1. Correct st.

- PHN - expenditures and resources for PH have increased in recent years

2. E.g. of primary goal in PH - conducting an infant car seat safety check
3. A PH midwife provides a clinic for HIV+ clients - e.g. of secondary prevention
4. Middle adult with chronic illness results in - reinforcement of prior family roles
5. DOH vision for 2030 - a global leader for achieving Health for All through better health outcomes,
responsive health system and equitable health care financing
6. Duterte’s 2016-2022 Goal for Philippine Health Agenda - All for Health towards Health for All
7. NOP nurses - salary grade 15 plantilla of the govt. - P 29,010
8. DOH functions under Executive Order 102
+++ Lead in the formulation, monitoring & evaluation of national health policies, plans &
programs
+++ Provide direct services for health concerns that require new complex technologies
+++ Create new strategies to improve effectiveness of health programs & the attainment of quality
health care
-X- ALLOCATE PERSONNEL BUDGET & PROVIDE STRUCTURES FOR CASCADING
HEALTH DELIVERY TO ALL
9. A characteristic of healthy communities - shared vision of EntrepreNurse - makes systems & resources
available to all members of the community
10. Home health care nurse role - health promotion in the home
11. Initial home visit to assess the client’s needs - nurse must inform client about - the client’s rights at the
start of care
12. Criteria to apply to determine the priority health problems - modifiability of the problem
13. Mission of DOH
+++ ensure accessibility, quality of healthcare, quality of life of all filipinos
-X- HEALTH FOR ALL FILIPINOS
14. Primary health care
+++ stresses the use of appropriate tech
+++ emphasizes partnership bet HCP and the people
+++ a total approach to community development
-X- AIMS TO PROVIDE FREE HEALTH SERVICE TO THE PEOPLE
15.Use of appropriate tech in the delivery of health services - PRIMARY HEALTH CARE
+++ teaching mothers how to.... (health ed)
+++ use of komiks in info and ed campaign against dengue
+++ use of bayabas for washing wounds & diarrhea
-X- USE OF PORTABLE XRAY MACHINES IN FAR FLUNG COMMUNITIES
16. Accessibility of health service implies that - HCP are within 5km from most of the catchment
population
17. Major lesson of Alma Ata & the diff charters of health promotion - community participation is a
fundamental requirement to achieve health and sustainable development
18. Political rally - spag, chicken - stomach pain, n&v, diarrhea, fever, dehydration - outbreak cause =
staphylococcal enterotoxins - illustration of statistical association of: direct causal
19. Above illness epidemic type : point-source epidemic
20. Point source epidemic
+++ epidemic terminates when supply of susceptible person is exhausted
+++ simultaneous exposure of the susceptible person
+++ cause originated from single event
-X- LOW NUMBER OG SUSCEPTIBLE PERSONS/HIGH NUMBER OF IMMUNE PERSONS
21. Magnitude of the problem - compute for: attack rate
22. Active mgmt of the third stage of labor (order) - IM injection oxytocin, controlled cord traction with
counter-traction to the uterus, uterine massage
23. + bleeding after placental delivery - FIRST: massage the uterus
24. FIRST step - newborn thermal protection: drying the baby thoroughly imm. after birth
25. Crowning - PRIORITY axn support to provide safety for the baby: place a hand firmly against the
perineum & expanding with her fingers at the vaginal opening
26. Upon birth of the fetus, in order to facilitate 3rd stage of labor: pull gently the umbilical cord to help
the placenta detach
27. DOH - Essential Newborn Care progam - same as number 24
28. After drying the baby -> remove used wet cloth & cover the baby with new clean, dry cloth
29. Cord care: cleansing with cooled, boiled water & leaving uncovered
30. Cord clamping and milking = now proven to be non-beneficial
New ENC modified practice = properly timed cord clamping
31. EINC = essential intrapartal newborn care
December 7, 2009 - Debunked practices by DOH and WHO
X use of enema to reduce risk of infections and shorten the duration of labor
X shaving the pubic hair of women in labor as a hygienic practice to min infection
X restricted intake of food and fluids during active labor for poss risk of aspiration due to anesthesia
X app of IV therapy to hydrate women due to food and drink restrictions
X early amniotomy and oxytocin augmentation in order to prevent operative delivery
32. X routine suctioning believed to be necessary to clear the airway and stimulate breathing
X foot printing as a means of ID for the newborn
X early bathing and washing as a form of hygiene practice
X routine separation (nursery)
