COMMUNITY HEALTH NURSING 12 Cranial Nerves

1 O Olfactory Sensory
Primary Goal: 2 O Optic Sensory
o Health in the hands of the people. 3 O Oculomotor Motor
4 T Trochlear Motor
Ultimate Goal: 5 T Trigeminal MIXED
o To raise the level of health of the citizen. 6 A Abducens Motor
7 F Facial MIXED
Community: 8 A Auditory Sensory
• Group of people interacting with each other. 9 G Glossopharyngeal MIXED
• Sharing common values, interests, and goals. 10 V Vagus MIXED
Health: 11 A Spinal Accessory Motor
• Optimum level of functioning. 12 H Hypoglossal Motor
• State of complete physical, mental, and social
well-being.
Nursing: VACCINES
• Art and science of rendering care.
– An act of assisting the sick and the well. Bacillus Calmette–Guerin Vaccine (BCG)
- At birth (1st 2 months of life)
3 Types of Community - Intradermal (Deltoid) (10° - 15° degree angle
▪ Urban = High View of Health Needle Position)
▪ Rural = Agricultural community - <12 months = 0.05mL
▪ Suburban = Mixed type - >12 months = 0.1mL

EPI\NIP Purified Protein Derivative (PPD) skin test

- 48 – 72 hours (2 – 3 days)
RA 10152: Mandatory Infants and children health Results:
immunization act of 2011. • 5mm (+) Positive
• All vaccines are free for children <5 years old. • 10mm High-Risk (+) Positive
• 15mm Low Risk (+) Positive
PD 996: To provide basic immunization services to all
preschool and primary school entrants who have not Drug of Choice
received such immunization
Drugs Side Effects
COLD CHAIN LOGISTICS
- To preserve the potency of the Vaccines. R Rifampicin Red-orange urine

