1. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
A.
DOH
Vision
2030
Bayabas
Psidium
quajava
Diarrhea
Toothache
A
Global
Leader
for
attaining
better
health
outcomes,
Mouth
and
wound
competitive
and
responsive
health
care
systems,
and
wash
equitable
health
financing.
Bawang
Allium
sativum
HPN
Toothache
B.
DOH
Mission
Yerta
Buena
Mentha
cordifelia
Same
as
Lagundi
except
asthma
To
guarantee
EQUITABLE,
SUSTAINABLE
and
QUALITY
Sambong
Blumea
Edema
health
for
all
Filipinos,
especially
the
poor
and
to
lead
the
balsanifera
Diuretic
quest
for
excellence
in
health.
Akapulko
Cassia
alata
All
forms
of
skin
diseases
C.
Levels
of
Prevention
Niyog
niyogan
Quisqualis
indica
Intestinal
Parasitism
PRIMARY
SECONDARY
TERTIARY
(Nematodes)
LEVEL
LEVEL
LEVEL
Tsaang
Gubat
Carmona
resuta
Diarrhea
Health
Prevention
of
Prevention
of
Infantile
colic
Promotion
and
Complications
Disability,
etc.
(Kabag)
Illness
thru
Early
Dx
Dental
caries
Prevention
and
Tx
Ampalaya
Mamordica
Type
II
Diabetes
charantia
(NIDDM)
Provided
at
–
When
When
highly-­‐
hospitalization
specialized
F.
Homemade
Oresol
Health
is
deemed
medical
care
is
care/RHU
A
volume
or
one
liter
Smaller
volume
or
a
glass
necessary
and
necessary
referral
is
referrals
are
homemade
oresol
homemade
oresol
Brgy.
Health
Stations
made
to
made
to
Water
1000
ml.
or
1
liter
250
ml.
emergency
hospitals
and
Sugar
8
teaspoon
2
teaspoon
Main
Health
(now
district),
medical
center
Salt
1
teaspoon
¼
teaspoon
or
a
pinch
of
Center
provincial
or
such
as
PGH,
salt=10-­‐12
granules
of
rock
regional
or
PHC,
POC,
salt:
iodized
salt=tips
of
thumb
Community
private
National
Center
&
index
finger
are
penetrated
Hospital
and
hospitals
for
Mental
with
salt
Health
Center
Health,
and
other
Private
and
gov’t
private
G.
Millennium
Goal
Development
(MDG)
Semi-­‐private
hospitals
at
the
agencies
municipal
level
1. ERADICATE
EXTREME
POVERTY
AND
HUNGER
2. ACHIEVE
UNIVERSAL
PRIMARY
EDUCATION
3. PROMOTE
GENDER
EQUALITY
AND
EMPOWER
WOMEN
D.
8
Common
Generic
Drugs
(Botika
sa
Baranggay)
4. REDUCE
CHILD
MORTALITY
(Phil.
focus)
5. IMPROVE
MATERNAL
HEALTH
(Phil.
focus)
1. Co-­‐Trimoxazole
:
GUT/GIT/URT
Infection
6. COMBAT
HIV/AIDS,
MALARIA
AND
OTHER
2. Amoxicillin
/
Ampicillin
DISEASES
3. Rifampicin
7. ENSURE
ENVIRONMENTAL
SUSTAINABILITY
4. Isoniazid
8. DEVELOP
A
GLOBAL
PARTNERSHIP
FOR
5. Pyrazinamide
DEVELOPMENT
6. Paracetamol
7. Oresol
H.
Field
Health
Service
Information
System
(
FHSIS)
8. Nifidipine:
HPN
Ø Individual
Treatment
Record
(ITR)
E.
Herbal
Plants
ü Fundamental
building
block
or
foundation
FHSIS.
