Health PHN

- State of complete physical, mental and social well being and WHO
not merely the absence of disease or infirmity. - Special field of nursing = (Nursing skills + PH + social
assistance)
Determinants of Health
1. Income and social status Ruth B. Freeman
2. education - Service rendered by a nurse with communities, individuals
3. physical environment at home, in health centers, clinics, schools and work place.
4. social support networks
5. culture 2005 standard definition
6. genetics - PHN refers to the practice of nursing in national and local
7. behavior government health department and public schools, his community
8. health services health nursing practiced in the public sector.
9. gender
DOH
Public Health by Dr. C.E. Winslow Roles and Functions
- The science and art of preventing disease, prolonging life 1. Leadership in health
and promoting health through the effort of the community in a. Policy maker
sanitation, control of common disease, hygiene, medical and 2. Enabler and capacity builder
nursing services, early diagnosis, preventive treatment, and a. Improve effectiveness of health program
development of technology. b. Disseminate information of health issues
c. Exercise overview function, monitoring, evaluation of
Public Health by WHO programs and policies
- The art of applying science in context of policies to reduce 3. Administrator of Specific services
inequalities of health while ensuring the best health for the a. Manage health facilities
greatest number. b. Programs such as TB, schistosomiasis, HIV-AIDS

[Business core] of PH Health Sector Reform Agenda (2004) = “…….pagbabago”

- Disease control
- Injury prevention Rationale for HSRA
- Health protection • Slow reduction of IMR and MMR
- Healthy public policy (guidelines) • Variety of health status
- Promotion of health (environment hazards) • High burden from infectious diseases
• Rising burden from chronic illness
Functions of Public Health • Emerging health risks
• Health monitoring and analysis • Burden of disease is heaviest on the poor
• Epidemiological monitoring (disease prevention and control)
• Development of policies and planning in public health Mga EPAL sa life – overriding
• Management of health systems • Inappropriate health care delivery system
• Regulation for protection of public health • Inadequate regulatory mechanics for providing public health
• HR development and planning in public health • Funding
• Health promotion, social participation and empowerment
• Quality health services
• Research and development
 • Integration of PH and curative hospital care
Framework for Implementation of HSRA • Strengthened cooperation between LGU and Health sectors

Guiding Principles in developing Inter LHS

FOURmula ONE for Health • Financial and administrative autonomy of the provincial and
municipal administrations (LGUs)
Goals of FOURmula ONE • Strong political support
• Better health outcomes • Strategic synergies and partnerships
• More responsive health system • Community participation
• Equitable health care financing • Equity of access to health services by the population,
especially the poor
FOUR elements of the strategy: • Affordability of health services
• Health financing – investment for health • Appropriateness of HP
• Health regulation – quality and affordability • Decentralized management (micromanagement)
• Health service delivery – accessibility of health (everyone) • Sustainability of health initiatives
• Good governance – enhancing health systems performance • Upholding of standards of qHS
Local Health System (Influential power) Composition of ILHZ
1. People
Objectives: 2. Boundaries
• Establishing local health systems for effective and efficient 3. Health facilities
delivery of health care 4. Health workers
• Upgrade the health care management and service
capabilities of local health facilities Primary Health Care
• Promote inter-LGU linkages and cost sharing schemes inc.
LHC financing system for better utilization of LHR Alma AtH, USSR
• Foster participation of the private sector, NGOs and September 6-12, 1978
community in LHS development. (to be able to recognize) Conducted by WHO
• Ensure the quality of health service delivery at the local Theme: “Health for all in 2000”
level
October 19, 1979
Interlocal Health System President Marcos
-ILHZ (Interlocal Health Zone) “Health in the hands of the people by 2020”

Expected achievements: “Partnership and empowerment”

• Universal coverage of health insurance “[CAAS] community-based, accepted, accessible, sustainable”
• Improve quality of hospital and in rural health unit service
• Effective referral system Elements of Primary Health Care
• Integrated planning 1) Environmental Sanitation
• Improved drug management system 2) Control of communicable diseases
• Developed human resources 3) Immunization
• Effective leadership through Inter-LGU 4) Health Education
5) Maternal and child health and family planning
• Financially visible or self-sustaining hospital
6) Adequate food and proper nutrition
• App. Health info. System 7) Provision of medical care and E treatment
8) Treatment of locally endemic diseases
9) Provision of essential drugs
4 cornerstones/pillars in PHC Percentage Years
protection
1) Active community participation TT1 ASAP
2) Intra and Inter-sectoral linkages TT2 4 weeks 80% 3 years
3) Use of appropriate technology TT3 6 months 95% 5 years
4) Support mechanism made available TT4 1 year 99% 10 years
TT5 1 year 99% Lifetime
2 levels of PHC