MOST SENSITIVE TO LESS SENSITIVE TO I Isoniazid Peripheral Neuropathy

HEAT HEAT P Pyrazinamide Hepatotoxic
Measles Tetanus Toxoid
OPV DPT E Ethambutol Optic Neuritis
Put on freezer = -15°C to S Streptomycin Ototoxic
Hepa B
-25°C
BCG
Body of refrigerator = TB (Tuberculosis)
+2°C to +8°C Causative Agent: Mycobacterium TB
Mode of Transmission:
o PNLE / Droplet
Formula:
o NCLEX / Airborne Droplet
 C° - (1.8 X C°+32=)
 F° - (32-F°/1.8=)
Diagnostic Tests for TB:
o PPD
Schedules
o X-Ray
▪ Every WEDNESDAY is Immunization Day.
o Sputum Smear – Confirmatory Test
▪ Every THURSDAY is TT Day.
Hepatitis B Vaccine (Hepa B)
- At birth (1st 24 hours)
Storage of Vaccines
- Intramuscular (Vastus Lateralis)
o Regional – 6 months
- (90° degree angle Needle Position)
o City\Municipality – 3 months
- Dose = 0.5mL
o Health Center – 1 month
- Give HBIG the first 12hrs. (0.5mL) if the mother is
Hepa B positive.
Note: Check vaccine temperature twice a day, once in the
morning and once in the evening
Pentavalent Vaccine 1
- At 6 weeks
- Intramuscular (Vastus Lateralis)
- Dose = 0.5mL
- Diphtheria, Pertussis, Tetanus, Hepatitis B
(DPTH)
- Hemophilus influenzae type B
Pneumococcal Conjugate Vaccine 1
LIVE ATTENUATED INACTIVATED
- At 6 weeks
- Intramuscular (Vastus Lateralis) BCG Hepa B Vaccine
- Dose = 0.5mL
Rotavirus Vaccine Pentavalent Vaccine
Inactive Polio Vaccine
- At 6 weeks Measles Vaccine PCV
- Intramuscular (Vastus Lateralis) JEV IPV
- Dose = 0.5mL MMR Vaccine Influenza Vaccine
Varicella Vaccine Hepa A Vaccine
Rotavirus Vaccine 1
- At 6 weeks
- Oral
MATERNAL SUPPLEMENTATIONS
- 2 types: RV1, RV5
• RV1: Rotarix Tetanus Toxoid
o 2 doses
o 1mL\ dose
o Give an additional 1 dose if the patient % of Yrs. Of
Vaccine Interval
vomited Protection Protection
• RV5: Rota Teq
o 2 doses ASAP (During
TT1 0% 0
o 2mL\ dose Pregnancy)
o No additional dose if the patient TT2 1 month 80% 3 years
vomited
TT3 6 months 95% 5 years
Pentavalent Vaccine 2 TT4 1 year 99% 10 years
Pneumococcal Conjugate Vaccine 2 TT5 1 year 99% Lifetime
Inactive Polio Vaccine
Rotavirus Vaccine 2
- At 10 weeks (Same Considerations) Vitamin A Supplementation
Pregnant:
Pentavalent Vaccine 3 • Dose = 10,000 IU X 2\ week
Pneumococcal Conjugate Vaccine 3 • Start 4 months from pregnancy until delivery.
Inactive Polio Vaccine • Vitamin A = Retinol
Rotavirus Vaccine 3
- At 14 weeks (Same Considerations) Pregnant with Xeropthalmia:
• Dose 10,000 IU\ week
Influenza Vaccine 1 • Give once a day for 4 weeks.
- At 6 months
- Intramuscular, Subcutaneous (Vastus Lateralis) Post-Partum:
- Trivalent (Both) – Dose = 200,000 IU (one dose)
- Quadrivalent (Intramuscular) – Give within 4 weeks after delivery.
- Dose = 6 months – 35 months: 0.25mL
= 36 months – 18 years: 0.5mL Iron Supplementation
Measles Vaccine - To prevent neural tube defects - folic acid
- At 9 months (2nd dose – after 6 months) Pregnant
- Subcutaneous (Outer Portion of Upper Arm) – Dose = 60mg with 400mg Folic Acid
- Dose = 0.5Ml – Give 1 tablet once a day for 6 months
- 85% Protected
Lactating:
Japanese Encephalitis Vaccine – Dose = 60mg with 400mg Folic Acid
- At 9 months (Booster dose – after 12 years) – Give 1 tablet once a day for 3 months
- Subcutaneous (Outer Portion of Upper Arm) Schedule of Clinical Visits
- Dose = 0.5mL • ASAP after a missed period (1st visit)
- 9 to 17 yrs, old (Primary Dose) • 4 weeks to 28 weeks (Once a week)
- 18 yrs. Old and above (Single Dose Only) • 28 weeks to 36 weeks (Every 2 weeks)
• 37 weeks to delivery (Every week)
Mumps, Measles, Rubella Vaccine (MMR)
- At 12 months (2nd dose – after 4-6 yrs. old) BBREASTFEEDING
- Subcutaneous (Outer Portion of Upper Arm) – Colostrum is rich in secretory immunoglobulin A
- Dose = 0.5mL (IgA), which helps to protect the infant from
infection. Colostrum also helps to establish a
Varicella Vaccine normal gut microbiome in the infant. The bowel is
- At 12 months (2nd dose – after 4-6 years old) considered sterile at birth.
- Subcutaneous (Outer Portion of Upper Arm) – Breastfeeding can help protect babies against
- Dose = 0.5mL some short- and long-term illnesses and
diseases. Breastfed babies have a lower risk of
Hepatitis A Vaccine (Hepa A) asthma, obesity, type 1 diabetes, and sudden
- At 12 months (2nd dose – after 6 months) infant death syndrome (SIDS).
- Intramuscular (Vastus Lateralis)
- Dose = 0.5mL
 LEVELS OF CLIENTELE Modifiability of the Problem
- Easily modifiable =2
▪ Individual: Point of entry in the community. - Partially modifiable =1
▪ Family: Bounded by birth, marriage, blood, - Not modifiable =0
adoption, and emotions. Preventive Potential
B – Basic unit of the society - High =3
F – Focus of care - Moderately =2
U – Unit of service - Low =1
Salience of the Problem
Types of Family - Serious problem = 2
o Nuclear - A problem =1
o Extended - Not a felt problem =0
o Blended
o Intergenerational
o Cohabitational EPIDEMIOLOGY
o Dyad  Study of health and illness
Community  Backbones in the prevention of the disease
– Primary client in the community.
– Focus of CHN  Sporadic
- Seasonal
 Municipal – Mayor - Occasional (On\Off)
 Provincial – Governor - Intermittent
▪ Primary Focus– Health Promotion  Endemic
▪ Primary responsibility– Health Education - Constant
▪ Fundamental Hallmark of Nursing - Continuous
Responsibility– Right documentation Example:
▪ Role– Facilitator
DENGUE MALARIA
▪ Population
• Group of people with distinct ways or patterns of Day Biting Night Biting
life. Low Flying High Flying
• e.g., elderly, adolescents, toddlers, etc. Stagnant Running
Urban Rural
PUBLIC HEALTH NURSING

Goal:  Epidemic
- To enable every citizen to realize his birthright of - Sudden increase in numbers
health and longevity. - Outbreak
- Location-based
3P’s
- Promote health  Pandemic
- Prevent disease - Worldwide epidemic
- Prolong life

