VITAL SIGNS ● 2.

5 - 5cm ang space sa brachial and cuff

● Measurements of the body’s most
basic functions. The four main vital
signs routinely monitored by medical
professionals and health care providers;
BODY TEMP, PULSE RATE, RR, BP
● Vital signs are useful in detecting or
monitoring medical problems. Vital signs
can be measured in a medical setting, at
home, at the site of a medical
emergency, or elsewhere.
● 5th vital sign: Pain
● Normal result: 120/80 mmHg
NEUROLOGIC VITAL SIGNS
● Supplement the routine measurement of
temperature,m pulse rate, blood
pressure, and respirations by evaluating
the patient’s level of consciousness
(LOC) ambot wa ko kaabot
GLASGOW COMA SCALE

TEMPERATURE ROUTES
● Oral - easy, fast and accurate; can’t be
used for clients unconscious, confused,
prone to seizures, etc.

● Rectal - can’t be used for clients who

have hemorrhoids, cardiac clients (may
stimulate vagus nerve and can decrease
heart rate ata ambot)
INTRAVENOUS FLUID THERAPY
● Tympanic - safe and good for children;
● Aseptic installation of fluid, electrolyte,
naay reports of accuracy conflicting
nutrients medication through a needle
ambot
into a vein
● Axillary
● For patients who cannot consume food
NORMAL BODY TEMPERATURE: orally

IV FLUIDS
● It is a supplemental fluids used in
intravenous therapy to restore or
RESPIRATORY RATE maintain normal fluid volume and
● Rise and fall sa chest electrolyte balance when the oral routine
is not possible
PULSE RATE
TYPES OF FLUIDS
● Radial pulse
● Hypertonic
● Use finger pads
○ Has a greater concentration of
CARDIAC RATE solutes

● Use stethoscope ○ Pulls fluid and electrolytes from

the intracellular and interstitial
● Warm the diaphragm para dili compartments into the
mabugnawan ang px tas basi maka alter intravascular
ug results
○ D5NSS and Lactated Ringers
BLOOD PRESSURE
● Isotonic
● Sphygmomanometer
 ○ Having the same concentration of ■ Plasma
solutes as blood plasma
■ albumin
○ Remain inside the intravascular
compartment, thus expanding it THINGS TO CONSIDER WHEN CHOOSING
IV THERAPY SITE
○ Burns, hemorrhage, surgery, ● Client’s age
dehydrated patients, vomiting ● Length of time
and diarrhea, fluid maintenance ● Type of solution used
● Condition of veins
○ PNSS, Lactated Ringers, 5% SITES
something ambot ● Cephalic vein
● Hypotonic ● Radial vein
● Ulnar vein
○ Lesser concentration of solutes ● Median antebrachial vein
OTHER SITES
○ Dilutes the serum, which
● Dorsal Aspect of Hand
decreases osmolarity
○ Cephalic vein
○ Intracellular dehydration- DKA
○ Basilic vein
(too much glucose sa cells)
○ Dorsal Metacarpal
○ Helps kidneys to excrete excess
fluids ● Lower Extremities
○ Great saphenous vein
○ D5 IMB
○ Dorsal plexus
CLASSIFICATION
● Nutrient
○ Contains some H2O EQUIPMENTS
○ Useful in preventing dehydration ● IV solution ordered
● Butterfly needle
○ Insufficient calories
● Arm board (if needed)
○ Examples: ● Medicine ticket
■ 5% Dextrose in Water ● IV label
■ .45% Sodium Chloride
● Electrolyte MACRODRIP MICRODRIP (with
○ Contains varying amounts of (without needle) needle)
cations and anions
Advantages: Advantages:
○ Examples:
● Allows fast ● Easy to titrate
■ 0.9% Sodium Chloride fluid infusion ● Avoid fluid
■ Ringer’s solutions ● Allows fluid overload

■ Lactated Ringer’s solution resuscitation

● Allows fluid
● Volume Expanders
○ Used to increase the blood boluses
volume following severe blood
loss or loss of plasma Disadvantages: Disadvantages:
● Potential for ● Does not allow
○ Examples:
 fluid overload fluid ○ Type 1

● Difficult to resuscitation ○ Type 2

titrate ● Does not allow ● Before Administration of Insulin
fluid boluses
○ Health check

○ Pre-operation
STANDARD FORMULA
● If you are calculating for the rate: ● Hyperglycemia
○ gtts/min = volume (cc) X
macro/micro drop factor ፥ ○ Hypoglycemia
duration (hrs) x 60 min/hr
○ Diabetic coma
(constant)
● Volume per hour ● Time of the day
○ cc/hr = amount of fluid hrs. to run
● Hours to consume (duration) ○ Breakfast
○ Hrs to consume = amount of fluid ○ Lunch
cc/hr
○ Dinner
CAPILLARY BLOOD GLUCOSE
○ Before bedtime
● It is the immediate measurement of
blood glucose using blood sample for a
fingerstick or heel stick otherwise known
as hemoglucotest or capillary blood CONTRAINDICATIONS
glucose
● Peripheral circulatory failure

● Hyperlipidemia
PURPOSES
● Helps individuals with diabetes manage ● Iv transfusion of ascorbic acid
their condition
● Pre-eclampsia
● Enables timely adjustments to
medication, diet, and lifestyle ● Shock or hypotension

● Reduces the risk of diabetes-related ● Site is bruised

complications such as nerve damage, ● Diabetic ketoacidosis
kidney problems, and cardiovascular
issues ● Severe dehydration

● Helps identify and address episodes of MATERIALS

hypoglycemia and hyperglycemia
● Glucometer
● Guide personalized care plans tailored
to an individual’s unique glucose ● Glucometer strips
patterns ● Kidney basin
● Contributes to long-term health by ● Needle and lancet
promoting glucose control and overall
well-being. ● Disposable gloves

