NLE REVIEWER
LAWS RELATED TO NURSING
RA 6173 – Code of conduct and Ethical Standards for Public Officials and Employees
LOI 949 – Legal basis of Primary Health Care (PHC)
RA 7160 – Local Government Code
RA 7305 – Magna Carta for Public Health Workers
RA 2382 – Philippine Medical Act
RA 3573 – Declared that all communicable diseases should be reported to the nearest health
station, and that any person may be inoculated, administered or injected with prophylactic
preparations.
RA 9173 – Philippine Nurses Act of 2002
RA 8749 – Clean Air Act of 2000
PD 825 – Requires penalty for improper disposal of garbage and other forms of uncleanliness
PD 856 – Code of Sanitation
RA 9211 – Tobacco Regulation Act
RA 8976 – Philippine Food Fortification
RA 6365 – National Policy on Population
EO 2009 – Family Code of the Philippines
RA 7432 – Entitles the elderly to a 20% discount in all public establishment
RA 7600 – Rooming-in and breastfeeding
RA 9288 – Newborn Screening Act
RA 9262 – Anti-Violence against Women and Children
RA 7719 – National Blood Service
RA 7875 – National Health Insurance Act
PD 996 – Compulsory immunization of all children below 8 years of age against the six childhood
immunizable diseases
RA 6675 – Generics Act
RA 6425 – Dangerous Drug Act
RA 4226 – Hospital Licensure Act
RA 8504 – Philippine Aids Prevention and control
LEADERSHIP AND MANAGEMENT
LEADERSHIP
 The art of developing people
 The process of influencing the behavior of actions of a person or group to attain the desired
objectives
 A dynamic interactive process the involves the dimensions (leader, follower, situation)
NURSING LEADERSHIP
 It is the process necessary to guide nursing personnel to a specific goal
 GOAL: Quality nursing care to patient
LEADERSHIP THEORIES
A. GREAT MAN THEORY
Great leaders are born and not made
Leaders arises then there is a great need
This theory argues that a few people are born with necessary characteristics to be great
B. CHARISMATIC THEORY
Leaders possess an inspirational quality and emotional commitment from followers
C. CONTINGENCY THOERY
Leadership behavior should be flexible
According to Fred Fledler (1960) leader’s ability to lead depends upon the situation
D. PATH-GOAL THEORY
Leader minimizes obstructions to facilitate accomplishment of tasks
Focuses on motivation and productivity
E. TRAIT THEORY
Persons have some innate abilities, personalities, traits or other characteristics to be a leader
LEADERSHIP TRAITS
 TASK ORIENTED – includes planning, scheduling and coordinating activities
 RELATIONSHIP ORIENTED - includes acting friendly and considerate, showing trust and
confidence
 PARTICIPATIVE THEORY – uses group meetings to enlist associate participation in decision
making
F. SITUATIONAL THEORY
Leader may vary differ according to varying situation
A person may be a leader in one situation and a follower in another or vice-versa
G. TRANSACTIONAL THEORY
Focuses on management tasks and trade-offs to meet goals
People are motivated by reward and punishment
H. TRANSFORMATIONAL THEORY
Inspiration leaders that:
 Promotes employee development
 Attends to needs and motives of followers
 Inspires through optimism
 Influences changes in perception
 Encourages follower creativity
I. STRATEGY THEORY
It is based on human handling skills of leaders
STRATEGIES
 Attention through vision
 Meaning thru communication
 Trust thru positioning
 Deployment of self through positive self regard
ACID BASE BALANCE
PH-7.35-7.45
HCO3-22-26
PCO2-35-45
REMEMBER “ROME”= R-RESPIRATORY,
O-OPPOSITE
M-METABOLIC
E-EQUAL
REMEMBER = WHERE PH GOES SO GOES MY PATIENT EXCEPT FOR THE POTASSIUM
ACIDOSIS =PT SYMPTOMS GOES DOWN
ALKALOSIS = PT SYMPTOMS GOES UP
REMEMBER
UNDER VENTILATION = RESPIRATORY ACIDOSIS EX. MOBITZ TYPE 2 HEART BLOCK, AMBU
BAGGING, COMA
OVER VENTILATION = RESPIRATORY ALKALOSIS EX. VENTRICULAR TACHYCARDIA, SUCTION
MACHINE, SEIZURE
REMEMBER
METABOLIC ALKALOSIS = SUCTIONING AND VOMITING
METABOLIC ACIDOSIS = ANYTHING EXCEPT SUCTIONING AND VOMITING AND EXCEPT LUNGS
ANYTHING THAT COMES FROM THE ASS IS ACIDOSIS
KUSSMAULS RESPIRATION-COMPENSATORY MECHANISM FOR METABOLIC ACIDOSIS
BURNS=METABOLIC ACIDOSIS + HYPER URICEMIA
HIGH PRESSURE ALARM = OBSTRUCTION/INCREASE RESISTANCE TO AIR FLOW (KINKS, WATER
CONDENSING WITHIN THE TUBE, MUCOUS SECRETION IN THE AIRWAY)
NSG = CHANGE POSITION, TURN COUGH DEEP BREATH BEFORE SUCTIONING
SUCTION ONLY AS NECESSARY (HYPER OXYGENATE FIRST)
LOW PRESSURE ALARM = DECREASE RESISTANCE (DISCONNECTION)
1. DISCONNECTION OF THE MAIN TUBING
2. OXYGEN SENSOR TUBING (SENSES FiO2 IN TRACH AREA)
ALCOHOLISM
DENIAL (ABUSE) – CONFRONT/REFUSAL TO ACCEPT THE REALITY OF THE PROBLEM
DENIAL (LOSS & GRIEF) – SUPPORT
D=DENIAL
A=ANGER
B=BARGAINING
D=DEPRESSION
A=ACCEPTANCE
DEPENDENCY & CO-DEPENDENCY
DEPENDENCY=ABUSER NEEDS A SIGNIFICANT OTHER TO DO THINGS FOR THEM
CO-DEPENDENCY=DERIVES POSITIVE SELF-ESTEEM FROM DOING THINGS FOR THE ABUSER
TREATMENT
1. SET LIMITS AND ENFORCE IT = EX. TEACHING THE SIGNIFICANT OTHER TO SAY “NO”
MANIPULATION=WHEN THE ABUSER GETS THE SIGNIFICANT OTHER TO DO THINGS FOR HER BUT IS
NOT IN THE BEST INTEREST OF THE SIGNIFICANT OTHER AND THE NATURE OF THE ACT IS
DANGEROUS AND HARMFUL
TREATMENT
1. SET LIMITS AND ENFORCE IT = EX. TEACHING THE SIGNIFICANT OTHER TO SAY “NO”
WERNICKE & KORSAKOFF
WERNICKE=ENCEPHALOPATHY
KORSAKOFF=PSYCHOSIS
WERNICKE’S KORSAKOFF=IS A PSYCHOSIS INDUCED BY VITAMIN B1 (THIAMIN) DEFICIENCY, LOOSE
TOUCH IN REALITY BECAUSE OF VITAMIN B1 DEFICIENCY (INSANE)
SYMPTOMS
1. AMNESIA WITH CONFABULATION=MAKING UP STORIES (MEMORY LOSS)/LIE IS JUST AS REAL AS
REALITY
NSG
1. REDIRECT=BECAUSE WERNICKE’S KORSAKOFF IS A PERMANENT PSYCHOSIS IN WHICH THE
BRAIN IS DAMAGED AND PRESENTING REALITY IS NOT AN OPTION.
CHARACTERISTICS
1. PREVENTABLE=TAKE VITAMIN B1 ( FOR ALCOHOL METABOLISM)
2. ARRESTABLE=STOP FROM GETTING WORSE (TAKE VITAMIN B1)
3. IRREVERSIBLE
ANTABUSE (DISULFIRAM)
1. AVERSION THERAPY=GUT HATRED FOR ALCOHOL
A. WORKS IN THEORY RATHER THAN IN REALITY
B. 2 WEEKS TO BE ON THE DRUG FOR THE MEDICATION TO WORK
C. 2 WEEKS TO BE OFF THE DRUG BEFORE THEY CAN SAFELY DRINK AGAIN
D. PT TEACHING (AVOID ALL FORMS OF ALCOHOL) “MOFAVS”
M=MOUTH WASH
O=OVER THE COUNTER MEDICATION (ELIXER) ON THE NAME
F=FERMENTED WINES
A=AFTER SHAVES
V=VINEGAR/VANILLA
S=SPRAYS/SANITIZER
OVERDOSE AND WITHDRAWALS
A. IS THE DRUG AN UPPER OR A DOWNER
UPPERS
A. CAFFEINE
B. COCAINE
C. PCP/LSP
D. METHAMPETHAMINES
E. ADDERAL (ATTENTION DEFICIT DRUG)
S/SX EUPHORIA, TACHYCARDIA, RESTLESSNESS, BORBORYGMI, DIARRHEA, SPASTIC,
SEIZURE, SUCTION MACHINE, (IMPULSE GOES UP)
DOWNERS
ANY MEDICINE THAT IS NOT AN UPPER
S/SX RESPIRATORY DEPRESSION LEADING TO ARREST (IMPULSE GOES DOWN)
B. OVERDOSE OR WITHDRAWAL
UPPER OVERDOSE/INTOXICATION=EVERYTHING GOES UP
DOWNER INTOXICATION-EVERYTHING GOES DOWN
UPPER WITHDRAWAL=EVERYTHING GOES DOWN
DOWNER WITHDRAWAL=EVERYTHING GOES UP
NEW BORN ADDICTION
REMEMBER=ALWAYS ASSUME INTOXICATION NOT WITHDRAWAL AT BIRTH
1ST 24 HRS=INTOXICATION
AFTER 24 HRS=WITHDRAWAL
ALCOHOL WITHDRAWAL SYNDROME VS DELIRIUM TREMENS
A. EVERY ALCOHOLIC GOES THROUGH ALCOHOL WITHDRAW (24HRS) AFTER THEY STOP
DRINKING, ONLY A MINORITY GETS A DELIRIUM TREMENS (72HRS)
B. ALCOHOL WITHDRAWAL SYNDROME ALWAYS PRECEEDS DELIRIUM TREMENS HOWEVER
DELIRIUM TREMENS DOES NOT ALWAYS FOLLOW ALCOHOL WITHDRAWAL SYNDROME
C. AWS IS NOT LIFE THREATENING, DT’S CAN KILL
D. PTS WITH AWS ARE NOT A DANGER TO SELF AND OTHERS, PTS WITH DT’S ARE DANGEROUS
TO SELF AND OTHERS
AWS
REGULAR DIET
SEMI-PRIVATE ANYWHERE
UP ADLIB-CAN GO ANYWHERE
NO RESTRAINTS
DT
NPO/CLEAR LIQUIDS
PRIVATE NEAR NURSE STATION
RESTRICTED BED REST (NO
BATHROOM PRIVILAGES
RESTRAINTS (VEST OR 2 POINT LOCK
LEATHERS) AFTER 2 HRS CHANGE
EXTREMITIES (LOCK FIRST BEFORE
RELEASE)
AMINOGLYCOSIDES
REMEMBER
A-MEAN-OLD-MYCIN=SERIOUS, LIFE THREATENING, RESISTANT GRAM (-) INFECTION
-TREAT A MEAN OLD INFECTION BY A MEAN OLD MYCIN
ALL AMINOGLYCOSIDES ENDS IN “MYCIN”, BUT NOT ALL DRUGS THAT ENDS IN MYCIN ARE
AMINOGLYCOSIDES (ERYTHROMYCIN, AZITHROMYCIN, CLARITHROMYCIN)
TOXIC EFFECTS
-NEPHROTOXIC-MONITOR CREATININE-BEST INDICATOR OF KIDNEY FUNCTION
-NUMBER 8 (SHAPE OF 2 EARS) TOXIC TO CN8 AND ADMINISTER EVERY 8HRS
-OTOTOXIC-(MONITOR TINNITUS)
-VERTIGO/DIZZINES/HEARING
-DO NOT GIVE BY PO (GIVEN BY IV OR IM)
-2 CASES BY PO
1. HEPATIC ENCEPHALOPATHY
GET AMMONIA DOWN (STERILIZE THE BOWEL) KILL GRAM (-) BACTERIA (E-COLI)
PRE-OP BOWEL SURGERY
STERILIZE THE BOWEL
REMEMBER
NEOMYCIN AND KANAMYCIN (BOWEL STERILIZERS)
CIRCULATORY SYSTEM
COMPONENTS OF BLOOD
A.
B.
C.
D.
ERYTHROCYTE (RBC)-RED
LEUKOCYTE (WBC)-PALE
THROMOCYTE (PLT)
PLASMA (55%)
HEMATOCRIT=BLOOD TEST THAT MEASURES THE PERCENTAGE OF RBC IN WHOLE BLOOD
REMEMBER
ADULT HAS APPROXIMATE BLOOD VOLUME OF 5 LITERS
MALE=5-6 LITERS
FEMALE=4-5 LITERS
ALBUMIN
FIBRINOGEN
PROTHROMBIN
GAMMA GLOBULIN
= 8% OF PLASMA
=HELPS MAINTAIN WATER BALANCE & THEY AFFECT THE OSMOTIC
PRESSURE, INCREASE BLOOD VISCOSITY & MAINTAIN BLOOD PRESSURE
=ALL PLASMA PROTEINS EXCEPT FOR GAMMA GLOBULINS ARE SYNTHESIZE
IN THE LIVER
OSMORECEPTOR= DETECTS PLASMA OSMOLALITY


IF PLASMA IS TOO LOW ADH IS SWITCHED OFF AND BLOOD SLOWLY CONCENTRATES AS WATER
IS EXCRETED THROUGH URINE
DEHYDRATION CAUSES ADH TO SWITCHED ON AND CONSERVE WATER
ISOTONIC=ASSUMES TO HAVE THE SAME OSMOLALITY AS BLOOD
PH=7.35-7.45
FUNCTIONS OF BLOOD
A. TRANSPORTATION=TRANSPORT NUTRIENTS & RESPIRATORY GASES INTO AND OUT OF THE CELL
B. MAINTAIN BODY TEMPERATURE=DISTRIBUTES HEAT PRODUCED BY THE CHEMICAL ACTIVITY OF
THE CELLS EVENLY THROUGHOUT THE BODY
C. MAINTAINING THE ACID-BASE BALANCE=BLOOD PH IS MAINTAINED BY THE EXCRETION &
REABSORPTION OF HYDROGEN & BICARBONATE ION
D. REGULATION OF FLUID BALANCE= WHEN BLOOD REACHES THE KIDNEYS EXCESS FLUID IS
EXCRETED OR REABSORBED TO MAINTAIN FLUID BALANCE
E. REMOVAL OF WASTE PRODUCT= BLOOD REMOVES ALL WASTE PRODUCT FROM THE CELL &
DISTRIBUTES IT TO DESIGNATED ORGANS FOR EXCRETION
F. BLOOD CLOTTING= CLOTTING PREVENTS LOSS OF BLOOD CELLS & BODY FLUIDS
G. DEFENCE ACTION= PHAGOCYTE ACTION OF NEUTROPHILS & MONOCYTE AND PRESENCE OF
ANTIBODIES AND ANTI TOXINS
BLOOD TRANSFUSION


TREATMENT FOR ANEMIA
30 MINUTES TO 4 HOURS
ANEMIA= BODY DOES NOT HAVE ENOUGH RED-OXYGENATED-CARRYING BLOOD CELLS WHICH
MEANS THE BODY TISSUES AND CELLS ARE NOT GETTING ENOUGH OXYGEN
BT POLICIES







PT IS WEARING AN IDENTIFICATION BRACELET WITH THEIR LAST NAME, FIRST NAME 7 DATE OF
BIRTH & NHS NUMBER
DATE AND TIME THE TRANSFUSION IS REQUIRED
PT’S BLOOD GROUP
PRESENCE OF KNOWN ANTIBODIES/ALLERGIES
GENDER
DIAGNOSIS
INFORMED CONSENT
HEMOGLOBIN=OXYGEN CARRYING PROTEIN, USES ANAEROBIC RESPIRATION BECAUSE IT DOES NOT
USE OXYGEN WHEN CARRYING OXYGEN AND CARBON DIOXIDE
IRON DEFICIENCT ANEMIA=



TAKE IRON SUPPLEMENTS
INCREASE FE IN THE DIET
FERROUS SULPHATE –MOST COMMONLY USED (2-3X/DAY
ABDOMINAL PAIN
EFFECTS ON TAKING ORAL FE SUPPLEMENT (FERROUS
CONSTIPATION OR DIARRHEA
SULPHATE)
FEELING SICK
BLACK STOOL

MATURE RBC LIFESPAN IS 120 DAYS
ERYTHROPOIETIN=HORMONE HTAT CONTROLS THE PRODUCTION OF RBC, PRODUCED BY THE
KIDNEYS WHICH THEN TRANSPORTED BY THE BLOOD TO THE BONE MARROW
OTHER COMPONENTS FOR THE SYNTHESIS OF RBC



IRON
FOLIC ACID
VITAMIN B12
DECREASE LEVEL OF OXYGEN TO TISSUES AS A RESULT OF HYPOXIA
RECEPTOR IN THE KIDNEYS DETECTS LOW OXYGEN LEVEL
KIDNEY INCREASE ERYTHROPOIETIN PRODUCTION
RETURN TO HOMEOSTASIS
BLOOD TRASNPORT ERYTHROPOIETIN INTO THE BONE MARROW
INCREASE RBC PRODUCTION
INCREASE LEVEL OF RBC
INCREASE OXYGEN DELIVERY TO TISSUES AND CELLS
RBC COLOR
BRIGHT RED=OXYGENATED
DARK-BLUISH RED=DEOXYGENATED
3 WAYS CARBON DIOXIDE IS TRANSPORTED
A. 10% CARBON DIOXIDE DISSOLVES IN PLASMA
B. 20% CARBON DIOXIDE COMBINES WITH HEMOGLOBIN TO FORM CARBAMINOHEMOGLOBIN
C. 70% CARBON DIOXIDE REACTS WITH WATER TO FORM CARBONIC ACID WHICH IS CONVERTED
TO BICARBONATE & HYDROGEN ION
CARBONIC ACID
CO2+H20
BICARBONATE ION
H2CO3
CARBONIC ANYHYDRASE
HCO3 + H2
HYDROGEN ION
WHITE BLOOD CELLS
NV=5000-10000
LEUKOCYTOSIS=INCREASE WBC
LEUKOPENIA=DECREAS WBC
GRANULOCYTES=CONTAINS GRANULES IN THE CYTOPLASM
B=BASOPHIL
E=EOSINOPHIL
N=NEUTROPHIL
NEUTROPHIL
 MOST ABUNDANT WBC
 60-65 % GRANULOCYTE AND ARE PHAGOCYTE (INGEST MICROORGANISM)
 CONTAIN LYSOSOMES, THEREFORE THEIR MAIN FUNCTION IS TO PROTECT THE BODY FROM
FOREIGN MATERIAL
 CAPABLE OF MOVING OUT OF THE BLOOD VESSEL BY THE PROCESS CALLED DIAPEDESIS
 FIRST IMMUNE CELL TO ARRIVE AT THE SITE OF INFECTION
NEUTROPENIA=DEFICIENCY OF NEUTROPHIL, COMPROMISED IMMUNE SYSTEM
FACTORS THAT INCREASE NEITROPHIL COUNT
 PREGNANCY
 INFECTION
 LEUKEMIA
 METABOLIC DISORDER SUCH AS ACUTE GOUT
 INFLAMMATION
 MYOCARDIAL INFARCTION
EOSINOPHIL
 2-4% OF GRANULOCYTE AND HAVE B-SHAPED NUCLEI
 ALSO A PHAGOCYTE
 CONTAINS LYSOSOMAL ENZYMES AND PERIXODASE IN THEIR GRANULE WHICH ARE TOXIC TO
PARASITES, RESULTING IN THE DESTRUCTION OF THE ORGANISM
 NUMBERS INCREASES IN ALLERGY
BASOPHIL
 LEAST ABUNDANT ONLY 1% OF GRANULOCYTE & CONTAIN ELONGATED LOBED NUCLEI
 IN INFLAMMED TISSUE THEY BECOME MAST CELL & SECRETE GRANULES CONTAINING HEPARIN,
HISTAMINE AND OTHER PROTEINS THAT PROMOTE INFLAMMATION
 SECRETE LIPID MEDIATORSM LEUKOTRIENES & CYTOKINS
 PROVIDES IMMUNITY AGAINST PARASITES & ALSO IN ALLERGIC RESPONSE, AS THEY HAVE IgE
ON THE SURFACE & RELEASE CHEMICAL MEDIATORS THAT CAUSES ALLERGIC SYMPTOMS WHEN
IgE BINDS TO SPECIFIC ANTIGEN
MONOCYTE
 5% OF AGRANULOCYTE AND ARE CIRCULATING LEUKOCYTE
 THE NUCLEUS OF THE MONOCYTE IS KIDNEY OF HORSESHOE SHAPED
 SOME MIGRATE TO TISSUES WHERE THEY DEVELOP INTO MACROPHAGES AND ENGULF
PATHOGENS OR FOREIGN MATERIAL
 MACROPHAGES PLAY A VITAL ROLE IN IMMUNITY & INFLAMMATION BY DESTROYING SPECIFIC
ANTIGEN
LYMPHOCYTE
 25% OF THE LEUKOCYTE, MOST ARE FOUND IN THE LYMPHATIC TISSUE SUCH AS LYMPH NODES
AND SPLEEN
 THEY CAN LEAVE AND RE-ENTER THE CIRCULATORY SYSTEM
 LYMPHOCYTES ARE NOT PHAGOCYTES
 T-LYMPHOCYTE-ORIGINATES FROM THYMUS, MEDIATE CELLULAR IMMUNE RESPONSE WHICH IS
PART OF THE BODY’S OWN DEFENCE
 B-LYMPHOCYTE-ORIGINATES FROM THE BONE MARROW, BECOME LARGE PLASMA CELLS &
PRODUCE ANTIBODIES THAT ATTACH TO ANTIGEN
PLATELET
 PLAY A VITAL ROLE IN BLOOD LOSS BY THE FORMATION OF PLATELET PLUGS WHICH SEAL THE
HOLES IN THE BLOOD VESSELSAND RELEASE CHEMICAL THAT AIDS IN CLOTTING
 DECREASE PLATELET = BLEEDING
 INCREASE PLATELET = BLOOD CLOT LEDING TO CVA, DVT, HEART ATTACK OR PE
HEMOSTASIS
 SEQUENCE OF RESPONSES THAT STOPS BLEEDING & CAN PREVENT HEMORRHAGE FROM
SMALLER BLOOD VESSEL
A. VASOCONSTRICTION
B. PLATELET AGGREGATION
C. COAGULATION
VASOCONSTRICTION
 RESULT FROM CONTRACTION OF THE VESSEL WALL, THUS PREVENTING BLOOD FLOW THROUGH
THEM. THIS ACTION IS SNS (SYMPATHETIC NERVOUS SYSTEM) WHICH RESTRICTS BLOOD FLOW
FOR SEVERAL MINUTES OR SEVERAL HOURS
PLATELET AGGREGATION
 ADHERES TO THE EXPOSED COLLAGEN FIBERS OF THE CONNECTIVE TISSUE OF THE DAMAGED
BLOOD VESSEL, RELEASE ADENOSINE DIPHOSPHATE, THROMBOXANE & OTHER CHEMICALSTHAT
MAKE OTHER PLATELET IN THE AREA STICKY, AND THEY WILL CLAMP TOGETHER TO FORM A
PLATELET PLUG
COAGULATION
 STOPS BLEEDING WITH THE AID OF CLOTTING FACTORS
EXTRINSIC PATHWAY
 RAPID CLOTTING SYSTEM ACTIVATED WHEN BLOOD VESSEL ARE RUPTURED AND TISSUE
DAMAGE TAKES PLACE
INTRINSIC PATHWAY
 SLOWER THAN THE EXTRINSIC PATHWAY AND IS ACTIVATED WHEN THE INNER WALL OF THE
BLOOD VESSEL ARE DAMAGED
CLOTTING DISORDERS
