPLEMENTARY FEEDING FOR BABIES 6-11 MONTHS OLD What are Complementary Foods? foods introduced to the child at the age

6 months to supplement breastmilk given progressively until the child is used to three meals and in-between feedings at the age of one year.

Why is there a Need to Give Complementary Foods? breastmilk can be a single source of nourishment from birth up to six months of life.

The childs demands for food increases as he grows older and breastmilk alone is not enough to meet his increased nutritional needs for rapid growth and development Breastmilk should be supplemented with other foods so that the child can get additional nutrients Introduction of complementary foods will accustom him to new foods that will also provide additional nutrients to make him grow well Breastfeeding, however, should continue for as long as the mother is able and has milk which could be as long as two years How to Give Complementary Foods for Babies 6-11 Months Old? Prepare mixture of thick lugaw/ cooked rice, soft cooked vegetables. Egg yolk, mashed beans, flaked fish/chicken/ground meat and oil. Give mixture by teaspoons 2-4 times daily, increasing the amount of teaspoons and number of feeding until the full recommended amount is consumed Give bite-sized fruit separately Give egg alone or combine with above food mixture

FAMILY PLANNING
The Philippine Family Planning Program is a national program that systematically provides information and services needed by women of reproductive age to plan their families according to their own beliefs and circumstances. GOALS AND OBJECTIVES: Universal access to family planning information, education and services. MISSION: To provide the means and opportunities by which married couples of reproductive age desirous of spacing and limiting their pregnancies can realize their reproductive goals. TYPES OF METHODS: A. NATURAL METHODS 1. Calendar or Rhythm Method 2. Basal Body Temperature Method 3. Cervical Mucus Method 4. Sympto-Thermal Method 5. Lactational Amenorrhea B. ARTIFICIAL METHODS I. CHEMICAL METHODS 1. Ovulation suppressant such as PILLS 2. Depo-Provera 3. Spermicidal 4. Implant II. MECHANICAL METHODS 1. Male and Female Condom

2. Intrauterine Device 3. Cervical Cap/Diaphragm III. SURGICAL METHODS 1. Vasectomy 2. Tubal Ligation WARNING SIGNS Pills IUD Period late, no symptoms of pregnancy, abnormal bleeding or spotting Abdominal pain during intercourse Infection or abnormal vaginal discharge Not feeling well, has fever or chills String is missing or has become shorter or longer Abdominal pain (severe) Chest pain (severe) Headache (severe) Eye problems (blurred vision, flashing lights, blindness) Severe leg pain (calf or thigh ) Others: depression, jaundice, breast lumps

INJECTABLES BTL Fever Dizziness Severe headache Heavy bleeding

Weakness Rapid pulse Persistent abdominal pain Vomiting Dizziness Pus or tenderness at incision site Amenorrhea

Vasectomy Fever Scrotal blood clots or excessive swelling

Nutrition
Goal To improve the nutritional status, productivity and quality of life of the population thru adoption of desirable dietary practices and healthy lifestyle

Objectives Increase food and dietary energy intake of the average Filipino Prevent nutritional deficiency diseases and nutrition-related chronic degenerative diseases Promote a healthy well-balanced diet Promote food safety

Nutrition is a state of well-being achieved by eating the right food in every meal and the proper utilization of the nutrients by the body. Proper nutrition is important because: it helps in the development of the brain, especially during the first years of the childs life.

It speeds up the growth and development of the body including the formation of teeth and bones It helps fight infection and diseases It speeds up the recovery of a sick person It makes people happy and productive

Proper nutrition is eating a balanced diet in every meal Balanced diet is made up of a combination of the 3 basic groups eaten in correct amounts. The grouping serves as a guide in selecting and planning everyday meals for the family. 1. Bodybuilding food which are rich in protein and needed by the body for: normal growth and repair of worn-out body tissues supplying additional energy fighting infections Examples of protein-rich food are: fish; pork; chicken; beef; cheese; butter; kidney beans; mongo; peanuts; bean curd; shrimp; clams

2. Energy-giving food which are rich in carbohydrates and fats and needed by the body for: providing enough energy to make the body strong Examples of energy-giving food are: rice; corn; bread; cassava; sweet potato; banana; sugar cane; honey; lard; cooking oil; coconut milk; margarine; butter

3. Body-regulating food which are rich in Vitamins and minerals and needed by the body for: normal development of the eyes, skin, hair, bones, and teeth increased protection against diseases Examples of body-regulating food are: tisa; ripe papaya; mango; guava; yellow corn; banana; orange; squash; carrot