• BHW – Barangay Health Workers

• IHW – Intermediate Health Workers

Levels of Health Care Micronutrient Supplementation

1) Primary Level of Care Vitamin A – 10000 IU 2x a week starting on the 4th month of
2) Secondary Level of Care pregnancy
3) Iron – 60mg/400ug tablet everyday
4) Tertiary Level of Care
Treatment of Diseases and Other Conditions
FAMILY HEALTH
1) DOB/Obstruction of Airway
Essential health Service Packages Available in the Health Care 2) Unconscious ---- Impending Shock
facility 3) Post Partum Bleeding
(Maternal health) - ergometrine 0.2mg IM – receptors, targets 5HT and alpha
receptors, vasoconstricts the blood vessels in the uterus to
Antenatal Registration prevent bleeding
• 1st visit: 1st trimester 4) Intestinal Parasite Infection
- Mebendazole (antibiotic) – 500mg
• 2nd visit: 2nd trimester (4th month)
• For the first 3 months, don’t give on the 1st trimester
• 3rd visit: 3rd trimester (7th month) because it might cause problems in organogenesis
• Every two weeks after the 8th month of pregnancy ‘til 5) Malaria (Caused by Plasmodium ____, a bacteria)
delivery - Sulfadoxine Pyrimethamine

Tetanus Toxoid Immunization

• Is an anti-folate, which inhibits absorption of FOLIC
ACID because the bacteria feed on folates.
- Contraction (spasm) of muscles
- Mother and child are both protected from tetanus and Clean and Safe Delivery
neonatal tetanus
- A.k.a lockjaw • Do a quick check upon admission for emergency signs
- *aching of the back – opisthotonos 1) Convulsions/unconscious
2) Vaginal bleeding
3) Severe abdominal pain
4) Looks very ill
5) Severe headache with visual disturbances
 6) Severe breathing difficulty  Assess the completeness of the placenta and
7) Fever membranes
8) Severe vomiting, DOB
• Make the woman feel comfortable 5) Monitor and manage labor
- Establish rapport, privacy, explaining the procedure to the 6) Monitor closely within 1 hour after delivery and give
patient. Deep breaths, accompanied with 2 shallow breaths supportive care (post partum blues may lead to psychosis)
(panting) 7) Continue post partum care q2 hours
8) Educate and counsel on family planning and provide FP
methods if available. Decision should be made by the
• Assess the woman in Labor woman.
1) LMP 9) Inform, teach and counsel the woman on the importance of
2) No. of pregnancies (gravity) (GPTPAL) Maternal and Child Health messages.
3) Age, height - Birth registration
4) Danger signs of pregnancy - Importance of breastfeeding
- Newborn screening
• Determine stage of labor - Discuss the return schedule
• Decide if the woman can safely deliver • 1st visit: 1st week post partum
• Give supportive care throughout labor • 2nd visit: 6 weeks post partum
- st
1 stage of labor – inactive labor, weak contractions which
is less than 2-10 minutes, cervix 0-3cm dilated.
• Check for emergency signs q1 Support to Breastfeeding
• Frequency of contraction - Initiate breastfeeding after 1 hour, the purpose is BONDING
• Assess v/s q4 hours - Colostrums – most vital nutrients, passes the immunity to
• Record time of rupture of membranes the child (neonate)
• Take note of the color of the amniotic fluid (cushion - 6 months EXCLUSIVE BREASTFEEDING
of the baby) - beyond 6 months – complimentary foods, increase fluid
- nd
2 stage of labor – Active labor, cervix 4-9cm dilated intake
- After 2 years – to prevent rape.
• Check for emergency signs q30.
• Check v/s q4 hours Benefits of Breastfeeding in an infant
• Do not push (to induce labor) 1) Complete food nutrients
• Never give meds to induce birth (upon discretion) 2) Increased Immunity
• Partograph – Tool used to monitor progress of labor 3) Decreases Chances of having infection
- 3rd stage – cervix 10cm dilated or crowning. 4) Rehydrates the baby
5) Increases IQ points
• Assess emergency signs q5
• Continue assessment of partograph Benefits of the Mother in Breastfeeding
• Do NOT apply fundal pressure. 1) Excessive blood loss prevention
2) Provides natural methods of FP (LAM, or Lactating
- 4th stage – happens between birth and delivery of the
Amenorrhea Method)
placenta
3) Reduces Ovarian Cancer
• nursing considerations: 4) Reduces Breast Cancer
 Do not squeeze/massage abdomen/fundus to 5) Continuous production of milk
deliver the placenta
3 General Causes of Cancer
 1) MISuse o Advantages: reversible, no need for daily intake,
2) Unused does not affect breast feeding
3) Abuse o Disadvantages: intrusive

