Child Care and Home Management of

INTEGRATED Common Diseases.

MANAGEMENT OF HUMAN RESOURCES

A. Clinical Instructors (CI’s)
CHILDHOOD ILLNESS
(RLE) DUVALL’S DEVELOPMENTAL STAGES
• Beginning Family
• Child Bearing Family (Birth – 2 ½ years
old)
RELATED LEARNING EXPERIENCE • Families with Pre-School Children (2 ½ to
TEACHING FACILITIES 6 years old)
• Families with School – aged Children (6 to
13 years old)
A. Fundamental laboratory thru online
• Families with Teenagers and young adults
B. Agencies (to orient students about (13 to 20 years old)
clinic activities thru online teaching) • Families launching young adults (1st to
1. Agdao Health Center last child living home)
• It is government facility which caters • Middle aged parents (empty nest to
health services to the people in Agdao, retirement)
Davao City. It has the most numbered • Aging Family ( retirement to death of both
patients enrolled in one of the programs spouses)
of DOH, the National Tuberculosis
Program. (ENUMERATE THE TASK UNDER EACH
2. Jacinto Health Center STAGE AND EXPLAIN THE TASK)
• It is a government facility which caters to
eight (8) barangays, Barangay 32 to FAMILY COPING INDEX
Barangay 43. 1. Physical Independence
3. Miniforest Health Center 2. Therapeutic Competence
• It is a government facility that covers the 3. Knowledge of Health Condition
biggest number of barangays in Davao 4. Application of the Principles of General
City. It caters health services to the Hygiene
people Davao. It is the Animal Bite Center 5. Health Attitudes
of Davao City. 6. Emotional Competence
4. Piapi Health Center 7. Family Living
• It is a satellite health facility under the 8. Physical Environment
management of Miniforest Health Center. 9. Use of Community Facilities
The center has Midwife and Barangay
Health Workers who cater to the need of
TYPOLOGY OF NURSING PROBLEMS IN
people in five (5) barangays, namely
Barangay 27 to barangay 31. FAMILY NURSING PRACTICE
5. San Pedro College Health Center
• It is a private health facility owned by San FIRST LEVEL ASSESSMENT
Pedro College that caters to the need of 1. Presence of Wellness Condition-stated
people in Agdao, Davao City specifically, as…
Barangay Duterte. The following services Potential or Readiness – a clinical or
offered are: Laboratory services, well nursing judgement about a client in
child clinic and immunization, transition from a specific level of wellness
consultation from Monday to Friday, or capability to a higher level.
Nutrition program, Dressing, Minor Wellness Potential – is a nursing
surgery (Incision and drainage, operation judgement on wellness state or condition
tuli) Suture removal, Rehabilitative based on client’s performance, current
services, Physical Therapy, Dental competencies, clinical data or explicit
Services, Mother Class, Maternal and expression of desire to achieve a higher