A. ATHEROMA
B. DVT
C. GENETIC CONDITION
D. CERTAIN MEDICATIONS
E. LIVER DISORDERS
TESTS
A. BLOOD COUNT
B. BLEEDING TIME=NV 3-8MIN
C. BLOOD CLOTTING TESTS=PT, PTT
D. PLATELET AGGREGATION TEST
ANTICOAGULANTS
 REDUCE THE ABILITY OF BLOOD TO CLOT, A BLOOD CLOT CAN LEAD TO STROKE AND HEART
ATTACK
 HEPARIN, WARFARIN
 OTHER ALTERNATIVE MEDS TO WARFARIN
RIXAROXABAN
DABIGATRAN
APIXABAN
 S/SX
A. PASSING BLOOD IN THE URINE OR STOOL
B. SEVERE BRUISING
C. EXCESSIVE BLEEDING (HEMORRHAGE)
D. BLEEDING GUMS
E. EPISTAXIS (PROLONGED)
F. MELENA (BLACK STOOL)
G. DOB/CHEST PAIN
H. INCREASE MENSTRUAL FLOW
 NSG
A. MONITOR CLOSELY TO CHECK THAT THEY ARE ON THE CORRECT DOSE AND NOT AT RISK OF
EXCESSIVE BLEEDING FOR PT TAKING ANTI-COAGULANTS
B. THE MOST COMMON TEST IS INR (INTERNATIONAL NORMALIZE RATION) MAGIC # 3.5
BLOOD PRESSURE (BP)
 PRESSURE EXERTED BY BLOOD WITHIN THE BLOOD VESSEL
3 FACTORS THAT REGULATE BP
1. NEURONAL REGULATION
 THROUGH AUTONOMIC NERVOUS SYSTEM
2. HORMONAL REGULATION
 ADRENALINE, NORADRENALINE, RENIN & OTHERS
3. AUTO REGULATION
 THROUGH RAS –RENIN-ANGIOTENSIN SYSTEM
PHYSIOLOGIC FACTORS REGULATING BP
A. CARDIAC OUTPUT
 VOLUME OF BLOOD PUMPEDOUT BY THE HEART IN 1 MINUTE
B. CIRCULATION VOLUME
 VOLUME OF CIRCULATING BLOOD PERFUSING TISSUES
C. PERIPHERAL RESISTANCE
 THE RESISTANCE PROVIDED BY THE BLOOD VESSELS
D. BLOOD VISCOSITY
 THE MEASURE OF THE RESISTANCE OF BLOOD FLOW
E. HYDROSTATIC PRESSURE
 THE PRESSURE EXERTED BY BLOOD ON THE VESSEL WALL
CONTROL OF ARTERIAL BLOOD PRESSURE
A. BARORECEPTOR
 SENSITIVE TO PRESSURE CHANGES WITHIN THE BLOOD VESSEL
B. CHEMORECEPTOR
 DETECTING CHANGES IN THE LEVEL OF OXYGEN, CARBON DIOXIDE & HYDROEGN IONS
C. CIRCULATING HORMONES
 ADH & ANP (ATRIAL NATIURETIC PEPTIDE)HELPS TO REGULATE CIRCULATING BLOOD VOLUME
D, RENIN-ANGIOTENSIN SYSTEM (RAS)
 MAINTAIN BP THROUGH VASOCONSTRICTION
D. HYPOTHALAMUS
 RESPONDS TO STIMULI SUCH AS EMOTION, PAIN & ANGER AND STIMULATES SYMPATHETIC
NERVOUS SYSTEM
LYMPHATIC SYSTEM
A. LYMPH
B. LYMPH VESSELS
C. LYMPH NODES
D. LYMPHATIC ORGANS SUCH AS SPLEEN & THYMUS
LYMPH
 A CLEAR FLUID INSIDE THE LYMPHATIC CAPILLARIES AND HAS A SIMILAR COMPOSITION TO
PLASMA
LYMPH NODES
 BEAN-SHAPED ORGANS LOCATED ALONG THE LYMPHATIC VESSELS
 THESE NODES ARE FOUND IN THE LARGEST CONCENTRATION IN THE NECK, ARMPIT, ABDOMEN
AND GROIN
 THE LYMPHOCYTE IN THE LYMPH NODE FILTER OUT HARMFUL SUBSTANCES FROM THE LYMPH
AND THE SITES FOR SPECIFIC DEFENCE OF THE IMMUNE SYSTEM
EDEMA
 BUILD UP OF FLUIDS CAUSING AFFECTED TISSUE TO BECOME SWOLLEN
 S/SX
SKIN DISCOLORATION
PITTING EDEMA
ACHING, TENDER LIMBS
STIFF JOINTS
WEIGHT GAIN OR LOSS
RAISED BP & PR


 TREATMENT
LOOSE WEIGHT
EXERCISE
DIURETICS
HODGKIN LYMPHOMA
 BLOOD CANCER
 DEVELOPS IN THE LYMPH NODES OF THE LYMPHATIC SYSTEM
 MOST COMMON FORM OF BLOOD CANCER IN TEENAGER AND YOUNG ADULTS
 APPEARS AS SOLID TUMOR IN THE GLAND IN THE NECK, CHEST, ARMPIT AND GROIN
 REED-STERNBERG CELLS
TREATMENT (ABVD)
A=ADRIAMYCIN
B=BLEOMYCIN
V-VINBLASTINE
D=DACARBAZINE
4 WEEKS CYCLE,ADMINISTER DRUG ON DAY 1 & 15 OF EACH CYCLE
 S/E OF CHEMOTHERAPY
NAUSEA
HAIR LOSS
LOW WBC
 S/E OF ABVD
A. HEART PROBLEM CAUSED BY ADRIAMYCIN
B. FEVER OR RASH CAUSED BY BLEOMYCIN
C. LUNG CONDITION CALLED FIBROSIS CAUSED BY BLEOMYCIN
D. ULCERS OR BLISTERS CAUSED BY VINBLASTINE
E. HEADACHES, FATIGUES OR DIARRHEA CAUSED BY DACARBAZIBE
PERICARDIUM
 SURROUNDS THE HEART
FIBROUS PERICARDIUM
 PREVENTS THE OVER STRETCHING OF THE HEART
 PROVIDES PROTECTION AND ANCHORS THE HEART
SEROUS PERICARDIUM
 THINNER AND MORE DELICATE LAYER
A. PARIETAL PERICARDIUM
 THE OUTER LAYER FUSED TO THE FIBROUS PERICARDIUM
B. VISCERAL PERICARDIUM (EPICARDIUM)
 ADHERE TIGHTLY TO THE SURFACE OF THE HEART
PERICARDIAL FLUID
 A THIN FILMED FLUID THAT REDUCES THE FRICTION BETWEEN THE MEMBRANES OF THE HEART
PERICARDIAL CAVITY
 THE SPACE CONTAINING THE PERICARDIAL FLUID
MYOCARDIUM
 HEART MUSCLE ONLY FOUND IN THE HEART
 RESPONSIBLE FOR HEART CONTRACTION
INTERCALATED DISC
 THICKENING OF SARCOLEMMA (PLASMA MEMBRANE)
2 FUNCTIONS OF INTERCALATED DISC
 DESMOSOMES HOLD THE CELL TOGETHER SO THAT THE FIBRES DO NOT PULL APART
 GAP JUNCTION ALLOW THE RAPID PASSAGE OF ACTION POTENTIAL (ELECTRICAL CURRENT)
BETWEEN CELLS
REMEMBER
CARDIAC MUSCLE REQUIRE A LARGE SUPPLY OF OXYGEN AND IS LESS ABLE TO COPE WITH
REDUCTION OF AVAILABLE OXYGEN
ENDOCARDIUM
 LAYER OF SMOOTH SIMPLE EPITHELIUM LINING THE INSIDE OF THE HEART MUSCLE & THE
HEART VALVES
 CONNECTED SESAMLESSLY TO THE LINING OF THE BLOOD VESSELS THAT ARE CONNECTED TO
THE HEART
THE HEART CHAMBERS
A. RIGHT HEART=DEOXYGENATED BLOOD FROM TISSUES AND PUMPS THE BLOOD TO THE
PULMONARY CIRCULATION
B. LEFT HEART=RECEIVES OXYGENATED BLOOD FROM THE PULMONARY CIRCULATION AND PUMPS
THE BLOOD TO THE SYSTEMIC CIRCULATION
ATRIA
A. RIGHT ATRIUM=RECEIVES BLOOD FROM 3 VEINS
1. SUPERIOR VENA CAVA=DRAINS BLOOD FROM UPPER PART OF THE BODY
2. INFERIOR VENA CAVA=DRAINS BLOOD FROM THE LOWER PART OF THE BODY
3. CORONARY SINUS=DRAINS BLOOD FROM THE CIRCULATION OF THE HEART
B. LEFT ATRIUM=FORMS MOST OF THE BASE OF THE HEART & RECEIVES BLOOD FROM THE LUNGS
THROUGH 4 PULMONARY VEINS
INTERATRIAL SEPTUM=DIVIDING WALL BETWEEN THE ATRIA
2 VALVES BETWEEN THE ATRIA AND VENTRICLES
A. TRICUSPID VALVE=MADE UP OF 3 CUSPS & LIES BETWEEN THE RIGHT ATRIUM AND RIGHT
VENTRICLE
B. BICUSPID VALVE (MITRAL)=MADE UP OF 2 CUSPS AND LIE BETWEEN THE LEFT ATRIUM AND LEFT
VENTRICLE
REMEMBER
THE PURPOSE OF THE AV VALVE IS TO PREVENT THE BACKFLOW OF BLOOD FROM THE VENTRICLES
INTO THE ATRIA
VENTRICLES
A. RIGHT VENTRICLE=RECEIVES BLOOD FROM THE RIGHT ATRIUM & PUMPS BLOOD OUT INTO THE
PULMONARY CIRCULATION (LUNGS) AS THE PRESSURE IN THE PULMONARY CIRCULATION IS
QUITE LOW THE RIGHT VENTRICLE HAS A THINNER WALL THEN THE LEFT VENTRICLE
B. LEFT VENTRICLE=RECEIVES BLOOD FROM THE LEFT ATRIUM AND PUMPS BLOOD INTO THE
SYSTEMIC CIRCULATION VIA THE AORTA, ALSO HAS A HIGHER PRESSURE & OVER A GREATE
DISTANCE , IT HAS A MORE THICKER WALL
INTERVENTRICULAR SEPTUM=DIVIDING WALL BETWEEN VENTRICLES
A. PULMONARY VALVE
 LIES BETWEEN THE RIGHT VENTRICLE OF THE PULMONARY ARTERIES TO PREVENT THE
BACKFLOW OF THE BLOOD INTO THE RIGHT VENTRICLE FROM THE PULMONARY ARTERIES
B. AORTIC VALVE
 LIES BETWEEN THE VENTRICLES AND THE AORTA & PREVENTS THE BACKFLOW OF BLOOD INTO
THE LEFT VENTRICLE FROM THE SYSTEMIC CIRCULATION
BALLOON VALVULOPLASTY=DILATION OF AORTIC VALVE USING A BALLOON DURING CARDIAC
CATHETERIZATION
VALVULAR INCOMPETENCE (REGURGUTATION)
 THE VALVE BECOMES UNABLE TO CLOSE PROPERLY AND THUS THERE IS A BACKWAWRD FLOW
OF BLOOD INTO THE HEART CHAMBER BEHINDTHE VALVE
 COMMON IN THE MITRAL AND AORTIC VALVE
 CAUSES INCLUDE AGE-RELATED DEGENERATION OF THE VALVE, INFECTION OF THE VALVE &
CORONARY HEART DISEASE
VALVE STENOSIS
 THE VALVE BECOMES STIFF AND THE LEAFLETSOF THE VALVE MAY FUSE TOGETHER, THUS
NARROWING THE OPENING THE BLOOD CAN PASS THROUGH
 USUALLY FOUND IN TRICUSPID, AORITC AND BICUSPID VALVE
 COMMON CAUSE IS FRHEUMATIC FEVER & AGE RELATED CHANGES IN THE CASE OF AORTIC
VALVE STENOSIS
CARDIAC CATHETERIZATION (ANGIOGRAM)
 IS THE INSERTION OF A CATHETER THROUGH A LARGE BORE ARTERY (NORMALLY IN THE GROIN
OR ARM) TO THE HEART WHERE X-RAY DYE CAN BE INJECTED INTO THE CORONARY ARTERIES IN
ORDER TO GAIN AN IMAGE OF ANY NARROWING OF THE LUMEN THAT MAY BE REDUCING THE
BLOOD FLOW TO THE CARDIAC MUSCLE
 NSG
A. ENCOURAGE PT TO INCREASE OFI
B. BR TO BR SAT 30 DEGREES-TO MOBILIZE
C. MONITOR BLEEDING AT THE INSERTION SITE
D. MONITOR FOR HEMATOMA
E. MONITOR BP & PR
CARDIAC MEDICATIONS
DILTIAZEM
 CCB
 REDUCE THE FORCE OF THE CONTRACTION OF THE HEART BY REDUCING THE INFLUX OF
CALCIUM INTO THE MYOCYTES
 REDUCES THE WORK OF THE HEART
 NOT AFFECTED BY GRAPEFRUIT
CCB
 TREATMENT FOR HYPERTENSION
 S/SX
SWOLLEN ANKLES
ANKLE OR FOOT PAIN
CONSTIPATION
SKIN RASHES
FLUSHED FACE
HEADACHE
DIZZINESS/TIREDNESS
 AVOID GRAPEFRUIT
MYOCARDIAL INFARCTION
 WHEN ONE OF THE ARTERIES SUPPLYING THE HEART BECOMES BLOCKED BY A THROMBUS
(BLOOD CLOT)
2 TREATMENTS FOR MYOCARDIAL INFARCTION (MI)
A. THROMBOLYTICS
 ADMINISTRATION OF THROMBOLYTIC DRUGS IN ORDER TO BREAK UP THE CLOT & RETURN
BLOOD FLOW THROUGH THE ARTERY
 MONITOR
BLEEDING
HYPOTENSION
DISTURBANCE IN HEART RHYTHM
B. PERCUTANEOUS CORONARY INTERVENTION (PCI)
 SPECIAL PROCEDURE REQUIRING DEDICATED CARDIAC CATHETERIZATION SUITE (A FORM OF
OPERATING THEATRE WITH SPECIAL IMAGING EQUIPMENT), TRAINED STAFF AND VARIOUS
CARDIAC CATHETERS BALLOONS AND STENTS
 CATHETER IS INSERTED THROUGH A HOLE MADE IN THE FEMORAL ARTERY AND THE CATHETER
IS MANEUVERED TO THE ARTERY WHERE THE BLOCKAGE IS SITUATED
 A BALLOON IS THEN PASSED THROUGH AND INFLATED TO PUSH THE THROMBUS INTO THE
WALLS OF THE ARTERY AND IF NECESSARY A METAL CAGE (STENT) IS INSERTED INTO THE
ARTERY TO KEEP THE ARTERY OPEN.
BLOOD FLOW THROUGHT HE HEART
THE LUNGS
RIGHT ATRIUM
LEFT ATRIUM
RIGHT VENTRICLE
RIGHT VENTRICLE
THE BODY
HEART ELECTRICAL IMPULSE
SA (SINOATRIAL)
AV (ATRIOVENTRICULAR)
BUNDLE IF HIS
BUNDLE BRANCHES
PURKINJI FIBERS
REMEMBER
RIGHT SIDED HEART FAILURE=SYSTEMIC COMPLICATION (EX. EDEMA)
LEFT SIDED HEART FAILURE=PULMONARY COMPLICATION (EX. SOB, DOB)
DIGOXIN
 CARDIAC GLYCOSIDE USED IN TREATMENT OF HEART FAILURE AND ARRHYTHMIA OF THE ATRIA
 SLOWS AND STRENGHTENS THE HEART
 DECREASE HR & INCREASE FORCE OF CONTRACTION
 TOXICITY
DECREASE HR
DIZZINESS
DECREASE EXCRETION OF DIGOXIN
 S/SX OF TOXICITY
N=NAUSEA
A=ANOREXIA
V=VOMITING
D=DIARRHEA
A=ABDOMINAL PAIN
X=XANTHOPSIA
K=POTASSIUM INCREASE
 ANTIDOTE=DIGIBIND
 NSG
CHECK PR BEFORE ADMINISTERING THE DRUG, IF THE PR IS BELOW 60BPM WITHHILD THE DRUG
AND SOUGHT FOR MEDICAL ADVICE
NODAL CELLS
 PACEMAKER CELLS
 CREATE ELECTRICAL IMPULSE
2 GROUPS OF NODAL CELLS
A. SA NODE
 LOCATED AT THE RIGHT ATRIUM WHICH GENERATE IMPULSE AT APPROXIMATELY 7080/MINUTE
B. AV NODE
 LOCATED JUST ABOVE THE POINT WHERE ATRIA AND VENTRICLES MEET
 GENERATES IMPULSE AT 40-60/MINUTE
ECG
RED=RIGHT ARM
YELLOW=LEFT ARM
BLACK=RIGHT LEG
GREEN=LEFT LEG
V1=4TH ICS, RIGHT STERNAL BORDER
V2=4TH ICS, LEFT STERNAL BORDER
V3=MIDWAY BEWEEN V2 & V4
V4=5TH ICS MIDCLAVICULAR LINE (APICAL PULSE AREA)
V5=LEVEL WITH V4, LEFT ANTERIOR AXILLARY LINE
V6=LEVEL WITH V4, MID AXILLARY LINE
SYSTOLE=CONTRACTION OF A HEART CHAMBER (ATRIUM & VENTRICLE)
DIASTOLE=RELAXATION OF A HEART CHAMBER (ATRIUM & VENTRICLE)
ECG READING
P=ATRIAL DEPOLARIZATION (ATRIAL CONTRACTION
QRS COMPLEX=VENTRICULAR DEPOLARIZATION (VENTRICULAR CONTRACTION HAPPENS AFTER THE
PEAK OF R-WAVE
T=VENTRICULAR REPOLARIZATION (VANTRICULAR RELAXATION)
CARDIAC OUTPUT=AMOUNT OF BLOOD THE HEART PUMPS OUT IN 1 MINUTE
CO=STROKE VOLUME (SV) X HEART RATE (HR)
STROKE VOLUME= END DIASTOLIC VOLUME (EDV)-END SYSTOLIC VOLUME (ESV)
FACTORS THAT AFFECTS ESV
A. PRELOAD
B. FORCE OF CONTRACTION
C. AFTER LOAD
FRANK-STARLING LAW
 THE FORCE THE CARDIAC MUSCLE FIBERS CONTRACT WITH DURING SYSTOLE IS AFFTED BY THE
AMOUNT OF STRETCH THEY ARE SUBJECTED TO (THE GREATER THE STRETCH, THE GREATER THE
FORCE)
ATORVASTATIN
 CHOLESTEROL-LOWERING MEDICATION
 ONCE A DAY
 TAKE AT NIGHT
 AVOID GRAPE FRUIT
REMEMBER
SYMPATHETIC NERVOUS SYSTEM (SNS)=NORADRENALINE-INCREASE HEART RATE
PARASYMPATHETIC NERVOUS SYSTEM (PNS)=ACETYLCHOLINE-DECREASE HEART RATE
S=SALIVATION
L=LACRIMATION
U=URINATION
D=DIGESTION
MNEMONIC FOR PARASYMPATHETIC NERVOUS SYSTEM
D=DIGESTION
U=URINATION
M=MIOSIS
B=BRADYCARDIA
B=BRADYPNEA
E=EMESIS
L=LACRIMATION
MEDULLA OBLONGATA=CARDIAC CENTER
HORMONES
A. ADRENALINE=RELEASE BY SNS
B. THYROXINE= FROM THYROID GLAND-INCREASE HEART RATE
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CALCIUM CHANNEL BLOCKERS
ARE LIKE VALIUM FOR YOUR HEART
CALMS DOWN THE HEART
(- INOTROPIC, -DROMOTROPIC, -CHRONOTROPIC)-CARDIAC DEPRESSANTS - RELAXES THE HEART
WEAKEN, SLOW DOWN AND DEPRESS THE HEART
+ INOTROPES, + CHRONOTROPES, + DROMOTROPES – STIMULATES THE HEART
TREAT A AA AAA
A=ANTI HYPERTENSIVES
AA=ANTI-ANGINA DRUGS-TREATS ANGINA BY DECREASING OXYGEN DEMANDS
AAA=ANTI-ATRIAL ARRHYTHMIA + SVT(SUPRA VENTRICULAR TACHYCARDIA)
S/E H & H (HEADACHE & HYPOTENSION)
ANYTHING ENDING IN “DEPINE” EX, AMLODEPINE & DILTIAZEM & VERAPAMIL & CARDIZEM
MONITOR BP
HOLD CCB IF THE SYSTOLIC IS UNDER 100
KEEP SYSTOLIC ABOVE 100 (TITRATE IF ON IV DRIP)
CARDIAC ARRYTHMIAS
NORMAL SINUS RHYTHM=PQRST WAVE IS PRESENT
V-FIB-CHAOTIC SQUIDDLY LINE-NO PATTERN
V-TACH-SHARP PEAKS-THERE IS PATTERN
ASYSTOLE-FLATLINE
WOLFF PARKINSON WHITE SYNDROME
QRS=VENTRICULAR DEPOLARIZATION
P= ATRIAL DEPOLARIZATION
FLUTTER=SAWTOOTH
CHAOTIC=FIBRILLATION
BAZAAR=TACHYCARDIA
LETHAL ARRHYTHMIAS
1. ASYSTOLE BOTH DOES NOT HAVE CARDIAC OUTPUT, NO BRAIN PERFUSION
2. V-FIB
V-TACH=MODERATE-HAS CARDIAC OUTPUT
PVC & V-TACH-USE LIDOCAINE OR AMIODARONE
ATRIAL ARRYTHMIAS USE ABCD
A=ADENOSINE/ADENOCARD- NEED TO PUSH IN LESS THAN 8 SEC (FAST IV PUSH)
 PT CAN GO TO ASYSTOLE FOR 30 SEC BUT PT CAN COME OUT OF IT
B=BETA BLOCKERS “LOL”= (-INO,-CHRONO,-DROMO) TREAT A AA AAA
 S/E H & H (HEADACHE & HYPOTENSION)
C=CCB “DEPINE”= (-INO,-CHRONO,-DROMO) TREAT A AA AAA
 S/E H & H (HEADACHE & HYPOTENSION)
D=DIGITALIS (DIGOXIN, LANOXIN)=
 DIGOXIN TOXICITY NAVDAX
N=NAUSEA
A=ANOREXIA
V=VOMITING
D=DIARRHEA
A=ABDOMINAL PAIN
X=XANTHOPSIA
REMEMBER
IN REGARDS TO ANY IV PUSH MEDICATION REMEMBER IF YOU DON’T KNOW YOU GO SLOW
REMEMBER
V-FIB=DEFIB (SHOCK THE PT)
ASYSTOLE= GIVE EPINEPHRINE FIRST THEN FOLLOWED BY ATROPINE
CHEST TUBE
 RE-ESTABLISH NEGATIVE PRESSURE IN THE PLEURAL SPACE
 NEGATIVE MAKES THINGS STICK TOGETHER
PNEUMOTHORAX=CHEST TUBE REMOVES AIR
HEMOTHORAX=CHEST TUBE REMOVES BLOOD
PNEUMOHEMOTHORAX=CHEST TUBE REMOVES AIR & BLOOD
2 LOCATION OF THE TUBE (APICAL & BASILAR)
A. APICAL= CHEST TUBE IS WAY UP HIGH (REMOVES AIR)=AIR GOES UP
B. BASILAR= CHEST TUBE IS AT THE BUTTOM (REMOVES BLOOD)=BLOOD GOES DOWN BY VIRTUE
OF GRAVITY
REMEMBER
WATER SEAL=INTERMITTENT BUBBLING IS GOOD (DOCUMENT IT)
WATER SEAL=CONTINUOUS BUBBLING IS BAD (LOOK FOR IT)
SUCTION CONTROL CHAMBER=INTERMITTENT BUBBLING IS BAD (SUCTION IS TOO LOW)
SUCTION CONTROL CHAMBER=CONTINUOUS BUBBLING IS GOOD (DOCUMENT IT)
NEVER CLAMP A TUBE FOR 15 SEC WITHOUT A DOCTOR’S ORDER (RUBBER TIP CLAMPS)
PNSS AT BEDSIDE
GASTRO INTESTINAL SYSTEM
 TO CONVERT FOODTO A FORM THAT CAN BE UTILIZED BY THE CELLS OF THE BODY IN ORDER TO
CARRY OUT THEIR SPECIFIC TASK
ACTIVITIES OF DIGESTIVE SYSTEM
INGESTION
 TAKING FOOD INTO THE DIGESTIVE SYSTEM
PROPULSION
 MOVING THE FOOD ALONG THE LENGTH OF THE DIGESTIVE SYSTEM
DIGESTION
 BREAKING DOWN FOOD
 MECHANICAL DIGESTION=FOOD IS CHEWED, MOVE THROUGH THE DIGESTIVE SYSTEM
 CHEMICALLY=BY THE ACTION OF ENZYMES MIXED WITH THE FOOD AS IT MOVES THROUGH THE
DIGESTIVE SYSTEM
ABSORPTION
 THE PRODUCT OF DIGESTION EXITS THE DIGESTIVE SYSTEM AND ENTERS THE BLOOD OR LYMPH
CAPILLARIESFOR DISTRIBUTIONTO WHERE THEY ARE REQUIRED
ELIMINATION
 THE WASTE PRODUCT ARE EXCRETEDFROM THE BODY AS FECES
GI ORGANS
MOUTH
 FOOD ENTERS THE ORAL CAVITY IN THE PROCESS CALLED INGESTION
 THE FOOD MIXES WITH SALIVA
 MASTICATION
TONGUE
 LARGE,VOLUNTARY MUSCULAR STRUCTURE THAT OCCUPIES MUCH OF THE ORAL CAVITY
 IT IS ATTACHED POSTERIORLY TO THE HYRID BONE & INFERIORLY BY THE FRENELUM
 PAPILLAE=TASTE BUDS
PALATE
 FORMS THE ROOF OF THE MOUTH
 HARD PALATE=LOCATEDANTERIORLY AND IS BONY
SOFT PALATE
 LIES POSTERIORLYAND CONSISTS OF SKELETAL MUSCLES & CONNECTIVE TISSUES
OVULA
 IS A FOLD OF TISSUE THAT HANGS DOWN FROM THE CENTER OF THE SOFT PALATE
