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MIDTERM: 1 (CHN)
- all of the options are positive, but the question is the
PRIMARY GOAL OF COMMUNITY HEALTH NURSING primary goal of CHN which is ….
- to let the different levels of clientele cope with the
The primary goal of Community Health Nursing is to help inequities/ discontinuities pagdating sa health and threats.
communities and families to cope with the discontinuities of TWO MAIN TYPES OF COMMUNITIES
health and threats in such a way as to maximize their 1. Geopolitical communities/Territorial communities
potential for high level wellness, as well as to promote > Defined or formed by both natural and man-made
reciprocally supportive relationship between people and boundaries.
their physical and social environment. - well defined by it boundaries (location)
- for example barangays.
MAJOR GOAL: Preserve the health of the community and
surrounding population by focusing on health promotion and Phenomenological communities/Functional communities
health maintenance of individual, family and group within > Share a group perspective or identity based on culture,
community. values, history, interest, and goals.
- employ more on promotive and preventive activities in CHN - considered functional of phenomenological if for example
merong share culture or interest of goals.
DIFFERENT LEVELS OF CLIENTELE: - commonality in terms of culture, values,goals and interest
1. Individual ng mga tao
2. Family- basic unit of life in CHN - for example: we in the UZ - kahit na we belong in different
3. Community barangays/ territory but lahat tayo may major goal na
4. Population maenhance ang nursing knowledge na we learn fro UZ and
also we adapt the culture of UZ kaya tinuturo ang philosophy,
“cope with the dicontinuities of health and threats” vision, mission ng UZ kase kailangan maembody natin as
- focuses on preventive, promotive, curative proud UZ representatives.
- pinaka focus: preventive & promotive - for example: fan groups of artists
- “threats”- wala pang problem pero gusto mo na tanggalin
ang possible risk of having the problem to achieve high level CHN VS. COMMUNITY-BASED NURSING
of wellness
COMMUNITY HEALTH COMMUNITY-BASED
“maximize their potential for high level wellness” NURSING NURSING
OLOF Preservation and protection Management of acute and
- optimum level of functioning/ high level wellness of health chronic condition
- goal in the community health nursing Community Individual and Family

“promote reciprocally supportive relationship between Community Health Nursing

people and their physical and social environment” − Major/Main Client: Community as a whole
- physical environment- ecology − Goal: more on preventive and promotive
- nakikita/ tangible outside − our patient generally they are well kaya nga yung focus
- social environment- people is more on promotion of health and prevention of
- not all problems are physiologically illness.
affecting, ngayon impt na rin na maensure ang psychological − Tinuturuan sila kung paano mas mapaganda pa ang
wellbeing ng tao, sometimes health disorders ay nakukuha lifestyle nila and environment para hindi magkaroon ng
because of social factors like for example bullying. In increase sakit kaya CHN ang tawag sa RLE exposure dahil ang
cases of bullying, there is also an increase in cases of mental patients are essentially well, wala pang mga sakit.
health disorders ie. Depression & anxiety disorders − Patient: well
- pasok pa rin sa CHN ang responsibilities in
promoting mental health because pasok pa rin sa definition Community-Based Nursing
ang social environment. − Major/Main Client: Individual & Family
− considered Community-Based Nursing because we
1. Which of the following is the primary goal of are attending the sickness/ illness ng specific individual
Community Health Nursing? or family
A. Enhance the capacity of individuals, families and − Focus: Management of acute and chronic condition
communities to cope with their heath needs − focus is currative, may sakit na nag mga tao. Ang
B. Increase the productivity of the people ginagawa mo is imanage ang sickness/ illness
C. Raise the level of health of the citizenry − Patient: Ill
D. Support and supplement the efforts of the medical
professions in the promotion of health and prevention 2. The context of Community Health Nursing is based on
of illness the nurse’s evaluation which of the following?