WHEN TO USE CBG MONITORING ● Dry and wet cotton balls

● Diabetes Mellitus SITES

 ● Tip of finger
○ The puncture is made on the
palmar surface of the fingertip, to
the left or right of the midline, and
away from the fingernail
● Tip of great toe
○ The location should be lateral to
the midline of the toe’s plantar
surface
● Heel
○ The puncture is made on the
plantar surface of the heel on the
farthest lateral or medial aspect,
not on the bottom
NORMAL BLOOD SUGAR LEVEL
ACCORDING TO AGE GROUPS
● Adults
○ 80-120 mg/dl
○ Hypoglycemia in newborns is
defined as blood sugar below 30
mg/dl: in children and adults if
below 50 mg/dL
INTAKE AND OUTPUT
● Intake
○ Refers to the fluids that a person
consumes or receives
● Output
○ Refers to the fluids that leaves a
person’s body
● I&O Monitoring
○ The measurement and recording
of all fluid intake and output
during a 24-hour period. This
provides important data about a
person’s fluid and electrolyte
balance
BLOOD TRANSFUSION
● A blood transfusion introduces whole or
components of blood, such as plasma,
serum, erythrocytes, or platelets, into
the venous circulation
PURPOSES
● To restore/increase circulating blood
volume after surgery, trauma, childbirth
● To restore or increase the red blood cell
level after severe and chronic anemias
and to maintain blood hemoglobin levels
such as in leukemia
● To provide selected cellular components
as replacement
● Therapy such as clotting factors,
platelets and albumin
PRIOR TO BLOOD TRANSFUSION
● Proper cross matching of the donor’s
blood and the blood of the recipient (to
assure compatibility)
BLOOD TYPES
BLOOD ANTIGEN
GROUP
A Has only A antigen on red blood
cells (and B antibody in the
plasma)
B Has only B antigen on red cells
(and A antibody in the plasma)
AB Has both A and B antigens on
red cells (but neither A nor B
antibody in the plasma)
O Has neither A nor B antigens on
red cells (but both A and B
antibody are in the plasma)
COMPONENTS OF THE BLOOD

TYPES OF BLOOD AND BLOOD
PRODUCTS AND IX
● Fresh whole blood (type A, B, AB, or
O, and RH plus or neg)
○ To treat volume deficiencies,
PRECAUTION
restore circulation and renal
blood flow when plasma volume
is decreased, to replace deficient
coagulation factors in bleeding
disorders
● Packed blood cells (PRCB)
○ High hematocrit, since
approximately 80% of the plasma
is removed
○ Used when blood volume is
adequate but the red cell mass is
inadequate as in chronic anemia
● Platelets
○ For patients with severe
thrombocytopenia (reduced
platelets). Replaces platelets for
example in Dengue Hemorrhagic
Fever
● Albumin
○ To expand the blood volume
rapidly when blood volume is
reduced in shock or burns; also
to increase level of albumin in
patients in hypoalbuminemia
● Prothrombin Complex
○ For example konyne, proplex
contains factors VII, IX, and XI
antiprothrombin
○ Used for bleeding associated with
deficiencies of those factors
● Factor VIII Fraction/Cryoprecipitate
○ For hemophiliacs
○ Caution: may transmit infection,
transfuse with a filter
● Fibrinogen preparations
○ Used particularly for bleeding
associated with congenital
hypofibrinogenemia (a deficiency
of fibrinogen, a necessary factor
for blood coagulation
● There is no margin for error when
administering blood products because
adverse reactions can be considerable
and life threatening.
SPECIAL CONSIDERATIONS
● Blood transfusion must be matched to
the patient’s blood type (A,B,O,AB), Rh
group and other factors
● A blood product infusion should begin
within 30 mins of leaving the blood bank
● A blood warmer may be used if the
patient is in a critical condition or if
patient is feeling chilly before
transfusion
● Blood transfusion should be checked
every 15-30 mins to ensure that it is
running on time
● Blood components that are still hanging
after 40 without refrigeration must be
discontinued
● In the post infusion period, the patient’s
urine is observed for signs of hematuria,
indicating a transfusion reaction
● If a transfusion reaction occurs, stop the
blood, start the saline, stay with the
patient and immediately notify the
physician if shortness of breath occurs,
start low flow oxygen (1-2 L/min) per
agency protocol. Return the blood
component bag to the blood bank or
 laboratory with the transfusion reaction ○ Sensitization to donor white blood
form cells, platelet or plasma proteins

TRANSFUSION REACTIONS ○ Sudden chills and fever (rise in

temperature of greater than 1
● The reaction of the body to a transfusion OC), headache, flushing, anxiety,
of blood that is not compatible with its muscle pain
own blood
● Mild allergic
SIGNS AND SYMPTOMS
○ Sensitivity to foreign plasma
● Anxiety proteins
● Flushing ○ Flushing, itching, urticaria (hives)
● Tachycardia ● Anaphylactic
● Hypotension ○ Infusion of IgA proteins to
● Chest IgA-deficient recipient who has
developed IgA antibody
● Pain
○ Anxiety, urticaria, wheezing,
● Back progressing to cyanosis, shock,
possible cardiac arrest.
● Pain
● Circulatory overload
● Dyspnea
○ Fluid administration faster than
● Fever
the circulation can accommodate
● Child
○ Cough, dyspnea, pulmonary
● Jaundice congestion (rales), headache,
hypertension, tachycardia,
TYPES OF TRANSFUSION REACTIONS distended neck veins
● Acute Hemolytic ● Sepsis
○ Infusion of ABO-incompatible ○ Transfusion of contaminated
whole blood, RBCs or blood components
components containing 10 ml or
more of RBCs. antibodies in the ○ Rapid onset of chills, high fever,
patient’s plasma attach to vomiting, diarrhea, and marked
antigens on transfused RBCs hypotension and shock
cause RBC destruction
● Iron overload
○ Chills, fever, low back pain,
○ Usually happens when patient
flushing, tachycardia, tachypnea,
receives numerous RBC
hypotension, vascular collapse,
transfusions when elimination
hemoglobinuria,
pathways for iron are limited
hemoglobinemia, bleeding, acute
renal failure, shock, cardiac ○ Damage of the liver, heart,
arrest, death kidneys, pancreas

● Febrile (non-hemolytic) ● Transfusion-associated lung injury

(TRALI)
 ○ Syndrome of acute respiratory ○ Vital signs and assessment data
distress gathered during transfusion

○ Fever, non-cardiogenic ○ Transfusions reaction and

pulmonary edema and interventions done
hypotension

● Transfusion-associated graft-vs-host
disease

○ Immune attack by transfused 10 RIGHTS

cells against the recipient ● Right patient
○ Can be prevented by irradiating ● Right drug
the blood products prior to
transfusion ● Right dose

POSITIVE OUTCOMES ● Right time

● Fluid balance ● Right route

● Improved cardiac output ● Right assessment

● Enhanced peripheral tissue perfusion ● Right documentation

EQUIPMENT ● Patient’s right to education

● Blood transfusion set (gauge 18-19 ● Right evaluation

needles)
● Patient’s right to refuse
● Sterile dry cotton balls (2pcs)
ROUTES
● Cross-matching result
● Oral medication (PO MEDS)
● Ordered blood component
○ Having swallowed
● Ordered 0.9% NACL (normal saline
■ Liquid
solution) 1L
■ Tablet, pills and capsules
● Plaster
■ Powders
● Working gloves
■ Drops
● Sterile OS (1pc)
■ Effervescent tablet
● Betadine Solution
● Intramuscular
WHAT TO DOCUMENT
○ Muscle tissue
● Nurses notes:
○ It is the introduction of medication
○ Start and completion time of
deep into the muscle tissue
transfusion
where a large network of blood
○ Amount of blood given vessel can absorb it readily and
quickly
○ Blood type and serial number
● Subcutaneous
 ○ Subcutaneous tissue