TEETH
 TEMPORARY TEETH (DECIDUOUD OR MILK TEETH) = BEGINS TO APPEAR ABOUT 6 MONTHS OLD,
THERE ARE 20 TEMPORARY TEETH AND THESE ARE REPLACED BY PERMANENT TEETH FROM
ABOUT 6 YEARS
 PERMANENT TEETH = THERE ARE 32 PERMANENT TEETH, 16 ARE LOCATED IN MAXILLA ARCH
(UPPER), 16 ARE LOCATED IN MADIBLE (LOWER)
 CUTTING & INCISORS=CUTTING/TEARING
 PRE-MOLARS = GRINDING
 CROWN = VISIBLE PART OF TOOTH, SITS ABOVE THE GUMS/GINGIVA
 PULP CAVITY = CENTER OF THE TOOTH, BLOOD AND LYMPH VESSEL AS WELL AS NERVES ENTERS
AND LEAVESTHE TOOTH HERE, RECEIVES BUTRIENTS & SENSATION THROUGH THE PULP
DENTINE
 SURROUNDS THE PULP CAVITY
 CALCIFIED MATRIX UNLIKE THE BONE
ENAMEL
 SURROUND THE DENTINE
CEMENTUM
 BONE-LIKE MATERIAL THAT ANCHORS THE TEETH
SALIVARY GLAND
A. PAROTID GLAND = LARGEST & LOCATED ANTERIOR TO THE EAR, SALIVA FROM THE PAROTID
GLAND ENTERS THE ORAL CAVITY CLOSE TO THE LEVEL OF THE SECOND UPPER MOLAR TOOTH
B. SUB-MADIBULAR GLAND = LOCATED BELOW THE JAW ON EACH SIDE OF THE FACE, SALIVA
FROM THIS GLAND ENTERS THE ORAL CAVITY FROM BESIDE THE FRENELUM OF THE TONGUE
C. SUBLINGUAL GLANDS = SMALLEST, LOCATED AT THE FLOOR OF THE MOUTH, PNS INCREASE
PRODUCTION OF SALIVA, SNS DECREASE PRODUCTION OF SALIVA
REMEMBER
1-1.5 LITERS OF SALIVA ARE EXCRETED DAILY
SALIVARY AMYLASE
 DIGESTIVE ENZYME RESPONSIBLE FOR BEGINNING THE BREAKDOWN OF CARBOHYDRATE
MOLECULES FROM COMPLEX POLYSACCHARIDES TO THE DISACCHARIDE MALTASE
LYSOZYME
 COMPONENT OF SALIVA WHEREIN IT HAS AN ANTI-BACTERIAL FUNCTION
IMMUNOGLOBULIN & CLOTTING FACTOR
 CONTRIBUTE TO THE PREVENTION OF INFECTION
PHARYNX
 OROPHARYNX, NASOPHARYNX, LARYNGOPHARYNX
EPIGLOTTIS
 RESPONSIBLE OF CLOSING THE ENTRANCE TO THE LARYNX DURNG SWALLOWING, AND THIS
ESSENTIAL ACTION PREVENTS FOOD FROM ENTERING THE LARYNX & OBSTRUCTING THE
RESPIRATORY PASSAGES
3 PHASES OF SWALLOWING (DEGLUTITION)
A. VOLUNTARY PHASE
 MANIPULATES THE FOOD BOLUS INTO OROPHARYNX
B. PHARYNGEAL PHASE
 CONTRACTION OF THE MUSCLE OF OROPHARYNX
 CLOSING THE NASOPHARYNX
C. ESOPHAGEAL PHASE
 FOOD BOLUS MOVES FROM PHARYNX TO ESOPHAGUS
ESOPHAGUS
 EXTENDS FROM LARYNGOPHARYNX TO THE STOMACH
 THICK-WALLED STRUCTURE, MEASURING ABOUT 25CM IN LENGTH & LIES IN THE THORACIC
CAVITY, POSTERIOR TO THE TRACHEA
 TRANSPORT FOOD FROM THE MOUTH TO THE STOMACH
UPPER ESOPHAGEAL SPHINCTER
 REGULATES THE MOVEMENT OF SUBSTANCES INTO THE ESOPHAGUS
LOWER ESOPHAGEAL SPHINCTER
 CARDIAC SPHINCTER
 REGULATES THE MOVEMENT OF SUBSTANCES FROM THE ESOPHAGUS TO THE STOMACH
OMEPRAZOLE (PPI)=PROTON PUMP INHIBITOR
 USE TO TREAT
DYSPEPSIA
ACID REFLUX
ESOPHAGITIS
PEPTIC ULCER DISEASE
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OMEPRAZOLE (PPI)=PROTON PUMP INHIBITOR
WORKS IN THE PARIETAL CELL IN THE STOMACH INHIBITING THE PRODUCTION OF HCL ACID
20-40 MG DAILY
TAKE BEFORE MEALS
S/E
VOMITING
DIARRHEA
CONSTIPATION
STOMACH PAIN
HEADACHE
INCREASE FLATULENCE
NAUSEA
STRUCTURE OF DIGESTIVE SYSTEM
MUCOSA
 INNER MOST LAYER
 PRODUCTS OF DIGEESTION IS IN CONTACT WITH THIS LAYER
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3 LAYERS OF MUCOSA
A. MUCOUS EPITHELIUM (MUCOUS MEMBRANE)
SECRETION OF MUCOUS AND OTHER DIGESTIVE SYSTEM SECRETION SUCH AS SALIVA OR
GASTRIC JUICE
PROTECT DIGESTIVE SYSTEM FROM CONTINUOUS WEAR / TEAR
IN SMALL INTESTINE THIS LAYER IS INVOLVED IN ABSORPTION OF THE PRODUCT OF DIGESTION
B. LAMINA PROPRIA
SUPPORTS THE BLOOD VESSELS AND LYMPHATIC TISSUE OF THE MUCOSA
C. MUSCULARIS MUCOSA
OUTER MOST LAYER
CONSISTS OF A THIN-SMOOTH MUSCLE LAYER THAT HELPS TO FORM THE GASTRIC PITS OR THE
MICROVILLI OF THE DIGESTIVE SYSTEM
SUB-MUCOSA
 THIN LAYER OF CONNECTIVE TISSUE
 CONTAINS BLOOD & LYMPHATIC TISSUE AND SOME GLAND
 MEISSNER’S PLEXUS = NERVE THAT STIMULATES THE INTESTINAL GLANDS TO SECRET THEIR
PRODUCT
MUSCULARIS
 CONSISTS OF INNER LAYER OF CIRCULAR SMOOTH MUSCLE 7 AN OUTER LAYER OF
LONGITUDINAL SMOOTH MUSCLE
PERISTALSIS
 WAVE LIKE CONTRACTION AND RELAXATION
SEROSA
 OUTER LAYER OF DIGESTIVE TRACT
PERITONEUM
 LARGESET LAYER OF SEROSA THAT IS FOUND IN THE ABDOMEN AND PELVIC CAVITY
 A CLOSED SAC
A. VISCERAL PERITONEUM
 COVERS THE ORGAN OF THE ABDOMEN AND PELVIC CAVITY
B. PARIETAL PERITONEUM
 LINES THE ABDOMINAL WALL
STOMACH
 LIES IN THE ABDOMINAL CAVITY
 CARDIAC SPHINCTER=ESOPHAGUS
 PYLORIC SPHINCTER= SMALL INTESTINE (DUODENUM) – CONTROLS THE EXIT OF CHYME
CELIAC ARTERY
 SUPPLIES ARTERIAL BLOOD TO STOMACH
HEPATIC VEIN
 VENOUS BLOOD LEAVES THE STOMACH
VAGUS NERVE (CN10)
 INNERVATES THE STOMACH, STIMULATES GASTRIC MOTILITY & SECRETION OF GASTRIC JUICE
RUGAE
 LONG FOLDS IN THE STOMACH
SURFACE VENOUS CELLS
 PRODUCE THICK-BICARBONATE –COATED MUCOUS
 PROTECTS THE STOMACH MUCOSAL EPITHELIA FROM CORROSION OF ACIDIC GASTRIC JUICE
PARIETAL CELLS
 PRODUCE HCL ACID AND INTRINSIC FACTOR
 INTRINSIC FACTOR = VITAMIN B12 ABSORPTION
 VITAMIN B12-NECESSARY FOR PRODUCTION OF MATURE RBC
CHIEF CELLS
 PRODUCE PEPSINOGEN WHICH IS CONVERTED TO PEPSIN
 PEPSIN = NECESSARY FOR THE BREAKDOWN OF PROTEIN INTO SMALLERPEPTIDE CHAINS
ENTEROENDOCRINE CELLS
 PRODUCE VARIETY OF HORMONES, INCLUDING GASTRIN
 GASTRIN = HELPS REGULATE GASTRIC MOTILITY
REMEMBER
ABOUT 2 LITERS OF GASTRIC JUICE IS PRODUCED DAILY
HYDROGEN BREATH TEST
 USES THE MEASUREMENT OF HYDROGEN IN THE BREATH TO DISGUISE A NUMBER OF
CONDITIONS THAT CAUSES GI SYMPTOMS
 TEST PROCEDURE
A. PT BLOWS AND FILLS A BALLOON WOTH A BREATH OF AIR
B. CONCENTRATION OF HYDROGEN IS MEASURED IN A SAMPLE OF BREATH REMOVED FROM
THE BALLOON
C. PT INGEST A SMALL AMOUNT OF THE TEST SUGAR
D. ADDITIONAL SAMPLE OF BREATH ARE COLLECTED & ANALYZED FOR HYDROGEN EVERY 15
MINUTES FOR 3 HOURS & UPTO 5 HOURS
 AFTER INGESTION TEST DOSES OF DIETARY SUGARS, ANY PRODUCTION MEANS THAT THERE
HAS BEEN A PROBLEM WITH DIGESTION OR ABSORPTION OF THE TEST SUGAR AND THAT SOME
OF THE SUGAR HAS REACHED THE COLON
 BEFORE THE TEST THE PT FASTS FOR 12 HOURS
REGULATION OF GASTRIC JUICE SECRETION
A. CEPHALIC PHASE
 SIGHT, SMELL, TASTE OF FOOD STIMULATES THE SECRETION OF GASTRIC JUICE
B. GASTRIC PHASE
 FOOD ENTERS THE STOMACH, GASTRIN IS SECRETED IN THE BLOOD STREAM & STIMULATES
SECRETION OF GASTRIN
C. INTESTINAL PHASE
 SECRETIN & CHOLECYSTOKIN (CKK) ARE SECRETED,
 REDUCE THE SECRETION OF GASTRIC JUICE AND MOTILITY
ONDANSETRON
 BLOCKS SEROTONIN WHICH PROMOTES VOMITING
 ADULT DOSE 8MG BID
 ANTI-EMETIC
 OFTEN PRESCRIBED DURING CHEMOTHERAPY
 S/E
CONSTIPATION
HEADACHE
FLUSHING
SMALL INTESTINE
FOOD IS BROKEN DOWN BY MECHANICAL & CHEMICALDIGESTION & ABSORPTION OF THE
PRODUCTS OF DIGESTION TAKES PLACE
DUODENUM
 ENTRANCE TO THE SMALL INTESTINE
JEJUNUM
 MIDDLE PART OF THE INTESTINE
ILEUM
 MEETS THE LARGE INTESTINE AT THE ILEOCECAL VALVE
ILEOCECAL VALVE
 PREVENTS THE BACKFLOW OF THE PRODUCTS OF DIGESTION
SUPERIOR MESENTERIC ARTERY
 ARTERIAL BLOOD
SUPERIOR MESENTERIC VEIN
 NUTRIEN RICH VENOUS BLOOD AND EVENTUALLY INTO THE HEPATIC PORTAL VEIN TOWARDS
THE LIVER
ABSORPTIVE CELLS
 PRODUCES DIGESTIVE ENZYMES & ABSORBS DIGESTED FOOD
GOBLET CELLS
 SECRET MUCOUS TO PROTECT THE INTESTINE FROM ABRASION AND FROM THE ACIDIC CHYME
ENTERING THE SMALL INTESTINE
ENTEROENDOCRINE CELLS
 PRODUCE REGULATORY HORMONES SUCH AS SECRETIN AND CKK, THESE HORMONES ARE
RELEASED INTO THE BLOOD STREAMAND ACT ON THEIR TARGET ORGANTO RELEASE
PANCREATIC JUICE AND BILE
PANETH CELLS
 PRODUCE LYSOZOME WHICH PROTECT THE SMALL INTESTINE FROM PATHOGENSTHAT HAVE
SURVIVED THE ACIDIC CONDITION OF THE STOMACH
PEYER’S PATCHES
 LYMPHATIC TISSUE OF THE SMALL INTESTINE, ALSO PROTECT THE SMALL INTESTINE
2 TYPES OF MECHANICAL DIGESTION IN SMALL INTESTINE
A. SEGMENTAL CONTRACTION = HELPS TO MIX VARIOUS ENZYMES IN THE SMSALL INTESTINE WITH
THE CONTENTS OF CHYME & PERISTALSIS WHICH PROPELS THE FOOD DOWN THE LENGTH OF
THE SMALL INTESTINE AS WELL AS FACILITATING MIXING
B. CHEMICAL DIGESTION = COMPLETES THE BREAKDOWN OF CARBOHYDRATES, FATS & PROTEIN,
PANCREATIC JUICE FROM THE PANCREAS, BILE FROM THE GALL BLADDER& INTESTINAL JUICE
CONTRIBUTE TO THIS
AMYLASE=CARBOHYDRATE (CHO)
BILE = FATS & FATTY ACID (LIPASE), BREAKDOWN OF FAT IS GLYCEROL
TRYPSIN = PROTEN (CHON)
PANCREAS
 EXOCRINE AND ENDOCRINE
ISLETS OF LANGERHANS
 ENDOCRINE HORMONES
INUSLIN
CARBOHYDRATE METABOLISM
GLUCAGON
ACINI GLAND
 EXOCRINE PANCREAS PRODUCES 1.2-1.5 LITERS OF PANCREATIC JUICE DAILY
 PANCREATIC JUICE TRAVELS FROM THE PANCREAS VIA PANCREATIC DUCT INTO THE
DUODENUM AT THE HEPATOPANCREATIC AMPULLA
CREON
 IS A MEDICATION PRESCRIBED FOR PTWHO CYSTIC FIBROSIS OR PANCREATIC INSUFFICIENCY
 AMYLASE-CHO
 LIPSE – FATS
 PROTEASES – CHON
 CREON IS TAKEN FOR LIFE
 S/E
ABDOMINAL DISTENTION
NAUSEA
VOMINTING
DIARRHEA
CONSTIPATION
 ENTERIC COATED TABLETS
PANCREATIC INSUFFICIENCY
 CAN OCCUR AS A RESULT OF PANCREATIC CANCER, PANCREATIC SYMPTOMS, ACUTE OR
CHRONIC PANCREATITIS
CYSTIC FIBROSIS
 THE DUCTS THAT TRANSPORTS THE PANCREATIC ENZYME BECOMES OBSTRUCTED WITH THE
INCREASE MUCOUS PRODUCTION ASSOCIATED WITH THE DISEASE
LIVER
 LARGEST GLAND
 RIGHT HYPOCHONDRIAC REGION & EXTENDS THROUGH PART OF THE EPIGASTRIC REGION, INTO
THE LEFT HYPOCHONDRIAC REGION
 RIGHT LOBE IS THE LARGEST OF THE 4 LIVER LOBES
PORTAL FISSURE
 ENTRY & EXIT OF BLOOD, LYMPH, VESSELS, NERVES & BILE DUCTS
HEPATOCYTE
 TINY HEXAGONAL-SHAPED LOBULES
KUPFFER CELLS (HEPATIC MACROPHAGES)
 PROTECT HEPATOCYTE
 DEALS WITH FOREIGH BODIES & WORN OUT CELLS
HEPATIC ARTERY
 SUPPLIES OXYGENATED BLOOD
HEPATIC VEIN
 DELIVERS NUTRIENT-RICH DEOXYGENATED BLOOD FROM THE DIGESTIVE TRACT
COMMON HEPATIC DUCT
 DUCT ON WHICH THE BILE LEAVES THE LIVER AND INTO THE DUODENUM OF THE SMALL
INTESTINE
BILE
 1 LITER OF YELLOW/GREEN ALKALINE IS PRODUCED/DAY
 BILE IS COMPOSED OF
BILIRUBIN=BREAKDOWN OF HEMOGLOBIN
CHOLESTEROL
FAT-SOLUBLE HORMONE
FAT
MINERAL SALT
MUCUS
 EMULSIFY FATS
FUNCTIONS OF THE LIVER
 DETOXIFICATION OF DRUGS
 RECYCLING OF ERYTHROCYTE
 DEACTIVATION OF MANY HORMONES
SEX HORMONE
THYROXINE
INSULIN




GLUCAGON
CORTISOL & ALDOSTERONE
PRODUCTION OF CLOTTING PROTEINS
STORAGE OF VITAMINS, MINERALS & GLYCOGEN
SYNTHESIS OF VITAMIN A
HEAT PRODUCTION
GALL BLADDER
 WHERE BILS IS STORED
 SMALL GREEN MUSCULAR SC THAT LIES POSTERIOR TO THE LIVER
 RESERVOIR FOR BILE=CONCENTRATES BILD BY ABSORBING WATER
CKK (CHOLECYSTOKIN)
 HORMONE FOR GALL BLADDER STIMULATION
LARGE INTESTINE
ILEOCECAL VALVE
 ENTRY OF FOOD IS CONTROLLED
 OPENS IN RESPONSE TO INCREASED ACTIVITY BY THE STOMACH & THE ACTION OF THE
HORMONE GASTRIN
 WATER ABSORPTION
APPENDICITIS
 INFLAMMATION OF THE APPENDIX
DIARRHEA
 EXCESS WATER IN FECES
CONSTIPATION
 OCCURS IF FOOD RESIDUE SPENDS TOO LONG IN THE LARGE INTESTINE
LACTULOSE (LAXATIVES)
 USED TO TREAT CONSTIPATION
 15ML TID (USUAL DOSE)
 CAN TAKE UPTO 48 HOURS BEFORE EFFECT
 S/E
NAUSEA
DIARRHEA
FLATULENCE
ABDOMINAL DISCOMFORT
CHD (CONGENITAL HEART DEFECT)
TROUBLE OR NO TROUBLE
REMEMBER
RIGHT TO LEFT SHUNT IS TRouBLe
 NEED SURGERY
 DELAYED GROWTH & DEVELOPMENT
 SHORT LIFE EXPECTANCY
 STRESS, GRIEF FINANCIAL
 PEDIATRICS CARDIOLOGIST
 NEEDS MEDICAL SUPPORT
 CYANOTIC=BLUE (LETTER B IN TROUBLE)
 ALL CONGENITAL HEART DEFECT THAT STARTS WITH LETTER T IS TROUBLE
TETRALOGY OF FALLOT
TRANSPOSITION OF GREAT VESSELS
TRUNKUS ARTERIOSUS
TRICUSPID ATRESIA
REMEMBER
ALL CHILDREN WITH CHD ALL HAVE A MURMUR AND ALL HAVE AN ECHOCARDIOGRAM DONE
4 DEFECTS OF TETRALOGY OF FALLOT
VERY PICTURES OF A RANCH
VENTRICULAR DEFECT
PULMONARY STENOSIS
OVERRIDING AORTA
RIGHT HYPERTROPHY
ASSESSMENT OF A PREGNANT PATIENT
 ASSESS OBSTETRIC HISTORY = LMP ( 1ST DAY OF THE LAST MENSTRUATION)
 EDC (EXPECTED DATE OF CONFINEMENT (NAEGELE’S RULE)
 GPTPALM
G=GRAVIDA (# OF PREGNANCY WHETHER ALIVE OR TERMINATED)
P=PARA (> 20 WEEKS)
T=TERM (37 WEEKS + 1 DAY UPTO 42 WEEKS)
P=PRE-TERM (20 WEEKS TO 37 WEEKS)
A=ABORTION (< 20 WEEKS)
L=LIVE BIRTHS
M=MULTIPLE GESTATION
 FIRST PRENATAL CARE
1. AS EARLY AS PREGNANCY IS DETERMINED
2. 2ND TRIMESTER (ONLY ONCE)
3. 7TH MONTH (ONCE)
4. 8TH MONTH (EVERY 2 WEEKS)
5. 9TH MONTH (EVERY WEEK)
 WHEN PT IS INDECISIVE WHETHER TO BREASTFEED OR NOT
NSG = ASSIST PT TO IDENTIFY BREASTFEEDING GOAL AND PLAN
 WHEN CAN WE HEAR THE FETAL HEART = 5TH MONTH
 PRE-ECLAMPSIA = SCREENING FOR PRE-ECLAMPSIA IS ON THE 2ND TRIMESTER OF PREGNANCY
PARAMETER IS 20 WEEKS ( 20 WEEKS AND ABOVE) –PRE ECLAMPSIA
TRIAD OF ECLAMPSIA ( INCREASE BP, EDEMA, PROTEINURIA)








ETHICAL AND MORAL PRINCIPLES
CODE OF ETHICS = ETHICAL AND MORAL PRINCIPLE
BENEFICENCE = DOING GOOD ALL THE TIME
NON MALEFICENCE = TO DO NO HARM
AUTONOMY = PT DECISION
EXCEPT PSYCHIATRIC PATIENTS
MINORS (EXCEPT EMANCIPATED MINORS)
MEDICATION THAT IMPAIRS JUDGEMENT
NEUROLOGIC CONDITIONS
MENTALLY CHALLENGED
JUSTICE = FAIRNESS, EQUALITY
VERACITY = TRUTHFULNESS
FIDELITY = LOYALTY TO PROFESSION & PROMISES
CONFIDENTIALLITY
ELDERLY
CONSIDERATIONS
 ACTIVITIES OF DAILY LIVING
 DEPENDENT TO OTHERS FINANCIALLY
 HOLISTIC CARE
 REGULAR HEALTH CHECK-UPS. ELDERLY ARE PRONE TO DEVELOP DISEASES
RECORD KEEPING
STRUCTURING
 ALPHABETICAL
 FAMILY NUMBER
STORING
 HOW LONG RECORDS ARE KEPT IN THE HEALTH CENTER – 10 YEARS
SECURING
 CONFIDENTIALITY & PRIVACY
FAMILY FOLDER
 INFORMATION SHEET OF FAMILY MEMBER
 CONSULTATION
 IMMUNIZATION
 FAMILY PLANNING
 REPRODUCTIVE CONSULTATION
PREGNANT (HOME BASED MOTHER RECORD) – PINK
YELLOW CARD – IMMUNIZATION (12 PREVENTABLE DISEASES)
WHITE CARD – (NEW BORN)
REMEMBER
RECORD – INDIVIDUALIZED
REPORT – SUMMARY
OBSTETRIC
CALCIUM
 PREVENT LOOSE TEETH
 CALCIUM DEFICIENCY IN PREGNANT – (LEG CRAMPS)
 NSG- STRETCH & DORSIFLEX
FERROUS (IRON)
 PREVENT IDA (IRON DEFICIENCY ANEMIA)
VITAMIN A
 DON’T EXCEED 10K IU > >10K IU IS TERATOGENIC
FOLATE
 PREVENT NEURAL TUBE DEFECT (SPINA BIFIDA)
REMEMBER
TREATMENT RECORD = ESSENTIAL RECORD ABOUT THE PATIENT IN COMMUNITY SETTING
CHART
KARDEX
HOSPITAL SETTING
PURPOSE OF RECORD KEEPING
 EVIDENCE OF HEALTH CARE
 SAFEGUARD INFORMATION – ULTIMATE PURPOSE
 DATA PRIVACY ACT 10912
SCABIES
 WEAR GOWN
 ITCHINESS – COMMON SYMPTOM
 PARASITE
 APPLY ANTI-SCABIES LOTION (SCABICIDE) – PERMETHRIN ONLY TO AFFECTED AREAS
 AVOID SHARING ITEMS USED BY INFECTED PERSON
RESOURCE MANAGEMENT
STRATEGIC
 ASSESS THE STRENGTH AND WEAKNESSES OF THE ORGANIZATION
PLANNING FUNCTION
 DETERMINE HOW TO ACHIEVE THE MANDATE WORK
TO ENHANCE WORK PERFORMANCE
 NURSE MANAGER SHOULD REVIEW THE STAFF’S JOB DESCRIPTION
CONTROLLING
 YEAR END PERFORMANCE EVALUATION OF THE STAFF
BUDGETING
 COST-EFFECTIVENESS – MOST IMPORTANT CRITERION
COLLABORATION
 PRIMARY GOAL IS ACCOMPLISH GOALS
KEY ELEMENTS OF COLLABORATION
1. SHARED VISION
2. PARTNERSHIP
3. WORKING TOGETHER
4. UNITY
TEAM WORK
1. WORK IS FASTER
2. PROMOTES TRUST
3. SENSE OF SECURITY
4. UNITY
COHESIVE
 EVIDENCE OF HEALTH CARE
REMEMBER
COLLABORATION & TEAMWORK ARE ESSENTIAL IN PUBLIC HEALTH TO IMPROVE QUALITY OF
HEALTH CARE
PSYCHIATRIC CONSULT
 ASSESS THE MENTAL STATUS OF THE PATIENT IN ORDER TO DETERMINE THE PATIENTS ABILITY
TO CONCENTRATE & FOCUS
 PRESENT REALITY
 TAKE PATIENT HISTORY > SCHOOLING IF STUDENT
 NEED EMOTIONAL SUPPORT
CATEGORIES OF COMMUNITY PROBLEMS
A. HEALTH STATUS
B. HEALTH RESOURCE – ABSENCE OF MIDWIFE IN THE COMMUNITY TO RENDER HEALTH SERVICES
C. HEALTH RELATED
MAGNITUDE OF THE PROBLEM
 ESTIMATING THE PROPORTION OF THE POPULATION AFFECTED BY THE PROBLEM
BARRIER TO GOAL SETTING BETWEEN THE NURSE AND FAMILY
 FAILURE OF THE FAMILY TO PERCEIVE THE EXISTENCE OF THE PROBLEM
 NSG – HELP THE FAMILY RECOGNIZE THE PROBLEM
COPAR – COMMUNITY ORGANIZING PARTICIPATIVE ACTION RESEARCH