Low Fat Tips 1. Eat at least 3 meals/day 2. Eat more fruits, vegetables, grain and cereals e.g. rice, noodles and potato 3. If you use butter or margarine, pat it on thinly

4. Choose low fat substitute i.e. replace whole milk with skimmed milk, low fat cheese 5. Become a label reader. Look for foods that have less than 5 g /100 g of product 6. Eat less high fat snacks and take away potato chips, sausage rolls or breaded meats 7. Cut all visible fat from meat, remove skin from chicken fat drippings and cream sauces 8. Aim for thin palm-size serving of lean meat, poultry and fish/ meal 9. Grill, bake, steam, stew, stir fry and microwave, try not to fry 10. Drink lots of water all dayAmbulate Start by walking for 10 min. Build up to 30-40 min/day Go for 3-4 times / week of any exercise you enjoy its a food quencher

Filipino Food Pyramid Drink a lot- water, clear broth Eat most rice, root crops, corn, noodles, bread and cereals Eat more vegetables, green salads, fruits or juices Eat some fish, poultry, dry beans, nuts, eggs, lean meats, low fat dairy Eat a little fats, oils, sugar, salt

IMPORTANT VITAMINS AND MINERALS

VITAMINS Vitamin A FUNCTIONS Maintain normal vision, skin health, bone and tooth growth reproduction and immune function; prevents xerophthalmia. Food sources: Breastmilk;poultry;eggs; liver; meat; carrots; squash; papaya; mango; tiesa; malunggay; kangkong; camotetops; ampalaya tops Help release energy from nutrients; support normal appetite and nerve function, prevent beri-

Thiamine

Riboflavin

Niacin Biotin Pantothenic Folic acid

Vitamin B 12

Vitamin C

Vitamin D Vitamin E

Vitamin K

MINERALS Calcium

Chloride Chromium Copper Fluoride Iodine

beri. Helps release energy from nutrients, support skin health, prevent deficiency manifested by cracks and redness at corners of mouth; inflammation of the tongue and dermatitis. Help release energy from nutrients; support skin, nervous and digestive system, prevents pellagra. Help energy and amino acid metabolism; help in the synthesis of fat glycogen. Help in energy metabolism. Help in the formation of DNA and new blood cells including red blood cells; prevent anemia and some amino acids. Help in the formation of the new cells; maintain nerve cells, assist in the metabolism of fatty acids and amino acids. Help in the formation of protein, collagen, bone, teeth cartilage, skin and scar tissue; facilitate in the absorption of iron from the gastrointestinal tract; involve in amino acid metabolism; increase resistance to infection, prevent scurvy. Food sources: Guava; pomelo; lemon; orange; calamansi; tomato; cashew Help in the mineralization of bones by enhancing absorption of calcium Strong anti-oxidant; help prevent arteriosclerosis; protect neuro-muscular system; important for normal immune function. Involve in the synthesis of blood clotting proteins and a bone protein that regulates blood calcium level. FUNCTIONS Mineralization of bones and teeth, regulator of many of the bodys biochemical processes, involve in blood clotting, muscle contraction and relaxation, nerve functioning, blood pressure and immune defenses. Maintain normal fluid and electrolyte balance. Work with insulin and is required for release of energy from glucose. Necessary for absorption and use of iron in the formation of hemoglobin. Involve in the formation of bones and teeth; prevents tooth decay. As part of the two thyroid hormones, iodine regulates growth, physical and mental

Iron

Magnesium

Manganese Molybdenum Phosphorus

Selenium Selenium Sodium Sulfur Zinc

development and metabolic rate. Aids in the development of the brain and body especially in unborn babies Food sources: Seaweeds; squids; shrimps; crabs; fermented shrimp; mussels; snails; dried dilis; fish Essential in the formation of blood. It is involved in the transport and storage of oxygen in the blood and is a co-factor bound to several nonhemo enzymes required for the proper functioning of cells. Food sources: Pork; beef; chicken; liver and other internal organs; dried dilis; shrimp; eggs; pechay; saluyot; alugbati Mineralization of bones and teeth, building of proteins, normal muscle contraction, nerve impulse transmission, maintenance of teeth and functioning of immune system. Facilitate many cell processes. Facilitate many cell processes. Mineralization of bones and teeth; part of every Cell; used in energy transfer and maintenance of acid-base balance. Work with vitamin E to protect body compound from oxidation. Work with vitamin E to protect body compound from oxidation. Maintain normal fluid and electrolyte balance, assists nerve impulse insulin. Integral part of vitamins, biotin and thiamine as well as the hormone. Essential for normal growth, development reproduction and immunity.