Laws Governing the Concept of Breastfeeding • Lactating Amenorrhea Method (LAM) – Natural postpartum
1) EO51 – milk code method of postponing pregnancy by lactating mother.
2) BF Act of 1992 o Advantages: Universally available, begins as early as
3) Food fortification law – strengthening the diet postpartum, no FP commodities are needed.
o Disadvantages: short-term
Family Planning
• Mucus/Billings/Ovulation – Abstaining from horny acts in
• Female Sterilization – surgical procedure that cuts or blocks fertile (wet) days
the 2 fallopian tubes of the female reproductive system. o Advantages: can be used by a woman in
o Advantages: Permanent, increased sexual reproduction age, except in presence of disease
enjoyment, minilaparotomy (visualization of organs o Disadvantages: cannot be used by a woman with a
inside the abdomen) can be performed. condition that could make pregnancy dangerous.
o Disadvantages: Infection, can lead to ectopic
pregnancy if she gets pregnant, expensive • Basal Body Temperature (BBT) – recording of BBT daily to
identify the sextrip days
o Advantages: very effective
• Male Sterilization – surgical procedure that cuts or blocks o Disadvantages: Time-consuming
the vas deferens.
o Advantages: permanent, easy to perform, no long • Sympto-thermal method – BBT+mucus/billings/ovulation
term health risk, does not affect erection
o Irreversible, painful, bleeding may result to EXPANDED PROGRAM OF IMMUNIZATION (EPI)
hematoma in scrotal area
Vaccine Time # doses Interval Dose Route
DPT 6 wks 3 4 wks 0.5 cc IM
• Pills – hormone-containing pills taken daily for pregnancy OPV 6 wks 3 4 wks 2-3 gtts Oral
prevention Hepa B 6 wks 3 4 wks 0.5 cc IM
o Advantages: safe, convenient, makes menstruation AMV 9 mos 1 0.5 cc SQ
regular, reversible, reduces pain in menses. BCG ASAP 1 0.05 cc ID
o Disadvantages: incorrect use lessens effectiveness,
nausea, dizziness, breast tenderness, can suppress
lactation

• Male Condom – latex rubber for the man’s DINGDING

o Advantages: safe, has no hormonal effects, prevents O, A – (-10)-(-25)degCelsius
STDs, easily accessible, managing premature
ejaculation
o Disadvantages: Allergy, decreased pleasure. D,H,B,TT – (+2)-(+8)degCelsius
• Injectables – contain synthetic hormones that suppress
ovulation
 • Iodine – prevents anemia and goiter