A. Current health status of the people
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B. Department of Health (DOH) goals − kahit na may solusyon na, if hindi pinepercieve na
C. Devolution of health problem ng mga tao, hindi sila gagalaw. Bakit nagfail ang
D. Existing health problems and needs of the people health service natin? Dahil hindi siya kinoconsider ng
− When we do CHN, it’s also very important na dapat mga tao as problema, hindi kinoconsider ng mga tao na
mamobilize natin ang community. Yes, as nurses tayo yun ang pangangailangan nila. Baka ang binibigay na
ang mag-aassess ng possible problems ng community bu health service kaya nagfail ay dahil hindi naman yun ang
ang maghahanap ng solution to this problem ay ideally it pangangailangan ng mga tao.
should be the community. Ang magdedefine talaga ng − This concept is important because although we are
problem is actually the community. being exposed to different barangays we do CHN, but in
− Example: Doc badge is assigned in Sindangan wherein each barangay they have their own unique problems,
marami ang hypertensive pt but they do not know that kumbaga kung ano ang ginawa mo sa barangay tetuan
they are hypertensive pala. As a medical practitioner, may not be applicable sa barangay labuan.
since nakikita niya na marami sa residents ang
hypertensive pero hindi nila alam, Doc badge coming − We integrate in the community, and the reason is that
from the scientific field is worried for their health but our goal is we want to mobilize the people, sila ang
ang mga tao is hindi worried and parang pinagtatawanan dapat maghanap ng paraan paano maresolve ang
lang nila kung nalaman nila na hypertensive sila. problem.
− In CHN ang dapat magdedefine kung ano ang dapat − Our role in the community ay facilitator lamang, hindi
tutukan when it comes to community ay ang mga tayo dapat ang gumagawa ng plano kung paano
people (communty people), dapat nating alamin kung maimprove ang health sa community, it should be done
ano ang sa tingin nila ang problema, because there are by the people.
certain issues in the community na for us medical − In the community, mag-oorganize tayo ng small
professionals ay problem siya for example the increased groups/core groups. Ang core groups kumbaga ang brain
cases of hypertension, pero kung sa mga tao/ of the community, sila ang imimeet regularly and
community hindi nila to kinoconsider na problem ipepresent mo sa kanila kung ano ang napansin mo as
therefore hindi yan sila mamomobilize kase hindi nga problem sa community. Then ang core group/ small
nila narerealize na problema ito. group, sila ang mag-iisip ng paraan/ solution para
− As nurses, it is alos very impt to assess what do these matugunan ang health problem.
people think the problem in their community. − For example in tetuan, nagkaroon ng ↑cases of dengue,
− In the example, if they say “ay okay lang po yang hindi tayo dapat ang nag-iisip ng solution kung paano
altapresyon, hindi naman po namin siya masyadong maeeradicate/bababa ang dengue cases, it should be
pinoproblema, yung pinoproblema namin ngayon kase the people, ideally sila dapat gagawa/mag-iisip ng
marami sa amin ang nagkakaroon ng diarrhea, marami solution… that’s how you empower the people.
ang sumasakit ang tiyan”. If for exmple, yung diarrhea − You let people think what they can do within their
ang mas nirerecognize nilang problem, ibig sabihin as a capacity ang you let them act on it.
nurse dapat papakinggan mo sila. Dapat gagawa ka ng − The problem if tayo ang mag-iisip ng solution and tayo
programs/ plans na more on diarrhea kasi yun yung pa ang mag-iimplement, if mag-phase out ka dyan/ pag
naiisip nilang problem rather than hypertension. umalis ka sa community, wala ng tutulong sa
− We always have to go back sa ano ang sa tingin nila na community, hindi na sila gagalaw on their own. Kaya ang
problema ng communiy. mga projects implemmented in the community na
− Ang goal natin as nurses ay immobilize lang sila, sila nurses lang ang gumawa, eventually kung nga-phase out
dapat ang magmove para maresolve ang problems. sila eventually mamamatay din ang mga projects na yon.
− If the community will not think na problema ang − The goal of the community health nursing is sustenance,
hypertension, hindi din sila gagalaw kahit na ituro sa yung tipong kahit umalis kayo, yung iniwan niyong
aknila ang mga dapat na gagawin para mabawasan ang proyekto ay kayang isustain/ ipagpatuloy ng mga
cases of hypertension. Pero if hindi nila to napepercieve community people. We cannot do sustenance if we do
na problem, kahit na may solution na, hindi sila gagalaw. not empower the people.
− The best way para makuha ang loob ng community is − One way to empower people is to get them involved, in
alamin ang kung ano ang problem at makipagtulungan identification of the problem and in finding solution to
sa kanila. Pag napeperceive kase nila na health problem this problem and let them act to solve this problem…
talaga siya, sila mismo ang gagalaw para masolve ang we are just mere facilitators (igaguide lang natin sila
problem. paano ang planning phase, ang process talaga,
supplementary lang tayo kumbaga, pwede tayong
3. If a particular health service fails, what will be the most maging speakers but sila dapat ang mag-isip na
basic question to ask? kailangan mag-conduct ng assembly/ meeting/ seminar,
A. Is this what the people demanded? sa knaila dapat galing ang idea)= community ang
B. Is this what the people need? nag-iisip, facilitators lang tayo.
C. What went wrong?
D. Who is responsible for the failure? COMMON GOALS OF COMMUNITY ORGANIZING AND CHN
PRACTICE
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● People empowerment
● Development of self-reliant community
- kahit iniwan mo na, kaya nilang tumayo on their
own dahil hindi mo sila ginawang dapendent sayo
- ang goal mo is gawin silang independent
● Improved quality of life
- for them to have OLOF

END GOAL OF COMMUNITY ORGANIZING:

COMMUNITY DEVELOPMENT
- magkaroon ng growth/ improvement
- example: kung dati mababa ang vaccination/family
planning, ngayon dapat is tumaas
4. Community Health Nursing is a specialized field of
nursing that follows the basic principles in community
development work. Which of the following statements − Hindi mo mapupuntahan ang nasa taas kung hindi
best described community development as a process of nameet yung nasa baba.
empowering people in the community? − Social needs/ love and belongingness
A. Community development is a learning process where − Self-actualization- if you are able to meet everything.
both women and men participate to improve their lives
Nurse Victoria noted that there were number of poor older
B. Community development is solely confined to the women, living alone, who are suffering from depression. Her
meeting of the day to day survival of the people FIRST goal is to
− “day to day” is only for short term goals which is not A. Improve level of function
correct because the goal is community/ self-reliant, for B. Improve quality of life
them to sustain the projects kahit na umalis ka, ang goal C. Provide recreation and entertainment
ng community development dapat is long term goal. D. Reduce suicide risk
− If we are going to follow maslow, no options above are
C. Community development may allow women to discover suggesting physiologic need, kung walang physiologic,
and strengthen their innate capabilities to enjoy and the next goal is safety.
utilize equal opportunities in all aspects of development − When it comes to psychiatric nursing, the priority is
work safety.
− Dapat iempower lahat sa community (lalake,babae,etc.),
the problem with this option is that nakafocus siya sa Epidemiology of Suicide
women lamang. ↑Suicide Risk Women
D. All of the above ↑Suicide Success Men
Suicide threat/attempt
When the nurse assesses a family, which family task would − Pinaplanong gawin pero hindi itutuloy talaga
she consider having highest priority for health family − Or sinimulan na pero hindi talaga lethal para magcause
functioning? ng death
A. Allocation of family resources − More on superficial only
B. Maintenance of order and security − Ways of Suicide ng Women:
C. Physiologic maintenance and safety 1. Overdose (hindi naman immediate nagkacause ng
D. Reproduction of new family members death)
− We will still use abraham maslow’s heirarchy of needs in 2. Superficial cutting
prioritization.
Suicide Success
− Ang mga lalake kapag nagpakamatay, lethal kaagad kaya
mas mataas ang suicidal success among men than
women.
− Pag ang lalake nagpakamatay, most often lethal ang
gagawin nila, isipin natin lagi LETHAL ang kanilang
metodology.
− Ways of Suicide ng Men:
1. Gunshot
2. Jumping off the building
3. Stabbing
4. Hanging

Suicide is common among:

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● Teenager OPD pt sa hospital but after how many hours ay
● Older population ididscharge/papauwiin din that’s why ang discharge
planning talaga ay magsisimula the moment na
Kailan nagiging delikado talaga ang suicide/kailan dumating sila sa hospital… ganon din pagdating sa
malalaman na magpapakamatay na talaga? rehabilitation.
− when there is a suicide plan already (the more detailed − It will start upon admission of the pt in the health care
it is, the more na magpapakamatay na siya) system.
− Marami tayong suicide pt pero ang
pinakamagpapakamatay na is yung may plano na. HEALTH CARE DELIVERY SYSTEM
− Assess for suicide ideation then assess for suicide plan: (In the Philippines)
Ask… Health services are provided by:
“Sir may plano ka bang magpakamatay” OO “Sir ● Government
dahil naiisip niyong magpakamatay, paano niyo po naiisip na ● Private Sector – for profit or non-profit (NGOs)
magpakamatay ngayon?” Mamaya around 12 mn maglalasing − Private sector
ako, tapos magdadrive ako from my house going to boulevard - example: diagnostic labs na private, offers
overspeeding then iswerve on a very tall wall… (the more diagnostic services to profit/ income
detailed ang plano, the more na magpapakamatay) − NGO - giving services not to generate income
− Pag may ginagawa ng treatment, mas higher ang chance - example: Mujer organization in Tetuan
na magpakamatay (habang ginagamot mo ang - private sector nagbibigay ng services para
depression, mas tumataas ang risk na magpapakamatay makatulong and not magkaincome (giving services
sila) *Implication: The more na dapat bantayan ang pt if for non-profit reason)
nag-eeffect na ang medication because they have the
greater energy to carry out the suicide plans Nagkaroon tayo ng Devolution, dati DOH talaga ang
responsible sa pagbibigay ng health services sa buong PH, but
Depression it was difficult because we only have one DOH office and
− happens because of lack of social support in older sobrang lawak ng PH so hindi niya mababantayan lahat ng
population. lugar dito sa PH kaya nagkaroon tayo ng devolution,
− As we age, napag-iiwanan din ang mga aging population nagkaroon tayo ng Local Government Units or Local
natin Government Code
− Example:
● yung mga anak starts to form their own families RA 7160- Devolution Code of the Philippines/
● namatay ang partner at mag-isa na lang natira sa bahay Local Government Code of the Philippines
− Nagbigay na trabaho na ng LGU ngayon ang health
Specific day: services
− Monday (dawn) − The primmary responsibility now will go to the LGU to
− Magpapakamatay sila kung kailan busy ang mga tao or provide health services.
walang makakapansin sa kanila kaya usually Monday − Effect: from DOH, ang pagbibigay ng health services will
now be the responsibility of the LGU’s. DOH now will
According to Dr. Margaret Shetland, the philosophy of public serve as a guide and tumutulong na lang sila sa LGU
health nursing is based on which of the following? paano maprovide ng LGU ang mga basic health services.
A. Health and longevity as birthrights
− Public Health Nursing definition by Charles Winslow ● Basic Health Services are regarded as priority services
B. Public health nursing as a specialized field of nursing for which LGUs are primary responsible.
− Public Health Nursing definition by Araceli Maglaya ■ Provincial Governments:
C. The mandate of the state to protect the birthrights of its - Provincial and District Hospitals
citizens ■ Municipal and City Governments:
− Public Health Nursing definition by Charles Winslow - RHUs, Health Centers, Satellite
D. The worth and dignity of man outposts/Barangay Health Stations
Example: Here in Zampboanga
In the Health Care Delivery System, ideally, rehabilitation − Ang responsible ng pagpapatakbo ng CHO,
services begin: barangay health centers is the Mayor or the
A. After the client's physical condition stabilizes Zamboanga Council.
B. Soon after the client had requested for rehabilitation
services The health care delivery systems is comprised of…
C. Upon admission of the client in the health care system Building blocks or Components:
D. Upon discharge of the client from the health care system ● Service delivery
− This is the same concept as with discharge planning − we have to make sure na accessible and available
− We start thinking of the discharge plans of our pt the ang health services to people kaya each barangay
moment naadmit siya sa hospital because not all pt ay here in the city have health centers wherein health
inaadmit for example the OPD pt, makikita natin ang
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services are provided ie. Immunization, family
planning, etc. DEPARTMENT OF HEALTH
− hindi na nila kailangan mag go sa CHO dahil sa health Task ngayon…
center nila mismo capable na magprovide ng basic ● Serves as the main governing body of health services in
health services. Example may first aid emergencies, the country.
hindi na need dalhin sa CHO or hospitals dahil − provides technical assistance to the LGU’s because
kaya na imanage basta mga first aid sa health centers LGU na ang responsible in giving health services
lamang. − DOH will serve as guidance/ tutulong na lang sila
− Goal ngayon ng Ph Government: Every Health Center but DOH pa rin ang magdedecide kung ano ang
must at least have 1 Doctor, 1 Nurse, 1 Midwife, and 1 protocol na dapat ifollow ng health centers.
Medtech.
− importance ng accessibility and availability: ang mga tao MAJOR ROLES
is not na kailangan mag-effort pa pumunta kung ● Leader in health
saan because we’re bringing the health services − DOH ay dapat talaga maging active when it comes to
at their very doorsteps. health promotion
− Being the leader in health, dapat sa kanila manggaling
ang initiative na gawin ang mga programs then uutusan
● Health workforce nila ang mga health centers na sundin or ilaunch ang
− we students are there to learn but we also already mga programs na for example resbakuna.
considered as one of the health workforce, we are ● Enabler and capacity builder
considered supplemental lang talaga. − Dapat natetrain nang maayos ang mga tao/personnel na
● Information nilalagay nila in the health center.
− example: health teaching/ education − Actually all personnel in the health centers are under
● Medical products, vaccines, and technologies the DOH.
− Health Center/RHU cannot function w/out − There should be an adequate seminar, training for the
products, vaccines, or technologies. personnel (that’s why sometimes wala ang
− technology in the community do not pertain to nurses/midwives dahil may seminar) to enhance their
computers and such, it may mean the use of herbal capacity.
plants: ● Administrator of specific services
- 10 approved herbal plants by the DOH − Being the leaders of health, hindi lang sila dapat
● Financing mag-utos, sila din mismo dapat mag-implement din sila
− budget coming from the public source in the form ng programs na yan kaya sometimes ang secretary of
of tax health sila mismo goes to barangays to implemment
− each health centers ay meron talagang allotted budget. their initiative.
− example: DOH will give budget to Zamboanga City, − DOH also comes up with different policies na kailangan
the mayor will divide the budget to different health sundin ng health center, sila yung magdedecide kung
centers in ZC. ano yung dapat nating gagawin in terms of health.
− the budget will depend on the population, if malaki
ang population ng barangay, mas malaki ang budget. TYPES OF PRIMARY HEALTHCARE WORKERS
− aside from the public sector pwede din manggaling 1. Village or Barangay Health Workers (V/BHWs).
sa private sector ang budget example: ● Trained community health workers
Sponsors/Donations. Some organizations gives − Residents na usually tinetrain.
allotted budget for different health facilities − They are usually the grassroot or the first line/ first
− Social Health Insurance- example: philhealth contac of the pt (unang nilalapitang ng mga pt in
the health center)
3 that provides budget for Health Services: ● Health auxiliary volunteer or
1. Public ● Traditional birth attendant or healer.
2. Private
3. Social Health Insurance 2. Intermediate level health workers.
● General medical practitioners or their assistants
● Leadership and Governance or Stewardship − Doctors & their assistants
− kahit na may pera ang halth center and complete ● Public Health Nurse
ang gamit, if poor ang leadership/ tamad ang ● Rural Sanitary Inspectors
nagpapatakbo ng health center hindi pa rin magiging ● Midwives
effective ang health center, magiging useless at − All medical professionals belongs to the ILHW
hindi mgatatagal.
− Midwives- in reality/ in the absence of doctors ang HOME VISITS
nagpapatakbo ng health centers. PURPOSES OF HOME VISITS:
− Doctor- ideally ang dapat magpatakbo ng health
center.
