ACKNOWLEDGEMENT The block M would like to thank the following for their continued guidance and undying support

to the groups endeavor of helping the community of Boboc-Bisal, Bokod. The group would not have completed this stage of COPAR without your help. First and foremost we would like to thank the Almighty Father, for without him we would not have the strength and determination to continue and finish what had been started. Father, thank you for reminding us what we need to do and what we ought to do. We would like to thank the municipality of Bokod, lead by Honorable Mauricio Macay, for allowing the school to conduct this community immersion. We extend our sincerest gratitude to the mayor and other government officials who made this immersion possible. To the barangay captain of Boboc-Bisal, Bokod. We send off our heartfelt thanks for welcoming us and supporting us in every step of COPAR. It was a lot of work but you gave us your helping hands and supported us all the way. We would also like to extend our million thanks to the rural health workers, headed by Dra. Lillian Velasco, for greeting us with your warmest welcome during our arrival in Bokod. To the pioneers of COPAR, Ms. Carmen Bolinto, Ms. Selerina Cosendo, Ms. Cherry Dalilis, thank you; for without you the whole concept of COPAR wouldnt came about and with communitys rise to development. Sitios of Boboc-Bisal, we thank you for taking a part and sharing a helping hand in order to accomplish this stage of COPAR. To the people of Boboc-Bisal who welcomed us with smiles and who participated in this activity, thank you for being a part of COPAR, with it came hard work but you got through it with patience and diligence, thank you for much coveted effort you have shown and thank you for being with us and sharing with us all of the difficulties of the days works. What you had shown inspired us to work hard. To our neighbors, thank you for helping us especially in times of need, thank you for lending us a helping hand whenever we needed one.

We also express our gratitude to our clinical instructor Mr. Jaylord Indalos, for the unstopping guidance and support. We thank you for leading us the way, and for being with us in hard and easy times of the community immersion. And lastly we thank our friends and families for the much needed emotional and financial support imparted to us, for reminding us what is waiting for us at the end of this long journey of life. A million thanks to everyone for inspiring us!!!

INTRODUCTION
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The World Health Organization defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. The organization also defines public health as the art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number. It entails therefore that public health is a core element of governments attempts to improve and promote the health and welfare of their citizens. Moreover, Dr. C.E. Winslow defines public health as the science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for the sanitation of the environment, control of communicable diseases, the education of individuals in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease and the development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these beliefs as to enable every citizen to realize his birthright of health and longevity. The World Health Organization Expert Committee of Nursing also defines public health nursing as a special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health programme for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability. Jacobson states that community health nursing is a learned practice discipline with the ultimate goal of contributing, as individuals and in collaboration with others, to the promotion of the clients optimum level of functioning through teaching and delivery of care. According to Dr. Ruth B. Freeman, community health nursing is a service rendered by a professional nurse with the community, groups, families and individuals at home, in health centers, in clinics, in school, in places of work for the promotion of health, prevention of illness, care of the sick at home and rehabilitation. Community Health Nursing is also a unique blend of nursing and public health practice woven into a human service that is properly developed applied and has a tremendous impact on human well being. Its responsibilities extend to the care and supervision of individuals and families in their homes, in places of work, in schools and clinics. It is one of the basic services of
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health departments. The community health nurses, as members of the health team, are expected to integrate within the context of family health care. Saint Louis University extend these services to barangays who have the following criteria for community selection such as depress, oppress, poor and exploited; clustered households of at least 100, presence of verbalized or requested need from community, absence of or inadequacy of similar health services. One of the chosen barangays is barangay Boboc-Bisal located in the municipality of Bokod in which community health nursing is needed. The concept on the Community Organizing Participatory Action Research (COPAR) approach or strategy is being used toward community health development. Community Organizing (CO) is the social development approach that aims to transform the apathetic, individualistic and voiceless poor into a dynamic, participatory and politically responsive community. It is also a collective, participatory, transformative, liberative, sustained and systematic process of building peoples organizations by mobilizing and enhancing their capabilities and resources for the resolution of their issues and concerns towards effecting change in their existing oppressive and exploitative conditions. Participatory Action Research (PAR) is an investigation of problems and issues concerning the life and the environment of the underprivileged by way of collaboration with them as equal partners. It is a strategy for development wherein community needs, conditions and problems are identified: solutions are planned and priorities are implemented thru a partnership with the community and with other connected agencies. The objective is is direct positive change will be for and by the people. On the other hand, concepts basic to nursing are used in working with the clients: individuals, families, groups and communities. Some concepts of community health nursing are:
The primary focus of community health nursing practice is on health