X continue to provide artificial feeding
33. Intrapartal care - maternal position - 1st stage of labor -Encourage any position comfy to them
34. Body fat measurement - Correlates body fat in reln to height and weight: BMI
35. Accurate meas of visceral fat - waist circumference
36. Legal mandate for emergency preparedness and response program - PO 1554
37. Disaster mgmt
+++ 1st priority is protection of people at risk
+++ 2nd priority is protection of critical resources
+++ disaster mgmt relies upon and understanding of hazard risks
-X- CAPABILITIES MUST BE DEVELOPED AFTER THE IMPACT OF A HAZARD
38. Principle of emergency preparedness
+++ an impt aspect of emergency mgmt
+++ should not concentrate only on disasters but integrate prevention as well
+++ a responsibility of all
-X- SHOULD BE DONE IN ISOLATION
39. Main focus on environmental health
+++ tx of water supple
+++ tx of waste water
+++ oral rehydration therapy
-X- BREASTFEEDING
40. Certification of potability of an existing water source is issued by the: health secretary or rep.
41. Level 1 approved type of water facility: point source
42. Level of toilet facility found in highly urbanized communities that have sewerage systems and treatment
plants are : level 3
43. Food establishments - sanitary req. for cooks & helpers - compliance health certificate
44. Situational analysis PROCESS - in the community to assess health needs
+++ allowing people to freely express what they consider as a health problem
+++ asking people why they think the health problems exist
+++ assisting the comm to identify health situations that need change
-X- PROVIDING IMMEDIATE SOLUTIONS TO IDENTIFIED HEALTH PROBLEMS
45. Out of school teenagers smoking, drinking and using drugs <- OFW parents
SOCIAL DX
+++ explore to what extent the situation affects life in the neighborhood
+++ assess how the educ level of the comm affects its ability to cope with the problem
-X- DETERMINE IF THIS SITUATION RESULTS IN BREAKDOWN OF FAMILIES
-X- DETERMINE WHAT POLICIES SHOULD BE ENACTED TO PROMOTE LIFESTYLE
CHANGES
46. Same situation in number 45. Nurse and community actions in ORDER
...1 - identify what manpower and money resources are need to implement the program
...2 - design the program that will meet goals/objectives
...3 - identify support activities that will sustain the program
...4 - determine the program’s impact to the target group
47. Activity to empower community members: give ownership & leadership to the comm
48. CH nurse - client advocate -> is assertive in speaking & acting on behalf of the client
49. integration (process of establishing rapport w/ the comm people) can be BEST achieved by: conversing
with the people where they are & participating in social activities
50. environmental characteristics - water, noise pollution, vegetation, sanitation
51. Assessment - identify spec health problems, threats & deficits & how the comm is able to cope
52. BEST motivation for people to participate in CH development program - allowing the people to
exercise decision making
53. CH nurse assigned in community empowerment -> essential - form partnerships with people in the
community
54. Characteristics - community competencies - ability to identify their needs, achiever consensus, plan
& implement goals
55. Community assessment process
+++ identify avail resources - time, money, team skills
+++ setting axn priorities based on comm needs and avail resources
+++ collecting and analyzing info
-X- WITHHOLDS RESULTS FROM THE COMM UNTIL THEY CAN BE STATISTICALLY BE
CONFIRMED TO AVOID ALARMING PEOPLE
56. Community Dx composed of: COMPREHENSIVE COMMUNITY DX
Demographic variables
Socio-economic variable
Health and illness patterns
Health resources
Political-leadership patterns
57. Ocular visit of CH nurse -> 1st. Pay a visit to the brgy captain
58. Mobilization - carrying out the planned activities involving max comm participation
59. Applying community organization - BEST APPROACH - primary health care
60. Community organizing - ends when the community is already self reliant (bc)
It indicates the community organization is finished
61. Participatory Action Research (PAR)
The task in identifying CH problems is done by the nurse and the community
Community people are both subjects and researchers at the same time
Results are conductive to subsequent actions
Traditional research
Done by a professional researcher
Community people are just subjects
Results are non conductive to subsequent actions
62. nurse FUNCTION as a CH PRACTITIONER -> facilitator
63. Tobacco regulation act of 2003 - no selling of cigarettes within 100 meters away from school
64. FHSIS component - to plan and carry out pt care and delivery, the nurse must: target client listing
65. lowest level of reporting unit - DOH - brgy health stations
66. CHITS (Community Health Information Tracking System) - National Telehealth Center
- an electronic medical record system developed by the NTHC to improve health information mgmt at the
RHU level. It was developed alongside health workers & features a workflow much akin to what is
employed in local health centers nationwide. It is also built to gather data and generate reports which
health workers need & decision makers require
67. Reduce the overall cost of healthcare by ensuring health workers to diagnose, monitor & treat patients
with the ff capabilities
Blood pressure
Pulse rate
O2 saturation
Temperature
ECG
Uterine contraction
Fetal heart rate
68. Polio eradication and End-game strategic plan by 2013-2016 (eradicate wild strains of polio viruses)
New recommended Polio immunization schedule
6 weeks - OPV 1
10 weeks - OPV 2
14 weeks - OPV 3 & IPV (inactivated polio vaccine)
69. Before administering IPV, the HCP should: make sure that the infant is not allergic to the vaccine
70. The ff vaccines are stored between 2-8 degrees Celsius
IPV, BCG, Pentavalent vaccine
71. Correct way of administering vaccine for a 14 week old infant:
Penta IM - upper right thigh
OPV 3 - orally
IPV IM - upper left thigh
PCV - upper left thigh (pneumococcal conjugated vaccine)
72. Sustainable development goals - global goals
A universal call to action to end poverty, protect the planet & ensure that all people enjoy peace & prosperity
73. Correct HIV classification
A 10 month old has a positive virological test. She stopped breastfeeding 30 days ago. She should be
classified as CONFIRMED HIV INFECTION.
