BASIC PRINCIPLES
§ Philosophy of CHN → worth and dignity of men
§ Ultimate goal → raise the level of citizenry
§ Primary goal → self reliance
§ Primary focus → Health promotion
§ Client in CHN → Community
§ Basic Unit of Care → Family
§ 4 levels of clientele → Individual, family, population
group, community (FREEMAN)
Millennium Developmental Goals (MDG)
1) Eradicate Extreme Poverty and Hunger
2) Achieve Universal Primary Education (eTWOcation)
3) Promote Gender Equality
4) Reduce Child Mortality (BATA)
5) Improve Maternal Health
6) Combat AIDS/HIV, Malaria & other diseases
7) Ensure Environmental Sanitation
8) Promote Global Opportunities and Partnership
FAMILY
1) Nuclear Family (FMC)
2) Extended Family (FMC+R)
3) Single Parent (Single/Separated+C)
4) Binuclear Family (divorce or separated who shared
conjugal rights with children)
5) Step Family (widowed/divorce/separated with
children) remarriage
6) Cohabiting Family (Live in)
7) Homosexual Family (FF, MM)
8) Communal Family (bahay ampunan, home for the
aged, kumbento)
FAMILY APGAR
§ A – adaptation
§ P – partnership
§ G – grow
§ A – affection
§ R – resolution
FAMILY NURSING PROCESS
a) Nature of the problem
§ Health DeJcit → failure in health maintenance
ü MAY SAKIT NA (hypertension, malnutrition,
parasitism)
ü disease, disorder, disability, developmental
problems
§ Health Threat → the family is healthy but there’s risk
ü Hazard (Fire/fall)
ü Inadequate / lack of immunization
ü Cross-infection
ü Environmental sanitation is poor
§
Foreseeable Crisis → anticipated periods of unusual
demands of the family in terms of adjustment and health
resources.
ü S – school entrance
ü A – adolescence
ü C – courtship and marriage
ü C – circumcision
ü I – illegitimacy
ü P – pregnancy
ü D – death
ü A – addiction
b) ModiJability of the problem
c) Preventive potential
d) Salience of the process
(perception of the family about the problem)
§
§
Population group → group of people with same
characteristics & features.
Community Diagnosis (CDx) → he CHN collects data
in the community then we identify factors that affects
directly/indirectly influence the health of the
community.
6 ELEMENTS OF CDx
1) Demographic Variables
- patterns of migration
- population projection
v Bar graph → shows comparison
v Line graph → shows trends
v Pie graph/chart → breakdown or distribution of
groups
Filling of birth certificate → PD651
How many days? → within 30 days
Who will file? → midwife
Where? → civil registrar
Signed by? → Municipal Health officer (doctor sa
community)
2 TYPES OF CENSUS
§ De Jure — data from place of origin
§ De Facto — data from place of registration
1) Demographic Variables
2) Socio-economic & cultural
3)
4)
5)
Primary Health Care (PHC)
§ First international Conference (sept. 6-12, 1978)
Alma Atta, USSR → Russia
v If place ang question → the more specific, mas tama
§ PHC in the Philippines → Oct. 19, 1979 (LOI 949)
§
§
STRATEGIES OF PHC
§ S – self reliance (mark of success)
§ A – active community participation
§ P – partnership with the people
§ A – availability, affordability, accessibility
§ C – community based
§
ALTERNATIVE MEDICINE
Legal basis → RA 8423
Local Government Code → RA 7160
Ø Filling of Birth Certificate → PD 651
Ø Basic Immunization Services → RA 10152
Ø Environmental Sanitation Code → PD 856
Room → well ventilated
Foods to be avoided
ü S – sour, salty, spicy
ü P – peanuts
ü A – alcohol
ü C – colds
Contraindications
ü Pregnant
ü Full stomach
ü Cardiac problem
ü Long nails
Approved Toilet Facilities
Ø Level 1 (no H20 is needed)
P – pit latrines
R – reed odorless earth closet
A – aqua privies (needs small amnt of H2O)
P – pour flush
Ø Level 2
S – septic tank (poso negro)
W – water sealed
F – flush type
Ø Level 3
S – septic tank with septic vault
W – water carriage type
S – sewerage system with treatment
10 HERBAL MEDICINES
§ N – niyog-niyogan → anthelminthic, anti-parasite
(roundworms)
§ Y – yerba buena → pain (swollen gums,
dysmenorrhea, toothache)
§ T – tsaang gubat → GI problems (diarrhea,
stomachache )
§ L – lagundi → cough/cold, fever, asthma, arthritis
§ A – akapulko → anti-fungal
