Community Health Nursing Day 3

Question 1

What is the GOAL of Maternal and Child Health?

Answer 1

Goal: to decrease Maternal Mortality Rate (MMR)

Question 2

How many prenatal visits to promote?

Answer 2

1 - first trimester
1 - second trimester
2 - third trimester

Question 3

• held by DOH

- Quality Assurance Program

Answer 3

Sentrong Sigla

Question 4

• all pregnant women are considered high risk pregnancy

- concept: address common problem of pregnancy

Answer 4

Basic Emergency Obstetrical Care (BEmOC)

Question 5

Under BEmOC:

• training for midwives, doctors, and nurses

Answer 5

Capability Building

Question 6

Basic Emergency Obstetrical Care (BEmOC):
Ex:
- hemorrhage is common in pregnancy - give _____ to prevent bleeding
- give ____; for infection
- preeclampsia can lead to convulsion; give _____ such as _____ (antidote: calcium gluconate)

Answer 6

• hemorrhage - give oxytocin
• infection - give antibiotics
• preeclampsia - give anticonvulsants like Magnesium sulfate (MgSO4); *antidote: calcium gluconate

Question 7

Basic Emergency Obstetrical Care (BEmOC):
Ex:
- give steroids, like _____ for pre-term labor and helps with lung maturity
- assisted delivery, also called ______
- manual removal of ____/retained products of conception

Answer 7

• steroids like Betamethasone
• forceps delivery
• placenta

Question 8

What is the advanced form of BEmOC?

What are the two under this?

• B
• C

Answer 8

Comprehensive Emergency Obstetrical Care (CEmOC) - (advanced)

• Blood Transfusion
• Caesarean Section

Question 9

• community-based care
• Unang Yakap
• evidence-based practice

Answer 9

Essential Intrapartal Newborn Care

Question 10

EINC: Time-bound

What are the 4 priorities intervention?

1. D
2. E
3. D
4. B

Answer 10

1. D - ry infant immediately; the act of drying will stimulate the baby to cry
2. E - early skin-to-skin contact; place the baby on mother’s abdomen
3. D - elayed cord clamping; wait for the pulsations to stop
4. B - reastfeeding; exclusively for 6 months

Question 11

What do you call the DOH Program of Expanded Program on Immunization (EPI)?

Answer 11

National Immunization Program (NIP)

Question 12

What law is also called EPI (Expanded Program on Immunization) Law?

• all children below 8 years old will received free vaccination
• Due to vaccination, polio and other diseases were decreased or no cases at all.

Answer 12

P.D. 996 (1976), also called EPI Law

Question 13

What law is called the Mandatory Immunization?

Answer 13

R.A. 10152 (2011), also called Mandatory Immunization

Question 14

R.A. 10152: Mandatory Immunization

• target: below 5 years old (since prior to this there’s BCG 2)

What are the 5 vaccinations under this Law?

Answer 14

1. Pentavalent (5in1); Diptheria-Pertussis-Tetanus (DPT), Hepatitis B (Hepa B), Haemophilus Influenza B Hib (prevents Meningitis and Pneumonia)
2. IPV - Inactivated Polio Vaccine; oral and injectable
3. Rota vaccine; prevents acute gastroenteritis (AGE) and diarrhea
4. PCV - Pneumococcal Conjugate Vaccine; prevents pneumococcal meningitis/pneumonia
5. MMR - Measle, Mumps, and Rubella

Question 15

What are the 5 elements of EPI?

1. S -
2. I -
3. C -
4. A -
   T. T -

Answer 15

1. S - urveillance
2. I - nformation Education Communication
3. C - old chain and logistics management
4. A - ssessment and Evaluation
   T. T - arget setting

Question 16

What element of EPI?

• searching for cases = for evaluation

Answer 16

Surveillance

Question 17

What element of EPI?

• National Immunization Day = Wednesday
• vaccine: monthly
• all vaccines are sensitive to heat

Answer 17

IEC - Information Education Communication

Question 18

What element of EPI?

• storage and transport of vaccination

What 3 vaccines are most sensitive to heat?
- should be placed in the freezer in what temperature?

Answer 18

• Cold chain and logistics Management

3 vaccines sensitive to heat: Varicella, Oral polio vaccine, MMR
Temp: -15 to -25 Celsius

Question 19

Element of EPI: Cold chain and logistics Management

What 7 vaccines are least sensitive to heat?
- should be placed in the body of refrigerator in what temperature?

Answer 19

7 vaccines least sensitive to heat: BCG, Pentavalent, IPV, Hepa B, Rota, PCV, T.T./T.D. (2in1 - Tetanus and Diptheria)
Temp: +2 to +8 Celsius

Question 20

What element of EPI?

• Why MMR is to be given late?

Answer 20

Assessment and Evaluation

• because the baby still has the mother’s antibodies that could interfere the effectiveness of the vaccine

Question 21

Element of EPI: Assessment and Evaluation

Pentavalent:
- What are the Side Effects and what medication to give?

• What are the Adverse Effects and what vaccinations not to give?

Answer 21

S/E:

• fever - give paracetamol every 6 hours for 24 hrs
• local tenderness - apply cold compress

A/E:
- seizures; pertussis (don’t give Pentavalent 2 and 3)

Question 22

Element of EPI: Assessment and Evaluation

BCG:

• What kind of attenuated microorganisms in BCG?
• BCG prevents _____ meningitis
• What to use in cleaning the site?
• Is having a scar normal?
• What are the Side Effects and the Nursing Management/Treatment?

Answer 22

• Live attenuated microorganisms
• TB (Tuberculous) Meningitis
• Water; don’t use alcohol coz the bacteria will be killed
• (+) scar is normal - means that effective vaccination
• S/E: Abscess (na-na): put Isoniazid/INH powder
  Deep Abscess: Incision and drainage + INH powder

Question 23

Element of EPI: Assessment and Evaluation

OPV:

• also called _____
• ___ attenuated vaccine; not allowed to _____
• __ the tongue
• What to do if it was spitted?
• What to do is it was vomited within 30mins or after 30mins?
• What is the Nursing responsibility after administration?

Answer 23

• also called, “Sabin Vaccine”
• Live attenuated vaccine; not to immunocompromised
• ON
• If spitted: Give another 2gtts (vax has no overdose)
• If vomited w/in 30mins: the vax is not yet absorbed, so give another dose
• If vomited after 30mins: the vax is already absorbed, do not give another dose
• N/R: NPO for 30mins

Question 24

Element of EPI: Assessment and Evaluation

IPV:

• also called ____
• _____ vaccine; can give to ______

Answer 24

• also called, “Salk vaccine”

- inactivated vaccine; can give to immunocompromised

Question 25

Element of EPI: Assessment and Evaluation What vaccine is made of recombinant RNA

Answer 25

Hepa B

Question 26

Element of EPI: Assessment and Evaluation MMR: - consists of M___, M____, R____ - ____ attenuated vaccine - should or should not distance the child to pregnant women? - What are the Side Effects and the Nursing Responsibilities?

Answer 26

- consists of Measles, Mumps, Rubella - live attenuated vaccine - SHOULD - S/E: Fever - give paracetamol every 6 hrs for 24 hrs Rashes - keep it dry ( usually seen after few hrs/a day)

Question 27

To remember: - Syringes are used ____ ONLY - What type of syringe where its plunger locks to prevent reusing?

Answer 27

- used ONE-TIME ONLY | - ADS (Auto Disable Syringe)

Question 28

What element of EPI? - primary element - solve the eligible population - What are the formulas for Eligible Population (Infants, Pregnant)?

Answer 28

Target Setting Formulas: Infants - Total Population x 2.7% Pregnant: Total Population x 3.5%

Question 29

Enumerate and Recite: Vaccines, # of dose, Schedule, Route and Dosage 1. BCG 2. Hepa B 3. Pentavalent 4. OPV 5. PCV 6. Rota Vaccine 7. IPV 8. MMR

Question 30

What is the nutrient called that includes CHO and CHON?

Answer 30

Macronutrient

Question 31

What is the nutrient called that includes vitamins and minerals?

Answer 31

Micronutrient

Question 32

Under Macronutrient: What form of malnutrition is: - (+) CHO - (-) CHON (for muscles and fluid balance) What are its Signs and Symptoms?

Answer 32

Kwashiorkor S/Sx: thin extremities, edema (fluid shifting), full moon-faced, thin brittle hair = Ascites

Question 33

- measure the upper arm circumference to identify malnutrition How many centimeters? 1. Red - severe malnutrition 2. Yellow - moderate malnutrition 3. Green - normal/no malnutrition

Answer 33

Mid Upper Arm Circumference (MUAC) Centimeters: 1. <11.5cm 2. 11.5 - 12.5cm 3. >12.5cm

Question 34

Under Micronutrient, What law is the Food Fortification Program? - foods should be fortified - fortified = added ____

Answer 34

R.A. 8976 fortified = means added nutrients

Question 35

Under Micronutrient, What law is the Food Fortification Program? - foods should be fortified - fortified = added ____ What is the program called which is a strategy in encouraging manufacturers to fortify foods? - Salt Iodization - Mandatory; rice (iron); flour (iron, vit. A., sugar, cooking oil, and vit. A) - Voluntary for processed food Kailan ang Araw ng Sangkap Pinoy Sealed?

Answer 35

R.A. 8976 fortified = means added nutrients Sangkap Pinoy Sealed Araw ng Sangkap Pinoy Sealed: 2x/year - Oct. April

Question 36

Vitamin A (Retinol) For normal: How many should you give? Infant (6-11months): 100,000 IU Child (12-60months): 200,000 IU When should you give?

Answer 36

Infant (6-11months): 100,000 IU Child (12-60months): 200,000 IU Sched: Today, and 6 months after

Question 37

Vitamin A (Retinol) For VAD: How many should you give? Infant (6-11months): 100,000 IU Child (12-60months): 200,000 IU When should you give? What are the S/Sx of a child with VAD (Vitamin A Deficiency)?

Answer 37

Infant (6-11months): 100,000 IU Child (12-60months): 200,000 IU Sched: Today, tomorrow, and 2 weeks after S/Sx: - dry eye; xerophthalmia - Bitot's spots - nightblindness

Question 38

Treatment: - disruption in society What are the two types? Two types based on Onset: Acute: within days - weeks Chronic/Creeping: months - years

Answer 38

Disaster 1. Natural Ex: Earthquake, Volcanic eruption 2. Man-made Ex: Terroristic attack

Question 39

What law is the National Disaster Risk Reduction Management Council? - National Government: 2%; LGU: 5% ``` Principles: 1. It is a responsibility of ACC 2. Disaster Drills - before the impact of the disaster 3. FIRST Priority: _____ SECOND Priority: ______ ```

Answer 39

R.A. 10121 First Priority: People Second Priority: Resources

Question 40

- it is a responsibility of all _____: Sanitation Code _____: Garbage Disposal Act What are the 4 rights of Food Sanitation?

Answer 40

P.D. 856: Sanitation Code P.D. 825: Garbage Disposal Act 4 rights: 1. Right source 2. Right preparation 3. Right cooking: min. temp = 70 Celsius; dangerous max of 2 hrs 4. Right storage: Cool = 10 Celcius, Warming = 60 Celcius

Question 41

Approved: Water facility Level 1: _____; protected well - developed spring - not more than 250 meters away from the source

Answer 41

Level 1: Point-source; protected well

Question 42

Approved: Water facility Level 2: _____; stand posts (poso) - 1: 4-5 household

Answer 42

Level 2: Communal Faucet; stand posts

Question 43

Approved: Water facility | Level 3: _____; individual household

Answer 43

Level 3: Waterworks System; individual household condition

Question 44

Approved: Faucet facility Level 1: _____ ``` Ex: Pit Latrines (doesn't need water) - small amount water facility - konting tubig - poor flush toilet ```

Answer 44

Level 1: non water carriage

Question 45

Approved: Faucet facility Level 2: _____ - flushed type to septic tank

Answer 45

Level 2: Water-sealed

Question 46

Approved: Faucet facility Level 3: _____ - to treatment plant

Answer 46

Level 3: Level 2 + sewerage system