○ It is the introduction of a small

amount of solution by means of a
syringe and needle into the
adipose tissue beneath the skin

● Intradermal

○ Corium (dermal layer)

○ It is the introduction of a solution

by means of a syringe and
needle into the superficial layer of
the skin or just below the
epidermis of the skin
Qs QUESTIONS FINAL ANSWERS:

1 How many incheS do you insert the needle against 1/8

the patients skin

2 TEAR HALFWAY AND FLIP

2 other things you do when carrying STAT BACKWARDS
medication

3 3
How many tiomes to check the label

4 Iv tubing
Give 2 equipment used starting intravenous Iv pole
Medicine ticket
Alcohol swab

5 What action is done when blood droplets is Milking, pinching, pressing

issufficient for cbg testing

6 What is the common source of discomfort during the lancet

process of CBG monitoring

7 T or f blood componentsthat are still hanging after 4 true

hours

8 T or f A blood product infusion should begin within 15 false

mins

9 true
T or F blood transfusion should be checked every
15-30 mins to ensure its running on time

10-12 A patient receiving 250 mL normal saline IV over 4 10 GTTS/MIN

hours, using tubing with a drop factor of 10
drops/mL. How many drops per minute should be
delivered?
13-15 Miley has been admitted to the medical-surgery unit.
During an 8 - hour shift, patient Miley consumed 300
mL of distilled water, received 400 mL of intravenous
fluids, and had a tube feeding of 250 mL. One of the
nurse on duty recorded that patient Miley’s urinary
output was 350 mL, and she also had drainage from
her wound of 75 mL Calculate the patient’s intake
during the 8 hour shift

-could not recall her childhood

ACUTE PYELONEPHRITIS immunizations
- has not receive any vaccines as an
● Type of upper urinary tract bacterial
adult
infection
- no food and drug allergies
● Caused by inflammation of the kidneys HISTORY OF PRESENT ILLNESS
which may permanently damage them - 1 day PTA persistent and
- slightly intensitied labor-like discomfort.
along with ongoing lower abdominal
discomfort. urinary symptoms (urgency
PATIENT DATA BASE
,frequent urination, and dysuria) watery
BIOGRAPHICAL DATA
discharges.
Client: CA Age: 35 Female
- She also developed a fever, and
Admission Date: August 19, 2023, 3:15pm
complained of worsening headaches.
and reported increasing fatigue.
CLINICAL DATA
- Day of Admission: lower abdominal
discomfort, urinary symptoms persisted,
FAMILY HEALTH HISTORY
and watery discharges were noted.
● MATERNAL SIDE
- Fever 38.5
1. LOLA-CATARACT (DECEASED)
2. LOLO-HYPERTENSIVE(DECEASED)
DEVELOPMENTAL TASK
● Patient C.A. has achieved several
● PATERNAL SIDE
developmental tasks in early adulthood.
- BOTH ARE DECEASED
She has accomplished the task of
Intimacy vs. Isolation by establishing a
● MOTHER- DIABETIC
loving and stable relationship with her
● FATHER- DECEASED DUE TO
spouse.
VEHICULAR ACCIDENT
● Furthermore, Patient C.A. has
successfully accomplished the tasks
● 3RD SIBLING- MULTIORGAN
outlined by Robert Havighurst, including
FAILURE/ DIABETIC
selecting a partner, learning to live
with a partner, starting a family,
PAST HEALTH HISTORY
rearing children, managing a home,
- has not been hospitalized since birth
 assuming civic responsibility, and
finding a congenial group.
● However, Patient C.A. has not
achieved the task of starting an
occupation, as she mentioned, "Sa
balay ra gyud ko, wala koy work, para
maka focus ko sa akong mga anak,"
indicating her choice to be a full-time
housewife.
● These accomplishments and the
acknowledgment of the task not
achieved indicate her successful
transition into and progression through
the early adulthood stage, paving the
way for her continued personal and
relational growth.
PHYSICAL ASSESSMENT
● GENERAL SURVEY
○ Weakness
○ Signs of bruising and discomfort
● SKIN AND NAILS
○ Bruising at IVF site (related to IV
medication)
○ Striae gravidarum (stretch marks)
on abdomen, hips, breasts, and
thighs
○ Edema on the left foot, possibly
related to her gdm or the heplock
placement.
● HEAD
○ None noted
● EYES
○ None noted
● EARS
○ None noted
● NOSE
○ None noted
● MOUTH
○ Minor cavity in the lower right
molar
● PHARYNX
○ None noted
● ABDOMEN
○ linea nigra is present
○ scars - lower part
○ incision site warm to touch
○ surgical staples present
● GENITO-URINARY SYSTEM
○ labia-asymmetrical
○ cloudy and foul smelling urine
○ flank pain, dysuria, urgent
urination, dribbling
DEFINITION OF DIAGNOSIS
According to Current Medical Diagnosis &
Treatment 2019 by Papadakis et al. (2019)
● Acute pyelonephritis is an inflammatory
illness that is infectious. It involves the
renal pelvis and kidney parenchyma.
● The most frequent causative agents are
gram-negative bacteria, which include
E coli, Proteus, Klebsiella,
Enterobacter, and Pseudomonas.
● Gram-positive bacteria, such as
Staphylococcus aureus and
Enterococcus faecalis, are less
frequent but still present.
● With the exception of S aureus, which
typically spreads by a hematogenous
pathway, the infection typically rises
from the lower urinary tract.
MEDICAL MANAGEMENT
Actual Tests:
● Chest X-ray
- Unremarkable chest findings
- Change to patient’s gown
- Remove jewelry and metallic
items
- May change positions to
completely assess organs
- Patient need to hold their breath
for a brief period of time while the
images are being captured
● Urinalysis
- To detect urinary tract infections,
kidney disease and diabetes
- Color: yellow = dehydrated
- transparency:
cloudy = concentrated urine
- Albumin ++
- Microalbumin 3+
- epithelial +
- Pus cells 50 - 60 /HPF =
indicating presence of UTI
 - bacteria ++ - Apply pressure to injected
- Urine urobilinogen 3.4 mg/dl site
- Leukocyte esterase 2+
- protein: trace = kidney not ● Hemoglobin A1c (HbA1c)
working well - Blood test used to measure
average blood sugar levels over
● Blood Chemistry the past 3 months
- To check whether various organs - Patient’s result: 8.5% =
are healthy and functioning DIABETES
properly
- calcium - low ● Arterial Blood Gas
- chloride - low - Rare but UTI can spread to lungs
- potassium - low that’s why this is indicated
- magnesium - high - pH - low & high
- sodium - low - PCO2 - Low
- PO2 - high
● Complete Blood Count - BEecf - low
- To further identify underlying - BE (B) - low
disorders - HCO3 - low
- To look for elevation in WBC, to - TCO2 - low
assess kidney function
- Hgb - low Possible Tests:
- Rbc - low ● Ultrasound
- MCHC - low ● CT Scan: Abdomen & Pelvis
- Differential count: ● Urine Culture
- Segmenters - low - identify bacteria or yeast causing
- Neutrophils - high a urinary tract infection
- Lymphocytes - low
- Eosinophil - low ● Other test not presented:
- Hematocrit - low ○ Blood Urea Nitrogen - to assess
kidney function, if high level it
● Serology and Immunology means kidneys are not working well
- Usually done for patients with UTI and dehydrated, or it means patient
because they have renal have urinary tract obstruction
impairment which makes them
susceptible for other infections ORDERS:
- To check if they are susceptible ● VSq4
to infections like hepatitis B or ● I&O
STIs ● Diet
- Anti-HBs negative ○ LSLF
- Anti-HBc IgM non reactive ● CBG Monitoring
- Anti-HBc Total: 173.860 ● Medication
- Nursing respo is the same with ○ Cefuroxime
CBC, Blood chemistry, HbA1c & - For UTI
ABG:
- Inform patient that slight ○ Dexamethasone
discomfort may be felt when - For tocolysis = baby’s lung
punctured maturation, survival of preterm
- Aseptic technique baby
○ Nifedipine upwards.
- Treatment of hypertension,
preterm labor, and ○ Tranexamic acid
prevention/treatment of ○ Reduce the risk for blood loss in
cesarean delivery
high-altitude pulmonary edema
○ Ca + Vitamin D
○ Ferrous + Multivitamins ○ Low blood calcium level result
- To prevent iron and vitamin
deficiencies since preggy ○ Linagliptin
○ For hypertension
○ Ascorbic acid
○ For faster wound or incision ○ Amlodipine
healing ○ For hypertension
○ MgSO 4
○ KCL
○ neutralizing gas in stomach
○ Treatment and prevention of
○ Ceftriaxone hypokalemia as shown in blood
○ Treatment ng acute chemistry
pyelonephritis
○ Kalium durule
○ Progesterone ○ For electrolyte balancing due to
○ Prevention of preterm birth, and renal impairment
prevention of further bleeding
during CS delivery ○ D5NSS
○ For electrolyte balancing due to
○ Humulin 70/30 renal impairment
○ Insulin shot for the patient’s GDM
○ PNSS
○ Glargine ○ For electrolyte balancing due to
○ Same with Humulin 70/30, for the renal impairment
GDM
○ D5W
○ Regular Insulin ○ For electrolyte balancing due to
○ Same with Humulin 70/30, for the renal impairment
GDM

