COMMUNITY FIELD VISIT

(FAMILY HEALTH ADVISORY)

Ashish Guragain

62046 (SN:33)
 DEMOGRAPHIC PROFILE OF FAMILY
Type of family:Three generation
Number of family members:4

RELATIONSHIP
MARITAL
NAME AGE SEX TO HEAD OF EDUCATION OCCUPATION
STATUS
FAMILY

Chandra Maya
31 Female Head Married Grade 6 Farmer
Danuwar

Ramesh Security guard

34 Male Husband Married Grade 8
Danuwar (Malaysia)

Muna Danuwar 9 Female Daughter Unmarried Grade 3 Student

Dalli Danuwar 74 Female Mother in law Widow Illiterate -

Housing condition
 Poor sanitation and living condition.
 2 rooms( Bed room and kitchen)
 Separate toilet, animal shed attached to house
 Inadequate lighting and ventilation, no cross ventilation
Economic Status
 2 working members in the family
 Average monthly income : Rs 20000
 Average monthly expenditure: Rs 15000
 Monthly saving : Rs 5000
 NUTRITIONAL STATUS

 Total calorie requirement :5880 kcal

 Total calorie consumption :6683 kcal
 Calorie excess: 803 kcal
 Micronutrient deficiency:Iron,Calcium, vitamin A, B1, B2,C
 Risk of nutritional deficiency diseases-
Iron deficiency anemia
Osteoporosis
Osteopenia
Night blindness
Beri beri
Scurvy
 HEALTH PROBLEM IN FAMILY
RESPIRATORY PROBLEM- Dalli Danuwar
 History(chief complaints)
 Cough(frequently during morning)
 Sputum production
 Shortness of breath(initially during work but now even during
walking on level ground)
 No history of smoking
 Examination:
 Wheezing
 Bilaterally decreased air entry
 Differential Diagnosis
 Chronic obstructive pulmonary disease(COPD)
 Asthma
 Tuberculosis
 Bronchiectasis
 Lung cancer
CHRONIC OBSTRUCTIVE PULMONARY DISEASE(COPD)

It is a preventable and treatable disease,

characterized by persistent airflow
limitation that is usually progressive and
associated with an enhanced chronic
inflammatory response in the airways and
the lung to noxious particles or gases.
Components of COPD
RISK FACTORS
 BURDEN OF COPD
 World-Prevalence of 251 million cases(2016)
 3 million deaths in 2012(6% of all death)
 4th leading cause of death in world
 Globally, 10%–20% of the population older than 40
years (an estimated 80 million) are COPD sufferers,
resulting in more than 3 million deaths each year.
 COPD is projected to be the third leading cause of
death by the year 2020
 Situation in Nepal
 In Nepal, COPD accounts for 43% of the non communicable
disease burden, and 2.56% of hospitalizations.

 In Nepal, more than 85% of households (98% in rural areas)

still rely on biomass fuel.

 Nepalese women are at higher risk of developing COPD

through exposure to indoor air pollution; additionally, about
15% of women also smoke tobacco.
MANAGEMENT
1. Reducing exposure to noxious particles and gases
2. Bronchodilators
3. Corticosteriods
4. Oxygen therapy

PREVENTION
A)Primordial prevention:
• Discourage smoking.
• Discourage the use of biomass fuel.

B)Primary prevention
-Avoid tobacco exposure(both active and passive measures) and toxic fumes
-Smoking cessation measures(pharmacotherapy & counselling)
-Reduce exposure in workplace
C)Secondary prevention
-influenza and pneumococcal vaccination(prevent infection)
-mass screening,early detection and treatent
 IMPACT OF COPD
Social impact:
Reduction on working capabilities causes emotional and financial impact
restricting them on reaching their goals.
Physical limitation: Unable to perform strenuous activities.
Poor quality of life:
Poor health leading to increased expenditure on health .
Psychological problems:
Frequent feeling of anxiety , depression, isolation.
Impact on family:
Increased physical, social and responsibilities.
 ADVICE TO FAMILY
 Visit health care center for investigation,diagnosis &
treatment
 Avoid exposure to passive smoking
 Construct a kitchen separated from other rooms
 Avoid exposure to indoor & outdoor pollutants
 Intake of healthy diet
 Regular medical check up
THANK YOU