COPAR PRIMARY GOAL
 MAKE THE COMMUNIRY EMPOWERED AND SELF RELIANT
PRE-ENTRY PHASE
 1ST STEP IN COPAR PROCESS (TRAIN TECHNICAL WORKING GROUP
PAR (PARTICIPATIVE ACTION RESEARCH)
PARTICIPATION AND ENGAGEMENT OF THE COMMUNITY
 EMPOWER THE COMMUNITY
ADVISER
 MOST IMPORTANT ROLE OF PUBLIC HEALTH NURSE IN COPAR
SECONDARY HEALTH FACILITY
 DISTRICT HOSPITAL
LAGUNDI
 TREAT COUGH
GUAVA LEAVES
 WASH WOUNDS
SUSTAINABLE DEVELOPMENT GOAL
 PROGRAM THAT AIMS TO END POVERTY & PROTECT THE PLANET
WELLNESS AND FITNESS PROGRAM
 DECREASE INCIDENCE OF RISK FACTORS ESPECIALLY OBESITY
 WEIGHT REDUCTION – OBESITY
 CUT DOWN ON SALT INTAKE
FOR OBESE PATIENT
 MORE FRUITS & VEGETABLES
 EAT REGULAR MEALS
 AVOID SATURATED FATS
 MONITOR CHOLESTEROL LEVEL
 MONITOR FOR HYPERTENSION > CHECK BP REGULARLY
 EXERCISE DAILY
PERFORMANCE EVALUATION
 EXCELLENT & QUALITY PROVISION OF SERVICES AND PERFORMANCE OF THE STAFF
BECOME A ROLE MODEL
 LET THE STAFF INITIATE THE CULTURE OF QUALITY AT THE HEALTH CENTER
PROVIDE MEANS TO EVALUATE SERVICES
 TO ENSURE PATIENT SATISFACTION ON THE DELIVERY OF HEALTH SERVICES
STANDARDS OF NURSING CARE
 WHAT TO DO - IN SIMPLE WORDS
CONDUCT STAFF MEETING
 BEST STRATEGY TO EMPLOY TO GET FEEDBACK ON PATIENT EVALUATION OF HEALTH SERVICES
COMMUNICABLE DISEASE
REPUBLIC ACT 3573
 AMMENDED 11332
 EPIDEMEOLOGY
 COMMUNICABLE DISEASES
 NURSES ARE TASK TO REPORT COMMUNICALBE DISEASES
DENGUE
 VIRUS
 H. FEVER, DANDE FEVER, INFECTIOUS THROMBOCYTOPENIC PURPURA
 5 TYPES (DENGUE 1,2,3,4 & CHIKUNGUNYA VIRUS)
 VECTOR: AEDES EGYPTI MOSQUITO
 INCUBATION PREIOD 3-15 DAYS
 PERIOD OF CUMMUNICABILITY: 1ST WEEK OF ILLNESS
 PATHOGNOMONIC SIGN: HERMAN SIGN(SEVERESTOMACH PAIN + VOMITING, MELENA,
HEMATEMESIS, EPSTAXIS)
STAGES OF DENGUE
FEBRILE OR INVASIVE STAGE =
 39-40 DEGREES CELSIUS FEVER + ABDOMINAL PAIN
 PRESENCE OF RASHES
 TOURNIQUET TEST
SYSTOLIC + DIASTOLIC PRESSURE /2 (EX 120/80/2)
THEN INFLATE BP CUFF TO 100 MMHG (RESULT OF THE ABOVE) AND CLOSE THE VALVE THEN
WAIT FOR 5-15 MINUTES, IF THERE ARE PRESENCE OF 20 OR MORE PETECHAIE (+ DENGUE)
 RAMPID LEAD TEST
TOXIC HEMORRHAGIC
 PRESENCE OF MELENA, HEMATEMESIS, EPISTAXIS
 PRESENCE OF ANOTHER MENSTRUATION IN WOMEN
LATE FEBRILE STAGE (CRITICAL) – DEFER VESCENCE
 24-48 HIOURSMARKED INCREASED IN VASCULAR PERMEABILITY
 BLEEDING IN BLOOD VESSELS
 PERSISTENT VOMITING, SEVERE ABDOMINAL PAIN, FLUID ACCUMULATION, MUCOSAL
BLEEDING, DECREASE BP (POSTURAL HYPOTENSION)
 LIVER ENLARGEMENT (HEPATOMEGALY)
SOURCES
 STAGNANT WATER (EMPTY IT)
CLEAN SURROUNDINGS
 GARBAGE (BREEDING PLAVE)
 4 O’ CLOCK HABIT PROGRAM OF DOH – CLEANING EVERY 4PM
 KULAMBO, LONGSLEEVES, PAJAMAS
TREATMENT
 SYMPTOMATIC TREATMENT (AVOID ASPIRIN CONTAINING PARACETAMOL) – CAN CAUSE
BLEEDING
TEST
 ELISA 9ENZYME LINK IMMUNOSORBENT ASSAY) – MOST SENSITIVE TEST
FILARIASIS
 AEDES ALBUPICTUS
 PARASITE
 CAUSATIVE AGENT: WUCHECHERIA BANCROFTI, WUCHECHERIA TIMARI, WUCHECHERIA MALAYI
 MANIFESTATIONS
LYMPH ADENOPATHY = SWOLLEN GLANDS OR SWELLING OF THE LYMPH NODES
ORCHITIS = INFLAMMATION OF 1 OR BOTH TESTICLES
 DIAGNOSTIC TEST
PE (PHYSICAL EXAMINATION)
BLOOD SMEAR (PRESENCE OF MICRO FILARIAE) – TAKE SPECIMEN FROM 10PM-2AM
 DRUG OF CHOICE
DIETHYL CARBAMAZINE (DEC)-HETRAZAN
ALBENDAZOLE
 METHOD OF PREVENTION
SAME WITH DENGUE & MALARIA
SCHISTOSOMIASIS
 SNAIL FEVER
 PARASITE
 CAUSATIVE AGENT: SCHISTOSOMA JAPONICUM, SHICTOSOMA HEMATOBIUM, SCHISTOSOMA
MANSONI
 DIAGNOSTIC EXAM
FA (FACALYSIS) – PRESENCE OF SERUM OVUM PRECIPITATE TEST
UA (URINE CS) – BYB USE OF CENTRIFUGE
EGG SERCARIA (LARVAE) – INFECTIVE STAGE
PORES OF THE SKIN
BLOOD CIRCULATION
GI (LIVER) – HEPATO CHANGES
JAUNDICE, RUQ TENDERNESS
(NOT ASSOCIATED WITH ALCOHOL OR HEPATITIS)
 PREVENTION
CONSTRUCTION OF TOILET (PROPER FECES DISPOSAL)
USE BOOTS
MOLLUSKCICIDE
 METHIODS OF INFECTION
WATER
TOILET
 DRUG OF CHOICE
PRAZI QUANTEL (ANTI-PARASITE)
MALARIA
 FEMALE ANOPHELES
 PARASITE
 FLOWING WATER
 CAUSATIVE AGENT
PLASMODIUM PALSIPARUM – FOUND IN THE PHILIPPINES
PLASMODIUM OVALE
PLASMODIUM FILARIAE
 DIAGNOSTIC TEST
MALARIAL SMEAR
SPECIMEN: BLOOD (TAKE AT THE HEIGHT OF THE FEVER)
 3 STAGES OF MALARIA
HOT STAGE – (+ FEVER) – HIGH
COLD STAGE – CHILLING SENSATION
DIAPHORETIC STAGE – SWEATING/DIPHORESIS
 AFFECTS CNS
 DRUGS OF CHOICE
ARTHEMETER
UMEFANTINE
FLOUROQUINE
 4 METHOD OF PREVENTION
1. STREAN CLEARING/ STREAM SEEDING
REMOVE PLANTS AND WOOD, PUT LARVAE EATING FISH
2. ZOOPHYLAXIS – PUT ANIMALS NEAR THE HOUSE
3. INSECT REPELLANTS – CITRONELLA, BASIL SOAP, KULAMBO
4. LONG SLEEVES & PAJAMAS
5. SCREENING OF DOORS & WINDOWS
EPIDEMEOLOGY ON VITAL STATISTICS
NURSES ROLE IN EPIDEMEOLOGY
 DISEASE CASE SURVEILLANCE
PATTERN OF DIEASES
A. EPIDEMIC – PRESENT VS PREVIOUS (IF CASES DOUBLED +1)
B. PANDEMIC – WHOLE WORLD
C. SPORADIC – DISEASE IS ON & OFF / SEASONAL (EX. RABIES)
D. ENDEMIC – CONSTANTLY OCCURING INF SPECIFIC LOCALITY
10 NON-COMMUNICABLE DISEASES
A. HEART DISEASES (CAD) – ATHEROSCLEROSIS
ARTERIOSCLEROSIS
ANGINE PECTORIS
MYOCARDIAL INFARCTION
CONGESTIVE HEART FAILURE
CARDIOGENIC SHOCK
DEATH
B. CARDIOVASCULAR SYSTEM
STENOSIS/REGURGITATION
IMMOBILITY
DVT/PE
STROKE
C. CANCER
LIFESTYLE
FEMALE – BREAST CANCER
LUNG CANCER
COLON CANCER
MALE – TESTICULAR CANCER
PROSTATE CANCER
D. PNEUMONIA
CAP – COMMUNITY ACQUIRED PNEUMONIA
E. ACCIDENTS
F. TUBERCULOSIS
G. CHRONIC RESPIRATORY DISEASES
H. DIABETES MILLETUS
I. NEPHRITIC/ NEPHROTIC
J. PERINATAL PERIOD
MOST IMPORTANT GUIDELINE IN WRITING A MEMORANDUM
 CONTENT IS CLEAR
FEEDBACK
 INDICATOR OF EFFECTIVE COMMUNICATION
NON-VERBAL COMMUNICATION
 OBSERVE GESTURES
PNA (PHILIPPINE NURSES ASSOCIATION INC)
 ACCRERDITED PROFESSIONAL ORGANIZATION OF NURSES
PROFESSION IS CHARACTERIZED BY
A. BODY OF KNOWLEDGE
B. CODE OF ETHICS
C. ENGAGES IN RESEARCH
CONTINUING EDUCATION PROGRAM
 WEBINARS, SYMPOSIUMS, ATTENDING PROFESSIONAL CONVENTIONS
SELF DIRECTED LEARNING ACTIVITY
 EX. ATTENDS WEBINARS
PRIMARY PURPOSE OF CONDUCTING COMMUNITY DIAGNOSIS
 DO ASSESSMENT OF THE COMMUNITY PROFILE
STEPS IN COMMUNITY DIAGNOSIS
A. FORMULATION OF OBJECTIVES
B. DEFINE THE STUDY POPULATION
C. DETERMINE THE DATA TO BE COLLECTED
D. COLLECT THE NEEDED DATA
E. ANALYZE THE COLLECTED DATA
F. IDENTIFICATION OF THE PROBLEM
G. PRIORITIZING PROBLEM
H. CREATE NURSING CARE PLAN (NCP)
TOOLS IN DATA COLLECTION
A. SURVEY QUESTIONNAIRE
B. INTERVIEW GUIDE
C. OBSERVATION CHECKLIST
D. REVIEW OF SECONDARY DATAS
 CASE STUDYT OF THE COMMUNITY
 MAGAZINES THAT FEATURES THE COMMUNITY
HEALTH EDUCATION IN PUBLIC
 IT IS EVERY HEALTH WORKERS RESPONSIBILITY
BEST RESULT OF HALTH EDUCATION
 IT INFLUENCES & CHANGE BEHAVIOUR
MOST IMPORTANT GOAL OF HEALTH PROMOTION
 TO MOTIVATE THEM TO DEVELOP SKILLS AND LITERACY IN HEALTH
 AS A WHOLE, HEALTH EDUCATION AIMS TO HAVE A BETTER HEALTH OPPORTUNITIES
COMMUNITY HEALTH NURSING
 GROUP OF PEOPLE SHARING A COMMON VALUES, INTEREST, NORMS, & CHARACTERISTICS
LIVING AND INTERACTING TOGETHER IN A GIVEN ENVIRONMENTAL BOUNDARY
 GUIDED BY THEIR OWN FORMS OF GEVERNANCE, FUNCTIONING WITHIN A DYNAMIC, SOCIAL,
CULTURAL, POLITICAL & GEOGRAPHICAL CONTENT
DIMENSIONS
 SOCIAL = MADE UP OF VARIOUS INSTITUTIONS USING SIMLE AND COMPLEX NETOWRK OF
COMMUNICATION THAT ARE ORGANIZED THROUGH A SYSTEM OF BOTH FORMAL AND NONFORMAL STRUCTURES OF INTERACTIONS
 CULTURAL = PRIMARILY COMPOSED OF PEOPLE SHARING A UNIQUE LANGUAGE FOR THEIR
DEFINING TRAIT THAT IDENTIFIES THEIR BINDING, COMMON CHARACTERISTICS, INTEREST,
VALUES AND NORMS
 POLITICAL = DEFINED BY POWER AND AUTHORITY IN THEIR ADMINISTRATIVE, LEGISLATIVE &
JUDICIAL SYSTEM REPRESENTED BY WRITTEN & NON-WRITTEN LAWS AS REGULATED BY
GOVERNING BODIES, PROVIDING RESOLUTIONS TO IDENTIFIED PROBLEMS & CONFLICTS
 GEOGRAPHICAL = DETERMINED BY BOUNDARIES THAT IDENTIFY THE LOCATION OF THE
ENVIRONMENT OF A GIVEN TERRITORY
TYPES OF COMMUNTY
RURAL = LESS DENSED, WITH SIMOLE STRUCTURE OF INTERPERSONAL, SOCIAL RELATIONS
CHARACTERIZED BY PRIMARY GROUP RELATIONS, WELL KNIT, HAVING A HIGH DEGREE OF GROUP
FEELING, AND USUALLY REPRESENTED BY AGRICULTURAL OCCUPATIONS RELATED TO FARMING,
FISHING AND FOOD GATHERING.
URBAN = HIGHLY-DENSED, WITH COMPLEX STRUCTURE OF INTERPERSONAL SOCIAL RELATION AND
USUALLY REPRESENTED BY NON-AGRICULTURAL OCCUPATIONS WHICH ARE MORE RELATED TO
TRADE & COMMERCE
RURBAN = COMBINATION OF BOTH RURAL AND URBAN COMMUNITIES
SUB-URBAN = IDENTIFIED BY ITS LOCATION IN THE PERIPHERY AND IS USUALLY CHARACTERIZED BY
RESIDENTIAL AREA
METROPOLITAN = REFERRED TO AS “MEGACITY” AND IS COMPOSED OF AN AGGREGATE OF
EXPANDING URBAN AREASADJACENT TO ONE ANOTHER WHOSE BOUNDARIES ARE ALMOST
OVERLAPPING IN TERMS OF SOCIO-CULTURAL INTERACTIONS
HEALTHY COMMUNITY CHARACTERISTICS
 PROMPTS MEMBERS TO HAVE A HIGH DEGREE OF AWARENESS THAT “WE ARE COMMUNITY”
 USES NATURAL RESOURCES & ALSO CONSERVING IT FOR FUTURE GENERATIONS
 RECOGNIZABLE EXISTENCE OF SUB-GROUPS & WELCOMES THEIR PARTICIPATION IN
COMMUNITY AFFAIRS
 PREPARED TO MEET CRISIS
 OPEN CHANNELS OF COMMUNICATION THAT ALLOWS INFORMATION TO FLOW AMONG ALL
SUB-GROUPS OF ITS CITIZEN AND IN ALL DIRECTIONS
 SEEKS TO MAKE EACH OF ITS SYSTEM’S RESOURCESAVAILABLE TO EACH MEMBERS OF THE
COMMUNITY
 HAS LEGITIMATE AND EFFECTIVE WAYSTO SETTLE DISPUTES AND MEET NEEDS THAT ARISES
WITHIN THE COMMUNITY
 ENCOURAGES MAXIMUMCITIZEN PARTICIPATION IN DECISION-MAKING
 PROMOTES A HIGH LEVEL WELLNESS AMONG ALL ITS MEMBERS
OLOF (OPTIMUM LEVEL OF FUNCTIONING)
 MODERN CONCEPT OF INDIVIDUAL, FAMILIES, GROUPS, COMMUNITIES
 FEATURES HEALTH WITH MULTI-DIMENSIONAL NATURE
ECOSYSTEM
 GREATLY AFFECTS THE OLOF OF THE POPULATION
FACTORS IN ECOSYSTEM THAT MAY INFLUENCE OLOF
A. BEHAVIOURAL
B. SOCIO-ECONOMIC
C. POLITICAL
D. HEREDITARY
E. HEALTH CARE DELIVERY SYSTEM
F. ENVIRONMENT
PUBLIC HEALTH
WINSLOW
 SCIENCE AND ART OF PROMOTING HEALTH, PREVENTING DISEASE, PROLONGING LIFE TO
ENSURE EVERYONE A STANDARD OF LIVING ADEQUATE FOR THE MAINTENANCEOF HEALTH, SO
AS TO ENCISE EVERY CITIZEN TO REALIZE HID BIRTH RIGHT OF HEALTH AND LONGEVITY
WHO
 ART OF APPLYING SCIENCE IN THE CONTENT OF POLITICS SO AS TO REDUCE INEQUALITIES IN
HEALTH WHILE ENSURING THE BEST HEALTH FIR THE GREATEST NUMBER
PUBLIC HEALTH NURSING
 NATIONAL LEAGUE OF PHILIPPINE GOVERNMENT NURSES INC. (NLPGNI) = THE PREACTICE OF
NURSING IN LOCAL/NATIONAL HEALTH DEPARTMENTS WHICH INCLUDES HEALTH CENTERS,
RURAL HEALTH UNITS AND PUBLIC SCHOOLS, IT IS COMMUNITY HEALTH NURSING PRACTICED
IN THE PUBLIC SECTION OF CHN PRACTICE WITHIN THE SCOPE OF THE GOVERNMENT.
COMMUNITY HEALTH NURSING
 BROADER THAN PUBLIC HEALTH NURSING BECAUSE IT ENCOMPASSES NURSING PRACTICE IN A
WIDE VARIETY OF COMMUNITY SERVICE AND CONSUMER ADVOCATE AREAS, AND IN A VARIETY
OF ROLES
WHO EXPERT COMMITTEE IN NURSING
 SPECIAL FIELD OF NURSING WHICH COMBINES THE SKILL OF NURSING, PUBLIC HEALTH AND
SOME PHASES OF SOCIAL ASSISTANCE AND FUNCTIONS AS PART OF THE TOTAL HEALTH
PROGRAM FOR THE PROMOTION OF HEALTH, IMPROVEMENT OF CONSULTATIONS IN THE
SOCIAL AND PHYSICAL ENVIRONMENT, REHABILITATION OF ILLNESS AND DISABILITIES
HANLON
 ATTAINMENT OF THE HIGHEST FORM OF PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND
LONGEVITY CONSISTENT WITH AVAILABLE KNOWLEDGE AND RESOURCES AT A GIVEN PLACE
AND TIME
JACOBSON
 LEARNED PRACTICE DISCIPLINE WITH THE ULTIMATE GOAL OF CONTRIBUTING AS INDIVIDUALS
AND IN COLLABORATION WITH OTHERS TO THE PROMOTION OF THE CLIENT’S OPTIMUM LEVEL
OF FUNCTIONING THROUGH TEACHING, AND DELIVERY OF SERVICES IN A WIDE VARIETY OF
AREAS, AND ROLES WHICH IS NOT ONLY CONFINED TO THE PUBLIC HEALTH NURSING AGENCIES
FREEMAN
 SERVICE RENDERED BY A PROFESSIONAL NURSE WITH THE COMMUNITY, GROUPS, FAMILIES
AND INDIVIDUALS AT HOME, IN HEALTH CENTERS, IN CLINICS, IN SCHOOLS, IN PLACES OF WORK
FOR THE PROMOTION OF HEALTH, PREVENTION OF ILLNESSES, CARE OF THE SICK AT HOME AND
REHABILITATION
BALLON –REYES
 A FIELD OF NURSING PRACTICE WHERE SERVICES ARE DELIVERED OUTSIDE OF PURELY CURATIVE
INSTITUTIONS
 IN COMMUNITY SETTINGS, THE SCOPE OF SERVICES PROVIDED COVERS THE WHOLE RANGE OF
HEALTH PROMOTIVE, PREVENTIVE, CURATIVE AND REHABILITATIVE NURSING SERVICES WITH
BIAS TOWARDS AND PRIORITY GIVEN TO HEALTH PROMOTION AND DISEASE PREVENTION
ESPECIALLY FOR THE UNDERSERVED AND HIGH-RISKED INDIVIDUALS, FAMILIES, POPULATION
GROUP AND AREAS OF THE COMMUNITY
 THE NURSE WORKS WITH FULL PARTNERSHIP WITH THE CLIENT UTILIZING THE BASIC
METHODOLOGY OF THE PROFESSION AND IN COLLABORATION WITH OTHER MEMBERS OF THE
HEALTH TEAM AS WELL AS WITH RELEVANT MEMBERS ON INTERSECTORAL TEAMS
CLARK IN ANA
 PRACTICE THAT PROMOTES & PRESERVE HEALTH BY INTEGRATING THE SKILL AND KNOWLEDGE
RELEVANT TO BOTH NURSING & PUBLIC HEALTH
FOUNDATIONS OF CHN PRACTICE
FOCUS OF CHN
 HEALTH PROMOTION
OTTAWA CHARTER
 PROCESS OF ENABLING PEOPLE TO INCREASE CONTROL OVER AND TO IMPROVE THEIR HEALTH
PRINCIPLES OF HEALTH PROMOTION
 INVOLVES POPULATION AS A WHOLE IN THE CONTEXT OF THEIR EVERYDAY LIFE. RATHER THAN
FOCUSING ON PEOPLE AT RISK FROM SPECIFIC DISEASE
 DIRECTED TOWARDS ACTION ON THE DETERMINANTS OF HEALTH
 COMBINES DIVERSE, BUT COMPLIMENTARY APPROACHES INCLUDING COMMUNICATION,
EDUCATION, LEGISLATION, FISCAL DEVELOPMENT AND PSONTANEOUS LOCAL ACTIVITIES
AGAINST HEALTH HAZARDS
 AIMS PARTICULARLY AT EFFECTIVE AND CONCRETE PUBLIC PARTICIPATION IN PUBLIC DEFINING
AND DECISION MAKING
 SOCIAL AND POLITICAL VENTURE AND NOT A MEDICAL SERVICE
GOALS OF CHN
PRIMARY
 ENHANCE THE HEALTH CAPABILITIES OF THE POPULATION (COPE WITH DISCONTINUITIES IN
HALTH TO MAXIMIZE POTENTIAL FOR HIGH LEVEL OF WELLNESS)
ULTIMATE
 RAISE THE LEVEL OF HEALTH OF THE CITIZENRY
AREAS OF CONTENT: NURSING & PUBLIC HEALTH
KNOWLEDGE BASES:
A. BILOGICAL SCIENCES
B. SOCIAL OR BEHAVIORAL SCIENCES
C. ECOLOGY
D. CLINICAL NURSING
E. COMMUNITY HEALTH ORGANIZATION
CLIENT = GENERAL POPULATION
LEVELS OF CLIENTELE:
A. INDIVIDUAL = UNIT OF ENTRY
B. FAMILY = UN IT OF SERVICE OR FOCUS OF CARE
C. GROUP = AGGREGATE OF PEOPLE IN THE POPULATION WITH COMMON CHARACTERISTICS WHO
ARE VULNERABLE TO CERTAIN HEALTH PROBLEMS
D. COMMUNITY = ENTIRE CLIENT OR THE OVERALL FOCUS OF CHN
PHILISOPHU (SHETLAND)
 CARE: BASED ON THE WORTH OR DIGNITY OF MAN
 END-VIEW: HUMAN DEVELOPMENT
PRINCIPLES (BALLON-REYES AND LEAHY, COBB & JONES) – CHN PRINCIPLES
C – COMMUNITY ORGANIZED GROUP FOR THE HEALTH DEVELOPMENT AND SELF RELIANCE
H - HEALTH RESOURCES AVAILABLE SHOULD BE USED
N – NURSING PROCESS AS BASIS FOR PROFESSIONAL PRACTICE
P - PERIODIC EVALUATION OF SERVICES WITH ACCURATE REPORTING AND RECORDING
R – RECOGNIZED NEEDS OF THE PEOPLE & SERVICES AVAILABLE FOR ALL
I – IMPROVED COMMUNITY HEALTH AS BASIC PURPOSE WITH CHN AS INTEGRAL PART OF THE
COMMUNITY HEALTH SEVICE SYSTEM
N – NURSE WORKS WITH AND NOT FOR THE PEOPLE, INVOLVING CLIENT AS ACTIVE PARTNERS
C – CONTINUING STAFF EDUCATION PROGRAM OPPORTUNITIES
P – POLICY & OBJECTIVE SHOULD BE UNDERSTOOD BY THE NURSE
L – LARGELY AFFECTED BY CHANGES IN COMMUNITY SITUATION INFLUENCING CHN
E – EDUCATION AS PRIMARY RESPONSIBILITY OF THE NURSE
S – SERVICE UNIT IS THE FAMILY WITH COMMUNITY AS THE OVERALL CHN CLIENT
PRIMARY GOAL OF CHN
 TO ENHANCE THE CAPACITY OF INDIVIDUALS, FAMILIES & COMMUNITIES TO COPE WITH THEIR
HEALTH NEEDS
CHN IS A COMMUNITY BASED PRACTICE
 THE NURSE HAS TO CONDUCT COMMUNITY DIAGNOSIS TO DETERMINE NURSING NEEDS &
PROBLEMS
 COMMUNITY BASED PRACTICE MEANS PROVIDING CARE TO PEOPLE IN THEIR OWN NATURAL
ENVIRONMENTS: THE HOME, SCHOOL, WORKPLACE ETC..