○ Ketorolac
○ NSAID same with Celecoxib pero
contraindicated to those with
renal impairment (MGSO4
counters this by neutralizing gas
in stomach)
NURSING THEORIES
○ Celecoxib
○ Treatment for pain post partum Self-Care Deficit Theory
CS; antiinflammatory - Dorothy Orem

○ Ranitidine - focuses on each individual’s ability to

○ Decreases gastric acid secretion perform self-care
and volume for post cesarean
- "the practice of activities that individuals
delivery,where there is higher
intragastric pressure due to the initiate and perform on their own behalf
gravid uterus, which causes
in maintaining life, health, and
gastric contents to be forced
 well-being."
Health as Expanding Consciousness
- Margaret A. Newman
- one can still be more than herself and
that she can still find greater life
meaning

PROGNOSIS
- Good
- The patient is already at status “may go
home” days after surgery
- the diagnosis was successfully resolved.
- With organized discharge planning for
the patient, as well as the cooperation of
the patient, the home recovery is sure to
progress steadily without any problems
HEPATITIS B INFECTION ● AOG: 39 6/7 weeks (by USD)

● HBV or Hepatitis B virus is transmitted FAMILY HEALTH HISTORY

through percutaneous inoculation or ● PATERNAL SIDE

mucosal exposure, with an incubation ○ Sibling of father sa px kay

period of 30-180 days. deceased because of liver cancer

● Yellowing of the skin and eyes ○ Px father died when she was still

(jaundice), black urine, light feces, and 1yr old

swelling with fluid in the abdomen, ● MATERNAL SIDE

limbs, and legs are all symptoms of liver ○ All siblings of mother died

disease ○ One of her mother’s brothers had

● Hepatitis B can also be transmitted hypertension and a stroke

through needlestick injuries, tattooing, ○ Px mother died due to relapse

piercing, and contact with contaminated when she was still 2 years old

blood and bodily fluids such as saliva, ● Client has 4 siblings (all without

menstrual, vaginal, and seminal diseases)

secretions ● Px diagnosed with hepatitis B and

PATIENT DATABASE syphilis

BIOGRAPHICAL DATA PAST HEALTH HISTORY

● Patient MMB ● No history of serious or chronic illness

● 18/F ● Fully immunized during her childhood

● Educational Attainment: Grade 2 and 2 doses of TT

CLINICAL DATA ● Vaccinated with COVID but without

● Admitted at SPMC OB Ward Bed 23 booster

● Date of Admission: August 15, 9:57 PM PRESENT HEALTH HISTORY

● CC: Labor pains ● Tested positive for hepatitis B and

● Admitting Diagnosis: Gravida 1 Para 1 syphilis infection 5 months prior to

(1001) PU = 39 6/7 weeks AOG by admission

LUTZ, NIL, HEPATITIS B infection by ● On August 16, 2023, the patient had an

unknown infectivity & chronicity; Latent indication of arrest in cervical dilation