74. 9 month old.
Weight = 6 kg.
Length = 65 cm.
Temp = 37 degrees Celsius
Not eating well
Child has:
no general danger signs
no cough or DOB
no diarrhea
no fever
ear discharge for 5 days and ear pain
no palmar pallor
Nurse checks for signs of acute malnutrition and anemia:
no edema on both feet
MUAC = 120mm (mid upper arm circumference)
MOTHER = seropositive
CHILD = PCR positive (polymerase chain rxn - bacteria/virus)
Nutritional status = MODERATE ACUTE MALNUTRITION
75. Anemia class = NO ANEMIA
76. HIV class = CONFIRMED HIV INFECTION
77. 15 months old, wt = 8.5kg,
not eating well, unable to be breastfed
not vomiting, no convulsion, not abnormally sleepy,
difficult to awaken
temp = 38.5 degrees Celsius
IMCI Strategy = illness = VERY SEVERE DISEASE
78. general danger sign = UNABLE TO BE BREASTFED (+++)
79. vomits everything
has had convulsion
80. Child begins to seize - Nsg mgmt
...1- turn the child to the side and clear the airway. Avoid putting things in the mouth.
...2 - Give 0.5mg/kg DIAZEPAM injection solution per rectum using a small syringe without a needle
(tuberculin syringe) or using a catheter)
...3 - Check for low blood sugar, then treat or prevent
...4 - Give oxygen and REFER
...5 - If convulsions have not stopped after 10 mins, repeat diazepam dose
81. IMCI strategy
+++ identify tx
+++ counsel and follow up
+++ assess and classify
-X- REFERRAL
82. “child vomits everything” SIGNS
+++ exp. occasional vomiting
+++ when offered fluid, not able to drink
+++ not able to keep anything down at all (reflux)
-X- MAYBE TOO WEAK TO EAT OR DRINK AT ALL
83. 3 year old child with anemia and some pallor
5 ml or 1 tsp of IRON FOLATE (2-3x/day)
500 mg MEBENDAZOLE (single dose)
84. Vitamin A = measles - resists the viral infection in the eyes, cell layers in the lungs, GI tract, mouth
and throat
85. In giving CHLOROQUINE, the nurse should: explain to the mother that she should watch her child
carefully for 30 mins after giving the medicine
86. Severe Dengue Hemorrhagic Fever
IMMEDIATELY - give fluids or ORS & refer urgently to the hospital
87. Mastoiditis mgmt
- give child appropriate antibiotics for 5 days
- Give the child 1st dose of antibiotics
- Give 1st dose of paracetamol for pain
- X - DO NOT GIVE ANY MEDICATIONS
88. Factor to be considered in utilizing case mgmt chart (IMCI): age of the child
89. 5 months old
Wt = 5.2 kg
Temp = 38 C
Not eating well, feels hot to touch, able to drink
No vomiting, no lethargy, no cough, no convulsions
Lives in a malaria risk area
Fever started 2 days ago
No measles, no stiff neck, no runny nose
Illness Class.: malaria
90. Acceptable tx:
+++ follow up in 3 days
+++ give oral anti malaria drugs
+++ advise when to return immediately
-X- GIVE 1 DOSE OF PARACETAMOL FOR TEMP 37.5 C
91. Check for capillary refill if: the extremities feel cold
92. Capillary refill is more than 3 seconds - indicates - circulatory failure
93. Child living in a NON-malaria risk area with stiff neck - SEVER FEBRILE DISEASE
94. Nsg Dx: Dehydration secondary to diarrhea.
ORS administered. Health instruction to mother once diarrhea has stopped after ORS therapy.
Return to the clinic
95. Home care for sick infants
+++ blood in the stool is a danger sign and must be reported
+++ bring the infant to the clinic if he/she has shown signs of DOB
+++ breastfeed frequently, day and night, sickness and health
-X- MAKE SURE THE INFANT STAYS COOL AT ALL TIMES
96. Vitamin A deficiency SIGN: corneal clouding
97. Case: Palmar Pallor, suggestive of ANEMIA
Doctor prescribed iron medications
3rd day of taking iron medications, next nursing action:
Instruct the mother to continue giving iron for 14 days
98. IMCI (Integrated Mgmt of Childhood Illness - WHO strategy which aims to curb the growing
infant/child mortality and morbidity concerns in many countries especially 3rd world economies like the PH.
The program integrates many dependent health programs to singular approach.
Safety & Quality = Nurse’s FOCUS

18 month child
Cough = 7 days
No gen danger signs
Temp = 37.5 C
RR = 41 bpm
Breathing class. = fast breathing
99. Illness class. = PNEUMONIA
100. After 3 days
...+ chest drawing
...+ stridor
Mother returned to health center immediately, the nurse should:
Give first dose of antibiotics and refer urgently