Nutritional Programs
• Micronutrient Supplementation – 2x a year of vitamin A
distribution, Iron
• Food fortification – Act of 2000, EO 51 (Milk Code)
• Flour with Iron and Vitamin A, cooking oil and refined sugar
with vitamin A and rice with iron and foods with sangkap
pinoy seal.
• Essential Maternal and Child Health package –
1)breastfeeding, 2)complementary feeding, 3)micronutrient
supplementation
• Nutrition information, comm. And edu. Food
• Home, school and community production
• Food assistance
• Livelihood assistance
Roles of the Nurse in EPI
1. Actively master list eligible infants for vaccination
2. Observe immunization schedule, route and dose Oral Health Programs
3. Aseptic Technique 3 concerns:
4. Health Teaching • Preventive
5. Collector Box o Oral exam
6. Record Immunization o Oral hygiene
o Fit and fissure sealant program
7. Submit Reports (morbidity, mortality)
• Curative
o Permanent filling
Danger Signs
o Gum treatment
1. Convulsions o Atraumatic restorative treatment
2. sleep abnormalities (difficult to arouse)
o Extraction
3. unable to drink/breastfeed
o Treatment of post extraction complication
4. vomits everything
o Drainage of local abscess
Main Symptoms o Temporary filling
• Promotive
1. Cough
2. DOB 1. Newborn resuscitation
3. Diarrhea - to initiate breathing
4. Fever - birth asphyxia prevention
5. Ear Problems 2. IVREP – to prevent eye infection ->opthalmia neonatorum
3. Prevention and management of hypothermia of the newborn
Nutrition Program 4. NS – for genetic, endocrinal, metabolic, hematological
• Vitamin A – fat soluble, responsible for growth and abnormalities
development of the baby (skin and mucous 5. exclusive breastfeeding, rooming-in
membranes) 6. Complimentary feeding? comp
• Iron
 DIABETES MELLITUS • Oral glucose tolerance test
• Ketonuria
- a genetically and clinically heterogeneous group of
metabolic disorders characterized by glucose intolerance, CANCER
with hyperglycemia at time of diagnosis
- Sometimes referred to as “high sugars.” - Is a disturbance of growth characterized primarily by an
excessive proliferation of cells without apparent relation to
Risk Factors: the physiological demands of the organs involved.
- Genetics
- Overweight (BMI > 23kg/m2), Obesity (BMI > 30kg/m2) 2 classes of tumors:
- Sedentary lifestyle - Benign
- Hypertension - Malignant
- HDL cholesterol < 35mg/dl
- Triglyceride level > 250mg/dl *Metastasis – process of migration
- History of gestational diabetes or delivery of a baby with
more than 9pounds (4kg) in weight 4 kinds of Cancer
- Impaired glucose intolerance 1. Carcinoma – compose the largest group of cancer
2. Sarcoma – cancer that rises in the body’s supportive
*Type 1 – juvenile onset diabetes (genetics) tissue
- Kahit anong kain mo pumapayat ka 3. leukemia – develop in tissues which produce blood cells
- Age (usually occurs before age 30, may occur at any age) 4. lymphoma – develop from lymphoid tissue
- Racial disposition (African-American, Hispanic, Native American)
- problem in B cells from islets of langerhans, does not produce Risk Factors
insulin)
• age
- Treatment: insulin
• sex
*type 2 – adult onset (gained because of obesity, et al) • occupation
- Treatment: OHA (oral hypoglycemic Agent) • health habits
*insulin – fat metabolism inhibitor • family history
• socio-economic status
Manifestations: • lifestyle
• Polyuria
• Polydipsia Causes:
• Polyphagia • Virus
• Weight loss o Cervical cancer – human papillomavirus (HPV)
• Recurrent blurred vision o Liver cancer – hepatitis B Virus
• Skin infections o Leukemia – Eipstein Barr
• Weakness, fatigue • Carcinogens – able to cause cancer
o Chemical – found in cigars, smokes (polycyclic
Diagnostic Exams hydrocarbon)
• Fasting Blood glucose o Environmental
• Casual Blood Glucose o Benzopyrene – grilled food (ihaw-ihaw)
• Acetic Acid test o Afflatoxin – found in peanuts and peanut butter
• Glycosylated hemoglobin o Nitrosamine – found in foods with preservatives
o Radiation
• Glycosylated albumin
 • multiple sex partners
LUNG CANCER • early age of first coitus
• short interval between menarche and first coitus
- is a pulmonary malignancy attributed in the majority of • sexual contact with men whose partners have had cervical
cases related to cigarette smoking cancer
• exposure to HPV
Symptoms:
• smoking
- persistent cough, purulent sputum, blockage of airway,
chest pain • genetics

Risk Factors: Medical Management

- tobacco use, including cigars, cigarettes, chewing tobacco • radial trachelectomy (alternative for hysterectomy)
and snuffing • hysterectomy
- exposure to radiation o total hysterectomy
- second-hand smoke o TAHBSO
• Biopsy/conization
Nursing Management/Intervention • LEEP (loopelectrocautery excision procedure)
- Advise smoking cessation • conservative treatment
- Avoid second hand smoke o cryotherapy/laser therapy

Medical treatment Nursing Management:

