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Prayer Before Examination Dear Jesus, Today I will have my examination. You know how important this is to me. So, I am humbly asking Your gracious help and divine assistance.   I pray to You, my dear Jesus. Please never let me panic nor get nervous. Just let me be at ease and give my very best. Please never let me guess nor rely on pure luck, but enlighten my mind and let me think clearly.
Today, O my Jesus, I will take my examination. Let me, with Your help, give my best effort. Let me, because of You, receive the best and  Fruitful results, Amen.
Please never let me resort to chances, nor to dishonesty, but let me work to the best of my ability. I pray for Your guidance so that I may be able to answer correctly the questions, and solve the difficult problems. I ask, O Lord, Your intercession so that, I may not be careless or overconfident as I write, I may not be more distracted but be more concentrated, I may not be in hurry nor take the exams too lightly.
17.A nurse is assessing a child admitted to the hospital with a diagnosis rheumatic fever. The child is accompanied by the mother. The initial nursing question that the nurse would ask during assessment is which of the following? “Has the child had difficulty urinating?” “ Has any family member had a sore throat within the past few weeks?” “Has any family member had gastrointestinal disorder in the past few weeks?” “Has the child been exposed to anyone with chikenpox
CHN RATIO By: RandelDalauta
Public Health Nursing (Winslow)-”science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for the sanitation of the environment, control of communicable disease, the education of individuals in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease & the development of social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as toenable every citizen to realize his birthright of health and longevity.”
GLOBAL & COUNTRY HEALTH IMPERATIVES Changes exerting pressures on the Public Health Systems: Shift in demographic & epidemiological trends in disease New technologies for health care, communication & information Existing & emerging environmental hazards associated with globalization. Health Reforms
Determinants of Health as listed by WHO: 1. Gender-men & women suffer diseases 2. Physical Health Environment-safe water supply & clean air 3. Personal behavior & coping skills-healthy lifestyle 4. Income and social status  5. Employment & working conditions 6. Culture-customs & traditions 7. Reduced Health Services-access & use 8. Inheritance/Genetics 9. Education-low education are link to poor health 10. Social support network-greater family support better
Determinants of Health as listed by WHO: 1. Gender-men & women suffer diseases 2. Physical Health Environment-safe water supply & clean air 3. Personal behavior & coping skills-healthy lifestyle 4. Income and social status  5. Employment & working conditions 6. Culture-customs & traditions 7. Reduced Health Services-access & use 8. Inheritance/Genetics 9. Education-low education are link to poor health 10. Social support network-greater family support better
WHO  ”the art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number.”
POLITICAL Safety Oppression People Empowerment SOCIO ECONOMIC Employment Education Housing BEHAVIOR Culture Mores Ethnic Customs OLOF Individuals Family Groups Communities Populations ENVIRONMENT Air, Food Water Waste Urban/Rural Noise Radiation Pollution HEREDITY Generic Endowment    - Defects    -Strengths    -Risks    Familial ,Ethnic Racial HEALTH CARE DEL. SYSTEM Promotive Preventive Curative Rehabilitative
JACOBSON   learned practice in a wide/huge variety of community services  supports OLOF
RUTH FREEMAN Is a service rendered by a professional nurse with the community, groups, families and individuals at home, in health centers, in clinics, in school, in places of work for the promotion of health, prevention of illness, care of the sick at home & rehabilitation ,[object Object]
 general			- enhancing people capability,[object Object]
Level of Clientele Individual – entry point to the family and care - least important  Family – basic unit of a society 		   -  basic unit of care 		   - main caregiver for primary levels of care 		   - may not be bound by marriage, blood or 			adoption - sharing emotional closeness and who 					identified themselves as family        *main function: 	a.  Reproduction 	b. socialization
Level of Clientele  Community –  common   	    geographical boundaries 					    values 					    interest 			 - no 2 are alike 			 - one affects the other 			 - changes is always frequent 		 - most important    characteristics: ( criteria used in intervening)  ,[object Object]