§ B – bayabas → wound washing, anti-septic, gurgling
§ B – bawang → decrease BP & cholesterol
(hypertension)
§ A – ampalaya → decrease blood sugar (NIDDM)
§ S – sambong → Antiurolithiasis, Diuretics, Antiedema
§ U – ulasimang bato → decrease uric acid (pansit
pansitan)
ACUPRESSURE
(-) YIN feminine
(+) YANG masculine
§
§
§
§
§
Imbalance → illness
Balance → health
Measurement → tsun (2 – 3 cycles)
Position → lying/sitting
painful spot, illness → AHSHI
LEVELS OF PREVENTION
Ø Primary (Promotion, Prevention WALANG SAKIT)
ü I – immunization
ü F – family planning
ü C – chemoprophylaxis
Ø Secondary (early sickness)
ü Screening and early detection
ü Surveillance
ü Case Finding
ü Identifying Sick Individuals
ü Contact Tracing
ü Conducting Clinics
Ø Tertiary (late sickness)
ü Chemotherapy
ü PT, OT, ORT
ü AIDS management
ü Prevent complications and disabilities
PATTERNS OF DISEASE OCCURRENCE
§ Epidemic – sudden, increase in number of cases
“outbreak”
§ Endemic – confned, “constant”
(palawan → malaria)
§ Sporadic – seasonal, “scattered”
(summer → rabies, rainy → typhoid fever)
§ Pandemic – worldwide (Covid 19, AIDS/HIV)
LEVELS OF PHC FACILITIES
GOALS OF REPRODUCTIVE HEALTH (3E’s)
1) Every pregnancy should be intended
2) Every birth should be healthy
3) Every sex act should be free from coercion and
infection
SEX EDUCATION → grade 5 to grade 12
3 DEPARTMENTS OF RH
1) Deped (sex education)
2) DOH (regulator)
3) Population Commission (monitoring of
population)
FAMILY PLANNING
Goal → improve MCN through proper timing (20-30 yr
old), spacing (3-5 years), number (2-3 children)
HOME VISIT
§ 1st → 1 day (24)
§ 2nd → 1 week (3-5 days)
§ 3rd → 1 month
Ø When is the best time? → weekend, at night
Ø Frequency of H.V. → base on the acceptance of the
family
Ø 1st thing to do → greet the family and introduce self,
state the purpose or objectives of home visit,
establish rapport
Ø last thing → set contract or schedule for the next visit.
Ø Purpose / objectives
ü G – giving health teaching
ü R – referral → post visit (pre visit → records
review)
ü E – establish rapport
ü T – o assess living condition of the family
Ø 3 COMPONENTS OF PLANNING
ü F – flexible and practical
ü I – involve all the members of the family
ü N – needs of the family (base on)
REPRODUCTIVE HEALTH
§ Vision → reproductive health as a way of life for every
men and women throughout life.
§ International framework of RH → focus on women’s
health
§ Local framework → both men and women
§ Ultimate goal → quality of life
§ Principal proponent → Edcel Lagman
Natural
§ Abstinence (no sex)
§ Billings method / cervical mucus method
(Fertile → elastic, clear)
§ BBT (fertile → increase temperature)
§ Symptothermal method (combination of BM and BBT)
§ LAM (6 months exclusive BF)
§ Standardized days method
ü Regular
ü Cycle → 26-32 days
ü Fertile → 8-19 days
Artificial
§ Condom (decrease sensation)
§ Cervical cup / diaphragm (do not remove 6-8 hours)
§ BTL (cutting or blocking of fallopian tube)
§ Vasectomy (cutting or blocking of vas deferens)
- decreases macho image
- 20-30 ejaculations
§ Pills (weight gain, acne, cancer → cervical, breast)
§ IUD (inside uterus, sterile inflammation)
- Ectopic pregnancy, PID, cervical & endometrial C
COMMON PRACTICES
1) Bulitas pasikap
2) Tawas pang virgin
NEWBORN SCREENING
Ø When? → 24-72 hours
Ø Result → 1 week working days
Ø Who? → medtech
(+) → repeat → confirmatory → (+) → referral →
appropriate
EPI
PD996 → compulsory immunization of all infant and
children under 8 years old (1970s)
RA10152 → mandatory immunization of all infant and
children under 5 years old (vulnerable groups)
BCG → at birth, RIGHT, .05 ml R → ID
school entrance, LEFT, .1 ml R → ID
HEPA B → at birth → 6 weeks (1 ½ m) → 14 weeks (3 ½)
DPT OPV → 6 weeks → 10 weeks → 14 weeks
Freezer → -15 to -25 C
Body of Ref → +2 to +8 C
Indications / Contraindications
§ Malnutrition → yes
§ Diarrhea → yes
§ Mild fever → yes
§ Convulsion / seizure (pertussis) → no
§ Mild respi problem → yes
§ Allergy to egg → no
§ Chemotherapy → no
§ Aids → no
§ OPV → vomits → repeat after at least 30 mins / 2-3
hrs
§ BCG → no scar → yes after 2-3 months