- Remove part/all of the lung • encourage to have a regular pelvic exam and pap smear
• Pneumonectomy –surgical removal of either side of • conduct health teachings about reproductive health and
the lung safe sex
• Lobectomy – surgical removal of the left? • smoking cessation
- Chemotherapy • proper nutrition
- Radiation
ESOPHAGEAL CANCER
LARYNGEAL CANCER
- malignancy of the esophagus
- common malignancy of the Upper respiratory Tract - squamous cell carcinoma
- adenocarcinoma – arises from glandular cells
*surgical and medical laryngectomy – removal of the larynx
*radiation – cleaning of the cancer cells Risk Factors:
*chemotherapy – localization/prevention of the spread of cancer • age over 60 (African-American)
cells • sex (most common in men)
• tobacco use
CERVICAL CANCER
• excessive alcohol intake
- third most common female reproductive cancer • heredity
- affects 13,000 women in the US every year
- most common in women ages 30-45 y/o but can occur as Diagnostic Tests:
early as 18y/o • Endoscopy

Risk Factors Medical Management:

• Surgery
 • Esophagectomy Medical Management
• Palliative esophageal stenting - prostatectomy – surgical removal of the prostate gland

LIVER CANCER SKIN CANCER

- hepatocellular carcinoma - a malignant condition caused by uncontrolled growth and
spread of abnormal cells in a specific layer of the skin
Risk Factors:
- cirrhosis of the liver Risk Factors:
- chronic damage of the liver cells - Exposed to sunlight
- Fair complexion
*laenex cirrhosis – caused by alcoholic substance - Occupational exposure
- Severe sunburns, especially blistering
Non-surgical
Laser therapy Diagnostic Procedure:
Immunotherapy - excisional biopsy
- incisional biopsy
Lobectomy
Liver transplant COLON/COLORECTAL CANCER
- Also called colorectal cancer, is cancerous growth in the
BREAST CANCER colon, rectum and appendix. It is the most common form of
- is a cancer that stores in the breasts, usually in the inner cancer and the second leading cause of cancer related to
lining of the milk ducts or lobules death in the world.
- Originated from epithelial cell lining of the gastrointestinal
Risk Factors: tract
- gender - Most common cancer type is adenocarcinoma
- age
- race Risk Factors:
- metastasis - increased age – 60-70y/o – most cases
- genetic risk factors - heredity
- dense breast tissue - smoking
- history of cancer
Medical Treatment: - diet
- breast conserving surgery - lifestyle
- breast chemotherapy - polyps of the colon
- radiation therapy - environmental factors

PROSTATE CANCER Signs and Symptoms:

- change in bowel movement
- Enlargement of the prostate gland - unexplained anemia
- *benign prostatic hyperplasia - fatigue
- abdominal pain and melena
Risk Factors: - narrowing stools
- men over 65y/o - blood in stool
- heredity - increased feeling after bowel movement
- high fat diet
Diagnostic Procedure: - Late menopause
- Digital rectal exam
- MRI Diagnostic Exams:
- CT scan - Gynecologic Exam
- Endoscopy - Endometrial Aspiration/Biopsy
• Colonoscopy
Medical Management:
Nursing Management (Surgical) - Total hysterectomy
- Assess for the risk factors such as history, ulcerative colitis, - Salphingo oopherectomy
polyps - Node Sampling
- Assess abdomen (pain, distention, masses) - Radiotherapy
- Give high fiber diet - Progest in therapy
- Administration of antibiotics such as sulfonamides, - Taxinofen – endometrial polyps
neomycin, and cephalexin
- Administration of enema to clean the bowels RENAL CANCER
- Identify client’s anxiety and provide support efforts
- Explain all procedures and treatment - AKA R.C.C. hyper nephroma
- Encourage client to ventilate their feelings and meet health
team to discuss treatment Risk Factors
- Nurse should be assessed to educate the client about • Smoking
astomy • Obesity
- The bacterial level in the bowel must be lowered to • Diet
decrease the risk of infection • Occupational exposure

Nursing Management to Postoperative Care: CORONARY ARTERY DISEASE

- Assess the return of peristalsis
- Monitor the coloromy output - heart disease caused by impaired coronary blood flow
- Teach stomy care - It can cause myocardial infarction, arrhythmias, heart
- Stoma drainage failure, and sudden death.