POPULATION FOCUSED NURSING PRACTICE
 REQUIRES COMMUNITY DIAGNOSIS
 POPULATION FOCUSED NURSING CARE MEANS PROVIDING CARE BASED ON THE FREATER NEED
OF THE MAJORITYOF THE POPULATION. THE GREATER NEED IS IDENTIFIED THROUGH
COMMUNITY DIAGNOSIS
RA 1054 – OCCUPATIONAL HEALTH ACT
 ASIDE FROM THE NUMBER OF EMPLOYEES, WHAT OTHER FACTOR MUST BE CONSIDERED IN
DETERMINING THE OCCUPATIONAL HEALTH PRIVILEDGE TO WHICH THE WORKERS WILL BE
ENTITLED
 LOCATION OF WORKPLACE IN RELATION TO HEALTH FACILITIES
 BASED ON RA 1054 AN OCCUPATIONAL NURSE MUST BE EMPLOYED WHEN THERE ARE 30 + 100
EMPLOYEES AND THE WORKPLACE IS 1KM AWAY FROM THE NEAREST HEALTH CENTER
 BUSINESS FIRM MUST EMPLY OCCUPATIONAL HEALTH NURSE WHEN IT HAS AT LEAST 30-100
EMPLOYEES BASED ON RA 1054
WHEN OCCUPATIONAL NURSE EMPLOY ERGONOMIC PRINCIPLE
 ENVIRONMENTAL MANAGER
 USE OF AVAILABLE ENVIRONMENTAL RESOURCES
WHEN A FACTORY DOESN’T HAVE AN OCCUPATIONAL HEALTH NURSE
 THE PUBLIC HEALTH NURSE OF THE RURAL HEALTH UNIT OF THEIR MUNICIPALITY WILL PROVIDE
CARE BASED ON RA 1054
PUBLIC HEALTH SERVICES ARE GIVEN FREE OF CHARGE (TRUE OR FALSE)
 FALSE, PEOPLE PAY INDIRECTLY FOR PUBLIC HEALTH SERVICES, COMMUNITY HEALTH SERVICES
ARE PRE-PAID, THROUGH TAXATION FOR EXAMPLE
ACCORDING TO CE WINSLOW WHAT IS THE GOAL OF PUBLIC HEALTH
 FOR PEOPLE TO ATTAIN THEIR BIRTH RIGHT OF HEALTH AND LONGEVITY
 ACCORDING TO WINSLOW, ALL PUBLIC HEALTH EFFORTS ARE FOR PEOPLE TO REALIZE THEIR
BIRTH RIGHTS OF HEALTH AND LONGEVITY
WE SAY THAT A FILIPINO HAS ATTAIN LONGEVITY WHEN HE IS ABLE TO REACH THE AVERAGE
LIFESPAN OF FILIPINOS
 SWAROOP’S INDEX – IS THE PERCENTAGE OF THE DEATH AGED 50 YEARS OR OLDER, ITS
INVERSE REPRESENTS THE PERCENTAGE OF UNTIMELY DEATHS (DIED YOUNGER THAN 50 YEARS)
MOST PROMINENT FEATURE OF PUBLIC HEALTH NURSE
 PUBLIC HEALTH NURSING FOCUSES ON PREVENTIVE, NOT CURATIVE SEVICES
MARGARET SHETLAND, PHILISOPHY OF PHN IS BASED ON
 THE WORTH AND DIGNITY OF A MAN
MISSION OF DOH
 ENSURE ACCESSIBILITY & QUALITY OF HEALTH CARE SERVICES
REGION 4 HOSPITAL ARE CLASSIFIED AS
 TERTIARY
 REGIONAL HOSPITALS ARE TERTIARY FACILITIES BECAUSE THEY SERVE AS TRAINING HOSPITALS
FOR THE REGION
PRIMARY FACILITIES
 THEIR SERVICES ARE PROVIDED ON AN OUT-PATIENT BASIS
 PRIMARY FACILITIES GOVERNMENT & NON-GOVERNMENT THAT PROVIDES BASIC OUT PATIENT
SERVICES
SCHOOL NURSE HEALTH CARE PROVIDER FUNCTION
 CONDUCTING RANDOM CLASSROOM INSPECTION DURING A MEASLE EPIDEMIC
 RANDOM CLASSROOM INSPECTION IS ASSESSMENT OF PUPILS AND TEACHERS FOR SIGNS OF A
HEALTH PROBLEM PREVALENT IN THE COMMUNITY
EFFICIENCY
 DETERMINING WHETHER THE GOALS ARE ATTAINED AT HE LEASE POSSIBLE COST
YOU ARE BSN GRADUATE, YOU WANT TO BECOME PHN WHERE WILL YOU APPLY?
 RURAL HEALTH UNIT (RHU)
 RA 7160 DEVOLVED BASIC SERVICES TO LOCAL GOVERNMENT UNIT, THE PHN IS AN EMPLOYEE
OF LGU
RA 7160 MANDATES DEVOLUTION OF SERVICES FROM THE NATIONAL GOVERNMENT TO LOCAL
GOVERNMENT UNIT, WHAT IS THE GOAL OF DEVOLUTION
 TO EMPOWERTHE PEOPLE TO PROMOTE SELF RELIANCE
 PEOPLE EMPOWERMENT IS THE BASIC MOTIVATION BEHIND DEVOLUTION OF BASIC SERVICES
TO LGU’S
PRIMARY HEALTH FACILITY
 USUAL POINT OF ENTRY OF A CLIENT INTO THE HEALTH CARE DELIVERY SYSTEM
 THE ENTRY OF A PERSON ONTO THE HEALTH CARE DELIVERY SYSTEM IS USUALLY THROUGH
CONSULATION IN OUT-PATIENT SERVICES
THE PHN IS THE SUPERVISOR OF RURAL HEALTH MIDWIVES
 PROVIDING TECHNICAL GUIDANCE TO MIDWIVES
 THE NURSE PROVIDES TECHNICAL GUIDANCE TO MIDWIFE IN THE CARE OF CLIENTS
PARTICULARY IN THE IMPLEMENTATION OF MANAGEMENT GUIDELINES AS IN INTEGRATED
MANAGEMENT OF CHILDHOOD ILLNESS
PATIENT IN LABOR WHO DEVELOP A COMPLICATION SHOULD BE REFERRED TO
 MUNICIPAL HEALTH OFFICER
 A PHN & RURAL HEALTH MIDWIFE CAN PROVIDE CARE DURING NORMAL CHILDBIRTH, A
PHYSICIAN SHOULD ATTEND TO A WOMAN WITH A COMPLICATION DURING LABOR
1 MIDWIFE = 5000 POPULATION
4 MID WIFE = 20000 POPULATION
IF THE RHU NEEDS ADDITIONAL MIDWIFE ITEMS, THE REQUEST WILL BE SUBMITTED FOR APPROVAL
TO THE
 MUNICIPAL HAELTH BOARD
 AS MANDATED BY RA 7160, BASIC HEALTH SERVICES HAVE BEEN DEVOLVED FROM THE
NATIONAL GOVERNMENT TO LGU
ACT 3573
 NURSE IS RESPONSIBLE FOR REPORTING CASES OF NOTIFIABLE DISEASES
 THE LAW ON REPORTING OF COMMUNICABLE DISEASES ENACTED IN 1929, MANDATED THE
REPORTING OF DISEASES LISTEED IN THE LAW TO THE NEAREST HEALTH STATION
FREEMAN & HEINRICH
 COMMUNITY HEALTH NURSING IS A DEVELOPMENTAL SERVICE
 HEALTH EDUCATION AND COMMUNITY ORGANIZING ARE NECESSARY IN PROVIDING
COMMUNITY HEALTH SERVICES
 THE COMMUNITY HEALTH NURSE DEVELOPS THE CAPABILITIES OF PEOPLE THROUGH HEALTH
EDUCATION AND COMMUNITY ORGANIZING ACTIVITIES
PRESIDENTIAL PROCLAMATION NUMBER 4 IS ON THE LIGTAS TIGDAS PROGRAM
 MEASLES WAS DECLARED TO BE ERADICATED IN THE PHILIPPINES
THE PHN IS RESPONSIBLE FOR PRESENTING THE MUNICIPAL HEALTH STATISTICS USING GRAPH &
TABLES
 BAR GRAPH – USED TO PRESENT COMPARISON OF VALUES
 LINE GRAPH – TRENDS OVERTIME OR AGE
 PIE GRAPH – POPULATION COMPOSITIONOR DISTRIBUTION
 SCATTER DIAGRAM – FOR CORRELATION OF 2 VARIABLES
STEP IN COMMUNITY ORGANIZING THAT INVLOVES TRAINING OF POPTENTIAL LEADERS IN THE
COMMUNITY
 CORE GROUP FORMATION – IN CORE GROUP FORMATIONTHE NURSE IS ABLE TO TRANSFER THE
TECHNOLOGY OF COMMUNITY ORGANIZING TO THE POTENTIAL OR INFORMAL COMMUNITY
LEADERS THROUGH A TRAINING PROGRAM
STEP FOR PLANS FORMULATED FOR SOLVING COMMUNITY PROBLEMS
 COMMUNITY ORGANIZATION – IS A STEP WHEN THE COMMUNITY ASSEMBLE TAKE PLACE,
DURING THE COMMUNITY ASSEMBLY
PRIMARY GOAL OF COMMUNITY ORGANIZING
 TO MAXIMIZE THE COMMUNITY’S RESOURCES IN DEALING WITH HEALTH PROBLEMS
 COMMUNITY ORGANIZING IS A DEVELOPMENTAL SERVICE, WITH THE GOAL OF DEVELOPING
PEOPLE’S SELF RELIANCE IN DEALING WITH COMMUNITY HEALTH PROBLEMS
AN INDICATOR OF SUCCESS IN COMMUNITY ORGANIZING IS WHEN PEOPLE ARE ABLE TO
 PARTICIPATE IN COMMUNITY ACTIVITIES FOR THE RESOLUTION OF COMMUNITY PROBLEMS
 PARTICIPATION IN COMMUNITY ACTIVITIES IN RESOLVING COMMUNITY PROBLEMS MAY BE IN
ANY OF THE PROCESS
TERTIATY PREVENTION IS NEEDED IN WHICH STAGE OF THE NATURAL HISTORY OF DISEASE
 TERMINAL
 TERTIARY PREVENTION INVOLVES REHABILITATION, PREVENTION OF PERMANENT DISABILITY &
DISABILITY, LIMITATION APPROPRIATE FOR CONVALESCENCE, THE DISABLED, COMPLICATED
CASES AND THE TERMINALLY ILL IN THE TERMINAL STAGE OF THE DISEASE
ISOLATION OF A CHILD WITH MEASLES
 PRIMARY PREVENTION
 THE PURPOSE OF ISOLATING CLIENT WITH COMMUNICABLE DISEASE IS TO PROTECT THOSE
WHO ARE NOT SICK (SPECIFIC DISEASE PREVENTION)
SECONDARY PREVENTION
 OPERATION TIMBANG (EXAMPLE) – IS DONE TO IDENTIFY MEMBERS OF THE SUSCEPTIBLE
POPULATION WHO ARE MALNOURISHED, ITS PURPOSE IS EARLY DIAGNOSIS AND SUBSEQUENT
PROMPT TREATMENT
TYPE OF FAMILY CONTACT THAT PROVIDES OPPORTUNITY TO OBSERVE FAMILY DYNAMICS
 HOME VISIT
 DYNAMICS OF FAMILY RELATIONSHIP CAN BEST BE OBSERVED IN THE FAMILY’S NATURAL
ENVIRONMENT WHICH IS THE HOME
HEALTH DEFICIT
 FAILURE OF A FAMILY MEMBER TO DEVELOP ACCORDING TO WHAT IS EXPECTED, AS IN MENTAL
RETARDATION, IS A HEALTH DEFICIT
FORSEEABLE CRISIS
 ENTRY OF A 6 YEAR OLD IN SCHOOL IS AN ANTICIPATED PERIOD OF USUAL DEMAND ON THE
FAMILY
ADVANTAGES OF HOME VISIT
 IT PROVIDES OPPORTUNITY TO PROVIDE FIRST HAND APPRAISAL OF THE HOME SITUATION
CONTRARY TO THE PRINCIPLES OF PLANNING A HOME VISIT
 HOME VISIT SHOULD BE CONDUCTED IN THE MANNER PRESCRIBED BY THE RHU (NOT TRUE)
 THE HOME VISIT SHOULD BE FLEXIBLE AND PRACTICAL, DEPENDING ON THE FACTORS, SUCH AS
THE FAMILY’S NEEDS AND THE RESOURCES AVAILABLE TO THE NURSE AND THE FAMILY
THE MOST IMPORTANT PRINCIPLE OF THE BAG TECHNIQUE STATES THAT IT
 SHOULD MINIMIZE IF NOT TOTALLY PREVENT THE SPREAD OF INFECTION
 BAG TECHNIQUE IS PERFORMED BEFORE AND AFTER AHNDLING A CLIENT IN THE HOME TO
PREVENT TRANSMISSION OF INFECTION TO AND FROM THE CLIENT
MAINTAINING THE CLEANLINESS OF THE BAG & ITS CONTENT
 WASH HIS/HER HANDS BEFORE & AFTER PROVIDING NURSING CARE TO THE FAMILY MEMBER
ANALYTICCAL EPIDEMIOLOGY
 STUDY OF FACTORS OR DETERMINANTS AFFECTING THE PATTERN OF OCCURRENCE AND
DISTRIBUTION OF DISEASE IN THE COMMUNITY
FUNCTION OF EPIDEMIOLOGY
 EVALUATE THE EFFECTIVENESS OF THE IMPLEMENTATION OF THE INTEGRATED MANAGEMENT
OF CHILDHOOD ILLNESS
 EPIDEMIOLOGY IS USED IN THE ASSESSMENT OF A COMMUNITY OR EVALUATION OF
INTERVENTIONS IN COMMUNITY HEALTH PRACTICE
EPIDEMIOLOGICAL FUNCTION OF A NURSE DURING AND EPIDEMIC
 PARTICIPATING IN THE INVESTIGATION TO DETERMINE THE SOURCE OF THE EPIDEMIC
 EPIDEMIOLOGY IS THE STUFY OF OCCURRENCE AND DISTRIBUTION OF DISEASE IN THE
COMMUNITY, AS WELL AS FACTORS THAT AFFECTS DISEASE PATTERN
 THE PURPOSE OF EPIDEMIOLOGICAL INVESTIGATION IS TO IDENTIFY THE SOURCE OF THE
EPIDEMIC
PRIMARY SOURCE OF CONDUCTING AN EPIDEMIOLOGICAL INVESTIGATION
 DELINEATE THE ETIOLOGY OF THE EPIDEMIC
 IDENTIFY ITS SOURCE
CHARACTERISTICS OF A PERSON TO PERSON PROPAGATED EPIDEMICS
 THERE IS A GRADUAL BUILD UP OF CASES BEFORE THE EPIDEMIC BECOMES EASILY NOTICEABLE
 A GRADUAL OR INSIDIOUS ONSET OF EPIDEMICS IS USUALLY OBSERVABLE IN PERSON TO
PERSON PROPAGATED EPIDEMICS
ESTABLISHING EPIDEMICS
 DETERMINING WHETHER THERE IS AN EPIDEMIC OR NOT, THIS IS DONE BY COMPARING THE
PRESENT NUMBER OF CASES WITH THE USUAL NUMBER OF CASES OF THE DISEASE AT THE
SAME TIME OF THE YEAR, AS WELL AS ESTABLISHING THE RELATEDNESS OF THE CASES OF THE
DISEASE
CYCLICAL VARIATION
 IS A PERIODIC FLUCTUATION IN THE NUMBER OF CASES OF A DISEASE IN THE COMMUNITY
IN YEAR 1980, (WHO) WORLD HEALTH ORGANIZATION DECLARED THE PHILIPPINES TOGETHER WITH
SOME OTHER COUNTRIES IN THE WESTERN PACIFIC REGION “ FREE OF WHICH DISEASE”?
 SMALL POX
 THE LAST DOCUMENTED CASE OF SMALL POX WAS IN 1977 AT SOMALIA
CENSUS OF PHILIPPINES IN 1995 THEY WERE ABOUT 35,299,000 MALES AND ABOUT 34, 968,000
FEMALES
 100.94:100
 SEX RATIO IS THE NUMBER OF MALES FOR EVERY 100 FEMALES IN THE POPULATION
PRIMARY HEALTH CARE IS THE TOTAL APPROACH TO COMMUNITY DEVELOPMENT, WHICH IS AN
INDICATOR OF SUCCESS
 HEALTH PROGRAMS ARE SUSTAINED ACCORDINGLY TO THE LEVEL OF DEVELOPMENT OF THE
COMMUNITY
 PRIMARY HEALTH CARE IS ESSENTIAL HEALTH CAE THAT CAN BE SUSTAINED IN ALL STAGES OF
DEVELOPMENT OF THE COMMUNITY
SPUTUM EXAM
 MAJOR DIAGNOSTIC EXAM FOR PTB, CLIENTS WOULD SOMITIMES GET FALSE NEGATIVE RESULT
IN THIS EXAM, THIS MEANS THE TEST IS NOT PERFECT IN TERMS OF
 SENSITIVITY – CPACITY OF THE EXAMINATION TO DETECT CASES OF THE DISESE, IF A TEST IS 100
SENSITIVE, ALL THE TEST WILL HAVE POSITIVE RESULT
LAGUNDI
 FEVER, HEADACHE, COUGH
SAMBONG
 IS A DIURETIC
TSAANG GUBAT
 USED TO RELIEVE DIARRHEA
AKAPULKO
 ANTI-FUNGAL PROPERTY
GINSENG, GINGER, GARLIC
 ANTI-COAGULANT
 WOF: BLEEDING
LAW FOR PHILIPPINE INSTITUTE OF TRADITIONAL & ALTERNATIVE HEALTH CARE
 RA 8423
IN TRADITIONAL CHINESE MEDICINE, THE YIELDING, NEGATIVE & FEMININE FORCE IS
 YIN
 YANG – IS THE MALE DOMINATING, POSITIVE AND MASCULINE FORCE
LEGAL BASIS OF PHV APPROACH IN PHILIPPINES
 LETTER OF INSTRUCTION NUMBER 949
 LOI 949 WAS ISSUED BY PRESIDENT FERDINAND MARCOS SR. DIRECTING THE FORMERLY CALLED
MINISTRY OF HEALTH, NOE THE DOH TO UTILIZE THE PHC APPROACH IN PLANNING &
IMPLEMENTING HEALTH PROGRAMS
INTERSECTORAL LINKAGES
 EX. COOPERATION BETWEEN THE PHN & PUBLIC SCHOOL TEACHER
 INTERSECTORIAL LINKAGES REFER TO WORKING RELATIONSHIPS BETWEEN THE HEALTH SECTOR
AND OTHER SECTORS INVOLVED IN COMMUNITY DEVELOPMENT
THE MUNICIPALITY ASSIGNED TO YOU HAS AS POPULATION OF 20000 ESTIMATE THE NUMBER OF
1-4 YEARS OLD CHILDREN WHO WILL BE GIVEN RETINOL CAPSULE 200,000 IU EVERY 6 MONTHS
 BASED ON THE PHILIPPINE POPULATION COMPOSITION TO ESTIMATE THE NUMBER OF 1-4
YEARS OLD MULTIPLY TOTAL POPULATION BY 11.5% (2300)
TO ESTIMATE THE NUMBER OF WOMEN WHO WILL BE GIVEN TETANUS TOXOID DURING AN
IMMJNIZATION OUTREACH ACTIVITY IN A BARANGAY WITH A POPULATION OF 1500
 MULTIPLY TOTAL POPULATION BY 3.5 %
 265
TO DECREASE THE SEX COMPOSITION OF THE POPULATION
 SEX RATIO
USED TO DETERMINE THE SEX COMPOSITION OF A POPULATION
 SEX PROPORTION
NATALITY RATE
 CHILD BIRTH RATE
 BIRTH RATE
CRUDE DEATH RATE COMPUTATION
 TOTAL NUMBER OF DEATHS
X 1000
TOTAL POPULATION
 EX. 94/18000 X 1000 = 5.2/1000
MALNUTRITION
 FREQUENT COMMUNITY HEALTH PROBLEM
 PRESCHOOLERS ARE MOST SUSCEPTIBLE TO PEM (PROTEIN ENERGY MALNUTRITION) BECAUSE
THEY HAVE BEEN WEANED, ALSO THEY UNABLE TO FEED THEMSELVES AND ARE OFTEN VICTIMS
OF POOR INTRAFAMILIAL FOOD DISTRIBUTION
SWAROOP’S INDEX
 IS THE PROPORTION OF DEATHS AGED 50 AND ABOVE
 THE HIGHER THE SWAROOP’S INDEX THE GREATER THE PROPORTION OF DEATHS WHO WERE
ABLE TO REACH THE AGE AT LEAST 50 YEARS
 MORE PEOPLE GREW OLD BEFORE THEY DIED
NEONATAL MORTALITY RATE COMPUTATION
 EX. 2 – DIED BEFORE 28 DAYS
_______________________ X 1000
46 – TOTAL # OF LIVE BIRTHS
 43.5/1000
1-4 YEAR OLD AGE SPECIFIC MORTALITY RATE
 PRESCHOOLERS ARE MOST SUSCEPTIBLE TO THE EFFECTS OF MALNUTRITION (PEM)
 CHILD MORTALITY RATE
NUMBER OF REGISTERED LIVE BIRTHS
 TO COMPUTE FOR GENERAL OR TOTAL FERTILITY RATE, DIVIDE THE NUMBER OF REGISTERED
LIVE BIRTHS BY THE NUMBER OF FEMALES OF REPRODUCTIVE AGE (15-45), THEN MULTIPLY BY
1000
SURVEY
 ALSO CALLED SAMPLE SURVEY
 IS DATA GATHERING ABOUT A SAMPLE OF THE POPULATION
DE JURE
 OTHER METHOD OF POPULATION ASSIGNMENT. IS BASED ON THE USUAL PLACE OF RESIDENCE
OF THE PEOPLE
FHSIS (FIELD HEALTH SERVICE AND INFORMATION SYSTEM)
 TALLY REPORT – IS PREPARED MONTHLY OR QUARTERLY BY THE RHU PERSONNEL AND
TRANSMITTED TO THE PROVINCIAL HEALTH OFFICE
TARGET CLIENT LIST
 EX MDT (MULTI DRUG THERAPY)
 THE MDT CLIENT LIST IS A RECORD OF CLIENTS ENROLLED IN MDT AND OTHER RELEVANT DATA,
SUCH AS DATES WHEN CLIENTS COLLECTED THEIR MONTHLY SUPPLY OF DRUGS
PD 651
 AMENDED RA 3753 REQUIRING REGISTRY OF LIVE BIRTHS WITHIN 30 DAYS FROM THE
OCCURRENCE OF BIRTH
PROFESSIONALS THAT CAN SIGN A BIRTH CERTIFICATE
 PUBLIC HEALTH NURSE
 RURAL HEALTH MIDWIFE
 MUNICIPAL HEALTH OFFICER
RA 3753
 STATES THA ANY BIRTH ATTENDANT MAY SIGN THE CERTIFICATE OF LIVE BIRTH
MAGNITUDE OF HEALTH PROBLEM
 REFERS TO THE PERCENTAGE OF THE POPULATION AFFECTED BY A HEALTH PROBLEM
 USED ONLY IN COMMUNITY HEALTH CARE
SENTRONG SIGLA MOVEMENT
 PROJECT OF DOH & LGU, MAIN STRATEGY IS CERTIFICATION OF HEALTH CENTERS THAT ARE
ABLE TO COMPLY WITH STANDARDS SET BY DOH
SPECIAL TARGETS FOR FAMILY PLANNING
 THOSE THAT HAVE A DELIVERY FOT HE PAST 15 MONTHS
 THE IDEAL BIRTH SPACING IS AT LEAST 2 YEARS (15 MOS + 9 MONTHS PREGNANCY = 2 YEARS)
FAMILY PLANNING PROGRAM OF THE PHILIPPINES
 ADEQUATE INFORMATION FOR COUPLES REGARDING THE DIFFERENT METHODS
RETINOL 200,000 IU
 TERATOGENIC EFFECT
 MEGADOSE VITAMIN A
HOME DELIVERY
 LESS THAN 5 PREGNANCY
 PRIMIGRAVIDA NEED TO HAVE A DELIVERY ON A CHILD BIRTH FACILITY
FOLIC ACID
 INADEQUATE INTAKE OF FOLIC ACID CAN LEAD TO NEURAL TUBE DEFECTS
DELIVERY
 FIRST TO DO – NOTE THE INTERVAL, DURATION AND INTENSITY OF LABOR CONTRACTIONS
 ASSESSMENT SHOULD BE DONE FIRST TO DETERMINE IF THE PATIENT IS EXPERIENCING TRUE
LABOR AND WHAT STAGE OF LABOR THE PATIENT IS IN
BREAST FEEDING
 EXPLAIN THAT PUTTING THE BABY TO BREAST WILL LESSEN THE BLOOD LOST AFTER THE
DELIVERY
 SUCKING THE NIPPLES WILL STIMULATE THE RELEASE OF OXYTOCIN BY THE POSTERIOR
PITUITARY GLAND WHICH CAUSES UTERINE CONTRACTION
PURPOSE OF OFFERING THE BREAST TO THE BABY 30 MINS AFTER THE DELIVERY
 TO STIMULATE MILK PRODUCTION BY THE MAMMARY ACINI
 SUCKING THE NIPPLES WILL STIMULATE THE PROLACTIN REFLEX WHICH STIMULATES LACTATION
SIGN THAT THE BABY IS LATCHED TO THE BREAST PROPERLY
 THE MOTHER DOES NOT FEEL NIPPLE PAIN
 WHEN THE BABY IS LATCHED TO THE BREAST, HE TAKES DEEP, SLOW SUCKS, HIS MOUTH IS
WIDE OPEN AND MUCH OF THE AREOLA IS INSIDE THE MOUTH
REMEMBER
MOTHER’S BREAST MILK IS SUFFICIENT TO BABY’S IRON NEED UPTO 6 MONTHS, AFTER 6 MONTHS
THE BABY’S IRON REQUIREMENT CAN NO LONGER BE PROVIDED BY THE MOTHER’S MILK ALONE
RETINOL 200, 000 IU
 GIVEN WITHIN 1 MONTH AFTER THE DELIVERY
POTASSIUM IODATE
 GIVEN DURING PREGNANCY
MALUNGGAY CAPSULE
 ROUTINELY ADMINISTERED AFTER DELIVERY
FERROUS SULFATE
 2 MONTHS AFTER DELIVERY
MEASLES VACCINE
 HIGHLY SENSITIVE TO HEAT
 REQUIRES STORAGE TO FREEZER
BCG VACCINE
 SCHEDULED ONLY IN THE MORNING
 DISCARDED 4 HRS AFTER RECONSTITUTION
 CAN BE GIVEN AT BIRTH
 PRODUCES PERMANENT SCAR
PD 996
 NOT OBLIGED TO SECURE PARENTAL CONSENT
 ENACTED IN 1976, IMMUNIZATION IS COMPULSORY FOR CHILDREN UNDER 8 YEARS OF AGE
 RA 7846 – HEPA B COMPULSORY FOR THE SAME AGE GROUP
DPT
 DO NOT GIVE IF THE BABY HAS HAD SEIZURE WITHIN 3 DAYS AFTER THE ADMINISTRATION, IT IS
AN INDICATION OF HYPERSENSITIVITY TO PERTUSSIS VACCINE. IT IS CONSIDERED AS A
CONTRAINDICATION TO THE SUBSEQUENT DOSES OF DPT
IMMUNIZATION
 FEVER 38.5
 DIARRHEA (SIMPLE)
 RESPIRATORY TRACT INFECTION
 MALNUTRITION
NOT CONTRAINDICATED ON GETTING IMMUNIZED
CHEST WITHDRAWING
 + SIGN OF DYSPNEA, INDICATING PNEUMONIA
DEMOGRAPHIC DATA
 PERSONAL INFORMATION – FIRST TO ASSESS
NAMES AND RELATIONSHIPS AMONG FAMILY MEMBERS
SOCIO-ECONOMIC
 2ND TO ASSESS
HOME & ENVIRONMENT
 3RD TO ASSESS
HEALTH PRACTICE/ HEALTH ENCIRONMENT/ HEALTH STATUS
 4TH TO ASSESS
IN ASSESSING THE FAMILY’S ABILITY TO COPE THE NURSE SHOULD ASK
 CAN YOU DESCRIBE HOW YOU SUCCESSFULLY HANDLE ONE FAMILY PROBLEM
 FAMILY COPING – PROMOTIVE & PREVENTIVE
WHY DO YOU WANT TO DO A FAMILY ASSESSMENT? MY TEENAGER IS THE PATIENT NOT THE REST
OF US. WHAT IS THE BEST RESPONSE BY THE NURSE?