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 level of state or function in a specific area HERBAL MEDICINE
on health promotion and maintenance. • As part of primary health care and
2. Presence of Health Threats because of the increasing cost of drugs,
• Conditions that are conducive to disease the use of locally available medical plants
and accident or may result to failure to and herbs in the Philippines backyard and
maintain wellness or realize health field have been found to be effective in the
potential. treatment of common ailments as
-Presence of risk factors of specific attested to by the National Science
disease (e.g lifestyle disease, Development Board, other government
metabolic syndrome) and private agencies/persons engaged in
-Threat of cross infection from research.
communicable disease case. • The DOH is advocating the use of the
-Family size beyond what family following ten herbal plants.
resources can adequately provide.
3. Presence of Health Deficits Herbal Medicine
• Instances of failure in health RA 8423
maintenance
A. Illness states, regardless of REPUBLIC ACT 8423
whether it is diagnosed or - Otherwise known as TAMA
undiagnosed by medical • TRADITIONAL AND ALTERNATIVE
practitioner. MEDICINE ACT OF 1997
B. Failure to thrive/develop according • An act creating the Philippine Institute of
to normal rate. traditional and Alternative Health Care
C. Disability – whether congenital or (PITAHC) to accelerate the development
arising from illness; of traditional and alternative health care
transient/temporary. in the Philippine s, providing for a
4. Presence of stress points/foreseeable traditional and alternative health care
crisis situations development fund and for other
• Anticipated periods of unusual demand purposes.
on the individual or family in terms of
adjustment/family resources. Example of REMINDERS ON THE USE OF HERBAL MEDICINE
this include: • Avoid the use of insecticides as these may
A. Marriage leave poison on plants.
B. Pregnancy, labor, puerperium • In the preparation of herbal medicine, use
C. Parenthood a clay pot and remove cover while boiling
D. Additional member – e.g. at low heat.
newborn, lodger • Use only the part of the plant being
E. Abortion advocated.
F. Entrance at school • Follow accurate dose of suggested
preparation.
• Use only one kind of herbal plant for each
type of symptoms or sickness.
• Use only half the dosage prescribed for
fresh parts like leaves when using dried
parts.
• Decoctions loose potency after some
time. Dispose of decoctions after one day.
To keep fresh during the day, keep
lukewarm in a flask or thermos.
• Leaves, fruits, flowers or nuts ust be
mature before harvesting. Less medical
substances are found in young parts.
• Stop giving the herbal medication in case
untoward reaction such as allery occurs.
• If signs and symptoms are not relieved
after 2 or 3 doses of herbal medication,
consult a doctor.
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SAMBONG
Scientific name: Blumea balsamifera
• A plant that reaches 1 ½ to 3 meters in
height with rough hairy leaves.
• Young plants around mother plant may be
separated when they have three or more
leaves.
Uses:
• Anti-edema
• Diuretic
• Anti-urolithiasis
Preparation:
• Boil chopped leaves in water for 15 min.
until one glassful remains. Cool and
strain.
• Divide decoction into 3 parts. Drink one
part 3 times a day.
Note: Sambong is not a medicine for kidney
infection.
AKAPULKO
Scientific name: Cassia alata
• Ringworm Bush
• Bayas-bayasan
• This plant is about 1 to 2 meters tall
• The leaves are embraced with 8 to 20
oblong elliptical shaped leaflets
• It has flowers with oblong sepals
Uses:
• Anti-fungal: Tinea Falava, Ringworm,
Athlete’s foot and scabies
Preparation:
• Fresh, matured leaves are pounded
• Apply as a soap to the affected part 1 to 2
times a day.
NIYUG-NIYOGAN
Uses:
• Anti-helmintic (used to expel parasitic
worms.)
Preparation:
• Seeds of niyug-niyogan are eaten raw
two hours before the patient’s last meal
of the day.
• Adults may rake 10 seeds; children 4 to 7
years of age may eat up to four seeds
only; ages 8 to 9 may take six seeds and
seven seed may be eaten by children 10
to 12 years old.
• Not to be given to children below four
years old.
TSAANG GUBAT
Scientific name: Carmona retusa
• Forest tea or Wild tea
• A shrub with small, shiny nice-looking
leaves that grows in wild uncultivated
areas and forests.
Uses:
• Diarrhea
• Stomach ache
Preparation:
• Boil the following amount of chopped
leaves in 2 glasses of water for 15
minutes of until amount of water goes
down to 1 glass. Cool and strain.
• Wash leaves and chop. Boil chopped
leaves in 1 glass of water for 15 minutes.
Cool and filter/strain and drink.
AMPALAYA
Scientific Name: Momordica charantia
• Bitter Gourd or Bitter melon
• A climbing vine with tendrils that grow
up to 20 cms long.