Plant
Name
Scientific
Name
Indications
Ø Target
Client
List
(TCL)
Lagundi
Vitex
negundo
Asthma,
cough,
ü Such
lists
will
be
of
considerable
value
to
colds
&
fever
midwives/nurses
in
monitoring
service
Pain
and
delivery
to
clients
in
general
and
in
inflammation
particular
to
groups
of
patients
identified
as
Ulasimang
Bato
Peperonia
Gout
“targets”
or
“eligibles”
for
one
or
another
pellucida
Arthritis
program
of
the
Department
Rheumatism
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

2. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
Ø Summary
Table
Maternal
Mortality
Rate
(MMR):
Reported
maternal
deaths
ü Composed
of
Health
Program
Accomplish
per
1000
registered
live
births
(RLB)
and
Morbidity
Diseases
Ø The
Monthly
Consolidation
Table
(MCT)
MMR=
#
of
maternal
deaths
x
1000
RLB
FHSIS
Reporting
Ø Monthly
Form
Infant
Mortality
Rate
(IMR):
Reported
#
of
infant
(0
to
12
1. Program
report
(M1)
months
of
age)
deaths
per
1000
RLB
2. Morbidity
report
(M2)
ü Prepare
by
Midwife
IMR=#
of
infant
deaths
x
1000
ü Every
2nd
week
of
the
month
is
the
RLB
submission
Ø Quarterly
Form
Neonatal
Mortality
Rate
(NMR):
Reported
#
of
neonatal
(0
1. Program
report
(Q1)
to
28
days
or
<1
month)
deaths
per
1000
RLB
2. Morbidity
report
(Q2)
ü Prepared
by
Nurse
NMR=#
of
neonatal
deaths
x
1000
ü Every
3rd
week
of
the
succeeding
quarter
RLB
month
is
the
submission
Ø Annual
Form
Swaroop’s
Index
(SI):
Reported
#
of
deaths
among
1. ABHS
report
individuals>
50
years
old
over
total
deaths
ü Contains
data
on
demographic,
environmental
and
natality.
SI=#
of
deaths
(individual
>50
years
old)
x
100
ü Prepare
by
Midwife
Total
Deaths
ü Every
2nd
week
of
January
is
the
submission
2. A1:
Report
on
vital
statistics:
demographic,
J.
Nature
of
the
Family
Problem
environmental,
natality
and
mortality.
3. A2:
Lists
all
diseases
and
their
occurrence
in
Ø Health
Deficit
(HD):
if
identified
problem
is
an
the
municipality/city.
The
report
is
broken
abnormality,
illness
or
disease,
there’s
a
down
by
age
and
sex.
gap/difference
between
normal
status
(ideal,
4. A3:
All
deaths
occurred
in
the
desirable,
expected)
&
actual
status
(the
municipality/city.
The
report
is
also
broken
outcome/result/problem
encountered
on
that
down
by
age
and
sex
actual
day)
ü Prepared
by
Nurse
ü Every
3rd
week
of
January
is
the
Ø Health
Threat
(HT):
any
condition
or
situation
submission
which
will
be
conducive
to
health
alteration,
health
interference
&
health
disturbance.
I.
Health
Indicators
Ø Foreseeable
Crisis
(FC):
stress
points,
anything
Crude
Birth
Rate
(CBR):
Overall
total
reported
births
per
which
is
anticipated/
expected
to
become
a
1000
population
problem.
CBR=overall
total
reported
births
x
1000
K.
Community
Organizing
(COPAR)
Population
Preparatory
Phase
Incidence
Rate
(IR):
Reported
new
cases
of
disease
per
1. Area
of
Selection
percent
(100/population)
population
Ø It
should
be
DOPE
Community:
Depressed,
Oppressed,
Poor
&
Exploited,
a
new
criteria
for
IR=new
cases
of
disease
x
100
community
organization
Population
2. Entry
Phase
Ø The
1st
thing
to
do
upon
entering
the
community
is
Prevalence
rate
(PR):
Reported
new
cases
of
disease
+
old
to
have
a
courtesy
call
with
the
Barangay
Captain,
cases
of
disease
per
percent
of
population
introduce
self
&
group,
purpose,
present
the
project,
activities,
etc.
