MAURÍCIO DE NASSAU UNIVERSITY CENTER COURSE OF

NURSING

RICHARDE ANDRÉ DA SILVA LIMA

REPORT ON THE ACTIVITIES DEVELOPED DURING THE INTERNSHIP

SUPERVISED I

RECIFE
MAY 2022
 RICHARD ANDRÉ DA SILVA LIMA

REPORT ON DEVELOPED ACTIVITIES

DURING SUPERVISED INTERNSHIP I

Report on Activities Developed in

Basic Health Unit, as a requirement for
Supervised Internship I course.

Advisor: Dr. Felicialle Pereira da Silva

Supervisor: Nurse Roseli Soares da Silva

RECIFE
MAY 2022
 LIST OF ACRONYMS, SYMBOLS AND ABBREVIATIONS

Primary Health Care

Family Health Strategy
SUS – Unified Health System
RAS – Health Care Networks
UBS - Basic Health Unit
ACS – Community Health Agent
 SUMMARY

Cover
1.0 Cover sheet ...................................................................................................... 02
2. Lists of acronyms, symbols or abbreviations.............................................................. 03
2.1 Summary ................................................................................................................ 04
05
2.3 The Institution.......................................................................................................... 06
2.4 Development .................................................................................................. 09
2.5 Final considerations
2.6 References ............................................................................................................ 11
2.7 Annexes and/or Appendices......................................................................................... 17
 INTRODUCTION

Primary Health Care (PHC) is the first level of health care and it
is characterized by a set of health actions, at the individual and collective level, that
it encompasses the promotion and protection of health, the prevention of harm, the diagnosis, the

treatment, rehabilitation, harm reduction, and health maintenance with the aim
to develop a comprehensive care that positively impacts the health situation
the collectives.

The Family Health Strategy (ESF) aims to reorganize primary care in the country,
in accordance with the principles of the Unified Health System (SUS), and is regarded by the Ministry of

Health and state and municipal managers as a strategy for expansion, qualification and
consolidation of basic care by favoring a reorientation of the work process
with greater potential to deepen the principles, guidelines, and foundations of care
basic, to expand the resolutiveness and impact on people's health situation and
collectivities, in addition to providing an important cost-effectiveness relationship.

In Brazil, Primary Care is developed with the highest degree of decentralization and
capillarity, occurring in the place closest to people's lives. It should be the
preferred contact of users, the main entry point and center of communication
with the entire Health Care Network (RAS). Therefore, it is essential that it is guided
by the principles of universality, accessibility, connection, continuity of
care, of the comprehensiveness of attention, of accountability, of humanization, of
equity and social participation.

The Basic Healthcare Units (UBS), which are the main physical structures of
Basic Care is installed close to the lives of users, performing a
central role in ensuring access to quality health care. The units offer
a diversity of services provided by SUS, including: welcoming with
risk classification, nursing consultations, medical and oral health consultations, distribution
the administration of medications, vaccines, dressings, home visits, activity in
group in schools, health education, among others.
INSTITUTION

The supervised internship I was developed at the Basic Health Unit Parque São
Francisco II. This unit operates in Camaragibe, a Brazilian municipality in the state of
Pernambuco, in the Timbi neighborhood. The unit has a terrace, reception, room
medications (where I do not consider it as a pharmacy, as it does not have a good structure
physics and ambient temperature required to preserve medications), room of
nurse, nursing technician room, doctor's room (with a bathroom), a
small open office for the ACS, two bathrooms (one for patients and the other
restricted to employees), a kitchen to prepare meals and a service area
small where no one uses it. Well-organized environment, however, the physical structure
leaves something to be desired due to the presence of some flaws. These flaws imply in the
professional field, leaving professionals and patients at the mercy of
deterioration of the environment. One of these failures is caused by the bad odor due to
sewage. Since I arrived at the unit, I have never seen any treatment for improvement of the

even. The layout of the rooms also leaves something to be desired, especially the room of

nurse, where the walls are moldy. It was reported by third parties that at the end of the year
In 2021, the unit underwent a renovation. This renovation did not achieve
many improvements in the structure of the place. The nurse of the unit attends to the following
demands: childcare, prevention and prenatal care; the doctor attends to hypertensive patients and

diabetics; the nursing technique is responsible for the administration of all vaccines that
the population receives and the ACS provide community services for the population, such as
the household and individual registration.
DEVELOPMENT

Numerous activities were carried out during the period of supervised internship I.
Everything is done with management, proposals focused on health education, conduct of
surveillance, among others.