ENDOMETRIAL CANCER Risk Factors:

• Increasing age
• Sex
- Caused by endometrial carcinoma and considered as the
• Heredity
fourth most common cancer in women
• Elevated blood lipids
Classification: • Sedentary lifestyle
- type 1 • Smoking
- type 2 • Obesity
• Hypertension
Risk Factors: • Diabetes mellitus
- Increased level of estrogen
- Obesity ATHEROSCLEROSIS
- Hypertension
- Nulliparity – decreased ability to dilate -> decreased blood supply - >
- Early menarche ischemia->necrosis->M1 (Troponin T&I) ->TP more effective
 ->hypoxia and acidosis->impairs function->contractility- • sputum production
>lower cardiac output • dyspnea

Diagnostic Exams: Medical Management:

• ECG 1. Pharmacologic Management – bronchodilators, most
• Echocardiography cell stabilizers, expectorants, antihistamines,
• Coronary Angiography antibiotics, steroids
• Treadmill test (TMT)
• Exercise Thallium Test – nuclear stress test • Albuterol
• Formoterol
Management/Prevention • Levalbuterol
• Monitor V/s • Cromolyn
• LSLF • nedrocomil
• Regular exam of total cholesterol level 2. Exercise
• Taking Aspirin every other day 3. Pulmonary Hygiene
• Avoidance of smoking and alcohol intake 4. Avoiding Irritants
• Promote regular exercise 5. psychological support
6. dietary management
• Limiting salt intake
7. controlling complications
• Monitor daily weight
CEREBROVASCULAR DISEASE/STROKE
*PCI – Percutaneous Coronary Intervention
*PTCA – Percutaneous Transluminal Coronary Angioplasty
o stroke – is the loss or alteration of bodily function that
*Beta Blockers
results form an insufficient supply of blood to some parts of
*Calcium Channel Blockers
the brain.
*PCl – Procedure in which catheter is placed in coronary artery to
o –Can lead to weakness/paralysis of one side of the body
remove or reduce a blockage within the artery
*PTCA – Balloon is inflated within a coronary artery to break an o death results if stroke is severe.
antheroma and open the vessel lumen to improve blood flow. o 3 types of stroke based on cause:
*Aspirin – Commonly used to treat angina and CAD. 2 tablets of o thrombotic stroke
Aspirin for stroke patients cut in fingers to decrease blood pressure o embolic stroke
o hemorphagic stroke
*thrombotic drug, streptokinase, urokinase o Risk Factors:
o Increasing age
CHRONIC OBSTRUCTIVE PULMONARY DISEASE o Sex
o Heredity
- also known as chronic obstructive lung o Hypertension
- refers to several disorders that affect the movement of air in o Cigarette smoking
and out of the lungs o Diabetes mellitus
- can occur as a result of increased airway resistance o Heart disease
secondary to bronchial mucosal edema/smooth muscle o Increased RBC count
contractions. It may be a result of decreased elastic recoil. o Season and climate
- Confirmed by spirometry (test that measures breathing) o Socioeconomic factors
o Excessive alcohol intake
Symptoms:
o Certain kind of drug abuse
• chronic cough
o S/Sx: o Race
o Change in stupor o Family history
o Difficulty of speech o Tobacco use
o Difficulty of writing or reading o Increased NAT
o Difficulty of swallowing o Not being physically active
o Headache o Decreased potassium
o Loss of coordination o Decreased Vitamin D
o Loss of balance o Increased alcohol intake
o Movement changes usually one side of the body o Stress
o n/v o Certain Chronic Conditions
o seizure o Conditions:
o sudden confusion o Constriction of blood vessels, density of blood,
o weakness of any body part condition of heart, increased blood volume
o changes in vision o Nursing Management:
o Anti-coagulants: o Advise to follow decreased sodium and decreased
o Warfarin – (coumadin) -> Vitamin K saturated fat diet
o Heparin ->protamin sulfate o Exercise
o APTT (activated partial thromboplastin time) o Avoid Stress
o Stroke Prevention o Diagnostic Procedure:
o Treatment and control of hypertension o T.ECG
o Smoking cessation and promoting a smoke free o Chest X-ray
environment o BUN and Creatinine
o Prevent thrombus formation in rheumatic heart o Renal Scan
disease and arrhythmias with appropriate medication o Renal Duplex Imaging
o Limit alcohol intake o CBC
o Avoid IV drug abuse and cocaine o Urinalysis
o Prevent all risk factors of atherosclerosis o Fasting Blood Glucose
o Diagnostic Procedures: o Medications:
o Carotid duplex o Atenolol – beta blocker
o CT Scan o Diltiazem
o Angiogram (head) o Plendil
o Lozartan
HYPERTENSION o Mentropolol – beta blocker
o Cathrophil – ACE inhibitor
o Sustained elevation in mean arterial pressure
o Malignant/secondary BRONCHIAL ASTHMA
o Essential/primary
o Signs and symptoms: o Disorder of the bronchial airways characterized by periods of
o Headache reversible bronchospasm.
o Nape ache o Often called Reactive Airway Disease
o Tinging of the ear - irreversible o Chronic inflammation caused by an association in airway
o Dizziness hyper responsiveness, that leads to episodes of wheezing,
o Risk Factors: breathlessness, chest tightness, and coughing particularly at
o Age night/in the morning.
o Diagnostic Procedure: • Ulasimang Bato
o Spirometry o Decreases uric acid (by-product of purine, which can
o Peak Expiratory Flow be found in mongo and beans)
o Chest X-ray (most reliable) o Tophi formation – if there is a big deposition of uric
o Long Term Control Medications: acid in joint
o Corticosteroids o Used for gouty arthritis and rheumatism
o Cromolyn Na • Lagundi
o Nedocromil o Multifunctional herbal meds
o Long acting beta-adrenergic agonist o Asthma
o Methyl anthines o Common cough
o Leukotriene modifiers o Fever
o Quick relief medication: o Dysentery
o Short-acting beta agonists o Skin diseases
o *status asthmaticus - irreversible o Headache
o Rheumatism
o Sprain
o Contusion
o Insect bites
HERBAL MEDICINES o Aromatic bath