PR=new
cases
+
old
cases
x
100
3. Integration/Immersion
(CIP)
Population
Ø Immersion
is
imbibing
the
life
situation/condition
of
the
community
.
Crude
Death
Rate
(CDR):
Overall
total
reported
deaths
per
4. Community
Study:
Diagnosis
of
Community-­‐COPAR
1000
population
Ø Makes
use
of
the
Nursing
Process/Problem
Solving
Approach
CDR=overall
total
deaths
x
1000
Population
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

3. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
Ø Prioritized
which
among
the
problems
identified
is
O.
Excreta
Disposal
to
be
attended
1st
like
in
nature,
magnitude,
modifiability,
preventive
potential,
salience
Household
Community
○
Burial
○
Sanitary
landfill
or
L.
Epidemiology
►
Deposited
in
1m
x
controlled
tipping
1m
deep
pits
covered
►
Excavation
of
soil
Ø Epidemic:
a
situation
when
there
is
a
high
with
soil,
located
25
deposition
of
refuse
and
incidence
of
new
cases
of
a
specific
disease
in
excess
m.
away
from
water
compacting
with
a
solid
of
the
expected.
supply
cover
of
2
feet
Ø Endemic
:
habitual
presence
of
a
disease
in
a
given
○
Incineration
geographic
location
accounting
for
the
low
number
○
Open
burning
of
both
immunes
and
susceptibles
• Animal
feeding
Ø Sporadic
:
disease
occurs
every
now
and
then
• Composting
affecting
only
a
small
number
of
people
relative
to
• Grinding
and
the
total
population
disposal
sewer
Ø Pandemic:
global
occurrence
of
a
disease
DOH
PROGRAMS
M
.
Approve
Water
Facilities
Level
I
Level
II
Level
III
EXPANDED
PROGRAM
ON
IMMUNIZATION
Point
Communal
faucet
Waterworks
v Law:
PD
996
Source
system
or
stand
system
or
posts
individual
house
Vaccine
Dosage
#
of
Doses
to
connections
complete
A
protected
A
system
composed
A
system
with
a
immunization
well
or
a
of
a
source,
a
source,
a
reservoir,
BCG
developed
reservoir,
a
piped
a
piped
distributor
1.
I
.05
ml
1
dose
spring
with
distribution
network
network
and
2.
SE
.1
ml
1
dose
an
outlet
but
and
communal
household
taps
DPT
.5
ml
3
doses
without
a
faucets,
located
at
that
is
suited
for
OPV
2-­‐3
gtts
3
doses
distribution
not
more
than
25
densely
populated
HBV
<10
y/o:
.5
3
doses
system
for
meters
from
the
urban
areas.
>10
y/o:
1
rural
areas
farthest
house
in
MV
.5
ml
1
dose
where
rural
areas
where
houses
are
houses
are
clustered
v It
is
safe
and
immunologically
effective
to
administer
all
thinly
densely.
EPI
vaccines
on
the
same
day
at
different
sites
of
the
scattered.
body.
v The
vaccination
schedule
should
not
be
restarted
from
the
beginning
even
if
the
interval
between
doses
N.
Approved
Toilet
Facilities
exceeded
the
recommended
interval
by
months
or
year.
Level
1
Level
2
Level
3
v DPT2
or
DPT3
is
not
given
to
a
child
who
has
Non-­‐water
On
site
toilet
Water
carriage
convulsions
or
shock
within
3
days
after
DPT1.
V
carriage
toilet
facilities
of
the
types
of
toilet
v Do
not
give
live
vaccines
like
BCG
to
a
individuals
who
facility:
water
carriage
facilities
are
immunosuppressed
due
to
malignant
disease
(child
-­‐
Pit
latrines
type
with
water
connected
to
with
AIDS)
,
going
therapy
with
immunosuppressive
-­‐
Reed
Odorless
sealed
and
septic
tanks
agents
or
radiation.
Earth
Closet
flushed
type
with
an/or
to
v Repeat
BCG
vaccination
if
the
child
does
not
develop
a
-­‐
Bored-­‐hole
septic
vault/tank
sewerage
scar
after
first
injection
-­‐
Compost
disposal
system
to
-­‐
Ventilated
facilities.
treatment
improved
pit
plant.