Objectives of PHN COPAR

o C – Control of communicable disease
o O – Organization of Medical and Nursing ▪ C – Community
services ▪ O – Organizing.
o D – Development of social machinery ▪ P – Participatory
o E – Education of individual, family, and ▪ A – Action
community ▪ R – Research.
o S – Sanitation of the environment
Goal of COPAR:
o Social transformation
Criteria for Prioritization of Health o Active Participation
• Nature of the problem
• Modifiability of the problem Community Organizing:
• Preventive potential - Identify, plan, and solve the problem
• Salience of the problem Participatory Action Research:
- Approach: “Active participation”
Nature of the Problem - Investigation of the Problem
o Health deficit = 3 Role of a nurse: Facilitator
- Existing problem Role of the people: Leaders
- Disability; a gap between actual and
achievable health status. Phases of COPAR
o Health threat =2 ▪ Pre-entry
- Risk or potential problem ▪ Entry
- Conditions conducive to acquiring the ▪ Study\diagnosing
disease. ▪ Organizing
o Foreseeable crisis =1 ▪ Action
- Anticipated period of unusual demand. ▪ Sustenance and Strengthening
- Needs adaptation or adjustment within the ▪ Turn over
family circle.
Pre-Entry Phase R.A. 9482 Anti-Rabies Act of 2007
- “Site selection” R.A. 6425 Comprehensive Dangerous Drug Act of 2002
- Preliminary social investigation Mandatory Reporting of Notifiable Diseases
- Community consultations R.A. 3573 and Health Events of Public Health Concern
- Community assembly Act
Criteria for Site Selection
D – Depressed
O – Oppressed CHN BAG
P – Poor
E – Exploited Bag Technique
S – Struggling, Safe - An indispensable tool used by the
nurse with ease and deftness.
Entry Phase Public Health Bag
- “Core group formation” - Essential and indispensable
- Courtesy call (Leaders) equipment of a public health nurse.
- Information campaigns Principles:
- Continuing social investigation • Minimize, if not, prevent the spread of infection.
- SALT • Effectivity of total care must be shown.
o Characteristics of Leaders • Save time and effort.
P – Poor • Avoid contamination.
R – Respected • Handwashing.
C – Communicator
D – Desire for change RATIONALE: To render total and effective nursing care.
O – Open-minded
C – Charismatic Considerations: 3C
- Content
Study\Diagnosis Phase - Cleanliness
- “Data\Study\Research” - Contamination
- Research phase
- Start of PAR Work field – Paper-lining touch
- Community profiling ❖ Inner surface: CLEAN
- Data analysis ❖ Outer surface: UNCLEAN
- Community diagnosis
- Prioritization of community needs HOME VISIT
o Purposeful, professional nurse-client face-to-face
Organization Phase interaction for the provision of various health care and
- “Form community health organization” nursing services.
- Capability phase o It is the best method of evaluating long-term care.
- Election of officers
- Training of officers Principles: PIN+O
- Plan a solution for the problem P – Plans must be flexible \ practical
I – Information available must be utilized
Action Phase N – Needs of the family should be the priority
- “Form Community Health Workers” + – Add or involve the family
- Activities to solve the problem O – Objectives and purpose must be present
- Exercise people’s power
- Setting up for linkages\network referral Purpose:
system • Give nursing care
- PIME - Newborn
- Post-partum
Sustenance\Strengthening Phase - Pregnant
- Formalization of linkages - Sick individuals
- Continue training and education • To assess the living conditions
- Develop and maintain medium and • To establish close-relationships
long-term CHD plans • To promote the utilization of community services
Turn-over Phase Steps in Home visit:
- Check the structure 1. Extend courtesy through a greeting.
- Monitor development 2. Introduce yourself.
- Phase out 3. Provide an overview of the purpose of visit.
4. Look for the client and observe.
LAWS 5. Explore the health needs.
Traditional & Alternative Medicine Act (TAMA 6. Place the bag in a convenient place.
R.A. 8423 7. Perform nursing procedure
1997)
Universal Accessible Cheaper and Quality - Bag technique
R.A. 9502 - Health assessment
Medicines Act of 2008
- Provide health teaching
Philippine AIDS Prevention and Control Act
R.A. 8504 8. Wash hands thoroughly and
of 1998
9. Documentation.
Act on Salt Iodization Nationwide (ASIN
R.A. 8172 10. Set an appointment for the next visit.
LAW)
R.A. 9211 Tobacco Regulation Act of 2003
P.D. 856 Code on Sanitation of the Philippines
Anti-Violence Against Women and their
R.A. 9262
Children Act of 2004
BENEDICT’S TEST: Crude Birth rate – Measure of natural growth increase
– To test simple carbohydrates and glucose in uric. in population.

Steps – Get the tube Total # of births

– Mix 8-10 drops of urine and 5mL of --------------------- X 1,000
Benedict’s solution. Population
– Heat the mixture with the alcohol lamp.
– Interpret the results. Crude Death rate – Measure of mortality from all causes
decrease in population.
BLUE 0
GREEN 0.5% Total # of Deaths
YELLOW 1% ----------------------- X 1,000
ORANGE 1.5% Population
BRICK RED 2% OR MORE
Infant Mortality rate – Measure of risk of dying during
the 1st year of life.
HEAT ACETIC ACID TEST: – To assess general health
condition of a community.
- To check albumin protein in urine.
Steps – Get the tube. Total # of deaths under 1 year
– Fill with 1\3 Acetic acid and 2\3 urine. ---------------------------------------- X 1,000
– Heat the mixture with the alcohol lamp. Live births
– Interpret the results.
Maternal Mortality rate – Measure of risk of dying from
No cloud (-) pregnancy, childbirth and puerperia.
Faint cloud (+1) – To assess obstetrical care
needed and received by
Heavy cloud (+2) women.
Opaque cloud (+3)
Total # of deaths from maternal causes
---------------------------------------------------- X 1,000
LEVELS OF HEALTHCARE FACILITIES Live Births

Primary – Barangay Health Station Fetal Death rate – Measure of pregnancy wastage.
– Rural Health Unit
– Puericulture Center Total # of fetal deaths
– Community Hospital ----------------------------- X 1,000
– Lying-in Live births
– City Health Office
Neonatal Death rate – Measure of risk of dying 1st
Secondary – Public Hospital month of life.
– Emergency Hospital Total # of deaths under 28 days
– District Hospital ------------------------------------------ X 1,000
– City Hospital Live births