 EVERY FAMILY MEMBERS PERCEPTION OF EVENTS IS DIFFERENT AND ADDS TO THE TOTAL
PICTURE
INFORMATION WHICH THE NURSE WILL FIND WHEN ASSESSING THE FAMILY OF A PATIENT WITH
MENTAL ILLNESS
 THE FAMILY EXHIBITS MANY CHARACTERISTICS OF DYSFUNCTIONAL FAMILIES
 FAMILY MEMBERS LACKS SUPPORT
IF NO ONE UNDERSTAND THE SITUATION OF THE FAMILY
 REFER THE PARENTS TO A SUPPORT GROUP
NOT RECOGNIZED AS PART OF THE NURSE’S ROLE AS MEMBER OF THE HEALTH TEAM
 PERFORMING PHYSICIAN’S FUNCTIONS WITH SUPERVISION
COLLABORATION AND TEAMWORK
 CO-WORKERS (NURSE TO NURSE)
 SUBORDINATE TO HEAD NURSE OR VICE VERSA
 CO HEALTH WORKERS
 NURSE TO OTHER HEALTH CARE PROFESSIONALS
COLLABORATIVE ENVIRONMENT
 DEVELOP A PLAN FOR THE DIFFERENT TEAM MEMBERS TO FOLLOW AND SHOW IMPACT OF
THEIR WORK
 HOLD EDUCATION SESSIONS REGARDING COLLABORATION FOR EACH UNIT
 INSTITUTE COLLABORATIVE STRATEGIES THAT ARE TRADITIONALLY PRACTICED
 EMPHASIZE THAT NO ONE PROFESSION HAS ALL THE NECESSARY COMPETENCE TO PROVIDE ALL
CARE – BEST TO DEVELOP FURTHER (- PARAGRAPH)
BEST EXAMPLE OF PROFESSIONAL COLLABORATION
 THE NURSE AND THE PHYSICIAN DISCUSS THE PATIENT’S MUSCLE WEAKNESS AND INITIATE A
REFERRAL FOR PHYSICAL THERAPY
ACTIVITIES THAT ARE APPROPRIATE FOR THE NURSE TO COLLABORATE WITH A PATIENT
 HEALTH PROMOTION
 END OF LIFE CONFORT DECISIONS
 LIFESTYLE CHANGES TO IMPROVE HEALTH
 PALLATIVE CARE (QUALITY OF LIFE, COMFORT MEASURES)
DISASTER
 THE EVENT RESULT IN MULTIPLE INJURIES, DEATHS AND PROPERTY DAMAGE
FOUR (4) AREAS OF DISASTER MANAGEMENT
 1. PREVENTION/MITIGATION – 1ST STAGE
 2. PREPAREDNESS – 2ND STAGE – BEFORE ACTUAL CALAMITY
 3. RESPONSE – 3RD STAGE – DURING ACTUAL CALAMITY
 4.. RECOVERY – 4TH STAGE – AFTER ACTUAL CALAMITY – DEBRIEFING
FLASH FLOOD
 CAUSED BY HEAVY RAINS
TYPES OF RECORDS
 EVENTS SUCH AS BIRTHS, ILLNESS, DEATHS
 CLINIC CONSULTATIONS
 WRITTEN DATA ON HOME VISIT
REPORT
 ARE PREPARED USUALLY FOR ADMINISTRATIVE PURPOSES
 EX. SUMMARY OF SERVICES DELIVERED, ACCOMPLISHMENTS AND FAILURES OF SERVICES,
CLIENT INFORMATION AND PROFILE
 NOT A REPORT – DESCRIPTION OF A PROGRAM AND PLANNED FOR
INDIVIDUAL CLINICAL RECORD CONTAINS THE FOLLOWING
 SOCIO-DEMOGRAPHIC CHARACTERISTICS
 PATIENT’S CHIEF COMPLAINT
 PHYSICAL EXAMINATION OF DRUGS
 FREQUENCY OF CLINICAL CHECK UP
FAMILY SERVICE AND PROGRESS RECORD (FSPR)
 SERVES AS A TOOL TO OPERATIONALIZE THE CONCEPT OF THE FAMILY AS THE UNIT OF CARE
4 PARTS OF FSPR
 1. ASSESSMENT OF THE FAMILY AND THE ENVIRONMENT – FIRST PART
 2. HEALTH AND NURSING PROBLEMS
 3. NURSING CARE PLAN
 4. SERVICE AND PROGRESS NOTES
SUPERVISORY PLAN
 IS A WRITTEN DOCUMENT ON HOW TO ORGANIZE AND SYSTEMATIZE SUPERVISORY ACTIVITIES
NEED FOR SUPERVISION MAY ARISE FROM THE FOLLOWING
 LACK OF STAFF MOTIVATION
 CONFLICT BETWEEN PERSONAL AND ORGANIZATIONAL GOAL
 LACK OF KNOWLEDGE AND SKILLS
INFORMATION REGARDING THE SUPERVISORY NEEDS OF THE MIDWIVES WHICH CAN BE TAKEN
FROM THE FOLLOWING
 REVIEW OF RECORDS AND REPORTS
 INTERVIEW OF THE MIDWIVES
 OBSERVATION OF THE MIDWIVES AT WORK
PRIORITIZING SUPERVISORY NEEDS AND PROBLEMS
 DEGREE OF IMPORTANCE OF THE IDENTIFIED NEED
 AVAILABILITY OF THE RESOURCES NEEDED
 ACTIVITIES NEEDED TO MEET THE IDENTIFIED NEED
INDICATORS FOR EVALUATION
 NEEDS MET
 PERFORMANCE INCREASED
 QUALITY OF SERVICE IMPROVED
ASSESSMENT
 COLLECTING DATA AND MONITORS THE HEALTH STATUS OF THE POPULATION
SOCIO-DEMOGRAPHIC DATA
 NUMBER AND PROPORTION OF PERSONS AGED 25 OR OLDER WITH LESS THAN A HIGH SCHOOL
EDUCATION
AGGREGATE POPULATION IN A COMMUNITY
 EX. STUDENTS IN A LOCAL HIGH SCHOOL
POPULATION FOCUSED- PRACTICE
 VOLUNTEERING FOR A COMMUNITY ACTION
TO IMPROVE POPULATION-FOCUSED PRACTICE IN THE COMMUNITY, WHICH IS A KEY
OPPORTUNITY FOR NURSES LIKE HER TO ACCOMPLISH THIS GOAL
 INFLUENCING PUBLIC HEALTH POLICY
APPROPRIATE APPROACH FOR THE COMMUNITY / PUBLIC HEALTH NURSE IN BALANCING
INDIVIDUAL PRIVACY AND AUTONOMY AND THE COMMUNITY’S NEEDS FOR SAFETY AND SECURITY
 SEEK A BALANCE BETWEEN INDIVIDUAL’S NEEDS AND THE COMMUNITY’S NEEDS
INFORMED CONSENT
 CONSENT MUST BE VOLUNTARY (AUTONOMY)
LIVING WILL
 PATIENT’S DESIRE FOR HEALTH CARE SERVICES THAT WILL BE PROVIDED TO HIM WHEN THE
TIME COMES THAT HE IS UNABLE TO MAKE THE DECISION FOR HIMSELF.
NEGLIGENCE
 EX. FAILURE TO REPORT YOUR FINDINGS
OBSERVANCE OF CONFIDENTIALITY
 EX. DESCRIBING A DIFFICULTY WITH A CLIENT IN A HEALTH TEAM CONFERENCE
HEALTH TEACHING FOR A DIABETIC PATIENT
 SYMPTOMS INDICATING THAT THE PATIENT SHOULD CONTACT THE HEALTH CARE PROVIDER
IN ORDER TO OBTAIN COMPLETE ASSESSMENT IN A GERIATRIC PATIENT
 USE A FERIATRIC ASSESSMENT INSTRUMENT TO EVALUATE THE PATIENT
WHEN CARING FOR OLDER ADULTS IN RURAL AREAS
 ASSESS THE PATIENT FOR CHRONIC DISEASES THAT ARE UNIQUE TO RURAL AREAS
SAMPLE OF LONG TERM NURSING MANAGEMENT
 60 HEAR OLD WITH BILATERAL KNEE OSTEOARTHRITIS WHO WEIGHS 350 LBS (159KG) – OBESE,
NEEDS TO LOOSE WEIGHT
WORLD HEALTH ORGANIZATION (WHO)
 THE KEY AGENCY THAT INITIATED THE ALMA ATA CONFERENCE ON PRIMARY HEALTH CARE
PHILIPPINES
 THE FIRST TO ADOPT THE PRINCIPLES OF PHC
APPROPRIATE TECHNOLOGY
 TOOLS AND METHODS THAT ARE SUITABLE AND ACCEPTABLE TO THE FAMILIES AND
COMMUNITIES
ACCEPTABILITY
 RECOGNIZES THAT THE HEALTH SERVICES OFFERED ARE TO BE IN ACCORDANCE TO THE
PREVAILING BELIEFS AND PRACTICES OF THE INTENDED CLIENTS OF CARE.
INTERSECTORAL COLLABORATION
 REFERRAL SYSTEM TO DIFFERENT PEOPLE, ORGANIZATION TO WORK TOGETHER TO SOLVE THE
PROBLEM/ ISSUES
OBJECTIVES OF ASSESSMENT OF PUBLIC HEALTH NURSE
 IDENTIFY SPECIFIC RISK FACTORS RELATED TO HEALTH AND HEALTH PROBLEMS
 DEFINE THE NATURE OF THE HEALTH STATUS AND HEALTH RELATED PROBLEMS
 DETERMINE WHO SHOULD BE REFERRED TO DIFFERENT HEALTH CARE FACILITIES
 EXCEPT – IDENTIFY CLIENTS WHO SHOULD BE GIVEN PRIORITY FOR CARE
MOST COMMON METHOD OF DATA COLLECTION THAT IS ACCURATE AND PROVIDES THE BIGGEST
BULK OF COMMUNITY DATA
 COMMUNITY CENSUS
BIRTHS AND DEATHS FROM THE CITY/ MUNICIPALITY REGISTRAR
 PROVIDE A MOST ACCURATE SET OF DATA
DATA ANALYSIS
 QUANTIFICATION
 DESCRIPTION
 CLASSIFICATION
HEALTH RELATED PROBLEMS
 SOCIAL
 ECONOMICS
 POLITICAL
MODIFIABILITY OF THE PROBLEM
 CRITERIA THAT REFERS TO THE PROBABILITY OF REDUCING, CONTROLLING OR ERADICATING
THE PROBLEM
REMEMBER
 PROFESSIONAL AND PERSONAL DEVELOPMENTS ARE REQUIRED IN ORDER TO MAINTAIN AND
ENHANCE PROFESSIONAL STANDARDS AND TO PROVIDE QUALITY, COMPETENT AND SAFE
PATIENT CARE
INDICATOR OF INCREASING ACCOUNTABILITY IN THE PROFESSION OF NURSING
 DEMONSTRATION OF COMPETENCY AND HIGH QUALITY CARE
MOST IMPORTANT ELEMENT IN NURSING’S ATTEMPT TO GAIN FULL AUTONOMY OF PRACTICE
 GAINING AND MAINTAINING CONTROL OF NURSING PRACTICE OF NURSES
BEST METHOD FOR NURSES TO PREPARE FOR FUTURE PROFESSIONAL PRACTICE
 UNDERSTAND AND EXPLORE THE ISSUES INVOLVED IN PROFESSIONAL PRACTICE
ALLOWS A NURSE TO EXERT LEGITIMATE POWER OVER A CLIENT WHEN PROVIDING NURSING CARE
 PROCEDURES / THE ABILITY TO PERFORM PROCEDURES TO ALLEVIATE PATIENT’S DISCOMFORT
IN SERVICE EDUCATION
 PROVIDES AN INFORMAL TRAINING SESSION ON HOW TO PROPERLY USE A NEW VITAL SIGN
MONITOR
QUALITY IMPROVEMENT
 PLAN – DO – CHECK – ACT (PDCA)
USE PDCA WHEN
 WORKING TOWARDS CONTINUOUS IMPROVEMENT
 IMPLEMENTING ANY CHANGE
 DEVELOPING A NEW DESIGN OF A PROCESS OR A SERVICE
 PLANNING DATA COLLECTION AND ANALYSIS TO PRIORITIZE PROBLEMS
SOME AREAS OF APPLICATION OF PDCA
 NEEDS ANALYSIS
 OVERALL STRATEGIC PLANNING
 STAFF GOAL SETTING AND EVALUATION
 EXCEPT – DELEGATION OF WORK TO LOWER LEVELS
CONTINUOUS QUALITY IMPROVEMENT (CQI)
 MONITOR PROCESSED INVOLVED IN THE PROVISION OF SAFE, EFFECTIVE CLIENT CARE
QUALITY PERFORMANCE STANDARD IMPORTANCE
 ARE USED TO GUIDE IMPROVEMENT IN THE PUBLIC HEALTH SYSTEM
OCCUPATIONAL HEALTH SERVICES
 ARE PROVIDED IN WORKPLACE TO ADDRESS THE HEALTH CARE NEEDS OF WORKING
POPULATIONS
 CAN MAKE A SIGNIFICANT CONTRIBUTION TO GEVERNMENT INITIATIVE THIS INCLUDES THE
FOLLOWING BY REDUCING THE
1. HEALTH INEQUALITIES
2. SOCIAL EXCLUSION
3. SICKNESS ABSENCE
4. OVERALL BURDEN OF ILL HEALTH
REMEMBER
 THE NURSE IS A KEY FIGURE IN DELIVERING QUALITY OCCUPATIONAL HEALTH SERVICES, SHE
WORKS INDEPENDENTLY OR AS PART OF A LARGER INTERPROFESSIONAL HEALTH TEAM, SHE
PERFORMS, ALONG WITH OTHERS A JOB SAFETY ANALYSIS, IN DOING SUCH THE FOLLOWING
METHODS MAY BE EMPLOYED
1. REVIEW OF RECORDS, INTERVIEWS, SURVEYS
2. WALK THROUGH, PROCESS AND OUTPUT REVIEWS
3. OBSERVATION, FOCUSED GROUP DISCUSSION
4. EXCEPT – PRESONAL CHOICES OR PREFERENCE OF THE ADMINISTRATION
PHYSICAL SAFETY
 EX. SHARPS ARE PROPERLY DISPOSED IN A PUNCTURE-PROOF CONTAINER TO DECREASE THE
RISK OF NEEDLE-PRICK INJURIES
TERTIARY LEVEL OF PREVENTION
 USE OF RAMPS AND ASSISTIVE EQUIPMENTS FOR PHYSICALLY CHALLENGED WORKERS
 REHABILITATION
LIFE THREATENING EMERGENCIES
 DOES NOT PROVIDE EXCEPTION TO EMPLOYEES RIGHT TO PRIVACY
PUBLIC HEALTH SURVEILLANCE INCLUDE THE FOLLOWING
 DATA ANALYSIS
 DATA COLLECTION
 DATA INTERPRETATION
 EXCEPT – DISEASE CONTROL
PUBLIC HEALTH SURVEILLANCE CAN BE BEST DESCRIBE PRIMARILY BY
 A SYSTEM FOR COLLECTING HEALTH RELATED INFORMATION
CRITERIA FOR PRIORITIXING HEALTH PROBLEMS FOR SURVEILLANCE
 INCIDENCE OF THE PROBLEM
 SOCIAL AND ECONOMIC IMPACT OF THE PROBLEM
 PUBLIC CONCERN ABOUT THE PROBLEM
 EXCEPT – NUMBER OF PREVIOUS STUDIES OF THE PROBLEM
PUBLIC HEALTH SURVEILLANCE TARGETS THE FOLLOWING
 CHRONIC DISEASES
 COMMUNICABLE DISEASES
 OCCUPATIONAL HAZARDS
 EXCEPT – POPULATION MIGRATION
COMMON USES AND APPLICATIONS OF PUBLIC HEALTH SURVEILLANCE
 DETECTING INDIVIDUAL PERSONS WITH MALARIA SO THAT THEY CAN RECEIVE PROMPT AND
APPROPRIATE TREATMENT
 HELPING PUBLIC HEALTH OFFICIALS DECIDE HOE TO ALLOCATE THEIR DISEASE CONTROL
RESOURCES
 IDENTIFYING CHANGES OVER TIME IN THE PROPORTION OF CHILDREN WITH ELEVATED BLOOD
LEAD LEVELS IN A COMMUNITY
 DOCUMENTIN CHANGES IN VARICELLA (CHICKENPOX) INCIDENCE, AFTER A LAW MANDATING
VARICELLA VACCINATION IN THE EXPANDED PROGRAM OF IMMUNIZATION TOOK EFFECT
FACTORS THAT CONTRIBUTE TO THE OCCURRENCE OF FOOD-TRANSMITTED DISEASES
 CONSUMPTION OF IMPROPERLY COOKED FOOD
 EATING HABITS OF THE POPULATION SUCH AS EATING RAW FOODS
 LACK OF FUEL FOR COOKING FOOD
 EXCEPT – OVERCONSUMPTION OF LOCALLY AVAILABLE FOOD
PARAGONISMUS WESTERMANI OR THE ORIENTAL LUNG FLUKE
 CAUSES INFECTION IN THE HUMAN POPULAITON BY EATING INADEQUATELY COOKED CRABS
 PATIENTS WITH PARAGONISMUS ARE USUALLY MISDIAGNOSED TO HAVE PULMONAY
TUBERCULOSIS
TAENIA SOLIUM / TAENIASAGINATA
 EGGS OF THE ABOVE MAY BE INGESTED BY PIGS OR CATTLE AND SERVES AS INTERMEDIATE
HOST
 PROPER DISPOSAL OF HUMAN FECES
ENTAMOEBA HISTOLYTICA
 BOILING OF WATER FROM QUESTIONABLE SOURCE
GIARDASIS
 IS A DISEASE CAUSED BY A FLAGELLATED PROTOZOAN AND ITS PREVALENCE IS ASSOCIATED
WITH THE FOLLOWING CONDITIONS
1. POOR ENVIRONMENTAL SANITATION
2. POOR HYGIENE
3. OVERCROWDING
INTRODUCTION
 SECTION IN THE ARTICLE WHERE RESEARCH QUESTION AND STUDY PURPOSE ARE FOUND
SOME DEHYDRATION
 2 MOS – 5 YRS WITH DIARRHEA + 2 OR MORE OF THE FOLLOWING SYMPTOMS (RESTLESS,
IRRITABLE, SUNKEN EYES, THE SKIN GOES BAC SLOWLY OFTER SKIN PINCH
 SUPERVISE THE MOTHER IN GIVING 200 TO 400 ML OF ORESOL IN 4HRS, ( THE AMOUNT OF
ORESOL IS BEST COMPUTED ON THE BASIS OF THE CHILD’S WEIGHT (75ML/KG BODY WEIGHT)
 IF THE WEIGHT IS UNKNOWN, THE AMOUNT OF ORESOL IS BASED ON THE CHILED’S AGE)IF THE
CHILD VOMITS (LET THE CHILD REST FOR 10 MIS THEN CONTINUE GIVING ORESOL MORE
SLOWLY
 IF PERSISTENT VOMITING (REFER THE CHILD URGENTLY RO THE NEAREST HOSPITAL)
PEM (PROTEIN ENERGY MALNUTRITION)
 KWASHIORKOR – IS CAUSED BY DECREASED COLLOIDAL OSMOTIC PRESSURE OF THE BLOOD
BOUGHT ABOUT BY HYPOALBUMINEMIA, DECREASE LEVEL OF ALBUMIN IS CAUSED BY PROTEIN
DEFICIENT CLIENT, EDEMA IS NOTICEABLE AS A RESULT OF LOW LEVEL OF ALBUMIN
BAGGY PANTS
 SEVERE SIGN OF MARASMUS
 REFER TO THE HOSPITAL
XEROPTHALMIA
 VIT A DEFICIENCY
 NIGHT BLINDNESS
 FUNCTIONAL CHANGE IS NOT OBSERVABLE DURING PHYSICAL EXAMINATION
 CONJUNCTIVAL XEROSIS – EARLIEST VISIBLE LESION, DULLNESS OF THE CONJUNCTIVA DUE TO
INADEQUATE TEAR PRODUCTION.