Type
of
Vaccine
Storage
Temp.
Hours
of
Life
after
opening
Toilets
requiring
OPV
-­‐15
to
-­‐25
C
small
amount
of
Measles
At
the
freezer
water
to
wash
Hepa
B
8
hours
waste
into
DPT
2
to
8
C
receiving
space
Tetox
Body
of
-­‐
Pour
flush
BCG
refrigerator
4
hours
-­‐
Aqua
privies
NATIONAL
TB
PROGRAM
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

4. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
Disease
Causative
Agent
Mode
of
Clinical
Reservoir
Diagnostic
Treatment
Nursing
Transmission
Manifestation
Exam
Implication
Tuberculosis
Mycobacterium
Droplet
Infection
• General
Man
• Sputum
DOTS
Pointers
for
“Primary
Tuberculosis
(
inhalation
of
weakness
And
Exam
-­‐
patient
is
teaching
on
Complex”
is
bacilli
from
patient
• Loss
of
Diseased
3
sample
required
to
take
Anti-­‐TB
drugs:
less
than
3
who
coughs
and
weight,
Cattle
are
taken
the
Ant-­‐Tb
drugs
years
old
sneeze)
cough
and
(Bovine
with
24
hrs:
in
the
presence
of
Rifampicin:
wheeze
TB)
-­‐
spot
a
health
care
taken
befor
-­‐
any
child
which
does
sample
(1st
provider
to
meals,
causes
who
does
not
not
respond
visit)
ensure
red
urine
urine
return
to
to
antibiotic
-­‐
early
compliance
to
Isoniazide:
normal
health
therapy.
morning
treatment
causes
after
measles
• Fever
and
specimen
regimen
peripheral
or
whooping
night
sweat
-­‐
spot
neuritis,
given
cough.
• Abdominal
sample
Anti-­‐TB
drugs:
with
Vit.B6
swelling
(2nd
visit)
(RIPES)
Pyrazinamide:
• Most
with
a
hard
Note:
at
• Rifampicin
cause
hazardous
painless
least
2
• Isoniazid
hyperurucemia
period:
mass
and
sample
are
• Pyrazinamide
Ethambutol:
first
6-­‐12
free
fluid
positive
• Ethambutol
causes
optic
months
• Hemoptysis
• Streptomycin
neuritis/
after
and
chest
• Chest
blurring
of
infection
pain
Xray
vision
• Highest
in
• Painful
firm
• Mantoux
Streptomycin:
risk
of
or
soft
Test
cause
tinnitus,
developin swelling
in
a
-­‐
.1
cc
loss
of
hearing
g:
under
3
group
of
injection
of
balance,
damage
years
old
superficial
PDD
and
to
8th
cranial
lymph
48-­‐72
hours
nerve
nodes.
reading
*
10
mm
+
Note:
After
2-­‐4
5
mm
+
weeks
of
(HIV
pt.)
treatment,
patient
is
no
longer
contagious
RECOMMENDED
CATEGORY
OF
TREATMENT
REGIMEN
Category
Type
of
TB
Patient
Treatment
Regimen
Intensive
Phase
Continuation
Total
Period
Phase
• New
smear
positive
PTB
• New
smear
positive
PTB
I
with
extensive
2
RIPE
4
RI
6
mos.
parenchymal
lesion
• EPTB
and
Severe
concomitant
HIV
disease
• Treatment
Failure
II
• Relapse
2
RIPES
/1
RIPE
5
RIE
8
mos.
• Return
after
default
• New
smear-­‐negative
PTB
III
• With
minimal
parenchymal
2
RIP
4
RI
6
lession
mos.