Tertiary – General Hospital Attack rate – a more accurate measure of risk of

– Regional Hospital exposure.
– Medical Center Total # persons acquiring a disease
– National and Trading Hospital ------------------------------------------------ X 100
– Teaching Hospital # Of exposed to same disease
– Specialized Unit
Case Fatality ratio – measure of killing power of a
Types of Public Health Workers disease.
• Village \ Barangay Health Worker Total # deaths on specific disease
- Grassroot ---------------------------------------------- X 100
- Trained individuals # Of case from same disease
• Intermediate Health Worker
- Professional individuals
DEPARTMENT OF HEALTH
VITAL STATISTICS
Roles and Function
Systematic study of vital elements • Leadership in Health
• Enabler and capacity builder.
➢ Births
➢ Deaths • Administrator of specific services.
➢ Marriages
➢ Divorce Primary function – Promotion of health for the people.
➢ Illness Vision
- Filipinos are among the healthiest people in the
Sources of Data Southeast Asia by 2022 and Asia by 2040.
Mission
- Population census - To lead the country in the development of a
- Registration of Vital data productive, resilient, equitable and people-
- Health survey centered health system.
- Studies and research
Overrides Goal – Health sector reform agenda • Adequate food and proper nutrition
Describes the Major SOP: • Provision of medical care and emergency
– S – Strategies treatment
– O – Organization • Provision of essential drugs
– P – Policies
4 Pillars \ Cornerstone
Framework for implementation of HSRA – FOURmula • Active community participation
ONE for Health • Intra and Inter-sectoral linkages
• Use of appropriate technology
GOALS – Better health outcomes • Support mechanism unavailable
– Equitable health care financing
– More responsive health systems
INTEGRATED MANAGEMENT OF CHILDHOOD
4 Elements of Strategy ILLNESS (IMCI)
1. Health Financing
- To foster greater, better, and sustained – 2 months – 5 years
investments in health.
- Philippine Health Insurance Corporation and General Danger Signs
Department of Health.
 C – Convulsions
2. Health Regulation
 U – Unable to drink or breastfeed
- To ensure the quality and affordability of health
 V – Vomiting
goods and services.
 A – Abnormally Sleeping
3. Health Service Delivery
- To ensure the accessibility and availability of basic GENERAL DANGER SIGNS
health services. URGENT ATTENTION
4. Good Governance VERY SEVERE DISEASE - REFER URGENTLY!
- To enhance health system performance at the
national and local levels. - PNEUMONIA
Does the child has cough or DOB?
Primary Health Care Count the breaths in 1 min
- Is essential health care made universally Assess for:
accessible to individuals and families. o Chest indrawing
o Stridor
HISTORY o Wheezing

1st International Conference of PHC Note: CHILD MUST HE CALM

Venue – Alma Ata, USSR
Date – September 6-12, 1978 FAST BREATHING
Sponsor – World Health Organization, UNICEF 2 MONTHS- 12 MONTHS - 50 bpm or more
Representative – Dr. Dizon 1 YR - 5 YRS - 40 bpm or more
– Dr. Villar
Note: GS = General Danger Sign

LEGAL BASIS CLASSIFY

GS (any)
Letter of Instruction 949 Stridor
Signed by: President Ferdinand Marcos Sr. SEVERE PNEUMONIA
Date: October 19, 1979 VERY SEVERE DISEASE
o 1ST DOSE ANTIBIOTIC
GOAL – Health for all Filipinos and Health in the Hands o REFER URGENTLY!!!
of the people by the year 2020.
MISSION - CLASSIFY
- To strengthen the health care system wherein Chest indrawing
people will manage their own healthcare. Fast breathing
Concept \ Strategies PNEUMONIA:
- Partnership and empowerment towards self- o Oral Amoxicillin for 5 days
reliance. o Wheezing: Bronchodilator for 5 days
o Cough (>14 days), Refer for TB ass.
7 Principles of PHN o Recurrent wheezing,
o Decentralization o Refer for asthma ass.
o Social participation o Safe remedy
o Community participation
o Recognition between health and government CLASSIFY
o Accessibility and availability of health service No signs of DOB
o Provision of quality basic health services Or very sever disease
o Self-reliance COUGH OR COLD:
o Wheezing: Bronchodilator for 5 days
Elements o Cough (>14 days), Refer for TB ass.
• Treatment of locally endemic diseases. o Recurrent wheezing, Refer for asthma ass.
• Immunization o Safe remedy
• Maternal and Child health and family planning.
• Environmental sanitation
• Control of communicable disease
• Health Education
 - DEHYDRATION o Treat dehydration
Does the child have diarrhea o Refer to hospital
o If with other severe class:
CLASSIFY o Refer URGENTLY!
- Sunken eyes
- Unable to drink/drink poorly CLASSIFY
- Skin pinch goes back VERY SLOWLY NO DEHYDRATION
- Unconscious o PERSISTENT Give minerals (zinc) for 14 days
o DIARRHEA FFUP: 5 DAYS
SEVERE DEHYDRATION o ZING SUPPLEMENTATION
o No other severe class: Plan C o 2 mos to 6 mos ½2 TAB OD for 14 days
o If with other severe class: o 6 mos or more 1 TAB OD for 14 days
o Refer Urgently with mother giving
o ORS on the way - DYSENTERY
o Advise to cont. BF
CLASSIFY
PLAN C: BLOOD IN THE STOOL
- Give 100ml/kg of PLR If not available, give PNSS. o Give Ciprofloxacin for 3
Under 12 months o DYSENTERY days
o 30 ml/kg = 1 HOUR
o 70 ml/kg = 5 HOURS CIPROFLOXACIN ADMINISTRATION
Above 12 months - 15 mg/kg BID for 3 days
o 30 ml/kg = 30 MINS - Less than B months
o 70 ml/kg = 2½ HOURS - 250 mg/tab: ½ tab
- 500 mg/tab: ¼ tab
What if I can't give IV? - 6 months to 5 yrs
REFER URGENTLY TO THE HOSPITAL (if within 30 - 250 mq/tab: 1 tab
mins nearby) Instruct mother to give ORS on the way
- MALARIA
What if no hospital 30 mins nearby? Does the child has fever?
Give ORS by NGT (or mouth) 20 ml/kg/hr for 6 hours
TOTAL: 120 ml/kg CLASSIFY
- After 6 hours, reassess the child. HIGH OR LOW MALARIA RISK