Syphilis of unknown duration, teenage leading to primary low-segment

pregnancy transverse cesarean section

● Procedure Done: Primary low segment DEVELOPMENTAL TASK

transverse cesarean section ● Erik Erikson

OBSTETRICAL DATA ○ Identity vs Role Confusion

● G1P1A0 ■ Achieved

● T1P0A0L1 ■ Gist ani kay px grew up

● LMP: December 15, 2022 without parents so bale

● EDC: September 21, 2023 early siya namulat sa

katotohanan ganern
 ■ She also said na ready na indicator for inflammatory
daw siya saiyang new role activity of the liver in
which is to be a mom sana patients with CHB.
all ● Digestive system
● Robert Havighurst ○ Esophagus
○ Adolescence (13-18 years old) ■ The esophagus is affected
■ Px has no friends and ang when the infection
maka bond ra niya kay worsens and it leads to
anak saiyang brother esophageal varices,
which is younger saiya dilated submucosal distal
■ The transition into esophageal veins
motherhood led her to connecting the portal and
embrace a more traditional systemic circulations. They
feminine social role form due to portal
■ Px noticed significant hypertension, which
changes saiyang body commonly is a result of
tung nanganak na siya cirrhosis, resistance to
and gi accept to niya portal blood flow, and
■ Able to control her increased portal venous
feelings, emotions and blood inflow.
able to decide for herself ○ Intestine
■ No intentions of getting ■ HBV infection alone DOES
married yet NOT alter GI motility.
■ She grew up saiyang ate However, if liver cirrhosis
PHYSICAL ASSESSMENT is involved, there is a risk
● Rashes sa breast ( small white rash) for delayed GI motility.
● Since bagong panganak, naay lochia Ascites is most likely a
serosa factor responsible for the
NEUROLOGICAL ASSESSMENT delayed GI transit among
● Normal tanan chronic HBV-infected
ANATOMY AND PHYSIOLOGY subjects.
● Lymphatic system ○ Liver
○ Lymph nodes ■ Having a chronic HBV
■ Chronic Hepatitis B (CHB) infection can lead to
is frequently associated serious complications,
with hyperplasia of lymph such as: Scarring of the
nodes in the hepatic hilum, liver (cirrhosis). The
and these enlarged lymph inflammation associated
nodes can be a good with a hepatitis B infection
 can lead to extensive liver ● Once an individual engages in activities
scarring (cirrhosis), which
with an infected person, the Hepatitis B
may impair the liver's
virus enters the body.
ability to function
○ Stomach ● The virus primarily targets liver cells
■ Symptoms can include
called hepatocytes.
fatigue, poor appetite,
● hepatocytes have specific receptors on
stomach pain, nausea,
and jaundice. For many the surfaces that allow the lipid
people, hepatitis B is a
envelope and viral proteins of the
short-term illness.
Hepatitis B Virus bind with the healthy
PATHOPHYSIOLOGY
● Predisposing factors hepatocyte
○ Only race ang naka check
● The circular DNA (cDNA) of the virus is
● Precipitating factors
delivered to the nucleus of the infected
○ Unprotected sex, maternal
infection (hepatitis b), hepatocyte cell and converted into
low-socioeconomic status,
covalently closed circular DNA
incomplete vaccination status,
(cccDNA). Because of its enclosed
immune suppression (syphilis)
and naka check nature, cccDNA permits viral replication
● Symptomatology
without drawing the attention of the
○ Poor appetite, fatigue,
host's natural antiviral defense
clay-colored stool ang naka
check mechanisms
○ NOT JAUNDICE
● cccDNA serves as a template for viral
● Schematic Diagram
RNA transcription, leading to the
● The Hepatitis B virus is transmitted
production of viral antigens.
through contact with infected body fluids
● The viral RNA is translated into
such as blood, semen, vaginal fluids, or
pregenomic RNA (pgRNA), which is
other body fluids.
essential for viral DNA and protein
● Common modes of transmission include
production.
unprotected sexual contact, sharing
● The enzyme that makes the DNA copy
needles for drug use, and
is called reverse transcriptase.
mother-to-child transmission during
● Now, the reverse transcription is the
childbirth.
 process in cells by which an enzyme the individual can manifest

makes a copy of DNA from RNA. The symptomatic/asymptomatic symptoms

pgRNA is transcribed reversely to of the said disease.

synthesize a new double-stranded viral ● If acute hepatitis B is treated within six

DNA months, it can lead to the regeneration

● The viral DNA and protein particles of healthy liver cells and a good

attempt to spread to neighboring prognosis.

hepatocytes, leading to the destruction ● If acute hepatitis B is not treated for

of infected cells. longer than six months, chronic hepatitis

● The host's immune system detects the B may develop. Chronic hepatitis B,

infection and responds by releasing which is the stage where the immune

cytotoxic T cells (CD8+ T cells) and system is unable to eliminate the virus

natural killer (NK) cells. signal malfunctions in a chronic liver

● This immune response causes disease because the inflammation

inflammation and persists and more collagen is deposited,

● Due to the liver's impaired state and stiffening the liver and impairing its

poor function it can result in symptoms capacity to function effectively. As the

such as nausea, dark urine, loss of function declines over time, so does the

appetite, exhaustion, and jaundice. body's capacity to eliminate toxins from

● Liver function tests are used to assess the blood, which eventually results in

enzyme and bilirubin levels during this liver cirrhosis and affects the other

phase. organs such as the Brain.

● liver attempts to repair and replace ● hepatic encephalopathy occurs when

damaged cells the nervous system is affected by the

● Now, the individual may not feel that live r's accumulated toxins.

he/she has Acute Hepatitis B Virus since ● If the person follows the treatment plan

during this phase, the immune system and makes lifestyle changes, recovery is

still tries to clear out the virus in an possible because this condition is

attempt to resolve the infection in which reversible 50 and has a favorable

 prognosis. unsuccessful, the person may receive

● However, if the patient only adheres to palliative care to alleviate some signs

the medication without making any and symptoms before passing away,

lifestyle changes, the patient may go which results in a poor prognosis for that

into a vegetative state and finally pass individual.

away, which gives us a poor prognosis. ● Depending on the course of the disease

● Liver cirrhosis may eventually develop and the individual's response to

the healthy liver tissue to be replaced treatment and lifestyle changes,

with fibrous scar tissue, impairing the outcomes range from recovery to

liver's ability to function chronic illness, cirrhosis, hepatocellular

● Prolonged liver inflammation and viral carcinoma, and liver failure.