• Guava (Bayabas) • Sambong

o Wounds o Anti-edema
o Diarrhea (leaves) o Diuretic agent
o toothache o Anti-urolithiasis (formation of kidney stones) +kidney
• Garlic (bawang) is a heroic organ
o For hypertension • Yerba Buena
o Toothache o Stomach ache
o Decreased cholesterol in the blood o Headache
o Consideration: take on a full stomach because it is a • Niyug-niyugan
gastric irritant o Anti-helminthic (worms)

• Ampalaya COMMUNICABLE DISEASES

o Anti-diabetes (Type II)
o Decreased sugar levels in the body Goals
• Tsaang Gubat • Prevention
o For diarrhea o Spread
• Acapulco o Recurrence
o Used as an anti-fungal (is manufactured to be green • Treatment
oil)
o Scabies 1. Filariasis
o Tinea flavis o EA: Wuchereria Bancrofti
o Tinea cruces – “jock itch” o Host: Aedes Poecilius (mosquito)
• Athlete’s Foot o S/Sx
o ringworm
 i. Asymptomatic stage: presence of progressing o for 1-4 days
microfilaria  high grade fever
ii. Acute stage: lymphadenitis (infection of the  abdominal pain (2 theories: dec. immune
lymph vessels), pain and tenderness in the response & pathogenesis)
scrotum  vomiting
iii. Chronic stage: it is still prevalent, but it lasts  conjuctival infection (immunocompromised)
10-15 years.  epistaxis (low platelet, eaten by the flavivirus
o Diagnostic Tests: physical exam, history taking, nocturnal o from 5-7 days
blood exam(look for microfilaria in the blood)  [*melena (Black and tarry stool)]
o Nursing Consideration: Always promote proper hygiene,  hematochezia (Bright red stool)
environmental sanitation, insecticide spraying.
o Medical Management: Diethyl carbonate citrate or Hetrazal
 Unstable blood pressure
 Narrow pulse pressure
V (kills almost all microfilaria)
o Diagnostic Tests:
o Surgical Management: Hydrocoelectomy in the blood
o CBC
(hydrocoele), Lymphovenous anastomosis (pagdidikit)
o Tourniquet Test (eliciting presence of petechial rash
2. Malaria by pumping cuff up to half of systolic pressure)
o EA: Plasmodium Vivax o Preventive Measure: use mosquito nets, mosquito repellants
o Host: Anopheles (Night biting Mosquito) o Nursing Interventions:
o S/Sx: o Increase fluid intake
o Fever o EDCF
o Recurrent chills o Treatment is only palliative; treating fever only, since
o Profuse sweating viruses are self limiting
4. Leprosy – Chronic communicable disease that mainly affects
o Anemia
the skin
o Malaise
o Hepatomegaly
o EA: Mycobacterium Leprae
o Spleenomegaly
o Signs and Symptoms:
o Use:
o Loss of sensation (specially. Lesion)
o House spraying
o Decreased sweating (loss)
o On stream seeding
o Larvaevorous fish – a fish that eats the larvae to
o Reddish/white skin
prevent spread o Painful nerves
o On stream cleaning (H2O lilies – remove) o Loss of hair growth
o Medical Management: o Ulcers that do not heal (decubitus)
o Sulfadoxine o Late signs:
o Quinine  Loss of eyebrows
o Quinidine  Lion face
o Tetracycline  Lagopthalmos (inability to close eyelids)
o Chloroquine o Mode of transmission: Airborne, STS
o Diagnostic Tests: slit Skin Smear (SSS)
3. Dengue Hemorrhagic Fever o Nursing Management: Supportive Care
o EA: Flavivirus o Classes:
o Host: aedes Aegypti (day-biting mosquito) o Paucibacillary – non-infectious type