What if I'm not trained to insert NGT? CLASSIFY

Refer URGENTLY to the nearest hospital for IV and NGT GS (any)
treatment. Stiff neck
VERY SEVERE FEBRILE DISEASE
CLASSIFY o Give first dose of artesunate/quinine
o Drinks eagerly, thirsty o Give first dose of antibiotic
o Irritable, restless o Give one dose of paracetamol (38.5 °C or above
o Sunken eyes o Refer URGENTLY!!!
o Skin pinch goes back SLOWLY
CLASSIFY
SOME DEHYDRATION: POSITIVE MALARIA TES
o Give fluid, Zinc, and Food (PLAN B) MALARIA
o If with other severe class: o Give oral antimalarial
o Refer Urgently with mother giving o Give appropriate antibiotic
o ORS on the way o Give one dose of paracetamol (38.5
o Advise to cont. o °C or above
o BF FF UP: 5 DAYS o If fever is present › 7 days, REFER
o FF up: 3 days (if fever persist)
PLAN B
- Up to 4 months = 200-450 ml CLASSIFY
- 4 months-12 months = 450-800 ml NEGATIVE MALARIA TEST
- 1yr to 2 yrs = 800-960 ml o Other cause of fever present
- 2 yrs to 5 yrs = 960-1600 ml o FEVER: NO MALARIA
o Give appropriate antibiotic
CLASSIFY o Give one dose of paracetamol (38.5
NOT ENOUGH SIGNS o °C or above
NO DEHYDRATION: o If fever is present » 7 days. REFER
Give fluid, Zinc, and Food (PLAN A) FF UP: 5 DAYS o FF up: 3 days (if fever persist)

PLAN A CLASSIFY
- Give ORS MASTOIDITIS
- Up to 2 YRS o Tender swelling behind ear
o 50 TO 100 ML FOR EACH LOOSE STOOL o Give first dose of antibiotic
- 2 yrs to 5 yrs o Give first dose paracetamol
o 100 ML TO 200 ML FOR EACH LOOSE o Refer URGENTLYIII
STOOL

CLASSIFY
DEHYDRATION IS PRESENT
SEVERE PERSISTENT DIARRHEA:
o No other severe class:
 CLASSIFY - wash hands and kitchen utensils before and after
ACUTE EAR PAIN preparing food
o Pus is draining < 14 days Ear paín - sweep kitchen floors to remove food droppings
o Sim antibiotic for 5 days
o Give paracetamol for pain 3. Right cooking
o Dry the ear by wicking - cook food thoroughly and ensure that temperature on all
o FF up: 5 days parts of the food should reach 70 degrees centigrade
- eat cooked food immediately
CLASSIFY - wash hands thoroughly before and after
o No ear pain
o NO EAR INFECTION 4. Right storage
o NO TREATMENT - Cooked foods should not left at room temperature for
NOT more than 2 hours
WATER SUPPLY SANITATION PROGRAM - store foods carefully: 4 -5 hours hot conditions: at least
or above 60 degrees centigrade cold conditions: below or
Approved type of water supply facilities: equal to 10 degrees centigrade
LEVEL I (Point Source) - do not overburden the refrigerator
- a protected well or a developed spring with an - reheat stored food before eating
outlet but without a distribution system. -at least 70 degrees centigrade
- serves 15 to 25 households
- outreach must not be more than 250 meters from Rule in Food Safey:
the farthest user “WHEN IN DOUBT, THROW IT OUT”

LEVEL II (Communal Faucet System or Stand-Posts)

- a system composed of a source, a reservoir, a piped MEDICINAL PLANT- SANTA LUBBY
distribution network and communal faucets. With one
faucet per 4-6 households ▪ S- Sambong
- located at not more than 25 meters from the farthest – Anti-edema
house – Diuretic
– Anti-urolithiasis
LEVEL III (Waterworks System or Individual House
Connections) ▪ Ampalaya
- a system with a source, a reservoir, a piped distributor – Diabetes Mellitus
network and household taps, generally suited for densely
populated urban areas requires minimum treatment or ▪ N- Niyug-niyogan
disinfection – Anti-helminthic