RETINOL 200,000 IU
 PREVENT XEROPHTHALMIA IN YOUNG CHILDREN
 GIVEN EVERY 6 MONTHS (PRE-SCHOOLERS)
 100,000 IU IS GIVEN TO INFANT AGED 6-12 MONTHS
 10,000 IU FOR PREGNANT WOMEN (HAS TERATOGENIC EFFECT IS THE DOSAGE IS HIGH)
PALLOR
 PALMS – ANATOMICAL STRUCTURE OF THE PALMS ALLOW A RELIABLE & CONVENIENT BASIS
FOR EXAMINATION FOR PALLOR
RA 8976
 FOOD FORTIFICATION
 PREVENT MICRONUTRIENT DEFICIENCY
 RICE, WHEAT, SUGAR, COOKING OIL WITH VIT A, IRON AND/OR IODINE
MEASLES VACCINE (AMV)
 GIVE MEASLES VACCINE TO BABIES AGED 6-8 MONTHS OLD IF THERE IS AN IMPENDING
EPIDEMIC, THE MOTHER WILL BE INSTRUCTED THAT THE BABY WILL HAVE ANOTHER DOSE
WHEN THE BABY IS 9 MONTHS OLD.
IMCI ASSESSMENT GUIDE
 DANGER SIGNS THAT INDICATE THE NEED FOR URGENT REFERRAL TO THE HOSPITAL
1. NOT ABLE TO FEED OR DRINK
2. VOMITS EVERYTHING
3. HAS CONVULSIONS
4. ABNORMALLY SLEEPY OF DIFFICULT TO AWAKEN
MALARIA
 ASK WHERE THE FAMILY RESIDES, IF ENDEMIC AREA
 IF NOT, ASK IF THE CHILED TRAVELED FOR THE PAST 6 MONTHS, WHERE IS THE LOCATION OR IF
HE/SHE STAYED OVERNIGHT IN THAT AREA
DENGUE
 AEDES EGYPTI – VECTOR – BREEDS IN STAGNANT CLEAR WATER, FEEDS DURING THE DAY
SECONDARY PREVENTION FOR MALARIA
 DETERMINING WHETHER THA PLACE IS ENDEMIC OR NOT
 SECONDARY LEVEL OF PREVENTION BECAUSE THIS METHOD IS DIAGNOSTIC
SCOTCH TAPE SWAB
 DONE TO CHECK PINWORMS
 PINWORMS OVA ARE DEPOSITED AROUND THE ANAL ORIFICE
SPUTUM EXAM FOR AFB (ACID FAST BACCILI)
 COUGH FOR 2 WEEKS OR MORE + 1 OR MORE OF THE FOLLOWING SYMPTOMS
1. FEVER 1 MONTH OR MORE
2. CHEST PAIN FOR 2 WEEKS OR MORE NOT ATTRIBUTED TO OTHER CONDITIONS
3. UNEXPLAINED WEIGHT LOSS
4. NIGHT SWEATS
5. HEMOPTYSIS
DOTS TARGET CATEGORY 1
 CLIENT DIAGNOSED FOR THE 1ST TIME THROUGH A POSITIVE SPUTUM TEST
DOTSINNOVATION IMPLEMENTATION
 HAVING THE HEALTH WORKER OR A RESPONSIBLE FAMILY MEMBER MONITOR DRUG INTAKE
(DRUG COMPLIANCE)
LEPROSY
 THE LESION OF LEPROSY IS NOT MACULAR, IT IS CHARACTERIZED BY A CHANGE IN SKIN COLOR
(EITHER REDDISH OR WHITISH) & LOSS OF SENSATION, SWEATING & HAIR GROWTH OVER THE
LESION. INABILITY TO CLOSE THE EYE LIDS (LAGOPHTHALMOS) AND SINKING OF THE NOSE
BRIDGE ARE LATE SYMPTOMS
MULTIBACILLARY LEPROSY CLASSIFICATION
 5 SKIN LESIONS, POSITIVE SLIT SKIN SMEAR
SCHISTOSOMIASIS (SNAIL FEVER)
 AFFECTS THE SMALL INTESTINE AND THE LIVER
 LIVER DAMAGE IS A CONSEQUENCE OF FIBROTIC REACTION TO SCHITOSOMA EGGS IN THE LIVER
 NSG – PROPER USE OF SANITARY TOILETS (HEALTH TEACHING)
LEVEL 2 – WATER FACILITY (APPROVED WATER FACILITY)
 COMMUNAL FAUCET OR WATER STAND POST
 ARTESIAN WELL
HEPA A/E
 BLOOD & SPECIMEN
 NEEDLE PRICK
 BLOOD TRANSFUSION
 INTERCOURSE
DPT
 SHOULD NOT BE STORED IN BC
 2-8 DEGREE CELSIUS
 REQUIRE FREEZING
OPV & MEASLES
 HIGHLY SENSITIVE TO HEAT
 REQUIRE FREEZING
MMR
 NOR ON EPI
INFANT RATE
 TO ESTIMATE THE NUMBER OF INFANTS, MULTIPY TOTAL POPULATIONS BY 3 %)
SEVER DEHYDRATION
 DOES NOT ALWAYS REQUIRE URGENT REFERRAL TO HOSPITAL
 IVF THERAPY
IF THESE DOES NOT WORK REFER TO THE HOSPITAL
 ORESOL/NGT
 NGT/OREM
CAPILLARY REFILL
 ADEQUATE BLOOD SUPPLY TO THE AREA ALLOWS THE RETURN OF THE COLOR OF THE NAILBED
WITHIN 3 SECONDS
KOPLIK’S SPOT
 PATHOGNOMONIC SIGN OF MEASLES FOUND IN THE BUCCAL MUCOSA (MOUTH OR THROAT)
MEASLES
 AIRBORNE
VIRAL CONJUNCTIVITIS
 DIRECT/INDIRECT CONTACT WITH DISCHARGES FROM THE AFFECTED EYE
ACUTE POLIOMYELITIS
 SPREAD THROUGH FECAL-ORAL ROUTE AND CONTACT WITH THROAT SECRETIONS
DIPHTHERIA
 DIRECT/INDIRECT CONTACT WITH RESPIRATORY SECRETIONS
HAEMOPHILUS INFLUENZA
 UNUSUAL OVER THE AGE OF 5 YEARS
 PEAK < 6 MONTHS
 CAUSES MININGITIS IN CHILDREN 2 TO 3 YEARS
MORBILLI VIRUS
 ETIOLOGY OF MEASLES
STREPTOCOCCUS PNEUMONIAE & NEISSERIA MENINGITIDIS
 CAUSES MENINGITIS BUT NOT SPECIFIC IN YOUNG CHILDREN
ZOOPROPHYLAXIS
 DONE BY PUTTING ANIMALS LIKE CATTLE OR DOGS CLOSE TO THE WINDOW OR DOORWAY JUST
BEFORE NIGHT FALL, THE ANOPHELES MOSQUITO TAKES HIS BLOOD MEAL FROM THE ANIMAL
AND GOES BACK TO ITS BREEDING PLACE, THEREBY PREVENTING INFECTION TO HUMANS
STREAM SEEDING
 PUTTING LARVIVOROUS FISH IN MALARIA CONTROL
CHOLERA
 PROFUSE WATERY STOOL
AMOEBAIASIS/DYSENTERY
 PRESENCE OF BLOOD/ MUCUS IN THE STOOL
GIARDIASIS
 STEATORRHEA
SCHISTOSOMA JAPONICUM
 PHILIPPINES
SCHISTOSOMA MANSONI
 AFRICA & SOUTH AMERICA
SCHISTOSOMA HAEMATOBIUM
 AFRICA & MIDDLE EAST
SCHISTOSOMA MALAYENSIS
 PENINSULAR MALAYSIA
LEPTOSPIROSIS
 IS TRANSMITTED THROUGH CONTACT WITH THE SKIN OR MUCUS MEMBRANE WITH WATER OR
MOIST SOIL CONTAMINATED WITH URINE OF INFECTED ANIMALS LIKE RAT
LEVEL 3 WATER SYSTEM
 WATER WORKS SYSTEM SUCH AS MWSS
AIDS
 (+) ELISA, REFER CLIENT TO UNDERGO A MORE CONFIRMATORY TEST (WESTERN BLOT), IF
WESTERN BLOT IS (-) NEGATIVE, IT MEANS THAT ELISA TESTE IS ALSO NEGATIVE AND THE CLIENT
IS NOT INFECTED
 BEING FAITHFUL – BEST CONTROL FOR AIDS
 INFECTIOUS MONONUCLEOSIS – TONSILLOPHARYNGITIS – CYTOMEGALOVIRUS – IS AN ACUTE
VIRAL DISEASE CHARACTERIZED BY FEVER, SORE THROAT & LYMPHADENOPATHY
CONTACT TRACING
 BEST METHOD THAT CAN BE TAKEN BY PUBLIC HEALTH NURSE
 MOST PRACTICAL & RELIABLE METHOD OF FINDING POSSIBLE SOURCES OF PERSON TO PERSON
TRANSMITTED INFECTION
AZT (ZIDOVUDINE)
 ANTI RETRO-VIRAL AGENT – USED IN MANAGEMENT OF AIDS
 THEY PROLONG THE LIFE OF PATIENT WITH AIDS
 THEY REDUCE THE RISK OF OPPORTUNISTIC INFECTIONS
 THEY SHORTEN THE PERIOD OF COMMUNICABILITY OF THE DISEASE
 THERE IS NO KNOWN CURE FOR AIDS
GERMAN MEASLES/RUBELLA
 RUBELLA VACCINE IS MADE UP OF ATTENUATED GERMAN MEASLE VIRUSES, THIS IS
CONTRAINDICATED IN PREGNANCY. IMMUNE GLOBULIN A SPECIFIC PROPHYLACTIC AGAINST
GERMAN MEASLES MAY BE GIVEN TO PREGNANT WOMEN
CHICKEN POX
 IS USUALLY MORE SEVERE IN ADULTS THAN IN CHILDREN, COMPLICATION SUCH AS
PNEUMONIA ARE HIGHER IN INCIDENCE IN ADULTS
MUMPS (INFECTIOUS PAROTITIS)
 EPIDIDYMITIS & ORCHITIS ARE POSSIBLE COMPLICATION OF MUMPS. IN POST ADOLESCENT
MALES, BILATERAL INFLAMMATION OF THE TESTES AND EPIDIDYMITIS MAY CAUSE STERILITY
COUNTRY CLUB MANAGEMENT
 PUTS CONCERN FOR THE STAFFS AS THE NUMBER 1 PRIORITY AT THE EXPENSE OF THE DELIVERY
SYSTEM
 HE/SHE RUNS THE DEPARTMENT JUST LIKE A COUNTRY CLUB WHERE EVERYONE IS HAPPY
INCLUDING THE MANAGERS
SERVANT LEADER
 ARE OPEN MINDED, LISTEN DEEPLY, TRY TO FULLY UNDERSTAND OTHERS & NOT BEING
JUDGEMENTAL
CHARISMATIC LEADER
 POSSESSES INSPIRATIONAL QUALITY THAT MAKES FOLLOWERS GETS ATTRACTED OF HIM AND
REGARDS HIM WITH REVERANCE
REMEMBER
 ASSESSMENT OF PEROSNAL TRAIT IS A RELIABLE TOOL FOR PREDICTING A MANAGER’S
POTENTIAL, IT IS NOT CONCLUSIVE THAT CERTAIN QUALITIES OF A PERSON WOULD MAKE HIM
A GOOD ONE. IT CAN ONLY PREDICT THE MANAGER’S POTENTIAL OF BECOMING A GOOD ONE.
PATH GOAL THEORY
 RECOGNIZES STAFF FOR GOING BEYOD EXPECTATIONS BY GIVING THEM CITATIONS
 ACCORDING TO HOUSE AND ASSOCIATES REWARDS GOOD PERFORMANCE SO THAT THE
OTHERS WOULD DO THE SAME
GREAT MAN THEORY
 LEADERS AND BORN AND NOT MADE
 LEADERS BECOME LEADERS BECAUSE OF THEIR BIRTH RIGHT
 ALSO CALLED GENETIC THEORY OR ARISTOTELIAN THEORY
LAISSEZ-FAIRE
 FOLLOWERS ARE SELF DIRECTED, EXPERTS & ARE MATURED INDIVIDUALS
 IS PREFERED WHEN THE FOLLOWERS KNOWA WHAT TO DO & ARE EXPERTS IN THE FIELD
 THIS LEADERSHIP STYLE IS RELATIONSHIP ORIENTED RATHER THAN TASK-ORIENTED
SHARED LEADERSHIP
 LEADERSHIP ARE SHARED AT THE POINT OF CARE
 SHARED GOVERNANCE ALLOWS THE STAFF NURSES TO HAVE THE AUTHORITY, RESPONSIBILITY
& ACCOUNTABILITY FOR THEIR OWN ACTIONS
TRANSACTIONAL LEADERSHIP
 FOCUSES ON THE MANAGEMENT TASK
 IS A CARE TAKER
 USES TRADE OFFS TO MEET GOALS
 FOCUSES ON THE DAY TO DAY OPERATION OF THE DEPARTMENT
TRANSFORMATIONAL LEADERSHIP
 INSPIRES OTHERS WITH VISION
BENEVOLENT-AUTHORITATIVE MANAGEMENT
 HAVE CONDESCENDING TRUST & CONFIDENCE IN THEIR SUBORDINATE
 PRETENTIOUSLY SHOW THEIR TRUST & CONFIDENCE TO THEIR FOLLOWERS
STAFF MEETING
 THIS WILL ALLOW FOR THE PARTICIPATION OF ALL THE STAFF IN THE UNIT. IF THEY WILL
CONTRIBUTE TO THE SOLUTION OF THE PROBLEM. THEY WILL OWN THE SOLUTIONS: HENCE THE
CHANCE FOR COMPLIANCE WILL BE GREATER.
EXTERNAL FORCES THAT INFLUENCE CHANGE
 MEMO FROM HIGHER UPS
 DEMANDS OF THE LABOR SECTOR TO INCREASE WAGES
 EXACTING REGULATORY & ACCREDITATION STANDARDS
 EMANATE FROM THE TOP EXECUTIVE OR FROM OUTSIDE THE INSTITUTION
MAJORITY RULE
 INVOLVES DIVIDING THE HOUSE AND THE HIGHEST VOTE WINS
SYSTEM USED TO DELIVERY CARE
 TERMED AS METHOD OF PATIENT ASSIGNMENT IN 1970’S
 MODALITIES OF NURSING IN 1980’S
 PATTERNS OF NURSING CARE IN 1990’S
 NURSING CARE SYSTEM – RECENTLY
FUNCTIONAL NURSING
 CONCENTRATES ON TASK & ACTIVITIES (FUNCTION) & NOT ON THE HOLISTIC CARE OF THE
PATIENT
 GREAT CONTROL OF WORK ACTIVITIES
 MOST ECONOMICAL WAY OF DELIVERING NURSING SERVICES
 WORKERS FEEL SECURE IN DEPENDENT ROLE
PRIORITY OF PATIENT NEED
 ASSESSING NURSING NEEDS AND PROBLEMS
 THIS FOLLOWS THE FRAMEWORK OF THE NURSING PROCESS AT THE SAME TIME APPLIES THE
MANAGEMENT PROCESS OF PLANNING, ORGANIZING,DIRECTING & CONTROLLING
BEST GUARANTEE THAT THE PATIENT PRIORITY NEEDS ARE MET
 PREPARING NURSING CARE PLAN IN COLLABORATION WITH THE PATIENT
 THE BEST SOURCE OF INFORMATION ABOUT THE PRIORITY NEEDS IF THE PATIENT IS THE
PATIENT HIMSELF
PATIENT WHO NEEDS THE MOST CARE
 IN SETTING PRIORITIES FOR A GROUP OF PATIENTS, THOSE WHO NEED THE MOST CARE WILL BE
THE # 1 PRIORITY TO ENSURE THAT THEIR CRITICAL NEEDS ARE MET ADEQUATELY
INTEGRATE SOLUTIONS TO HIS DAY TO DAY ACTIVITIES
 IS EXPECTED TO HAPPEN DURING THE 3RD STAGE OF CHANGE, WHEN THE CHANGE AGENT
INCORPORATE THE SELECTED SOLUTIONS TO HIS SYSTEM & BEGINS TO CREATE A CHANGE
STRATEGIC PLANNING
 LONG TERM GOAL SETTING
 EXTENDS 3-5 YEARS IN THE FUTURE
 DETERMINES DIRECTIONS OF THE ORGANIZATION
VISION
 REFERS TO WHAT THE INSTITUTION WANTS TO BECOME WITHIN A PARTICULAT PERIOD OF
TIME
GOAL
 PROVIDE PATIENT CENTERED CARE IN A TOTAL HEALING ENVIRONMENT
 IT IS A DESIRED RESULT TOWARDS WHICH EFFORT IS DIRECTED
BROKEN LINE
 IS A STAFF RELATIONSHIP
UNITY OF COMMAND
 EMPLOYEES SHOULD RECEIVE ORDERS COMING FROM ONLY ONE MANAGER AND NOT FROM 2
MANAGERS
 THIS AVERTS THE POSSIBILITY OF SOWING CONFUSIONS AMONG THE MEMBERS OF THE
ORGANIZATION
HIERARCHY
 REFERS TO THE PATTERN OF REPORTING OR THE FORMAL LINES OF AUTHORITY IN THE
ORGANIZATIONAL STRUCTURE
UNITY OF DIRECTION
 MEANS HAVING 1 GOAL OR 1 OBJECTIVE FOR THE TEAM TO PURSUE, HENCE ALL MEMBERS OF
THE ORGANIZATION SHOULD PUT THEIR EFFORTS TOGETHER TOWARDS THE ATTAINMENT OF
THEIR COMMON GOAL OR OBJECTIVE
ESPRIT D’ CORPS
 REFERS TO PROMOTING HARMONY IN THE WORK PLACE WHICH IS ESSENTIAL IN MAINTAINING
A CLIMATE CONDUCIVE TO WORK
ORGANIZATIONAL CULTURE
 REFERS TO THE WAY THE MEMBERS OF THE ORGANIZATIONTHINK TOGETHER AND DO THINGS
AREOUND THEM TOGETHER, IT’S THE WAY OF LIFE IN THAT ORGANIZATION
POSITIVE CULTURE
 IS BASED ON HUMANISM AND AFFILIATIVE NORMS
 PROACTIVE & CARING WITH ONE ANOTHER
ORGANIZATIONAL STRUCTURE
 PROVIDES INFORMATION ON THE CHANNEL OF AUTHORITY, WHO REPORT TO WHOM, AND
WITH WHAT AUTHORITY, THE NUMBER OF PEOPLE WHO DIRECTLY REPORTS TO THE VARIOUS
LEVELS OF HIERARCHY AND THE LINES OF COMMUNICATION WHETHER LINE OR STAFF
INFORMAL
 USUALLY NOT PUBLISHED & OFTEN TIMES CONCEALED
TALL ORGANIZATION
 ARE HIGHLY CENTRALIZED ORGANIZATION WHERE DECISION MAKING IS CENTERED ON ONE
AUTHORITY LEVEL.
 HIGHLY COST EFFECTIVE
 MAKES MANAGEMENT EASIER
AUTHORITY
 IS A LEGITIMATE OR OFFICIAL RIGHT TO GIVE COMMAND
 THIS IS AN OFFICIALLY SANCTIONED RESPONSIBILITY
 HAVING LEGITIMATE RIGHT TO ACT
EFFECTIVE STAFFING
 MEET PATIENT NEEDS
 COVER ALL TIME PERIODS ADEQUATELY
 ALLOW FOR GROWTH & DEVELOPMENT OF NURSING STAFF
STAFF PREFERENCE
 SHOULD BE THE LEAST PRIORITY IN FORMULATING OBJECTIVES OF NURSING CARE, INDIVIDUAL
PREFERENCES SHOULD BE SUBORDINATE TO THE INTEREST OF THE PATIENTS
TRANSFORMATIONAL LEADERSHIP
 USES VISION AS ESSENCE OF LEADERSHIP
 RELIES HEAVILY ON VISIONING AS THE CORE OF LEADERSHIP
TEAM MANAGEMENT
 HAS HIGH CONCERN FOR SERVICES & HIGH CONCERN FOR STAFF
PROBLEM SOLVING APPROACH
 IDENTIFY THE SOURCE OF THE CONFLICT & UNDERSTAND THE POINT OF FRICTION
CONFLICT
 CAN BE DESTRUCTIVE IF THE LEVEL IS TOO HIGH
 MAY RESULT IN POOR PERFORMANCE
 MAY CREAT LEADERS
 IS BENEFICIAL BECAUSE IT SURFACES OUT ISSUES IN THE OPEN AND CAN BE SOLVED RIGHT
AWAY
AVOIDANCE
 REFERS TO THE POSTPONEMENT OF THE ISSUE, THE PROBLEN REMAINS UNSOLVED
STAFF EXPERIENCING BURNOUT
 LET THE STAFF CENTILATE HER FEELING AND ASK HOW SHE CAN BE OF HELP
 REACHING OUT & HELPING THE STAFF IS THE MOST EFFECTIVE STRATEGY IN DEALING WITH
BURNOUT
PERFORMANCE APPRAISAL
 SETTING SPECIFIC STANDARDS & ACTIVITIES FORINDIVIDUAL PERFORMANCE
 USING AGENCY STANDARDS AS GUIDE
 DETERMINES AREAS OF STRENGHT & WEAKNESSES
 DEALS WITH BOTH POSITIVE & NEGATIVE PERFORMANCES. IT IS NOT MEANT TO BE A FAULT
FINDING ACTIVITY.