promotion. The community health nurse, by the nature of his/her work, has the opportunity and responsibility for evaluating the health status of people and groups and relating them to practice. Community health nursing practice is extended to benefit not only the individual but the whole family and the community.
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 Community health nurses are generalists in terms of their practice through lifes continuum its full range of health problems and needs. Contract with the client and/or the family may continue over along period of time which includes all ages and all types of health care. The nature of community health nursing practice requires that current knowledge derived from the biological and social sciences, ecology, clinical nursing and community health organizations be utilized. The dynamic process of assessing, planning, implementing and intervening periodic measurements of progress, evaluation and a continuum of the cycle until the termination of nursing is implicit in the practice of community health nursing.

MAP OF BENGUET

The municipality is bounded on the north by Kabayan, on the south by Itogon, on the west by Atok, and on the east by Kayapa, Nueva Vizcaya.

MAP OF BOBOC-BISAL

HISTORY

HISTORICO-GENEOLOGICAL BACKGROUND The scope and bounds of the present Bokod, Municipality were first settled by early people mostly coming from the northeast, specifically the Tinek-Culture areas: Ahin, Tukukan, Tebboy. Daclan was founded by Tinek warriors or hunters; some of these ensure intermarried with the people of the Batan (Kabayan) who, by oral accounts, were also mostly earlier arrivals from the Tinek areas. Ambuclao was settled by Ibalois of Kalanguya extract or admixture from the point of origin near hat is known today as modern Kabayan. Later, many of them intermarried with the people of Bisal and the Poblacion (then Central Bokod). Beneng now a sitio of Barangay Boboc-Bisal, was peopled by the Iowaks who were the relatives of the Domolpos (Tinongdan, Itogon) and Sinapang (now upper Eastern Binga, Itogon) iowaks. From Beneng, those Iowaks spread into the other settlements especially to neighboring Bisal, to Central Bokod, and to the eastern flank of the Karao-Ekip belt, getting themselves culturally absorbed in the process since they were the most liberal and non-endogamic of the early obokot settlers. Early Bokod Central was occupied by Tinek descendants too; but most of them were third or fourth generation Kalanguyas or Kalanguya- Ibalois whose parents or grandparents had some generation roots in the Amlimay (Buguias); then the second homeland of most Kalanguyas who moved away from Tinek, Benaljan. In later years, more Kalanguyas left their southern Ifugao homes to settle Vizcaya until reaching what is now the Carangalan (Nueva Ecija) mountain. In these waves of movement, Palanza (in Barangay Bila) was founded and so was southern wise Barangay Pito. Early Karao was occupied by the Igwaan-speaking peoples after an agreement with the Booked and Daklan villagers that they will help in preventing the entry of the Busols into the Boked territories. The Ikaraos are reputed in history as the descendants of the Archers Ituy and Panupuy, the only tribes not subjugated by the Spaniards in the lowland Magat culture areas. So originally, there were seven (7) settlements of Bokot, namely: Poblacion or Central, Poblacion, Pito, Bisal, Daclan, Tikey and Karao. Eventually, however, Booked was divided into ten (10) barangays: Poblacion, Ambuclao, and Pito were retained. Bisal
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was combined with the related sitios of Otbong and Nawal to from Barangay Bobok; from Daclan, branched Barangay Bila; branched Barangay Nawal ; and from Karao, branched barangay Ekip. POLITICAL CREATION On November 22, 1900 the Philippine Commission created under the American Regime issued a law called Commission Act No. 48 creating 19 townships in the province of Benguet. Three of these 19 townships were the town of Ambuclao, Daclan and Bokod. Ten years later or on March 23, 1910 then American Governor General William Cameron Forbes issued Executive Oder No. 24 which merged these three townships on. Thus, the township of Ambuclao and Daclan were abolished and only the town of Bokod remained. The foundation Day therefore, for the Municipality of Bokod is March 23. The Municipality of Bokod however, does not observe or celebrate its Foundation Day. For years, it had been celebrating its yearly fiesta on December 8, the Towns Saint Day. Then in recent years, it decided to celebrate its own Town Fiesta on the 7th day of December