DNA integration into the host genome

MEDICAL MANAGEMENT
can promote the growth of liver cancer
1. Diagnostic and Lab tests
(hepatocellular carcinoma).
● Actual tests
● Genomic instability and mutagenesis of > All Lab results are normal except:
1. Red Blood Cells (RBC) - result:
cancer-related genes are consequences
4.19 - Low [Below Normal Values:
of HBV DNA integration.
<4.0 10^6/L is categorized as
● As the illness worsens, it can lead to anemia]
2. Albumin - result: 27.29 g/L - Low
liver failure, which may require a liver
[Below Normal Values: <35.00
transplant.
g/L is considered as
● Recovery post-transplantation is hypoalbuminemia which can be a
sign of liver or kidney disease or
possible with lifestyle changes and
another medical condition.]
adherence to treatment, resulting in a
3. Alpha fetoprotein (AFP) - result:
good prognosis.On the other hand, 28.210 - High [Above Normal
Values: >9.00 ng/ml High AFP
there is a considerable risk of the
levels indicate that the fetus has
condition coming back if the patient
a fetal tube defect or an
merely takes the prescription without abdominal wall defect.]
4. HBsAg - Quantitative - result:
changing their lifestyle.
757.070 - Reactive [Positive
● On the other side, if the treatment is
result indicates an active or
 recent hepatitis B infection.] 3. Liver Ultrasound - An
5. TP-PA Qualitative - result: ultrasound is recommended by a
Positive [Positive result indicates doctor to determine whether the
syphilis was found.] liver is inflamed
6. VENEREAL DISEASE
RESEARCH LABORATORY 4. Liver Biopsy - understand the
TEST (VDRL) - result: reactive [A extent of liver damage caused by
positive result means there’s chronic hep B infection
detected presence of the syphilis
antibodies.] Nganong ang syphilis 5. Hepatitis B Surface Antibody
man ang gina pangita/gina test? (anti-HBs) Test - presence of
Unsay characteristics niya? kay these antibodies mean stronger
syphilis ang pinakadali nga mag immunity against hep b; (+)
spread through skin-skin vaccinated with hep B or has
contact/sexual. Dili tanan naay antibodies & (-) unvaccinated
hepa b naay syphilis. with hep B or has no antibodies
7. Anti HBC total - result: 96.140 -
Positive [Positive results indicate 6. Hepatitis B e Antigen (HBeAg)
infection with HBV] Test - active viral replication; (+)
8. URINALYSIS NIYA AY NORMAL high infectivity & (-) low infectivity
LAHAT.
7. Hepatitis B e Antibody
2. Diagnostic and Lab tests (anti-HBe) Test - presence of
● Possible tests these antibodies mean hbv is
1. Antibiotic sensitivity test - The less active or in an inactive state;
antibiotic sensitivity test results (+) inactive hbv & (-) active hbv
inform the doctor how the
8. Hepatitis B DNA (viral load)
bacteria causing the infection
Test - quantify the amount of
respond to different antibiotics.
hepatitis B virus (HBV) DNA; (+)
viral loads & (-) no viral load
2. Fluorescent Treponemal
Antibody Absorption
(FTA-ABS) - The fluorescent
B. Drug Study
treponemal antibody absorption
● Ketorolac
(FTA-ABS) test is a blood test
○ NSAIDs
that checks for the presence of
○ MOA: Inhibits prostaglandin
antibodies to Treponema
synthesis producing peripherally
pallidum bacteria.
mediated analgesia
 ○ IV Antagonist
○ Ordered dose: 30 mg q6 x3 ● Ordered dose: 10mg IVTT q8hrs
○ For short term management of PRN
pain ● S/E: Drowsiness, dizziness,
○ *Given pre-op since patient nausea, diarrhea, incontinence,
underwent CS urinary frequency
● Celecoxib
○ NSAIDs ● Cefuroxime - Given post-op. Antibiotic
○ MOA: Prevents the synthesis of a sya na PO. Since NPO si patient at first,
chemical called prostaglandin by yung isang antibiotic ang ginabigay
inhibiting an enzyme called through IV. After op, switch na to
cyclooxygenase 2 (COX-2) cefuroxime since di na NPO si patient.
○ Tablet ● Antibiotics; Second-generation
○ Ordered Dose: 200 mg/tab 1 tab cephalosporins
BID x 5 ● Indication: Used to treat a
○ *Given post-op (shift from IV number of illnesses, including
NSAIDs to PO NSAIDs) gonorrhea, early lyme disease,
acute bacterial otitis media, many
● Tramadol upper respiratory tract infections,
○ Analgesics skin infections, UTI, and
○ Binds to opioid receptors in CNS, impetigo.
inhibiting ascending pain ● S/E: diarrhea, hemolytic anemia,
pathways thrombocytopenia, transient
○ 50 mg. very slow IVTT q6 hours, neutropenia, eosinophilia, rashes,
PRN for severe pain pain

● Ranitidine
○ Histamine H2-receptor antagonist
○ Inhibits histamine at H2-receptor
site in parietal cells which inhibits
gastric acid secretion
○ 50 mg. IVTT q8 hours while on
NPO
○ Ihatag before surgery due to
NPO (to prevent ulcer)
● Metoclopramide - To prevent or reduce
postoperative nausea and vomiting.
● GI stimulant ; Dopamine
● Ascorbic Acid
○ Antioxidants
○ MOA: Ascorbic acid is required
for collagen formation and tissue
repair by acting as a cofactor in
the posttranslational formation of
4-hydroxyproline in Xaa-Pro-Gly
sequences in collagens and other
proteins.
○ 1 tab PO OD
○ *For tissue repair since patient
has incision due to CS
 ○ A liver resection is a surgical
● Cefazolin procedure wherein part of the
○ Cephalosporin antibiotic liver is removed. Up to two-thirds
○ MOA: exert bactericidal activity of the liver may be removed if the
by interfering with the later stages remaining portions are healthy.
of bacterial cell wall synthesis ○ Naay ability ang liver na mag
through inactivation of one or grow back so possible na within 3
more penicillin-binding proteins months mag grow ang liver back
and inhibiting cross-linking of the near saiyang normal size
peptidoglycan structure. ○ Hepatectomy is an effective
○ 1g IV treatment option for early HCC or
○ Given before surgery to prevent hepatocellular carcinoma which is
bacterial infection a cancer sa liver.
○ S/E: diarrhea, nausea, vomiting, NURSING THEORIES
cramps, rash, pruritus, urticaria, Goal Attainment Theory
Stevens-Johnson syndrome, ● Imogene King
Seizures (high doses) ● First published in the 1960s.
● Three interacting systems: the
Unsay ginahatag sa baby after birth if iyang personal, interpersonal, and social.
mama naay hepa b? HBIG (Hepa B IgG na ● Personal system concepts include
vaccine) perception, self, personal development,
body image, space, and time.
● Interpersonal systems also have
POSSIBLE SURGICAL MANAGEMENT
concepts such as interaction,
● Liver Transplant
communication, transaction, role, and
○ A medical surgery in which a
stress.
surgeon removes a damaged
● The social system concept indicates
person's liver and replaces it with
organization, authority, influence,
a healthy liver from another
prestige, and decision-making.
person, known as the donor.
● Concentrates on achieving particular life
○ So as we all know, hepatitis b is
goals and describes how the nurse and
not curable and the illness can
patient collaborate to communicate
clear up without treatment within
information, define goals, and then
1-2 months. Once a patient
engage in activities to achieve those
develops CHB, they can be
goals.
treated with antiviral medications
● The objective achievement factors focus
and liver transplant may be an
on roles, stress, space, and time.
option.
● Nurses maintain patients' health so they
● Hepatectomy (Liver Resection)
can function in their respective duties by
 interpreting information in the nursing favorable prognosis. Additionally, the patient
process and planning, implementing, demonstrated normal cognitive thinking,
and evaluating nursing care. mannerisms, and memory, suggesting no
● Provides a strong foundation of significant neurological deficits. The timely
nurse-client interaction by determining identification of the infection, consistent
the best response to a particular monitoring, and the application of appropriate
condition, such as giving health medical care, including antiviral therapy,
teachings to the patient. immunization schedule, and medical guidance,
● Allows nurses to comprehend the health can be instrumental in decelerating the
of their patients to explain and enhance progression of the disease and are essential to
their outcomes. Therefore, it implies that achieving a good prognosis.
nurses are responsible for all actions
that affect their patients' health.