PROPER EXCRETA AND SEWAGE ▪ T- Tsaang Gubat

DISPOSAL PROGRAM – Stomachache
Approved types of toilet facilities: – Tsaang gubat
– Diarrhea
LEVEL I - Non-water carriage toilet facility – no water is
necessary to wash the waste into the receiving space. ▪ Akapulko
– Anti-fungal
Ex. Pit latrines, Reed odorless earth closet Toilet facility
requiring a small amount of water to wash the waste into ▪ L- lagundi (Vitex Negundo)
the receiving space. – S-kin diseases
Ex. Pour flush toilet, Aqua privies – H-eadache
– A-sthma, cough and fever
LEVEL II - on site toilet facilities of the carriage type with – R-heumatism, sprain, insect bites
water-sealed and flushed type with septic tank/vault – E-czema
disposal facilities – Dysentery

LEVEL III - water carriage types of toilet facilities ▪ U-Ulasimang bato

connected to septic and/or to sewerage system to – Uric acid excretion
treatment plant
▪ B- Bawang
– Hypertension
FOOD SANITATION PROGRAM (to lower cholesterol levels in the blood)
– Toothache
FOUR RIGHTS IN FOOD SAFETY:
▪ B- Bayabas/ Guavas
1. Right source – Diarrhea
- Always buy fresh meat, fish, fruits and vegetables – Washing of wounds
- check for expiry dates of processed foods – Gargle to relieve toothache
- avoid buying canned foods with dents, bulges,
deformation, broken seals and improper seams ▪ Y- Yerba Buena
- use clean and safe water – S-wollen gums
- if doubt of water source – boil water for at least 2 minutes – P-ain
– I-nsect bites
2. Right preparation – T-oothache
- avoid contact between raw and cooked foods – M-enstrual and gas pain
- Always buy pasteurized milk and fruit juices – A-rthritis
- wash vegetables well if eaten raw – N-ausea and fainting
– D-iarrhea
Reminders on the Use of Herbal Medicine ▪ O- OVULATION METHOD
This method involves tracking changes in cervical mucus
1. Avoid the use of insecticides. to identify the fertile period when ovulation is likely to
2. Use a clay pot and remove cover while boiling at low occur.
heat. ▪ L- Lactational Amenorrhea Method (LAM)
3. Use only the part of the plant being advocated. This method relies on exclusive breastfeeding and the
4. Follow accurate dose of suggested preparation. suppression of ovulation that occurs during breastfeeding
5. Use only one kind of herbal plant for each sickness. to provide temporary contraception in the postpartum
6. Stop giving in case with untoward reaction. period.
7. If signs and symptoms are not relieved after 2 or 3 ▪ T - Two-Day Method
doses, consult a doctor This method involves checking cervical mucus for two
consecutive days to identify the presence of fertile mucus,
FAMILY PLANNING indicating the possibility of ovulation and fertility.
Standard Days Method (SDM)
FAMILY PLANNING This method relies on exclusive breastfeeding and the
Family planning is far more than simply birth control, and suppression of ovulation that occurs during breastfeeding
aims at improving the quality of life for everybody. to provide temporary contraception in the postpartum
Family planning is an important part of primary healthcare period.
and includes:
ARTIFICIAL FAMILY
OBJECTIVES PLANNING REMEMBER:
▪ P - Promote reproductive health: CAPSULE
Family planning aims to promote reproductive health by
providing individuals and couples with the information and ▪ C- Condom
services they need to make informed decisions about This method involves the use of a barrier device, usually
their sexual and reproductive lives. made of latex or polyurethane, to prevent sperm from
▪ R - Reduce unintended pregnancies: reaching the egg during sexual intercourse
One of the main objectives of family planning is to reduce A- Abstinence
the number of unintended pregnancies through the use of This method involves refraining from sexual intercourse
contraception methods and education on their effective as a means of contraception.
use. ▪ P- Pills
▪ E - Enhance maternal and child health: This method involves the use of oral contraceptive pills,
Family planning helps to improve maternal and child which contain hormones to prevent ovulation and alter the
health outcomes by spacing pregnancies appropriately, cervical mucus, making it difficult for sperm to reach the
reducing the risks associated with closely spaced egg.
pregnancies, and ensuring women have access to ▪ S- Sterilization
prenatal and postnatal care. This method involves permanent surgical procedures to
▪ V - Voluntary and informed choice: block or interrupt the fallopian tubes in women (tubal
Family planning emphasizes the importance of individuals lIgation) or the vas deferens in men (vasectomy),
and couples making voluntary and informed choices preventing sperm and egg from meeting.
about their reproductive health, including the decision to ▪ Intra U-terine Device
use contraception or have children. This method involves the insertion of a small T-shaped
▪ E - Empower women and girls: device into the uterus. It can be hormonal or non-
Family planning plays a crucial role in empowering hormonal and works by preventing fertilization and
women and girls by giving them control over their implantation of the fertilized egg.
reproductive lives, lives, enabling them to pursue ▪ L - Long-acting Reversible Contraceptives
education, employment, and other opportunities, and (LARCs)
reducing gender inequalities. This category includes contraceptive methods that
▪ N - Normalize healthy family sizes: provide long-term protection against pregnancy.
Family planning encourages the concept of healthy family Examples include hormonal implants
sizes, ensuring that families have the resources and and hormonal intrauterine devices (IUDs).
support they need to provide for the well-being of their ▪ E - Emergency Contraception
children and achieve their desired quality of life. This method involves the use of high-dose hormonal pills
▪ T - Tackle population growth and environmental or copper IUD within a specific time frame after
concerns: unprotected intercourse to prevent pregnancy.
Family planning contributes to addressing population
growth and environmental concerns by helping to stabilize
population growth rates, reducing strain on resources,
and promoting sustainable development.