All procedures were carried out under the supervision of the Unit Nurse.
Basic Health Unit Parque São Francisco II. Among the nursing consultations,
highlighted for this report: Child Care, Prenatal, Examination Collection
Cytopathological (Pap smear), Home Visits, Vaccination Room, Registration
Individual and Home.

During child care, the professional needs a set of rules and

notions of taking care of children. Some of these actions are the physical examination,

anamnesis, anthropometric data, and cardiac auscultation. Consultations are conducted.

monthly routines, where I had the opportunity to carry out some of these actions.
During the physical exam, the weight is checked; the face, skin, eyes, and if there is presence
about edema in the child during the consultation. In the anamnesis, the mother should inform

some complaints that she observes in the child and inform during the consultation to
that we maintain a complete physical examination and highlight it in our file
evaluation. In the anthropometric data stage, one should take the measurements of
weight
thoracic perimeter and abdominal perimeter. All this information needs to be
filled in the Child Health Book.
During Prenatal care, the consultations are held monthly, biweekly, and weekly.
depends on the weeks of gestation. Until the 28th week, consultations are held
From the 28th to the 36th week, biweekly consultations are held, and from the 37th week
Until birth, the appointments become weekly. In these appointments, I was able to evaluate the
exams performed by the pregnant woman, I did the palpation technique, where I measured from the symphysis

pubic to the highest point of the uterine fundus to check the number of
weeks of pregnancy (the number of weeks is proportional to the uterine height in cm,
 with a tolerance of 2 cm either way, during the
procedure, always asking about how the diet is going and checking
if the feet are swollen. I could also verify that the prescriptions for
pregnant women should take Ferrous Sulfate: 40mg per day, she should take it 40 minutes before the

lunch. And Folic Acid: 0.2mg/ml – 40 drops per day.

During the 1st trimester of pregnancy, it is necessary to do the rapid test for HIV, Syphilis and

Hepatitis B and C; Complete blood count, Blood typing; Fasting blood sugar; Summary

urine and urinalysis; stool parasitology; toxoplasmosis (IgM and IgG);

HBSAg and Anti HBC; TSH; HTLV; Cytomegalovirus (IgG and IgM).
In the 2nd trimester, a rapid test for syphilis and Toxoplasmosis was done (if IgG and IgM)

negatives); Cytomegalovirus (if IgG and IgM are negative); Fasting Blood Sugar;
Urine summary and urine culture; Indirect Coombs (if Rh negative).
In the 3rd Quarter, the rapid test for Syphilis, HIV, and Hepatitis B and C was performed;
Complete blood count; Urine culture and urinalysis; Streptococcus culture
Agalactiae.
The collection of Cytopathological Exam is a test to detect if the woman has
any changes in the cells of the cervix. To ensure a better
result, the woman should not be menstruating (since the presence of blood can
change the result), not having had sexual relations two days before the exam and
the use of vaginal medications should be avoided. During collection, it is important
we will guide the purpose of the exam and all the steps of the procedure, in
Next, we must fill out the form for the exam request, identify the
blade with the initials of the woman's name, date of birth at the end
blade sheath to pencil. After that, we should introduce the speculum in position
tilt it slightly so that the cervix is exposed,
then, we performed a visual inspection of the inside of the vagina and the cervix
uterus to visualize if there is any type of injury. For collection of the ectocervix
we should use the Ayre spatula. Then, we introduce a spatula of
wood and a small brush to collect the secretion.
Home visits are carried out by the ACS (Community Health Agent)
Health), the Nurse and all the professionals working in the Family Health Strategy. The greatest

the action of the home visit occurs through the nursing assistance provided,
favoring user autonomy, focusing on care and
clinical monitoring, taking blood pressure measurements, checking for
 by means of rapid testing the glycemic indices, and providing guidance on nutrition
of this individual.
In the Vaccination Room, the opportunity to vaccinate the neighborhood population with the

following vaccines: COVID-19, Influenza, Triple Viral, Influenza and Hepatitis B. A

vaccination was carried out both at the UBS and during home visits. The UBS
there was a vaccination plan for the elderly during home visits.
In the Individual and Household Registration, I was able to learn how it worked.

the entire process of registering people by territory, that is, in the registration
individual we put all the information about the patient's residence (street in
where you live, whether the house is owned or rented, if you have pets, if the street is paved,
if the garbage is collected). In the household registration, we put all the information
of the head of the family and all the people who live in the residence, like the SUS,
date_of_birth
FINAL CONSIDERATIONS

During the undergraduate period, it was possible to correlate the theories seen in class.
class, with nursing care in the Basic Health Unit (UBS). I was able to do the
correlation of theory with practice and it was possible to carry out the internship more safely,
having a broad view of all the situations experienced in the internship and everything
this served as the basis for the conclusion of the supervised internship I.