Health Promotion Theory

● Nola Pender
● emphasizes the importance of individual
traits, behavior-specific cognitions and
feelings, and environmental factors
● useful tool for understanding and
promoting healthy behaviors in
healthcare and nursing
● It encourages the development of
self-efficacy and a sense of
empowerment that promotes beneficial
health choices and activities.
● provide patients individualized
instruction and therapies that address
these characteristics in an effort to
increase their sense of self-efficacy and
enable them to make better decisions

Prognosis:
In this case, a good prognosis is observed as
the mother has no complications during and
after her delivery. The person follows the
treatment plan and makes lifestyle changes,
which makes recovery possible because this
condition is reversible and that leads to a
 system in sustaining community
NCM 213 RLE - COMMUNITY HEALTH programs or projects;
NURSING 2 CARE OF POPULATION, 11. Identify practical strategy to make
GROUPS AND COMMUNITY participation and partnership meaningful
GOAL: and feasible;
● At the end of the community health 12. Develop skills in motivating and
nursing rotation, the BSN 3 students will preparing peope to take on
be able to integrate concepts of responsibilities, listen to and develop
community… others to become facilitative leaders;
OBJECTIVES 13. Share thoughts and experiences about
Within 3-4 weeks, the BSN 3 students will: community engagement;
1. Integrate concepts of leadership and 14. Document key events, progress and
management in each phase of reflection;
community organizing participatory 15. Professionally and personally evaluate
action research; specific role developed from the
2. Demonstrate effective communication experience; and
skills; 16. Discuss the importance of support
3. Develop an understanding of the role of system in sustaining community
government and politics in health care programs or projects.
delivery;
4. Develop skills in situational analysis,
leadership, development and reflective
practice;
5. Apply various methods needed in
translating and interpreting
health-related problems seen in the
community;
6. Identify approaches to organizing,
based on theories, strategies, impact
and experiential learning;
7. Foster collaboration with the people to
achieve community goals;
8. Demonstrate/appreciate how linkages
between community and health care
agencies be done for the continuity of
community projects/programs;
9. Construct a plan to evaluate community
service interventions;
10. Discuss the importance of support
PRIORITIZATION OF PROBLEMS