• Leaves are heart-shaped, which are 5 to
10 cms in diameter
• Fruits have ribbed and wrinkled surface
that are fleshy green with pointed ends
at length and has a bitter taste.
Uses:
• Lowers blood sugar levels
• Diabetes Mellitus (Mild-non insulin
dependent)
Preparation:
• Gather and wash young leaves very well.
Chop. Boil 6 tablespoons in two glassfuls
of water for 15 minutes under low fire.
Do not cover pot. Cool and strain. Take
one third cup 3 times a day after meals.
LAGUNDI
Scientific Name: Vitex negundo
• 5 Leaved-Chaste Tress
• A shrub growing wild in vacant lots and
waste land.
• Matured branches are planted.
• The flowers are blue and bell-shaped.
• The small fruits turn black when ripe. It
is better to collect the leaves when are
in bloom.
Uses:
• Asthma and cough
• Fever, Dysentery, Colds & pain
• Skin diseases and wounds
• Headache
• Rheumatism, sprain, contusions, insect
bites.
• Aromatic bath for sick patients
Preparation:
• For Asthma, cough and fever, boil
chopped raw fruits or leaves in 2 glasses
C.E.B
 of water left for 15 minutes until the
water left in only 1 glass (decoction).
Strain.
• For dysentery, colds and pain, boil a
handful of leaves and flowers in water to
produce a glass full of decoction 3 times
a day.
• For skin diseases (dermatitis, scabies,
ulcer, eczema) and wounds, prepare a
decoction of the leaves. Wash and clean
the skin/wound with decoction
• For headache, crushed leaves may be
applied on the forehead.
• For rheumatism, sprain, contusions and
insect bites, pound the leaves and apply
on the affected part.
ULASIMANG BATO
Scientific Name: Peperomia pellucida
• Silver bush or Shiny bush
• Pansit-pansitan
• A weed with heart-shaped leaves that
grow in shady parts of the garden and
yard.
Uses:
• Lowers uric acid (Rheumatism and Gout)
Preparation:
• Wash the leaves well. One and a half cup
leaves are boiled in two glassfuls of
water over low fire. Do not cover pot.
Cool and strain. Divide into three parts
and drink each part 3 times a day.
• May also be eaten as salad. Wash the
leaves well. Prepare one and a half cups
of leaves (not closely packed). Divide
into three parts and take as salad 3
times a day.
BAWANG
Scientific Name: Allium sativum
• Garlic
• A low herb and grows up to sixty cms
high
• Leaves are flat and linear
• Bulbs consist of several tubers
Uses:
• For hypertension
• Toothache
• Lowers cholesterol levels in the blood
Preparation:
• May be fried, roasted, soaked in vinegar
for 30 minutes, or blanched in boiled
water for 5 minutes. Take two pieces
three times a day after meals.
• For toothache, pound a small piece and
apply to affected part.
Caution: Take on full stomach to prevent stomach
and intestinal ulcers.
BAYABAS
Scientific Name: Psidium guajava
• Guava
• A tree about 4 to 5 meters high with tiny
white flowers with round or oval fruits
that are eaten raw.
Uses:
• For washing wounds
• For toothache
• For diarrhea
Preparation:
• Warm decoction is used for gargle.
• Freshly pounded leaves are used for
toothache. Guava leaves are to be
washed well and chopped. Boil for 15
minutes at low fire. Do not cover pot.
Cool and strain before use.
YERBA BUENA
Scientific Name: Mentha cordifelia
• Peppermint
• A small multi-branching aromatic herb.
The leaves are small, elliptical and with
toothed margin.
• The stem creeps to the ground, and
developed roots.
Uses:
• For pain in different parts of the body as
headache, stomach ache
• Rheumatism, arthritis and headache
• Cough and cold
• Swollen gums & toothache
• Menstrual and gas pain
• Nausea and fainting
• Insect bites & Pruritus
Preparation:
• For pain in different parts of the body,
boil chopped leaves in 2 glasses of water
for 15 minutes. Cool and strain.
• For rheumatism, arthritis and headache,
crush the fresh leaves and squeeze sap.
Massage sap on painful parts and
eucalyptus.
• For cough and cold, get about 10 fresh
leaves and soak in a glass of hot water.
Drink as tea. Act as an expectorant.
• For toothache, cut fresh plant and
squeeze sap. Soak a piece of cotton in
the sap and insert this in aching tooth
cavity. Mouth should be rinsed by
gargling salt solution before inserting
the cotton.
To prepare the salt solution: add 5g of table salt
to one glass of water
C.E.B
 • For Menstrual pain and gas pain, soak a
handful of leaves in a glass of boiling
water. Drink infusion. It induces
menstrual flow and sweating.
• For nausea and fainting, crush leaves
and apply at nostrils of patient.
• For insect bites, crush leaves and apply
juice on affected part or pound leaves
until paste-like and rub this on the
affected part.
NATIONAL TB PROGRAM
VISION: A Country where TB is no longer in a public
health problem
GOAL: Cure at least 85% of the new sputum smear
positive TB cases discovered
Detect at least 70% of the estimated new sputum
smear positive cases
OBJECTIVES
• Improvement of access to and quality of
services
• Enhancement of patient’s health seeking
behavior
• Sustainability of support for TB control
activities
• Strengthening management of TB control
services at all levels
CASEFINDINGS
• Is a method of identifying and diagnosing TB
cases among individuals suspected signs
and symptoms of TB.
• Fundamental to case finding is the detection
of infectious cases through DSSM.
Objective:
_________________ - is the principal diagnostic
method accepted by the NTP
❑ Provides a definitive diagnosis of active TB
❑ The procedure is simple
❑ It is economical, and
❑ A microscopy center can be put up even in
remote areas
DSSM result severe as bases for categorizing TB
symptomatics according to standard case definition
DSSM is used to:
• Monitor progress of patients with sputum
smear positive TB while they are receiving
anti TB treatment, and
• Confirm cure at the end of the treatment
ACTIVE CASE FINDING – A healthy worker’s
purposive effort to find TB cases
(Among TB symptomatics in the community) who do
not consult with personnel in a DOTS facility
PASSIVE CASE FINDING – finding cases among
TB symptomatics who present themselves in a DOTS
facility.
POLICIES
• DSSM shall be the primary diagnostic tool in
NTP case finding
• All TB symptomatics identifies shall be
asked to undergo DSSM for diagnosis before
start of the treatment
• The only contraindication for DSSM is
hemoptysis.
• Pulmonary TB symptomatics can only
undergo other diagnostic test (such as
cxr/culture) if necessary, only after they
have undergone DSSM with 3 sputum
specimens
• No TB diagnosis shall be made based on the
results of chest X ray examination alone.
PPD result should not also be used as bases
for TB diagnosis
C.E.B
IDENTIFYING TB SYMPTOMATICS
✓ Identify TB symptomatics consulting at the
DOTS facility
Signs and symptoms:
1. Cough for 2 weeks or more
2. Nausea
3. Fever
4. Loss of appetite
5. Chills / Night sweats
6. Other symptoms:
• Motivate TB symptomatics to undergo DSSM
• Record detail of each specimen submission
(name of pt., date of submission, and result)
• Encourage household members of identified
TB cases, who are also TB symptomatics to
undergo DSSM
COLLECTION AND TRANSPORT OF
SPUTUM SPECIMEN
 Submit three sputum specimen within 2
days. If quality sputum is not collected
within 2 days the patient is given 1 week
to complete the three specimen. If the
patient fails to complete the three
specimen collection within one week,
another three set of three should be
collected
a. First spot specimen / On the spot –
is collected at the time of
consultation or as soon as the TB
symptomatics is identified
b. Early Morning Specimen – first
sputum produced early in the
morning immediately after waking
up. It is collected by the patient
according to instructions given by
the DOTS facility staff.
c. Third specimen or Second spot
specimen – is collected when the TB
symtomatics somes back to the
DOTS facility to submit the second
specimen
INSRTUCTIONS ON HOW TO PRODUCE
QUALITY SPUTUM
• Rinse mouth with water
• Breathe deeply, hold breath, then exhale
slowly. Repeat the entire sequence twice,
• Cough strongly at the height of deep
inspiration after inhaling deeply for the
third time and spit the sputum in the
container
INTERPRETATION OF SPUTUM
RESULTS/LABORATORY DIAGNOSIS
• Smear Positive – at least 2 positive sputum
smear results
• Doubtful – only 1 positive out of 3 sputum
specimens. ACTION TO TAKE: Request for
another set of 3 sputum specimens
Result:
1. If at least 1 specimen from the second set
specimen is positive = diagnosis is positive
2. If all 3 specimens from the second set of
specimens are negative = diagnosis is
negative
NOTE: The specimen out of the smear (+) results
with highest number is the final AFB quantification
• Smear Negative – all three sputum smear
results are negative
Decision on Patient’s Diagnosis Based on Lab
Results
1. IF POSITIVE – refer to physician for
assessment and initiation of treatment
2. IF DOUBTFUL – ask patient to submit
another 3 sputum specimens within one
week
3. IF NEGATIVE – re-assess negative with
persistent symptoms, refer patient for CXR,
if CXR finding are suggestive of TB, refer to
TBDC
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CASE HOLDING
• Is the procedure which ensure that patients
TWO FORMULATIONS OF ANTI TB DRUGS
complete their treatment
• The shortest duration of treatment is 6 mos.
• Treatment compliance is necessary to cure
TB and avoid development of drug
resistance
Objective: Effective and complete treatment of
TB cases, especially pulmonary sputum smear
positive cases
5. TRANSFER IN – transferred to another
facility adopting NTP policies with proper
referral slip to continue treatment
1. Fixed Dose Combination (FDC’s) – 2 or more
first time anti TB drugs are combined in one
tablet
2. Single Drug Formulation (SDF) – each drug
is prepared individually

DIRECTLY OBSERVED TREATMENT – is a

strategy developed to ensure treatment
compliance providing constant an motivational
supervision to TB patients
• DOT works by having a responsible
person referred to as TREATMENT
PARTNER, watch the TB pt. take
medicines everyday during the whole
course of treatment
• QUALIFIED TREATMENT PARTNERS
A. DOTS facility staff (midwife or nurse)
B. Trained community member (BHW, Local
gov’t official, or former TB pt)
C. Family member
CLASSIFICATION OF TB
• Pulmonary TB
• Extra Pulmonary TB

TYPES OF TB CASES
1. NEW – has never had treatment for TB or
who has taken anti TB drugs for less than
one month
2. RELAPSE – previously treated for Tb,
declared cured or treatment completed, and
is diagnosed with bacteriologically positive
(smear or culture) TB
3. TREATMENT FAILURE – a patient who, while
on treatment, is sputum smear positive at
five months or later during the course of
treatment
4. RETURN AFTER DEFAULT (RAD) – returns to
treatment with positive bacteriology
following interruption of treatment for 2
months or more
C.E.B
ANTI TB DRUGS AND ITS MINOR ADVERSE
REACTIONS
1. RIFAMPICIN – GI intolerance, orange colored
urine, flu like symptoms, mild skin reaction
2. ISONIAZID – peripheral neuropathy, GI
intolerance, mild skin reactions
3. PYRAZINAMIDE – hyperuricemia and mild
skin reactions
4. ETHAMBUTOL – optic neuritis
5. STREPTOMYCIN – ototoxicity pain on the
injection site

TREATMENT OUTCOME
1. CURED
2. COMPLETE TREATMENT
3. DIED
4. FAIL
5. DEFAULT
6. TRANSFERRED OUT

C.E.B