PERFORMANCE APPRAISAL
 INFORMING THE STAFF ABOUT THE SPECIFIC IMPRESSIONS OF THEIR WORK HELP IMPROVE
THEIR PERFORMANCE
 A VERBAL APPRAISAL IS AN ACCEPTABLE SUBSTITUTE FOR A WRITTEN REPORT
 THE OUTCOME OF PERFORMANCE APPRAISAL RESTS PRIMARILY WITH THE STAFF
 THE PATIENT CAN BE A SOURCE OF INFORMATION ABOUT THE PERFORMANCE OF THE STAFF
BUT IT IS NEVER THE BEST SOURCE. DIRECTLY OBSERVING THE STAFF IS THE BEST SOURCE OF
INFORMATION FOR PERSONNEL APPRAISAL
INFORMAL APPRAISAL
 THE STAFF MEMBER IS OBSERVED IN NATURAL SETTING
 INCIDENTAL CONFRONTATION AND COLLABORATION IS ALLOWED
 THE EVALUATION MAY PROVIDE VALID INFORMATION FOR COMPILATION OF A FORMAL
REPORT
 COLLECTING OBJECTIVE DATA SYSTEMATICALLY CANNOT BE ACHIEVED IN AN INFORMAL
APPRAISAL. IT IS FOCUSED ON WHAT ACTUALLY HAPPENS IN THE NATURAL WORK SETTING
PERFORMANCE REVIEW
 THE SESSION IS PRIVATE BETWEEN THE 2 MEMBERS. THE SESSION IS PRIVATE BETWEEN THE
MANAGER AND THE STAFF AND REMAINS TO BE SO WHEN THE 2 PARTIES DO NOT DIVULGE THE
INFORMATION TO OTHERS
CONSULTATIVE MANAGER
 IS ALMOST LIKE A PARTICIPATIVE MANAGER
 PARTICIPATIVE MANAGER – HAS CPMPLETER TRUST AND CONFIDENCE IN THEIR SUBORDINATE,
ALWAYS USES OPINIONS AND IDEAS OF THE STAFF AND COMMUNICATE IN ALL DIRECTIONS
ORGANIZATIONAL STRUCTURE
 LEVEL OF AUTHORITY
 LINES OF COMMUNICATION
 SPAN OF CONTROL
UNITY OF DIRECTION
 IS A MANAGEMENT PRINCIPLE, NOT AN ELELMENT OF ORGANIZATIONAL STRUCTURE
STAFFING
 IS A MANAGEMENT FUNCTION INVOLVING PUTTING THE BEST PEOPLE TO ACCOMPLISH TASK
AND ACTIVITIES TO ATTAIN THE GOALS OF THE ORGANIZATION
INDUCTION
 THE STEP IN THE RECRUITMENT PROCESS WHEREIN IT GIVES TIME FOR THE STAFF TO SUBMIT
ALL THE DOCUMENTARY REQUIREMENTS FOR EMPLOYMENT
DECENTRALIZED STRUCTURE
 ALLOWS THE STAFF TO MAKE DECISIONS ON MATTERS PERTAINING TO THEIR PRACTICE AND
COMMUNICATE IN DOWNWARD, UPWARD, LATERAL AND DIAGONAL FLOW
 PROMOTES B ETTER INTERPORSONAL RELATIONSHIP, INVOLVED IN DECISION MAKING, GIVEN
THE OPPORTUNITY TO INTERACT WITH ONE ANOTHER
HORIZONTAL CHART
 THE LEFT NOST BOX IS OCCUPIED BY THE HIGHEST AUTHORITY WHILE THE LOWEST LEVEL
WORKER OCCUPIES THE RIGHT MOST BOX
PRIMARY NURSING
 COLLABORATE WITH THE PATIENT
 PROVIDE CARE FOR 5-6 PATIENTS DURING THEIR HOSPITAL STAY
 PERFORMS COMPREHENSIVE INITIAL ASSESSMENT
MODULAR NURSING
 IS A VARIANT OF TEAM NURSING, THE DIFFERENCE LIES IN THE FACT THAT THE MEMBER IN
MODULAR NURSING ARE PARAPROFESSIONAL WORKERS
TEAM NURSING
 PROVIDE CARE FOR A GROUP OF PATIENTS WITH A GROUP OF NURSES
IDENTIFY THE VALUES OF THE DEPARTMENT
 THIS WILL SET THE GUIDING PRINCIPLE WITHIN WHICH THE DEPARTMENT WILL OPERATE ITS
ACTIVITIES
STRUCTURE STANDARDS
 THE PATIENTS VERBALIZED SATISFACTION OF THE NURSING CARE RECEIVED
 ALL PATIENTS SHALL HAVE THEIR WEIGHTS TAKEN AND RECORDED
 PATIENTS SHALL ANSWER THE EVALUATION FORM BEFORE DISCHARGE
 INCLUDES MANAGEMENT SYSTEM, FACILITIES, EQUIPMENTS, MATERIALS NEEDED TO DELIVER
CARE TO PATIENTS
PROCESS STANDARDS
 INCLUDE CARE PLANS, NURSING PROCEDURE TO BE DONE TO ADDRESS THE NEEDS OF THE
PATIENT
CONTROL PROCESS
 MEASURE ACTUAL PERFORMANCE
 MET NURSING STANDARDS AND CRITERIA
 COMPARE RESULT OF PERFORMANCE TO STANDARDS AND OBJECTIVES
CRITERIA
 CHARACTERISITC USED TO MEASURE THE LEVEL OF NURSING CARE
CONTROL PROCESS
 REVIEWING THE EXISITNG POLICIES OF THE HOSPITAL
 EVALUATING THE CREDENTIALS OF ALL THE NURSING STAFFS
 CHECKING IF THE ACTIVITIES CONFORMS TO SCHEDULE
SAMPLES OF PROCESS STANDARDS
 INITIAL ASSESSMENTS SHALL BE DONE TO ALL PATIENTS WITHIN 24 HRS UPON ADMISSION
 INFORMED CONSENT SHALL BE DONE/SECURED PRIOR TO ANY INVASIEV PROCEDURES
 PATIENT EDUCATION ABOUT THEIR ILLNESS & TREATMENT SHALL BE PROVIDED FOR ALL
PATIENT AND THEIR FAMILIES
OUTCOME STANDARD
 RESULT FO THE CARE THAT IS RENDERED TO THE PATIENT
EVIDENCE THAT CONTROL PROCESS IS EFFECTIVE
 THE THINGS THAT ARE PLANNED ARE DONE
 SEEING TO IT THAT WHAT IS PLANNED IS DONE
SPAN OF CONTROL
 REFERS TO THE NUMBER OF WORKERS WHO REPORT DIRECTLY TO A MANAGER
GROUP INTERATION
 OPPORTUNITY TO DISCUSS THE PROBLEM IN THE OPEN
EXTRANEOUS VARIABLE
 IS NOT HE PRIMARY CONCERN OF THE RESEARCH BUT HAS AN EFFECT ON THE RESULT OF THE
STUDY, EX ADULT PATIENT MAY BE YOUNG, MIDDLE AND LATE ADULT
 EX. AGE OF PATIENT
SR CALLISTA ROY
 DEVELOPED THE ADAPTATION MODEL WHICH INVOLVES THE PHYSIOLOGIC MODE, SELFCONCEPT MODE, ROLE-FUNCTION MODE, AND DEPENDENCE MODE
 4 MODES OF ADAPTATION
SELF REPORT MEHOD
 MOST DIRECT MEANS OF GATHERING INFORMATION
 VERSATILE IN TERMS OF CENTENT COVERAGE
 YIELDS INFORMATION THAT WOULD BE DIFFICULT TO GATHER NY ANOTHER METHOD
 THE MOST SERIOUS DISADVANTAGE OF THIS METHOD IS ACCURACY AND VALIDITY OF
INFORMATION GATHERED
SALARY OF NURSES
 IS NOT AN INDICATOR OR PATIENT SATISFACTION, HENCE NEED NOT BE INCLUDED AS A
VARIABLE IN THE STUDY
LIKERT SCALE
 IS A 5 POINT SUMMATED SCALE USED TO DETERMINE THE DEGREE OF AGREEMENT OR
DISAGREEMENT OF THE RESPONDENTS IN A STATEMENT OF A STUDY
RELIABILITY
 IS REPEATABILITY OF TH INSTRUMENT, IT CAN ELICIT THE SAME RESPONSES EVEN WITH VARIED
ADMINISTRATION OF THE INSTRUMENT
SENSITIVITY
 IS AN ATTRIBUTE OF THE INSRUMENT THAT ALLOWS THE RESPONDENTS TO DISTINGUISH
DIFFERENCES OF THE OPTIONS WHERE TO CHOOSE FROM
VALIDITY
 IN ENSURING THAT THE INSTRUMENT CONTAINS APPROPRIATE QUESTIONS ABOUT THE
RESEARCH TOPIC
RANDOM
 GIVES EQUAL CHANCE FOR ALL THE ELEMENTS IN THE POPULATION TO BE PICKED AS PART OF
THE SAMPLE
ETHNOGRAPHY
 FOCUSED ON PATTERNS OF BEHAVIOUR OF SELECTED PEOPLE WITHIN A CULTURE
 TRANSCULTURAL NURSING
MADELEINE LENINGER
 DEVELOP THE THEORY OF TRANSCULTURAL THEORY BASED ON THE OBSERVATIONS ON THE
BEHAVIOUR OF SELECTED PEOPLE WITHIN A CULTURE
PHENOMENOLOGIVAL THEORY
 INVOLVES UNDERSTANDING THE MEANING OF EXPERIENCES OF THOSE WHO EXPERIENCED THE
PHENOMENON
ACCIDENTAL SAMPLING
 IS A NON-PROBABILITY SAMPLING METHOD WHICH INVOLVES THOSE WHO ARE AT THE SITE
DURING DATA COLLECTION
JUDGEMENTAL SAMPLING
 INVOLVES INCLUDING SAMPLES ACCORDING TO THE KNOWLEDGE OF THE INVESTIGATOR
ABOUT THE PARTICIPANTS IN THE STUDY
 DETERMINES THE DIFFERENT NATIONALITY OF PATIENTS FREQUENTLY ADMITTED AND DECIDES
TO GET REPRESENTATION SAMPLE FROM EACH
HAWTHORNE EFFECT
 BASED ON THE STUDY OF ELTON-MAYO AND COMPANY ABOUT THE EFFECT OF AN
INTERVENTION DONE TO IMPROVE THE WORKING CONDITIONS OF THE WORKERS ON THEIR
PRODUCTIVITY BUT NOT DUE TO THE INTERVENTION BUT TO THE PSYCHOLOGICAL EFFECTS OF
BEING OBSERVED, THEY PERFORM DIFFERENTLY BECAUSE THEY ARE BEING OBSERVED
SATURATION
 IS ACHIEVED WHEN THE INVESTIGATOR CANNOT EXTRACT NEW RESPONSES FROM THE
INFORMANTS, BUT INSTEAD GETS THE SAME RESPONSE REPEATEDLY
SEARCH FOR THEMES
 THE INVESTIGATOR STARTS DATA ANALYSIS BY LOOKING FOR THEMES FROM THE VERBATION
RESPONSES OF THE INFORMANTS
GROUNDED THEORY
 INDUCTIVELY DEVELOPS A THEORY BASED IN THE OBSERVED PROCESSES INVOLVING SELECTED
PEOPLE
REVIEW OF RELATED LITERATURE
 AFTER FORMULATING & DELIMITING THE RESEARCH PROBLEM, THE RESEARCHER CONDUCTS A
REVIEW OF RELATED LITERATURE TO DETERMINE THE EXTENT OF WHAT HAS BEEN DONE ON
THE STUDY BY PREVIOUS RESEARCHES
HELSINKI DECLARATION
 IS THE FIRST INTERNATIONAL ATTEMP TO SET UP ETHICAL STANDARDS IN RESEARCH INVOLVING
HUMAN RESEARCH SUBJECTS
BELMONT REPORT
 BENEFICENCE
INCLUDED IN BELMONT REPORT
 RESPECT FOR HUMAN DIGNITY
 JUSTICE
 NON-MALEFICENCE – NOT INCLUDED IN BELMONT REPORT
PRESERVATION OF LIFE
 PRIMARY RESPONSIBILITY OF THE NURSE. THIS IS EMBODIED IN THE CODE OF ETHICS FOR
REGISTERED NURSES (BON RESOLUTION 220s, 2004)
FULL DISCLOSURE
 IS GIVING THE SUBJECT OF THE RESEARCH INFORMATION THAT THEY DESERVE TO KNOW PRIOR
TO THE CONDUCT OF THE STUDY
REMEMBER
 SIGNING THE DOCUMENT IS DONE TO SERVE AS A PROOF THAT THE PERFORMANCE REVIEW
HAS BEEN CONDUCTED DURING THAT DATE AND TIME
PASSING THE BOARD EXAMS & TAKING THE OATH OF PROFESSIONALS
 FOR A NURSE TO OBTAIN LICENSE TO PRACTICE NURSING IN THE PHILIPPINES, HE MUST PASS
THE BOARD EXAMINATIONS AND THEN TAKE THE OATH OF PROFESSIONALS BEFORE THE BOARD
OF NURSING
REMEMBER
 ACCORDING THE PHILIPPINES NURSES ACT OF 2002, FOREIGN NURSES WANTING TO PRACTICE
NURSING IN THE PHILIPPINES MUST SHOW PROOF THAT HIS COUNTRY OF ORIGIN MEETS THE 2
ESSENTIAL CONDITIONS
1. THE REQUIREMENTS FOR REGISTRATION BETWEEN THE 2 COUNTRIES ARE SUBSTANTIALLY
THE SAME
2. THE COUNTRY OF ORIGIN OF THE FOREIGN NURSE HAS LAWS ALLOWING THE FILIPINO
NURSES TO PRACTICE IN HIS COUNTRY JUST LIKE ITS OWN CITIZEN
 NURSES PRACTICING THE PROFESSION IN THE PHILIPPINES AND ARE EMPLOYED IN
GOVERNMENT HOSPITALS ARE REQUIRED TO PAY TAXES SUCH AS
A. INCOME TAX ONLY SINCE THEY ARE EXEMPTED FROM PAYING PROFESSIONAL TAX. THIS IS
ACCORDING TO THE MAGNA CARTA FOR PUBLIC HEALTH WORKERS
 RA 9173 SECTION 13 STATES THAT THE QUALIFICATIONS TO TAKE THE BOARD EXAMS ARE
A. FILIPINO CITIZEN OR CITIZEN OF A COUNTRY WHERE THE PHILIPPINES HAS THE RECIPROCITY
, OF GOOD MORAL CHARACTER, AND GRADUATE OF BSN FROM A RECOGNIZED SCHOOL OF
NURSING. THERE IS NO EXPICIT PROVISION ABOUT THE AGE REQUIREMENT IN RA 9173
UNLIKE IN RA 7164 (OLD LAW)
 MEMBERSHIP TO ANY ORGANIZATION INCLUDING THE PNA IS ONLY VOLUNTARY AND THIS
RIGHT TO JOIN ANY ORGANIZATION IS GUARANTEED IN THE 1987 CONSTITUTION OF THE
PHILIPPINES, HOWEVER THE PRC CODE OF ETHICS STATES THAT THE ETHICAL OBLIGATION OF
THE PROFESSIONAL NURSE TOWARDS THE PROFESSION IS TO BE AN ACTIVE MEMBER OF THE
ACCREDITED PROFESSIONAL ORGANIZATION
 RA 9173 SECTION 24 STATES THAT FOR EQUITY AND JUSTICE, A REVOKED LICENSE MAYBE REISSUED RPOVIDED THAT THE FOLLOWING CONDITIONS ARE MET
1. THE CAUSE OF THE REVOCATION OF LICENSE HAS ALREADY BEEN CORRECTED OR REMOVED
2. AT LEAST 4 YEARS HAS ELAPSED SINCE THE LICENSE HAS BEEN REVOKED
 THE MAXIMUM EDUCATIONAL QUALIFICATION FOR A FACULTY MEMBER OF A COLLEGE OF
NURSING IS MATER’S DEGREE. THIS IS ACCORDING TO RA 9173
 ACCORDING TO RA 9173 THE MINIMUM EDUCATIONAL QUALIFICATION TO BE A SUPERVISOR IN
A HOSPITAL IS ATLEAST BSN WITH 9 UNITS OF POST GRADUATE STUDIES IN NURSING
ADMINISTRATION. A MASTERS DEGREE IN NURSING IS REQUIRED FOR THE CHIEF NURSE OF A
SECONDARY OR TERTIARY HOSPITAL
 QUASI-JUDICIAL POWER MEANS THAT THE BOARD OF NURSING HAS THE AUTHORITY TO
INVESTIGATE VIOLATIONS OF THE NURSING LAW AND ISSUE SUMMONS, SUBPOENA OR
SUBPOENA DUCUS TECUM AS NEEDED
 RES IPSA LOQUITUR – LITERALLY MEANS THE THINS SPEAKS FOR ITSELF. THIS MEANS IN
OPERATIONAL TERMS THAT THE INJURY CAUSED IS PROOF THAT THERE WAS A NEGLIGENT ACT
PRIVILEGED COMMUNICATION
 ALL THE CONFIDENTIAL INFORMATION THAT COMES TO THE KNOWLEDGE OF THE NURSE IN THE
CARE OF HIS PATIENT IS CONSIDERED PRIVILEGED COMMUNICATION, HENCE, HE IS NOT
ALLOWED TO JUST REVEAL TO CONFIDENTIAL INFORMATION ARBITRARILY , HE MAYBE ONLY
ALLOWED TO BREAK THE SEAL OF SECRECY IN CERTAIN CONDITIONS. ONE SUCH CONDITION IS
WHEN THE COURT ORDERS THE NURSE TO TESTIFY IN A CRIMINAL OR MEDICO-LEGAL CASE
DNR
 IS A MEDICAL ORDER WHICH IS WRITTEN ON THE CHART AFTER THE DOCTOR HAS CONSULTED
THE FAMILY AND THIS MEANS THAT THE MEMBERS OF HEALTH CARE ARE NOT REQUIRED TO
GIVE EXTRAORDINARY MEASURES BUT CANNOT WITH HOLD THE BASIC NEEDS LIKE FOOD,
WATER, AIR. IT ALSO MEANS THAT THE NURSE IS STILL DUTY BOUND TO GIVE BASIC NURSING
CARE TO TERMINALY ILL PATIENT AND ENSURE THAT THE SPIRITUAL NEEDS OF THE PATIENT IS
TAKEN CARED OF
ABORTION IN THE PHILIPPINES
 INDUCED ABORTION IS CONSIDERED A CRIMINAL ACT WHICH IS PUNISHABLE OF
IMPRISONMENT WHICH MAYBE UPTO A MAXIMUM OF 12 YEARS (IF THE NURSE GETS PAID FOR
IT). ALSO THE PRC BOARD OF ETHICS STATES THAT THE NURSE MUST RESPECT LIFE AND MUST
NOT DO ANY ACTIONS THAT WILL DESTROY LIFE. ABORTION IS AN ACT THAT DESTOYS LIFE AL
BEIT THE BEGINNING OF LIFE
HYPOTHESIS
 IS NOT PROVEN (IT IS EITHER ACCEPTED OR REJECTED)
 TESTABLE
 STATES A RELATIONSHIP BETWEEN VARIABLES
TRIANGULATION
 MAKE USE OF DIFFERENT SOURCES OF INFORMATION TO DRAW CONCLUSIONS
RESEARCH FINDINGS
 MOST IMPORTANT CATEGORY OF INFORMATION THAT THE RESEARCHER SHOULD COPY
BECAUSE THIS WILL GIVE HER VALUABLE INFORMATION AS TO WHAT HAS BEEN DISCOVERED IN
PAST STUDIES ABOUT THE SAME TOPIC
CINAHL (CUMULATIVE INDEX TO NURSING & ALLIED HEALTH LITERATURE)
 RICH SOURCE OF LITERATURE FOR REVIEW FOR NURSES
ABSTRACT
 CONTAINS CONCISE DISRUPTION OF THE BACKGROUND OF THE STUDY, RESEARCH QUESTIONS,
RESEARCH OBJECTIVES, METHODS, FINDINGS, IMPLICATIONS TO NURSING PRACTICE AS WELL
AS KEYWORDS USED IN THE STUDY
PRIMARY SOURCE
 DIRECT ACCOUNT OF THE INVESTIGATION DONE BY THE INVESTIGATOR. IN CONTRAST TO THIS
IS A SECONDARY SOURCE WHICH IS WRITTEN BY SOMEONE OTHER THAN THE ORIGINAL
RESEARCHER
META ANALYSIS
 TECHNIQUE FOR QUANTITATIVELY COMBINING & INTEGRATING THE RESULT OF MULTIPLE
STUDIES ON A GIVEN TOPIC
CASE STUDY
 INDIVIDUAL OR GROUPS AND PRESENTED IN NARRATIVE FORM
 FOCUSED ON DEPTH INVESTIGATIONS OF A SINGLE ENTITY OR SMALL NUMBER OF ENTITIES. IT
ATTEMPTS TO ANALYZE AND UNDRSTAND ISSUES OF IMPORTANCE TO HISTORY, DEVELOPMENT
OR CIRCUMSTANCES OF THE PERSON OR ENTITY UNDER STUDY
NULL HYPOTHESIS
 PREDICTS THAT THERE IS NO CHANGE, NO DIFFERENCES, OR NO RELATIONSHIP BETWEEN THE
VARIABLES IN THE STUDY
IMPROVE PATIENT CARE
 THE ULTIMATE GOAL OF CONDUCTING A RESEARCH IS TO IMPROVE PATIENT CARE WHICH IS
ACHIEVED BY ENHANCING THE PRACTICE OF NURSE WHEN THEY UTILIZE RESEARCH RESULT IN
THEIR PRACTICE
AVAILABILITY OR RESEARCH SUBJECTS
 IT IS THE MOST IMPORTANT CRITERIA TO BE CONSIDERED BY THE RESEARCHER IN
DETERMINING WHETHER THE STUDY IS FEASIBLE OR NOT, NO MATTER HOW SIGNIFICANT THE
STUDY MAYBE IF THERE ARE NO AVAILABLE SUBJECTS THE STUDY CANNOT PUSH THROUGH
CHARACTERISTICS OF A GOOD RESEARCH PROBLEM
A. CLEARLY IDENTIFIED THE VARIABLES/PHENOMENON UNDER CONSIDERATION
B. SPECIFIES THE POPULATION BEING STUDIED
C. IMPLIES THE FEASIBILITY OF EMPIRICAL TESTING
PURPOSE OF A STUDY
A. ESTABLISHES THE GENERAL PURPOSE OF THE STUDY
B. CAPTURES THE ESSENCE OF THE STUDY
C. FORAMLLY ARTICULATES THE GOAL OF THE STUDY
D. SOMETIMES WORDED AS INTENT
REMEMBER
 ACCURACY AND VALIDITY ARE THE MOST SERIOUS WEAKNESSES OF THE SELF REPORT DATA.
THIS IS DUE TO THE FACT THAT THE RESPONDENTS SOMETIMES DO NOT WANT TO TELL THE
TRUTH FOR FEAR OF BEING REJECTED OR IS ORDER TO PLEASE THE INTERVIEWER
PRE-TESTING
A. DETERMINE HOW MUCH TIME IT TAKES TO ADMINISTER THE INSTRUMENT PACKAGE
B. IDENTIFY THE PARTS THAT ARE DIFFICULT TO READ OR UNDERSTAND
C. DETERMINE IF THE MEASURES YIELD DATA WITH SUFFICIENT VARIABILITY
BUDGET ALLOCATION FOR THE STUDY
 DONE AT AN EARLIER STAGE OF DESIGN & PLANNING PHASE
FACE VALIDITY
 MEASURES WHETHER THE INSTRUMENT APPEARS TO BBE MEASURING THE APPROPRIATE
CONSTRUCT. IT IS THE EASIEST WAY OF VALIDITY TESTING
POST TEST ONLY DESIGN
 USED TO FIND OUT CAUSE AND EFFECT RELATIONSHIP BETWEEN THE STRUCTURED DISCHARGE
PLAN & COMPLIANCE TO HOME REGIMEN AMONG THE SUBJECTS
 APPROPRIATE BECAUSE IT IS IMPOSSIBLE TO MEASURE THE COMPLIANCE TO HOME CARE
REGIMEN VARIABLE PRIOR TO THE DISCHARGE OF THE PATIENT FROM THE HOSPITAL
PERSONAL INTERVIEWS
 IT IS THE BEST METHOD OF COLLECTING SURVEY DATA, BECAUSE THE QUALITY INFORMATION
THEY YIELD IS HIGHER THAN OTHER METHODS AND BECAUSE RELATIVELY FEW PEOPLE REFUSE
TO BE INTERVIEWED IN PERSON
EXPLORATORY RESEARCH
 1ST LEVEL OF INVESTIGATION AND IT DEALS WITH IDENTIFYING THE VARIABLES IN THE STUDY
EXPERIMENTAL RESEARCH
 IS A LEVEL 3 INVESTIGATION WHICH DETERMINES THE CAUSE AND EFFECT RELATIONSHIP
BETWEEN VARIABLES
3 ELEMENTS OF EXPERIMENTAL RESEARCH
A. MANIPULATION
B. RANDOMNIZATION
C. CONTROL
QUASI-EXPERIMENTAL
 DONE WHEN RANDOMNIZATION & CONTROL IS NOT POSSIBLE
PHENOMENOLOGICAL RESEARCH
 DEALS WITH THE MEANING OF EXPERIENCES AS THOSE WHO EXPERIENCE THE PHENOMENON
UNDERSTANDS IT
RETROSPECTIVE DESIGN
 STUDY OF VARIABLES IN THE PRESENT WHICH IS LINKED TO A VARIABLE THAT OCCURRED IN THE
PAST
 DONE IN ORDER TO ESTABLISH A CORRELATION BETWEEN PRESENT VARIABLES AND THE
ANTECEDENT FACTORS THAT HAVE CAUSED IT
4 BASIC RIGHTS OF SUBJECTS FOR RESEARCH
A. CONFIDENTIALITY OF INFORMATION GIVEN TO HIM AS THE SUBJECT
B. SELF DETERMINATION WHICH INCLUDES THE RIGHT TO WITHDRAW FROM THE STUDY GROUP
C. PRIVACY OR RIGHT NOT BE EXPOSED PUBLICLY
D. FULL DISCLOSURE ABOUT THE STUDY TO BE CONDUCTED
USE OF LABORATORY DATA
 INCIDENCE OF NOSOCOMIAL INFECTION IS BEST COLLECTED THROUGH THE USE OF
BIOPHYSIOLOGIC MEASURES PARTICULARLY IN VITRO MEASUREMENTS, HENCE LABORATORY
DATA IS ESSENTIAL
PATIENTS REFUSAL TO FULLY DIVULGE INFORMATION
 IS A LIMITATION BECAUSE IT IS BEYOND THE CONTROL OF NURSES
DESCRIPTIVE CORRELATIONAL
 IS THE MOST APPROPRIATE STUDY BECAUSE IT STUDIES THE VARIABLES THAT COULD BE THE
ANTECEDENTS OF THE INCREASE IN INFECTION
EXTERNAL VALIDITY
 REFERS TO THE GENERALIZABILITY OF RESEARCH FINDINGS TO OTHER SETTINGS OR SAMPLES.
THIS IS AN ISSUE OF IMPORTANCE TO EVIDENCED – BASED NURSING PRACTICE