REMEMBER THE MNEMONICS PREVENT

NATURAL FAMILY
PLANNING REMEMBER:
F-BOLTS

F - Fertility Awareness Method (FAM)

This method involves tracking and interpreting changes in
a woman's body to identify fertile and infertile days. It
includes monitoring basal body temperature, cervical
mucus, and menstrual cycle patterns.
B- Billings Ovulation Method (BOM)
This method focuses on monitoring changes in cervical
mucus throughout the menstrual cycle to identify fertile
and infertile days.
 COMMUNICABLE DISEASE NOTE: Patient should be advised to stay well hydrated
and to avoid aspirin (acetylsalicylic acid)
A disease where an infectious agent spreads from one
host to another, either directly or indirectly. 2. Communicable Disease: Filariasis
BOARD EXAM QUESTION Causative Agent: Wunchereria Bancrofti
A disease that easily spreads from one person to another Vector:
is known as? INFECTIOUS DISEASE • Africa: Anopheles
• America: Culex
Chain of Infection • Asia: Aedes and Mansonia
Incubation Period: 10 – 12 Months
Diagnostic Tests: Blood Smear
Drug of Choice: Diethylcarbamazine

3. Communicable Disease: Leptospirosis (Weil’s

Disease)
Causative Agent: Leptospires (Spirochetes)
Vector: Animal Urine
Incubation Period: 5 – 14 Days
Diagnostic Tests: Leptospira Agglutination Test
Drug of Choice: Penecillin G.

4. Communicable Disease: Malaria

Causative Agent: Plasmodia
Vector: Female Anopheles Mosquito
INFECTIOUS AGENT Incubation Period: 7 – 30 Days
Infectious agents (pathogens) include not only bacteria Diagnostic Tests: Malarial Blood Smear
but also viruses, fungi, and parasites. The virulence of Drug of Choice: Chloroquine
these pathogens depends on their number, their potency,
their ability to enter and survive in the body, and the 5. Communicable Disease: Bacterial Meningitis
susceptibility of the host. Causative Agent:
• Neisseria Meningitis
RESERVOIR • Streptococcus Pneumonia
A reservoir is any person, animal, arthropod, plant, soil or • Haemophilus Influenza
substance (or combination of these) in which an infectious Vector:
agent normally lives and multiplies. The infectious agent Incubation Period: 3 – 4 Days with a range of 2 – 10 Days
depends on the reservoir for survival, where it can Diagnostic Tests: Spinal Tap
reproduce itself in such manner that it can Drug of Choice:
be transmitted to a susceptible host. • Penecillin
▪ Animate reservoirs include people, insects, birds, • Ampicillin
and other animals. • Ceftriaxone
▪ Inanimate reservoirs include soil, water, food,
feces, intravenous fluid, and equipment. 6. Communicable Disease: Poliomyelitis
Causative Agent: Legio Debilitants
PORTAL OF EXIT Vector: Feces of Infected Person
Portals of exit is the means by which a pathogen exits Incubation Period:
from a reservoir. For a human reservoir, the portal of exit • Non Paralytic Poliomyelitis: 3 – 6 Days
can include blood, respiratory secretions, and anything • Paralytic Poliomyelitis: 7 – 21 Days
exiting from the gastrointestinal or urinary tracts. Diagnostic Tests: Pandy’s Test
Drug of Choice: NO CURE
MODE OF TRANSMISSION
Refers to how an infectious agent, also called a pathogen, 7. Communicable Disease: Tetanus
can be transferred from one person, object, or animal, to Causative Agent: Clostridium Tetany
another. Vector:
• Direct transfer of Clostridium Tetany spores from
PORTAL OF ENTRY soil and excreta of animals and humans to
Infectious agents get into the body through various portals wounds and cuts.
of entry, including the mucous membranes, non-intact Incubation Period: 3 – 21 Days (Average: 8 Days)
skin, and the respiratory, gastrointestinal, and Diagnostic Tests:
genitourinary tracts. Drug of Choice: Metrodinazole
SUSCEPTIBLE HOST 8. Communicable Disease: Schistosomiasis
The final link in the chain of infection is a susceptible host, Causative Agent: Schistosoma Japonicum
someone at risk of infection. Infection does not occur Vector: Transmitted by Water Snails
automatically when the pathogen enters the body of a Incubation Period: 14 – 84 Days
person whose immune system is functioning normally. Diagnostic Tests: Urine and Stool Examination for Ova
Drug of Choice: Praziquantel
COMMUNICABLE DISEASES
9. Communicable Disease: Typhoid Fever
1. Communicable Disease: Dengue Hemorrhagic Causative Agent: Salmonella Typhosa
Fever Vector: Contaminated Food and Water
Causative Agent: Flaviviridae Incubation Period: 6 – 30 Days
Vector: Aedes Aegypti Diagnostic Tests: Blood, Urine, and Stool Examination
Incubation Period: 2 - 7 days Drug of Choice: Chloramphenicol
Diagnostic Tests: Tourniquet test
 1. AMOEBIASIS GASTROINTESTINAL SUITABLE AND INCLUSIVE MILESTONES
2. CHICKEN POX RESPIRATORY o USE OF GENERICS
3. CHOLERA GASTROINTESTINAL o PHILHEALTH
4. DIPHTERIA RESPIRATORY o MILK CODE
5. GONORRHEA REPRODUCTIVE o GOOD GOVERNANCE PROGRAMS
6. HEPATITIS A GASTROINTESTINAL o FUNDING FOR UHC
7. HEPATITIS B BLOOD o FISCAL
8. HIV BLOOD o AUTONOMY
9. INFLUENZA RESPIRATORY o FOR GOV'T HOSPITALS
10. MEASLES RESPIRATORY o DEVOLUTION
11. PNEUMONIA RESPIRATORY o DOH RESOURCES
12. PTB RESPIRATORY
13. SYPHILIS REPRODUCTIVE PERSISTENT INEQUITIES
14. THYPHOID GASTROINTESTINAL - Every year, 2000 mothers die due to pregnancy-
related cx.
1. KOPLIKS SPOTS MEASLES - A child from the poorest family is 3 times more
2. HYDROPHIBIA RABIES likely. Not reach their 5th birthday
3. LANDRY'S SIGN POLIOMYELITIS - Every year, 1.5 families are pushed into poverty
4. LOCK JAW TETANUS due to healthcare expenditures
5. HANSEN'S DSE. LEPROSY - 3 out of 10 children are STUNTED
6. ROSE SPOTS TYPHOID FEVER - Php 4,000 per month health care expenses are
7. ACUTE PAROTITIS MUMPS considered catastrophic.
8. RICE WATERY STOOL CHOLERA
9. MORNING DROP GONORRHEA ALL FOR HEALTH –TOWARDS HEALTH FOR ALL
10. NIGHT SWEATS PULMONARY TB Lahat Para sa Kalusugan! Tungo sa Kalusugan Para
sa Lahat