I had the opportunity to understand all the development linked to Primary Care and
I could notice that the Basic Health Unit and the Unified Health System (SUS) is the
gateway to the comprehensive care of the community. In the face of all the challenges
during the internship period, I experienced all the actions and services provided in the Unit
Health Basic, in the field of Nursing.
Thus, I conclude this phase of supervised internship I with the utmost
I make the most of and am grateful for everything that happened to me during this period. But, I also conclude.
with a concern about the demands of the USF (Family Health Unit), a
since it is the foundation of self-care at the level of actions and services in Primary Care for
the entire population.
REFERENCES
SECRETARY OF PRIMARY HEALTH CARE. Ministry of Health. What is it?
Attention Primary? [s.l.] 2021. Available em:
Unable to access the URL provided for translation.Accessed on: March 10, 2022.

SECRETARY OF PRIMARY HEALTH CARE. Ministry of Health.

Family Health Strategy (ESF). [s.l], 2021. Available at:Portal of the Secretary of
Primary Health Care (health.gov.br).Accessed on: March 10, 2022.

MINISTRY OF HEALTH. Secretariat of Health Care. Department of Care

Basic. National Policy on Basic Care (PNAB). Brasília, DF, 2012. P, 9-108.
Available at:capa_pnab.inddAccessed on: March 10, 2022.

SECRETARY OF HEALTH. Basic or Primary Care - Main gateway to

entry into the Unified Health System (SUS) - Health Secretariat. Available
em: Division of APS - Primary Care of RS (saude.rs.gov.br).Accessed on: March 10.
2022.
5 ANNEXES AND/OR APPENDICES

MAP OF THE AREA ADJACENT TO USF PARQUE SÃO FRANCISCO II

Annex 01: First day at the UBS in the Vaccination Room

On 03/03/22 I arrived at the unit and had my first experience in the vaccination room,
where I had the opportunity to administer the COVID-19 vaccine to patients,
administered Astrazeneca and Pfizer in the population. I was with the nursing technician.
present, where she gave me all the support.

Annex 02: Preparation of Material for the Conversation Wheel about the Day
International Women's Day will be held on 03/11/22.

I prepared and assembled 20 letter-sized sheets in writing about what the day is during the week.
International Women's Day, for what women fight for and I set up some questions for
that they could answer me during the discussion circle.

Annex 03: Holding the Conversation Circle on International Women's Day

I conducted a survey of the entire historical context of how the kickoff began.
the importance of March 8, bringing all the achievements of women to date,
referring to all the struggles that women have gone through and continue to go through today
current, as it is a continuous struggle that requires a lot of change. It was a very
productive, in which I loved to participate and feel the interaction of the whole group. The professionals
who participated together with me in this conversation circle: the Nurse, all the
ACS's, the Speech Therapist and the Psychologist.

Annex 04: Home Visit

On 03/16/22, I had my first home visit along with the doctor.
nurse and ACS. We visited hypertensive and diabetic patients, measured blood pressure, it was done
The saturation and heart rate of all home-based patients are assessed.

Annex 05: Making the Nursing Evolution

Still on 03/16/22 upon arriving at the UBS after the home visit, I went to make the Evolution of
Nursing of all patients monitored on this day. There were 05 patients.
visited on this day and I made the progress of all of them.

Annex 06: Home vaccination for bedridden patients and the elderly
On 03/17/22, it was the day to vaccinate the elderly population and bedridden patients with Pfizer.
We went out to vaccinate 20 patients. It was a very enjoyable day. It was very satisfying.
vaccinate the elderly population and have this practice with the vaccine.

Annex 07: Fraternal Action for Mother's Day + the return of the Hiperdia Program
On 05/05/22, the action for Mother's Day was carried out, marking the beginning of the return of
hiperdia program that was inactive for 2 years due to the pandemic. We met with
all the women to celebrate the event, we gave out gifts (a pair of earrings) and after all the
celebration we started about how the group will work. Everyone gave some
ideas on what to address in each meeting and everyone decided on the purpose of the meetings
occur biweekly in the morning.