SCHEDULE OF ACTIVITIES
RESEARCH GENERATION/FUNDRAISING
CONCEPT AND MEANINGS
● It is a science because it requires a
systematic way of doing it
● It is a process since it involves steps or
procedures on how to go about it
● It is an art because it takes one’s
creativity to come up with new ideas to
convince a prospective donor to give;
and, different people can employ
different “tricks” or ways and means to
get what they are asking for.
● It is a profession that is why there are
lot of professional fundraisers hired by
different organizations just to source
funds
BASIC ELEMENTS OF FUNDRAISING AND
THEIR MEANINGS
● OBJECTIVES/PURPOSE
○ The requesting party or
prospective user of funds
■ If you were to give funds to
anyone or to any
 organization, what else will
you look for? What is the
track record of the
organization
○ The prospective donor-provider
of funds
■ Depends on the purpose
and amount needed
■ Request matches priority
thrusts of the donor
○ The process of exchange or
transaction between the
grantee/recipient of funds and the
grantor/provider of the funds
■ The quality of transaction
of “fit” between you as
fund sources and your
donor or granting
organization spells mutual
satisfaction over the
process
○ The funds involved in the actual
usage of such funds
PRINCIPLES: SUCCESSFUL FUNDRAISING
(Chamala et al, 1990)
● A cause that is worthy and far greater
importance than the present specific
needs of the institution; and/or ‘a cause
greater than one’s own.’
● Needs which are genuine and can be
explained in a convincing way so that
the case of support is sound and
practical, and has specific objectives
that are attractive to the majority of
potential members
○ Kailangan kabalo ta sa needs sa
tao and dapat practical
● Leaders who are dedicated, willing to
accept membership at the top level are
prepared to devote considerable time
and effort to carry out the program and
to enjoin new members.
○ Labor of love
○ Need i explain na this is non
profit
● An identifiable constituency whose
interest and imagination may be roused
and cultivated to create the desire to
support the cause.
○ Get members na same mo tanan
ug goal
● A favorable climate of opinion which
may have been created, so that an
informed constituency will recognize that
an appeal will satisfy a vital and urgent
need and feel disposed to support it.
○ Dapat harmonious ang
relationship para favorable ang
climate
○ Dili dapat si leader lang ang
sigeg ambot
BASIC TRUTHS OF FUNDRAISING
1. Organizations are not entitled to
support; they must earn it
2. Successful fundraising is not magic; it
is simply hard work on the part of people
who are thoroughly prepared
3. Fundraising is not raising money; it is
raising friends
a. Gain connections
b. Basi makita daw si mr. right
4. You do not raise money by begging for
it; you raise it by selling people on you
organization
5. You don’t wait for the right moment to
ask; you ask now
6. You don’t decide today to raise money
and then ask for it tomorrow: It takes
 time, patience, and planning… wa ○ Talandang is situated at
nahuman sorry approximately 7.1524, 125.5094,
7. Prospects and donors are not cash in the island of Mindanao.
crops waiting to be harvested; treat Elevation at these coordinated is
them as you would customers in a estimated at 204.4 meters or
business. 670.6 feet above mean sea level
a. Money does not grow from trees
WE RAISE MONEY FROM PEOPLE WHO:
● Have it
● Can afford to give
● Are sold on the benefit of what you are
doing
● Wouldn't have given it to us unless we
had asked
● Receive appreciation and respect for
their gifts
It doesn't take a genius to raise money. The
money is a combination of common sense,
hard work, preparation, courtesy,
commitment, enthusiasm, understanding,
and a belief in what you are asking others to
support.
COMMUNITY DEVELOPMENT: TALANDANG
BARANGAY PROFILE
● Talandang is a barangay in Tugbok,
Davao City. its population as determined
by the 2015 Census was 3,392. This
represented 0.21% of the total
population of Davao City
● Demographics
○ According to the 2015 Census,
the age group with the highest
population in Talandang is 5 to 9,
with 403 individuals. Conversely,
the age group with the lowest
population if 80 and over, with 17
individuals
● Location
PRINCIPLES AND ACTIVITIES OF
COMMUNITY ORGANIZING
● A social development approach that
aims to transform the apathetic,
individualistic, and voiceless poor into
dynamic, participatory and politically
responsive community
COMMUNITY ORGANIZING PARTICIPATORY
ACTION RESEARCH (COPAR)
● A collective, participatory,
transformative, liberative, sustained and
systematic process of building people’s
organization by mobilizing and
enhancing the capabilities and
resources of the people for the
resolution of their issues and concerns
towards effecting change in their
existing oppressive and exploitative
conditions (1994 National Rural CO
Conference)
○ Dapat daw mulihok ang
community
● A process which a community
identifies its needs and objectives
develops confidence to take action in
respect to them and in doing so,
extends and develops cooperative and
 collaborative attitudes and practices in ○ Which begins with small, local
the community (Ross 1967) and concrete issues identified by
○ Learn how to identify their own the people and the evaluation
needs and reflection of and on the
● A continuous and sustained process action taken by them
of educating the people to understand ● CONSCIOUSNESS-RAISING
and develop their critical awareness of ○ Experiential learning is central to
their existing conditions working with the COPAR process because it
people collectively and efficiently on places emphasis on learning that
their immediate and long-term problems emerges from concrete action
and mobilizing the people to develop and which enriches succeeding
their capability and readiness to respond action.
and take action on their immediate ● COPAR IS PARTICIPATORY AND
needs towards solving their long-term MASS-BASED
problems (CO: A Manual of Experience; ○ Because it is primarily directed
PCPD) towards and biased in favor of
○ Maski mag change rotation na the poor, the powerless, and the
kay mag continue gihapon ang oppressed
project ○ Not about the leaders,
○ Kaya mag withstand ug any organizers, etc. ang main
circumstance character dapat kay ang
IMPORTANCE OF COPAR community
● COPAR is an important tool for ● COPAR IS GROUP-CENTERED AND
community development and people NOT LEADER-ORIENTED
empowerment as this helps the ○ Leaders are identified, emerge,
community workers to generate and are tested through action
community participation in development rather than appointed or selected
activities. by some external force or entry
● COPAR prepares people/clients to ○ This project is not about kay
eventually take over the management kapitan, purok leader, and
of a development program(s) in the kagawad
future. PHASES OF COPAR
● COPAR maximizes community 1. Pre-Entry Phase
participation and involvement a. The initial phase of the organizing
● Community resources are mobilized for process where the
community services community/organizer looks for
PROCESS/METHODS USED communities to serve/help.
● A PROGRESSIVE CYCLE OF b. It is the simplest phase in the
ACTION-REFLECTION-ACTION community organizing process in
 terms of expected outputs, b. This phase signals the actual
activities, and strategies entry of the CO/Community
c. Most complex phase in terms of Worker into the community
actual outputs, activities and c. Social preparation phase
strategies, and time spent on it i. Integration with the
Recommended Activities: community
● Statement of objectives, a realization of ii. Sensitization of the people
community immersion principles on critical events in their
● Laying out the site criteria life
● Site selection iii. Motivating them to share
● Develop survey tools their dreams and ideas on
● Meeting and courtesy call to the local how to manage their
government unit of the selected site concerns
● Courtesy call to the barangay level iv. Mobilizing them to take
● Meeting with the “will be” foster parents collective action
of the health care students. d. Most crucial phase since project
● Setting the target date of immersion, site varies from each others, no
exposure, and departure single strategy is best employed
Criteria for site selection e. Its success depends on how
● The area must be economically much the project implementers
disadvantaged have integrated with the
● Must have a relative concentration of community people, their
poor families understanding of the place &
● Must have a population of ten thousand events, and their willingness &
and above readiness to commit themselves
● As much as possible o hospital but with towards the program
RHU and BHS Recommended Activities:
● Accessibility of transportation must be ● Inform/ update local government leader
considered Barangay officials of the selected site
● No strong resistance from the ● Meeting with foster parents
community ● Appreciating the environment
● Peace and order problem must be ● Meeting with community officials and
considered residents
● Rural community will be a top priority ● General assembly
● Preferably with adjacent barangays ● Actual survey
2. Entry Phase ● Analysis of data
a. Immersion phase ● Core group formation
● Self-awareness and leadership training /
Action planning
 3. Organization-Building Phase ● Meeting with the organizational leaders
a. The formation of more formal ● Evaluation of the programs
structures & inclusion of more ● Re-implementation of the program
formal procedure of planning, ● Education and training
implementing and evaluating ● Networking and linking
community wide activities ● Conducting mobilization on health and
b. Phase where the organized development concerns
leaders or groups are being given ● Implementation of livelihood projects
training (formal/informal) to ● Developing secondary leaders
develop their ASK in managing 5. Phase Out
their own concerns/programs a. The phase when the health care
Recommended Activities: workers leave the community to
● Meeting with officials be independent
● Identifying problems b. This phase should be stated
● Spreading awareness and soliciting or during the entry phase to prepare
suggestions the people.
● Analysis of the presented solution c. The organization built should be
● Planning of the activities ready to sustain the test of the
● Organizing the to build their own community itself because the real
organization (election of officers) evaluation will be done by the
● Registration of the organization (legality residents of the community
purposes) Recommended Activities:
● Link with LGUs or NGOs for financial ● Leaving the immersion site
and technical assistance ● Documentation
● Evaluation IDEAL COPAR
4. Sustenance & Strengthening Phase
1. Time Frame &
a. Community organization has Mode of Exposure
already been established
2. Methodology and
b. Different committees that were survey form
created in the previous phase are 3. Number of
already expected to be recipients
functioning by way of planning, 4.Organization-buildi
implementing, & evaluating their ng phase

own programs, with guidance 5.Problem Statement

from the community health org. 6. Implementation
c. Projects implementers prepare
7. Evaluation
the community for their eventual
PHASE OUT
COMMUNITY DIAGNOSIS
Recommended Activities:
 ● Process use… community will respond to
THE COMMUNITY DIAGNOSIS PROCESS the health risk or problem
● “A means of examining aggregate and
social statistics in addition to the
knowledge of the local situations, in
order to determine the health needs of
the community”
TYPES OF COMMUNITY DIAGNOSIS
1. Comprehensive
a. Aims to obtain general
information about the community
or a certain population group
2. Problem-Oriented
a. Type of assessment that
responds to a particular need
GANTT CHART

OMAHA SYSTEM
● Applications for Community Health
SCHEMES IN STATING COMMUNITY
Nursing
DIAGNOSIS
● This is the oldest of the nursing
1. NANDA
classifications and was developed in the
2. Shuster and Goeppinger (2004)
1970s by Karen Martin
a. Three Part Statement
● It was designed for nurses in community
i. The health risk or specific
and public health services
problem to which the
community is exposed
ii. The specific aggregate or
community with whom the
nurse will be working to
deal with the risk or
problem
iii. Related factors that
influence how the