o s/sx  Drug of choice:
 • Dapsone iv. Management:
• Rifampicin a. Antibiotic – cotraemoxizole (no
• Ofloxacin need for prescription)
• (three drugs are given 6-9 months b. Vitamin A
treatment) c. Avoid low blood sugar (could
o Multibacillary – infectious type precede hypoglycemia)
 Drug of Choice: o Pneumonia/Fast Breathing
• Rifampicin i. 2 mos – 12 mos old > 50 cycles per minute
• Dapsone ii. 12 mos up - > 40 cycles per minute
iii. Management:
• Clofazimine
o Antibiotics for 5 days
• (24 months to 30 months treatment, 3
o Soothe throat
drugs)
o Relieve cough
IMCI
ADPIE o No pneumonia
A- i. Cough
ii. Colds
D- iii. Without signs of pneumonia
iv. Management:
P- o Soothe throat
6. Measles
I- o Highly Communicable infection characterized by:
i. Fever
E- ii. Rashes
iii. Upper Respiratory Tract infection
Classification: o EA: rubeola
A. Sick Young Infant (1 wk-2 months) o MOT: Droplet, airborne (sometimes), direct
o Bacterial infections o Incubation Period: -10 days exposure to appearance
o Dehydration of fever, and about 14 days ‘til appearance of rash
o Diarrhea o Period of Communicability: from coryza up to 9 days
o Dysentery o Preventive Measures:
o Feeding problem i. Avoid children having contact persons with
B. Sick Child (2 mos-5 y/o) fever
o Pneumonia ii. Disinfect all articles soiled with secretions
o Diarrhea (catarrhal symptoms)
o Febrile iii. AMV
o Ear Infection o Nursing Management:
o Malnutrition i. Protect eyes from clear or strong light
o (Priests don’t feel engaging in marriage) ii. Promote adequate ventilation
iii. Sponge bath
5. Pneumonia iv. Medications as ordered (antipyretic
o Very sever disease/severe pneumonia drugs=palliative treatment)
i. Danger signs
ii. Stridor 7. Chicken Pox
iii. In drawing chest o Acute inflammatory disease
o EA: Varicella Zoster Virus
 o Signs and symptoms: iii. Headache
i. Slight fever iv. n/v
ii. Eruption v. chest pain
o Maculopapular rash – happens in few o Diagnostic Tests:
hours i. CSFA – first week
o Vesicular rash – appears in 3-4 days ii. UA – 10th day
o MOT: direct, droplet iii. CBC na rin
o IP: 2-3 days o Medical treatment:
o Period of Communicability – 1 day before vesicles i. Penicillin
appear then 6 days after ii. Tetracycline
o Prevention: iii. Erythromycin
i. Report to local authority *LI lives in CSF (lumbar puncture) and blood
ii. Isolate *CSF is 50% glucose
iii. Disinfect throat and nose discharges
iv. Exclude from school for 1 week
v. Investigate at age 15 to eliminate variola
(small pox)

8. Schistosomiasis
o EA: Schistosoma Japonicum
o MOT: skin contact (In water, foot -> oncomelercia
quadrasi<snail>
i. Highly vascular liver, where it proliferate,
feeding on blood
ii. Manganganak ang schisto sa submucosa ng
intestine -> ulcer -> butas -> tae ->water 2
mos with snail
iii. Karaniwang nagkakaroon ay farmers
o S/Sx:
i. Diarrhea
ii. Bloody stools
iii. Enlarged abdomen
iv. Spleenomegaly
v. Inflamed liver
o Medication:
i. Praziquantel (preferred)
ii. oxamniquine
9. Leptospirosis
o EA: Leptospira Interrogans (pigs, cattle, rabbits, rats
– common)
o MOT: Skin contact
o IP: 7-19 days, average of 10 days
o S/Sx:
i. Fever
ii. Cough