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1. To give nursing care to the sick, to a postpartum mother visit, except:
and her newborn with the view to teach a responsible A. Home visit should have a purpose
family member to give the subsequent care. B. Plans are based in available information including those
2. To assess the living condition of the patient and his from other agencies that may have rendered services to
family and their health practices in order to provide the the family
appropriate health teaching. C. Planning of continuing care must be developed by the
3. To give health teachings regarding the prevention and nurse
control of diseases. − Should involve the individual and family and not just the
4. To establish close relationship between the health nurse.
agencies and the public for the promotion of health. D. Planning should be flexible and practical
− to increase the health-seeking behavior kung may
nararamdaman sila, kung panget ang relationship PHASES OF HOME VISITS:
natin with the community, hindi sila pupunta dahil 1. PREVISIT PHASE
masama ang ugali ng mga nurses − Reviewing of records of the pt / family na
5. To make use of the inter-referral system and to promote pupuntahan
the utilization of community services. 2. IN-HOME PHASE
- to encourage the use of what is available in the ● INITIATION
health centers for example implants, medications. − Kakatok sa bahay, introduce self, and state the
- instead na bumili, we can give it to them for free purpose
and nakatulong pa sa condition nila − Establishing rapport
● IMPLEMENTATION
Purpose of Home Visit: CHUNA − Working with the pt
C- Close relationship − Example; pt is kakapanganak pa lang, tinuruan mo
H- Health Teachings paano linisan ang cord ng baby which is a health
U- utilization of community services. teaching
N- Nursing Care − Includes the planning phase and interventions
A- Assess the living condition ● TERMINATION
− Pagpapaalam
PRINCIPLES OF HOME VISITS: − Before magpaalam dapat isummarize mo muna
1. A home visit must have a purpose or objective. kung ano yung ginawa mo/ niyo for that day.
− Kung pupunta, dapat may plano na kung ano ang Example: “ Ma’am diba sabi ko ang reason kung
gagawin sa tao bakit nag-bisita ako ngayon kase kakamustahin ko
− The purpose should be related to the health and ang condition mo at ni baby, sa pagbisita ko
the pt should be given health benefit naturuan din kita kung paano ang proper cord care,
2. Planning for a home visit should make use of all so yun ang nagawa natin ngayon, next week ma’am
available information about the patient and his family babalikan kita para kamustahin ka ulit”
through family records. 3. POSTVISIT PHASE
− Before doing home visits, dapat actually kilala na − Babalik ka na sa health center and record what
natin ang lalapitan and alam na natin ang problema activity is done for that particular day and the
nila that’s why we need to make use of all available conversations with the patient in their record in the
info through the family records health center.
− Dapat/ ideally speaking nareview natin ang health
records bago pumunta sa bahay nila THE BAG TECHNIQUE
3. In planning for a visit, we should consider and give Tool by which the nurse, during her visit will enable her to
priority to the essential needs of the individual and his perform a nursing procedure with ease and deftness, to save
family. time and effort, with the end view of rendering effective
− As emphasized above, ang important is ano ang nursing care to the clients.
pangangailangan ng mga tao. If they think it’s not a
health need, they will not be cooperative. Dito PRINCIPLES OF BAG TECHNIQUE:
pumapasok na kailangan nating ieducate ang pt 1. Performing the bag technique will minimize, if not
and make them realize na bakit siya health prevent, the spread of any infection
problem. 2. It saves time and effort in the performance of nursing
4. Planning and delivery of care should involve the procedures.
individual and family. 3. The bag technique should show the effectiveness of
− Just like when we do our care plans in the total care given to an individual or family.
fundamentals, we always include our pt 4. The bag technique can be performed in a variety of ways
5. The plan should be flexible. depending on the agency’s policy, the home situation, or
as long as principles of avoiding transfer of infection is
Planning for a home visit is an essential tool in achieving best always observed.
results in health care. The following are principles in a home
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The nurse should understand which rationale when
performing the bag technique?
A. It should minimize or prevent the spread of infection
B. It should not overshadow the concerns for the client
C. It should render effective nursing care to clients or other
family members
D. It should save time and effort when performing nursing
procedures