• Chronic
(
still
smear-­‐ Refer
to
Specialized
facility
IV
positive
after
supervised
or
DOTS
Plus
Center
refer
re-­‐treatment
)
to
City
Provincial
NTP
Coordinator
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

5. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
INTEGRATED
MANAGEMENT
OF
CHILDHOOD
ILLNESS
MAIN
SYMPTOM:
Diarrhea
(IMCI)
Danger
Sign
MAIN
SYMPTOM:
Cough
and
Difficulty
Breathing
Dehydration
Classification
A
child
who
has
had
diarrhea
for
14
days
or
more
and
who
has
no
signs
of
dehydration
is
classified
as
having
PERSISTENT
DIARRHOEA
Pneumonia
Classification
Classify
a
child
with
diarrhea
and
blood
in
the
stool
as
having
DYSENTERY.
A
child
with
dysentery
should
be
treated
for
dehydration
MAIN
SYMPTOM:
Fever
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

6. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
MAIN
SYMPTOM:
Ear
Problem
High
Malaria
Risk
Classification
Ear
Problem
Classifications
Low
Malaria
Risk
Classification
No
Malaria
Risk
Classification
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

7. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
3:
COMMUNITY
HEALTH
NURSING
MAIN
SYMPTOM:
Malnutrition
and
Anemia
ü Diarrhea Bloody stools (on and off dysentery)
Enlargement of abdomen Splenomegaly
Hepatomegaly Anemia / pallor weakness
ü Diagnostic Test: COPT or cercum ova precipitin test
(stool exam)
ü Drug-of-Choice: PRAZIQUANTEL (Biltracide)
Oxamniquine for S. mansoni Metrifonate for S.
haematobium *Death is often due to hepatic
complication
ü Dispose the feces properly not reaching body of water
Use molluscides Prevent exposure to contaminated
water (e.g. use rubber boots)
ü Apply 70% alcohol immediately to skin to kill surface
cercariae
ü Allow water to stand 48-72 hours before use
Ø Malaria
ü Plasmodium Parasites: Vivax Falciparum (most fatal;
most common in the Philippines)
ü Bite of infected anopheles mosquito Night time biting
High-flying
Malnutrition
and
Anemia
Classification
ü Rural areas Clear running water
ü Malarial Smear – best time to get the specimen is at
height of fever because the microorganisms are very
active and easily identified
ü Chemoprophylaxis: only chloroquine should be given
(taken at weekly intervals starting from 1-2 weeks
before entering the endemic area). In pregnant women,
it is given throughout the duration of pregnancy.
ü Treatment:
1. QUININE – oldest drug used to treat malaria; from
the bark of Cinchona tree; ALERT: Cinchonism –
quinine toxicity
2. CHLOROQUINE
3. PRIMAQUINE – sometimes can also be given as
chemoprophylaxis
4. FANSIDAR – combination of pyrimethamine and
sulfadoxine
ü CLEAN Technique
*Insecticide – treatment of mosquito net
*House Spraying (night time fumigation)
*On Stream Seeding – construction of bio-ponds for
fish propagation (2-4 fishes/m2 for immediate impact;
COMMUNICABLE
DISEASES
200-400/ha. for a delayed effect)
*On Stream Clearing – cutting of vegetation
Ø Cholera overhanging along stream banks
ü Other names:El tor *Avoid outdoor night activities (9pm – 3am)
ü Fecal-oral route 5 Fs *Wearing of clothing that covers arms and legs in the
ü Incubation Period: Few hours to 5 days; Usually 3 evening*Use mosquito repellents
days *Zooprophylaxis – typing of domestic animals like the
ü Pathognomonic Sign: Rice watery stool carabao, cow, etc near human dwellings to deviate
ü Diagnostic Test: Stool culture mosquito bites from man to these animals Intensive
ü Treatment:Oral rehydration solution (ORESOL) IVF IEC campaign
ü Drug-of-Choice: tetracycline (use straw; can cause
staining of teeth). Oral tetracycline should be
administered with meals or after milk.
Ø Shistosomiasis
ü Other Names: Snail Fever Bilharziasis
ü Endemic in 10 regions and 24 provinces High
prevalence: Regions 5, 8, 11
ü Contact with the infected freshwater with cercaria and
penetrates the skin
POSSIBLE
TOPICS
ON
COMMUNITY
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE