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FAMILY CARE PLAN The nursing care plan focuses on actions which are designed to solve or minimize existing

problem. The plan is a blueprint for action. The core of the plan are the approaches, strategies, activities, methods and materials which the nurse hopes will improve the problem situation. The nursing care plan is a product of a deliberate systematic process. the planning process is characterized by logical analyses of data that are put together to arrive at rational decisions. The interventions the nurse decides to implement are chosen from among alternatives after careful analysis and weighing of available options. The nursing care plan, as with all plans, relates to the future. It utilizes events in the past and what is happening in the present to determine patterns. It also projects the future scenario if the current situation is not corrected. The nursing care plan is based upon identified health and nursing problems. The problems are the starting points for the plan, and the foci of the objectives of care and intervention measures. The nursing care plan is a means to an end, not an end in itself. The goal in planning is to deliver the most appropriate care to the client by eliminating barriers to family health development. Nursing care planning is a continuous process, not a oneshot-deal. The results of the evaluation of the plans effectiveness trigger another cycle of the planning process until the health and nursing problems are eliminated. TSAANG GUBAT -stomach ache Preparation & Use:

Thoroughly wash the leaves of tsaang gubat in running water. Chop to a desirable size and boil 1 cup of chopped leaves in 2 cups of water. Boil in low heat for 15 to 20 minutes and drain. Take a cupful every 4 hours for diarrhea, gastroenteritis and stomach pains. Gargle for stronger teeth and prevent cavities. Drink as tea daily for general good health. The Alma Ata Conference defines Primary Health Care as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to them, through their full participation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and selfdetermination. It forms an integral part of both the countrys health system, of which it is the central function and the main focus and of the overall social and economic development of the community. Goal: The global goal as stated in the Alma Ata Declaration is Health for All by the year 2000 through self-reliance. Health begins at home, in schools and in the workplace because it is there where people live and work that health is made or broken. It also means that people will use better approaches than they do now for preventing diseases and alleviating unavoidable disease and disability and have better ways of growing up, growing old and dying gracefully. It also means that here will be even distribution among the

population of whatever resources for health are available. It means that essential health services will be accessible to all individuals and families in an acceptable and affordable way. Principles and Strategies: Accessibility, Availability, Affordability and Acceptability of Health Services Strategies: Health services delivered where the people are Use of indigenous/resident volunteer health worker as a health care provider with a ratio of one community health worker per 10-20 households Use of traditional (herbal medicine) with essential drugs. Provision of quality, basic and essential health services Strategies: Training design and curriculum based on community needs and priorities. Attitudes, knowledge and skills developed are on promotive, preventive, curative and rehabilitative health care. Regular monitoring and periodic evaluation of community health workers performance by the community and health staff. Community Participation Strategies: Awareness, building and consciousness raising on health and health-related issues. Planning, implementation, monitoring and evaluation done through small group meetings (10-20 households cluster) Selection of community health workers by the community. Formation of health committees. Establishment of a community health organization at the parish or municipal level.

Mass health campaigns and mobilization to combat health problems. Self-reliance Strategies Community generates support (cash, labor) for health programs. Use of local resources (human, financial, material) Training of community in leadership and management skills. Incorporation of income generating projects, cooperatives and small scale industries. Recognition of interrelationship of health and development Strategies: Convergence of health, food, nutrition, water, sanitation and population services. Integration of PHC into national, regional, provincial, municipal and barangay development plans. Coordination of activities with economic planning, education, agriculture, industry, housing, public works, communication and social services. Establishment of an effective health referral system. Social Mobilization Strategies Establishment of an effective health referral system. Multi-sectoral and interdisciplinary linkage. Information, education, communication support using multi-media. Collaboration between government and nongovernmental organizations. Decentralization Strategies Reallocation of budgetary resources. Reorientation of health professional and PHC. Advocacy for political and support from the national leadership down to the barangay level.

8 Essential Health Services in Primary Health Care (ELEMENTS) E Education for Health L Locally endemic disease control E Expanded program for immunization M Maternal and Child Health including responsible parenthood E Essential drugs N Nutrition T Treatment of communicable and noncommunicable diseases S - Safe water and sanitation Fourmula One for Health is the Philippine Department of Health's implementation framework for reforms in the health sector covering the period from 2005 to 2010. It seeks to achieve better health outcomes, a more responsive health system and more equitable health care financing. These end goals are consistent with the health system goals of the World Health Organization, the Millennium Development Goals and the Medium Term Philippine Development Plan. The Functional Management Structure of the F1 A functional management structure has been institutionalized across the different levels of FOURmula One implementors to ensure effective and efficient operations4. Under a decentralized context, there are two general functions retained by the DOH: (1) Governance and Stewardship over the Health Sector, and (2) Health Policy and Standards Development (and Technical Assistance). DOH units and attached agencies were grouped together under the following