  conserve natural resources
  recognition of subgroups
  participation of subgroups
  prepared to meet crisis
  ability to solve problems
  channels of communication
  available resources
  resolve disputes
  allow citizen to participate in decisions,[object Object]
HANLON Dedicated  to the highest level of physical, mental, social well being  3 A’s  - Accessible	DEVELOPMENT OF HEALTH IN 						ALL ASPECT 		   - Acceptable		holistic 		   - Affordable
United Nations General Assemblyadopted a common vision of poverty reduction and sustainable development in September 2000 exemplified by the  Millennium Development Goals(MDG) based on:freedom,equality,solidarity,tolerance,health respect   for nature and shared responsibility 8Millennium Development  Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
Primary Health Care(Alma Ata, USSR Sept. 1978) Main concepts: ,[object Object], 	sound and socially acceptable methods and appropriate technology made universally accessible through the community’s full participation and at cost that is affordable in the spirit of self reliance and self determination. 4 cornerstones/pillars in PHC  	Intra and inter- sectoral linkages  	Support  Mechanism Available  	Active Community Participation 	Appropriate technology use
Primary Health Care(Alma Ata, USSR Sept. 1978)  “health for all by year 2000, 		health in the hands of the people by 2020”
8 Millennium Development  Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
8 Millennium Development  Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
Core Business of Public Health Disease Control Health Protection Healthy Public Policy – Environment Injury Prevention Equitable Health Gain - promotion
Participationof all members in the society both developing and developed countries is required
The Health Sector Reform Agenda (HSRA) implemented through FOURmula ONE
DOH Vision    -  Leader 		        -  staunch advocate 		        -  model in promoting health for all   	Mission - guarantee    equitable  				          sustainable   HEALTH FOR ALL 				          quality 	Overriding goal of the DOH Health Sector Reform Agenda (HSRA)
Health Sector Reform Agenda (HSRA) RATIONALE :  1. Heavy burden on the poor in maintaining health  2. Sudden rise in diseases  3. Rise in IMR and MMR   4. Abrupt increase in chronic and degenerative disease  REASON: 3 I’s Inappropriate health delivery system Inadequate regulatory mechanism (poor health quality) Insufficient financing
FOURmulaOne 1. Health financing  2. Health regulation - quality & affordability  3. Health service delivery - accessibility  					                 - availability  4. Health good governance
Health promotion (1980’s) ,[object Object]
 an approach to  fulfill alma ata goals which is health for all in 2000
Focuses on determinants of health and not the manifestations of illness
recognizes that people’s health is affected by a broad range of factors (determinants) beyond their individual genetic makeup
 helping poor people protect their health and prevent illness
Goal: increase wellness level in which enhance health full potential,[object Object]
GAYLORD  Organized community program designed to PROLONGED LIFE by preventing unnecessary illness
COPAR (Community Organizing Participatory Action Research)  ,[object Object],[object Object]
 	Importance of COPAR COPAR maximizes community participation and involvement COPAR could be an alternative in situations wherein health interventions in Public Health Care do not require direct involvement of modern medical practitioners COPAR gets people actively involved in selection and support of community health workers Through COPAR, community resources are mobilized for selected health services COPAR improves both projects effectiveness during implementation
PURDOM   Public health pertains to all phases of human development
 MAGLAYA   utilization of nursing process   APIE, FNCP
Community Health Nursing Process   	-  Systemic 	-  Scientific				      nurses and client as a 					           system affecting 						   each other Clientele which will be the GOAL OF CARE Individual Family Community Population group -   Dynamic -   Ongoing interpersonal 	process
ASSESSMENT:  The first major phase of nursing process Measure status of the client STEPS: Initiate contact, show caring behavior, establish trust Collection of data Identify and categorizes health problems 	-base on typology 	- categorize as: 		 a. Health deficit  		b. Health Threat 		c. Foreseeable crisis
Foreseeable crisis  	1. Marriage 	2. Pregnancy 	3. Parenthood 	4. Additional family 	5. Entrance at school 	6. Adolescence 	7. Divorce or separation 	8. Loss of job 	9. Death of a member 	10. Resettlement in a new community
PLANNING NURSING ACTION Blueprint of the care Based on        actual problems 	                   potential problems    STEPS: Prioritize needs Goal Setting  based on needs and capabilities – intent that gives direction to action (SMART) Constructing a Plan of Action – selecting appropriate and available resources for care Developing operational plan -  Develop evaluation parameters
Formula: (Score/Highest Score) x weight
IMPLEMENTATION OF PLANNED CARE ,[object Object]
Involve the patient and his familyActivities: Put nursing plan to action Coordinate care/services Utilize community resources Delegate Monitor health services provided Provide health education and training Document responses to nursing action
 EVALUATION OF CARE & SERVICES PROVIDED   Framework: 	S-tructural elements- physical setting, instruments, condition, 	financial resources/budget, org structure, objectives 	P-rocess elements- steps of nursing process ( involves nursing 	process APIE) 	O-utcome elements- changes in clients health status resulted from 	nursing intervention   Activities Nursing audit Outcome of care Assessment of problems Identify needed alterations Revise plans

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Chn Ratio

  • 1. Prayer Before Examination Dear Jesus, Today I will have my examination. You know how important this is to me. So, I am humbly asking Your gracious help and divine assistance.   I pray to You, my dear Jesus. Please never let me panic nor get nervous. Just let me be at ease and give my very best. Please never let me guess nor rely on pure luck, but enlighten my mind and let me think clearly.
  • 2. Today, O my Jesus, I will take my examination. Let me, with Your help, give my best effort. Let me, because of You, receive the best and Fruitful results, Amen.
  • 3. Please never let me resort to chances, nor to dishonesty, but let me work to the best of my ability. I pray for Your guidance so that I may be able to answer correctly the questions, and solve the difficult problems. I ask, O Lord, Your intercession so that, I may not be careless or overconfident as I write, I may not be more distracted but be more concentrated, I may not be in hurry nor take the exams too lightly.
  • 4. 17.A nurse is assessing a child admitted to the hospital with a diagnosis rheumatic fever. The child is accompanied by the mother. The initial nursing question that the nurse would ask during assessment is which of the following? “Has the child had difficulty urinating?” “ Has any family member had a sore throat within the past few weeks?” “Has any family member had gastrointestinal disorder in the past few weeks?” “Has the child been exposed to anyone with chikenpox
  • 5. CHN RATIO By: RandelDalauta
  • 6. Public Health Nursing (Winslow)-”science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for the sanitation of the environment, control of communicable disease, the education of individuals in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease & the development of social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as toenable every citizen to realize his birthright of health and longevity.”
  • 7. GLOBAL & COUNTRY HEALTH IMPERATIVES Changes exerting pressures on the Public Health Systems: Shift in demographic & epidemiological trends in disease New technologies for health care, communication & information Existing & emerging environmental hazards associated with globalization. Health Reforms
  • 8. Determinants of Health as listed by WHO: 1. Gender-men & women suffer diseases 2. Physical Health Environment-safe water supply & clean air 3. Personal behavior & coping skills-healthy lifestyle 4. Income and social status 5. Employment & working conditions 6. Culture-customs & traditions 7. Reduced Health Services-access & use 8. Inheritance/Genetics 9. Education-low education are link to poor health 10. Social support network-greater family support better
  • 9. Determinants of Health as listed by WHO: 1. Gender-men & women suffer diseases 2. Physical Health Environment-safe water supply & clean air 3. Personal behavior & coping skills-healthy lifestyle 4. Income and social status 5. Employment & working conditions 6. Culture-customs & traditions 7. Reduced Health Services-access & use 8. Inheritance/Genetics 9. Education-low education are link to poor health 10. Social support network-greater family support better
  • 10. WHO ”the art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number.”
  • 11. POLITICAL Safety Oppression People Empowerment SOCIO ECONOMIC Employment Education Housing BEHAVIOR Culture Mores Ethnic Customs OLOF Individuals Family Groups Communities Populations ENVIRONMENT Air, Food Water Waste Urban/Rural Noise Radiation Pollution HEREDITY Generic Endowment - Defects -Strengths -Risks Familial ,Ethnic Racial HEALTH CARE DEL. SYSTEM Promotive Preventive Curative Rehabilitative
  • 12. JACOBSON learned practice in a wide/huge variety of community services supports OLOF
  • 13.
  • 14.
  • 15. Level of Clientele Individual – entry point to the family and care - least important Family – basic unit of a society - basic unit of care - main caregiver for primary levels of care - may not be bound by marriage, blood or adoption - sharing emotional closeness and who identified themselves as family *main function: a. Reproduction b. socialization
  • 16.
  • 17. conserve natural resources
  • 18. recognition of subgroups
  • 19. participation of subgroups
  • 20. prepared to meet crisis
  • 21. ability to solve problems
  • 22. channels of communication
  • 23. available resources
  • 24. resolve disputes
  • 25.
  • 26. HANLON Dedicated to the highest level of physical, mental, social well being 3 A’s - Accessible DEVELOPMENT OF HEALTH IN ALL ASPECT - Acceptable holistic - Affordable
  • 27. United Nations General Assemblyadopted a common vision of poverty reduction and sustainable development in September 2000 exemplified by the Millennium Development Goals(MDG) based on:freedom,equality,solidarity,tolerance,health respect for nature and shared responsibility 8Millennium Development Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
  • 28.
  • 29. Primary Health Care(Alma Ata, USSR Sept. 1978) “health for all by year 2000, health in the hands of the people by 2020”
  • 30. 8 Millennium Development Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
  • 31. 8 Millennium Development Goals are as follows: Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality& empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria & other diseases Ensure environmental sustainability Develop a global partnership for development
  • 32. Core Business of Public Health Disease Control Health Protection Healthy Public Policy – Environment Injury Prevention Equitable Health Gain - promotion
  • 33.
  • 34.
  • 35.
  • 36. Participationof all members in the society both developing and developed countries is required
  • 37. The Health Sector Reform Agenda (HSRA) implemented through FOURmula ONE
  • 38. DOH Vision - Leader - staunch advocate - model in promoting health for all Mission - guarantee equitable sustainable HEALTH FOR ALL quality Overriding goal of the DOH Health Sector Reform Agenda (HSRA)
  • 39. Health Sector Reform Agenda (HSRA) RATIONALE : 1. Heavy burden on the poor in maintaining health 2. Sudden rise in diseases 3. Rise in IMR and MMR 4. Abrupt increase in chronic and degenerative disease REASON: 3 I’s Inappropriate health delivery system Inadequate regulatory mechanism (poor health quality) Insufficient financing
  • 40. FOURmulaOne 1. Health financing 2. Health regulation - quality & affordability 3. Health service delivery - accessibility - availability 4. Health good governance
  • 41.
  • 42. an approach to fulfill alma ata goals which is health for all in 2000
  • 43. Focuses on determinants of health and not the manifestations of illness
  • 44. recognizes that people’s health is affected by a broad range of factors (determinants) beyond their individual genetic makeup
  • 45. helping poor people protect their health and prevent illness
  • 46.
  • 47. GAYLORD Organized community program designed to PROLONGED LIFE by preventing unnecessary illness
  • 48.
  • 49. Importance of COPAR COPAR maximizes community participation and involvement COPAR could be an alternative in situations wherein health interventions in Public Health Care do not require direct involvement of modern medical practitioners COPAR gets people actively involved in selection and support of community health workers Through COPAR, community resources are mobilized for selected health services COPAR improves both projects effectiveness during implementation
  • 50.
  • 51.
  • 52.
  • 53. PURDOM Public health pertains to all phases of human development
  • 54. MAGLAYA utilization of nursing process APIE, FNCP
  • 55. Community Health Nursing Process - Systemic - Scientific nurses and client as a system affecting each other Clientele which will be the GOAL OF CARE Individual Family Community Population group - Dynamic - Ongoing interpersonal process
  • 56. ASSESSMENT: The first major phase of nursing process Measure status of the client STEPS: Initiate contact, show caring behavior, establish trust Collection of data Identify and categorizes health problems -base on typology - categorize as: a. Health deficit b. Health Threat c. Foreseeable crisis
  • 57. Foreseeable crisis 1. Marriage 2. Pregnancy 3. Parenthood 4. Additional family 5. Entrance at school 6. Adolescence 7. Divorce or separation 8. Loss of job 9. Death of a member 10. Resettlement in a new community
  • 58. PLANNING NURSING ACTION Blueprint of the care Based on actual problems potential problems    STEPS: Prioritize needs Goal Setting based on needs and capabilities – intent that gives direction to action (SMART) Constructing a Plan of Action – selecting appropriate and available resources for care Developing operational plan - Develop evaluation parameters
  • 60.
  • 61.
  • 62. Involve the patient and his familyActivities: Put nursing plan to action Coordinate care/services Utilize community resources Delegate Monitor health services provided Provide health education and training Document responses to nursing action
  • 63. EVALUATION OF CARE & SERVICES PROVIDED   Framework: S-tructural elements- physical setting, instruments, condition, financial resources/budget, org structure, objectives P-rocess elements- steps of nursing process ( involves nursing process APIE) O-utcome elements- changes in clients health status resulted from nursing intervention   Activities Nursing audit Outcome of care Assessment of problems Identify needed alterations Revise plans
  • 64.
  • 65. LAGUNDI (VitexneGUNDO) ULASIMANG BATO (PeperoniaPellucida) BAYABAS (PsidiumGUAJAVA) BAWANG (alliuMsativuM) YERBA BUENA (MenthaCordifeliA)
  • 66. EPIDEMIOLOGY study of the occurrence and spread/distribution of the disease in the community Pattern of Disease Occurrence Sporadic Intermittent occurrence or on-and-off presence of a disease Endemic Continuous or constant occurrence of a disease in a certain area Epidemic Sudden increase in the number of cases in a short period of time in a certain area outbreak Pandemic Worldwide epidemic or global outbreak
  • 67.
  • 68. Health teachings- primary responsibility
  • 69. Generalist – in terms of PHN practice
  • 70. referral system – longer period of time contact with the client
  • 71. CHN is population based
  • 72. Mass approach – community focused not individual
  • 73. Health promotion & Health education – goal of CHN/PHN
  • 74. FNCP – focused on Family problems
  • 75. NHCP – entire Country
  • 76.
  • 77. Health education/Counseling – integral part of CHN
  • 78.
  • 79. * STI’s 4 C’s Counseling Contact tracing Compliance Condom
  • 80. * ABC of AIDS Abstinence Be Faithful Condom Don’t use drugs Education
  • 81. * 3 C’s of DOH clean and safe delivery a. clean cord b. clean hands c. clean surface.
  • 82. *5 Too’s of Pregnancy 1. too young – 18 y.o 2. too old – 35 to 65 y.o. 3. too close – 2 years ( ideal 3 yrs.) 4. too many – 4 pregnancies ( ideal 3 pregnancies) 5. too sickly – Hpn, anemia, toxemia
  • 83. Best for baby Reduced Allergens Easily established Always available Safe Temperature is always right Fresh Emotional bonding Economical Digestible Immunity Nutritious GIT d/o decreases
  • 84. Host (man) 1.change peoples behavior (food safety practices) 3. increase man’s immunity (EPI) Agent Environment 2. prevent production of disease agents (treatment of waste water)