➢ UNIVERSAL HEALTH COVERAGE

BOARD EXAMS QUESTIONS ➢ STRENGTHEN IMPLEMENTATION OF RPRH
LAW
1. What is the difference between a communicable ➢ WAR AGAINST DRUGS
disease and a non-communicable disease? ➢ ADDITIONAL FUNDS FROM PAGCOR
Answer: A communicable disease can be
passed from person to person, a non- GUARANTEE #1:
communicable disease cannot. ALL LIFE STAGES AND TRIPLE BURDEN DISEASE
- ALL LIFE STAGES
2. A disease is. - Pregnant- Newborn- Infant
Answer: Recognize by a set of symptoms and - Child-Adolescent- Adults- Elderly
results in abnormal conditions or dysfunction in
the body. TRIPLE BURDEN DISEASE
o Communicable disease
3. What is a term for mosquitoes transmitting a o Non-communicable disease and malnutrition
disease such as the Zika Virus? o Diseases of rabid urbanization and industraltation
Answer: Vector
COMMUNICABLE DISEASES
4. What is the difference between a sterilant and a o HIV/AIDS, TB, Malaria
disinfectant? o Diseases for Elimination
Answer: A sterilant is more powerful than a o Dengue, Lepto, Ebola, Zika
disinfectant because if kills of all living microbes,
as opposed to most living microbes. NON-COMMUNICABLE DISEASES & MALNUTRITION
o Cancer, Diabetes, Heart Disease and their Risk
5. What is the purpose of vaccine? Factors - obesity, smoking, diet, sedentary
Answer: Vaccines improve the immune lifestyle
system’s fight against disease. o Malnutrition

DISEASES OF RAPID URBANIZATION &

DUTERTE'S PHILIPPINE HEALTH AGENDA INDUSTRIALIZATION
o Injuries
BETTER HEALTH OUTCOMES o Substance abuse
Filipinos attain the best possible health outcomes with no o Mental Illness
disparity o Pandemics, Travel Medicine
o Health consequences of climate change /
FINANCIAL PROTECTION disaster
Filipinos, especially the poor, marginalized, and
vulnerable are protected from high cost of health care. GUARANTEE #2: SERVICE DELIVERY NETWORK
o FULLY FUNCTIONAL (Complete Equipment,
RESPONSIVENESS Medicines, Health Professional)
Filipinos feel respected, valued, and empowered in all of o COMPLIANT WITH CLINICAL PRACTICE
their interaction with the health svstem o GUIDELINES
o PRACTICING GATEKEEPING
VALUES PROVIDES HIGH-QUALITY SERVICES o AVAILABLE 24/7 & EVEN DURING DISASTERS
(SES RESOURCES ARE EFFICIENTLY o LOCATED CLOSE TO THE PEOPLE (Mobile
TRANSPARENT AND ACCOUNTABLE) Clinic of Subsidize Transportation)
o ENHANCED BY TELEMEDICINE
GUARANTEE #3: UNIVERSAL HEALTH INSURANCE
o Services are financed by Philhealth

A.C.H.I.E.V.E.
▪ Advance quality, health promotion and primary
care
▪ Cover all Filipinos against health-related financial
risk
▪ Harness the power of strategic HRH development
▪ Invest in eHealth and data for decision-making
▪ Enforce standards, accountability and
transparency
▪ Value all clients and patients, especially the poor,
and vulnerable
▪ Elicit multi-sectoral and multi-stakeholder support
for
▪ health