reform clusters and organized according to F1 functions and roles. GMA 50 is the name of the Department of Health (DoH) undertaking to effect the SONA pledge of President Gloria Macapagal-Arroyo. The primary goal of the project is to ensure that affordable, high quality, safe and effective drugs and medicines are always available, especially to the poor Telehealth is the delivery of health-related services and information via telecommunications/technolog ies using videoconferencing , radio programs, television Hospice: A program or facility that provides special care for people who are near the end of life and for their families. Community diagnosis generally refers to the identification and quantification of health problems in a community Chloroquine is the drug of choice for the prophylaxis and treatment of sensitive malaria species during pregnancy. Chloroquine should only be given during pregnancy when need has been clearly established. 1.census - gathering the bulk of community data (every five years) What is "Iligtas sa Tigdas ang Pinas"? - A measles supplemental immunization activity (SIA) for a measles-free Philippines. This is a sequel to the 1998, 2004 and 2007 mass measles campaigns. MeaslesRubella(German Measles) vaccines shall be provided during immunization activity(for FREE).

What vaccination strategy will be used in this activity? - Strictly "Door to Door" immunization strategy Objectives of the campaign: To reduce the number or pool of children at risk of getting measles or being susceptible to measles To achieve at least 95% measles-rubella immunization coverage of all children 9 months and below 8 years old. (target is 31 million children in the Philippines) Ultimate Goal: To eliminate measles by 2012 To accelerate the control of rubella What are the "doors" referred to in this campaign? - it includes all doors of houses, condominiums, apartments, tenements, orphanages and halfway homes as well as nonconventional doors in the community. - Non-conventional doors include the following: Informal settlements such families/persons living under the bridge inside the parks cemeteries open spaces in tents carts abandoned buildings old vehicles/trans/motorboats under the trees in islands on the middle of the street, etc. All business/commercial establishments and market stalls where children may reside Institutions How is it different from the previous campaign? - Measles-free certification will be issued to provinces and

cities if all the following criteria are met: All barangays have passed the Rapid Coverage Assessment (RCA) with no missed child and > 95% house marking accuracy(stickers will be used for marking) There are no measles cases for the next 3 months after the campaign Measles surveillance indicators have met the national standard

In children of under 12 months, persisting maternal measles antibodies may interfere with immune response. However, in situations where severe measles is common in children under this age, the benefit of vaccination at, for example, nine months may outweigh the risk of vaccine failure. Vaccination up to 72 hours after exposure to natural measles may offer some protection, but no protection against rubella can be expected if vaccination is carried out more than 24 hours after exposure to natural rubella. Vaccination a few days before exposure to these diseases will provide substantial protection. The vaccine is quickly inactivated by ether, alcohol or detergents and care should be taken to avoid contact with these substances when cleaning skin prior to vaccination. Contra-indications Never give to pregnant women, or women of child-bearing age not fully aware of the need to avoid pregnancy for one month after vaccination, since theoretically the vaccine virus could have an effect on the foetus. Do not use Eolarix in the presence of acute febrile illness, whether active or expected, following exposure to infection other than measles or rubella. This applies particularly to active tuberculosis and respiratory tract infection. A minor infection is not a contraindication. Eolarix should not be given to subjects with impaired immune responses. These include patients with primary and secondary immunodeficiencies. However, Eolarix can be given to asymptomatic HIV-infected persons without adverse consequences to their illness and may be considered for those who are symptomatic. Eolarix is contra-indicated in subjects with known systemic

Measles, Rubella Vaccine, Live attenuated Presentation Eolarix is a mixed preparation of the highly attenuated live measles virus (Schwarz strain) prepared in chick embryo tissue, and rubella virus (RA27/3 strain) prepared in human diploid cell culture, presented as a pink pellet in a glass vial with a separate container of clear colour less sterile diluent, (Water for Injections PhEur). Each 0.5 ml dose of the reconstituted vaccine contains not less than 1000 TCID50 of the Schwarz and 1000 TCID5O of the RA27/3 rubella virus strains and not more than 25 micrograms (17 IU) of neomycin sulphate. Eolarix is indicated for active immunisation of children and susceptible adults against measles and rubella. Dosage and administration Adults and Children: 0.5 ml of the reconstituted vaccine given by deep subcutaneous or intra muscular injection. Do not give intravenously. The vaccine should be reconstituted using the sterile diluent provided. Due to minor variations in pH. the colour of the reconstituted vaccine may vary from light orange to light red.

hypersensivity to neomycin but a history of contact dermatitis to neomycin is not a contraindication. Precautions Transmission of vaccine virus to susceptible contacts, whilst accepted as a theoretical possibility, has not been regarded as a significant risk. Eolarix may contain traces of chick embryo protein but this does not normally contra-indicate its use except in cases of severe hypersensitivity to eggs (past anaphylactoid reactions to egg ingestion). A solution of 1:1000 adrenaline should be available for injection in rare cases of anaphylactic reaction. As with all injectable vaccines, appropriate medical treatment should always be readily avail able in cases of rare anaphylactic reactions following the administration of the vaccine. For this reason the vaccinee should remain under medical supervision for a short time after immunisation. Since pyrexia may occur five to 10 days after vaccination, parents, especially of children with a personal or close family history of febrile convulsions, should be given advice about reducing fever. For example should the child appear unwell and develop a temperature, measures such as removal of clothing, tepid sponging and administration of paracetamol may be indicated. Vaccination of children with a history of convulsions may be delayed until the age of two years. Because of the possibility of interference from passive antibodies, the vaccine should not normally be given to subjects who have received blood or human plasma transfusions or human immunoglobulin within the previous three months. If the vaccine is given in these circumstances, serum antibodies should be checked at a later date.

Tuberculin testing may be carried out before or at the same time as vaccination with Eolarix. It should otherwise be delayed for about eight weeks after vaccination since false-negative results may be obtained during this period. At least three weeks should normally intervene between the administration of any two live vaccine preparations. Eolarix can however be given simultaneously with live oral poliomyelitis vaccine and with DTP vaccine, but at a different site. Adverse reactions Eolarix produces modified noncommunicable attenuated measles and rubella infections in susceptible subjects. The side effects are usually mild and similar in incidence to those seen after separate administration of the respective monovalent vaccines. Side effects are usually delayed for several days and may include rash, mild irritability, malaise, cough. pharyngitis, coryza, pyrexia, headache and lymphadenopathy. In a very few subjects convulsions may accompany the fever. Rarely, transient erthralgia and arthritis with or without effusion may occur. Immediate allergic-type reactions have been reported rarely. Rarely, transient polyneuropathy, encephalitis or thrombocytopenic purpura could occur. Reactions at the site of injection are rare and usually mild. There have been very rare reports of both Guillain-Barre syndrome, hemiplegia and retrobulbar neuritis. There have been isolated reports of subacute sclerosing panencephalitis (SSPE). The reported rate is less than the frequency associated with natural measles.
The WHO defines exclusive breastfeeding as the practice of feeding only breast milk (including expressed breast

milk) and allows the baby to receive vitamins, minerals or medicine. Water, breast milk substitutes, other liquids and solid foods are excluded.
WHO advises different strategies for giving fluids and foods during diarrheal illness, according to the presence/degree of dehydration and a childs age and normal feeding pattern.

Diarrhea with no dehydration

Infant under 6 months old If exclusively breastfed breastfeed frequently and longer at each feed. Give additional clean water or ORS to prevent dehydration. If not breastfed - give the normal milk or formula at least every three hours. Give additional clean water or ORS. If receiving mixed feeding breastfeed more frequently and longer at each feed. Give other liquids with a cup and spoon, not a bottle. Child over 6 months old Breastfeed frequently and longer at each feed. Give more fluids than usual to prevent dehydration. When possible, give home fluids that normally contain salt (e.g., soup, rice water, and yogurt drinks). Dangerous fluids to avoid during diarrhea include drinks sweetened with sugar such as commercial sodas, commercial fruit juices, and sweetened tea. Fluids with stimulant, diuretic, or purgative effects (such as coffee or some medicinal teas) should also be avoided. Continue to give normal food. Do not dilute usual foods. Continued feeding speeds recovery of intestinal function and the ability to digest and absorb nutrients. If the child is not yet being given semi-solid foods,

the mother should be counseled to begin soon after the diarrhea stops.

Diarrhea and moderate dehydration

A child with signs of dehydration should be rehydrated, preferably with packaged ORS according to weight and age (see WHO Guidelines Plan B). Use a clean spoon or cup. Rehydration may take four hours or longer. In addition: For an infant under 6 months old, continue breastfeeding during rehydration whenever the child wants. For a non-breastfed infant under 6 months old, give 100-200 ml of clean water during rehydration; then resume full strength milk or formula. For an older child, continue breastfeeding whenever the child wants. Begin feeding after the initial four-hour rehydration period.

Severe dehydration
A child with severe dehydration requires intravenous treatment and should be hospitalized.

Potable water supply in the province reaches the populace through three levels namely: Level I (point source system), Level II (communal faucet system), and Level III (individual connections) The communal faucet system (Level II) serves the rural areas while the Level III system is managed by the Local Water Utilities Administration (LWUA).