of every year a day before its Patron Saints Day. Thus, by tradition, Bokod Town Fiesta is on December 7 of every year while its Patron Saints Day Fiesta is December 8 of every year. On June 18, 1966, Congress passed R.A. 4695 which created Benguet as a separated regular province with capital at La Trinidad, Beguet and no longer a sub province of Benguet Province which used to be since the American Regime. GEOGRAPHICAL AND PHYSICAL CHARACTERISTICS Bokod Municipality is one of the thirteen municipalities of Benguet Province. Bokod is located at the southern part of Benguet Province, some 55 kilometers from Baguio City and about 320 kilometers from Manila. It is bounded on the north by municipality of kabayan, on the south by municipality of Tublay and the east by municipality of Itogon and on the west by Municipality of Atok. It has a land are of Forty Eight thousand hectares, Five Hundred Eighty Six square meters. Bokod forms part of Cordillera mountain range and is largely characterized by a rugged mountainous terrain with patches of gently sloping areas along
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or near river banks and along the foot of the mountains. Mountain peaks, valleys and ridges are the predominant land forms in the area. Generally, Bokod is warmer, compared to the other municipalities of Benguet, in the parts transverse by the Boko- Kabayan Highway; especially in Ambuclao and in the POblacion, but colder in the northern and eastern parts like: Ekip, Karao, Bila and Daclan, Bokod has two seasons: the wet and the dry. The west seasons lasts from May to Nevember and the dry seasons lasts from December to April. DEMOGRAPHIC DATA UPDATES According to the latest NCSO figures (1995) Bokods population as of September 30, 1995, stood at 10,496 persons. Two thousand One hundred Sixty Seven (2167) or 20.65 percent of its population are found in barangay Ambuclao. The second most populated barangay is Poblacion with 13.86 percent of the total. Barangay Daclan, Bila, Boboc-Bisal, have populations of more than One thousand (1,000) persons each. The five other barangays have populations of less than One thousand (1,000) each with Tikey as the least populated, with only 508 persons. (Files from Benguet Provincial Library) In earlier times, the people of Bokod lived clustered according to their areas of settlement and concentration as well as their ethnic affiliations, thus the Iowaks were found in Beneng towards Bisal and upstream until the eastern fringers of the Central and of Karao- Ekip; the Ibalois in the flat paway or semi-flat areas; and the Karo, of course, in Karao. But because of changes in abode and extensive intermarriages, it is difficult now to pinpoint among the present citizens who came from which, rather, when asked, who are you?, they all respond to the reference of I-bokot or somenone who is from Bokod. As to language, the Iowaks language has now disappeared among the modern day Ibokot; a fact that now linguistically severs them from their eastern Itogon cousins. Kalanguya is still spoken in Pito and palanza. Karao or Igwaan is widely spoken in barangays Karao and Ekip. Nabaloi, the language of the majority, is spoken by all and as such, is true lingua franca of all the Ibokots. PLACE OF INTEREST AND NATURAL BEAUTY
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Although most of these are not yet developed to the standards of tourists attractions. The nature-lover, the artist, and the adventurer will find unique fulfillment after he shall have come and seen all, some, or any of the following locations: a. The Badekbek Sulfur Springs in Barangay Daclan; b. The Ambuclao man-made lake in Barangay Ambuclao; c. The Pigingan mini rice terraces in Karao; d. The Pre-Hispanic Nalseb Nawal in Nawal Proper; e. The mossy virgin forest of Naswak in Ekip; f. The Palanza natural viewdecks at Bila; g. The Bisal Mango Grooves at Boboc-Bisal; h. The Debbeng natural lake which was a site of W.W. II American first aid forces and their Head quarters; i. The mysterious Binejayeng natural lake at Ambangeg, Daclan; j. The unmarked battle sites of Booked USAFIP-NL Guerillas and private citizen against the Japanese forces in: 1. Mowatong (near Central) 2. Pinokpok (between Bagdan and Bangao) 3. Pagal (approaching Camangan and Liboong). The municipality of Bokod has ten (10) barangays namely Poblacion, Ambuclao, Bila, Boboc-Bisal, Daclan, Ekip, Karao, Nawal, Pito and Tikey.

BARANGAY PROFILE OF BOBOC-BISAL A. Location Barangay Boboc-Bisal is located on the southern part of the municipality of Bokod. The barangay shares its boundaries to the north by barangay Poblacion, municipality of Itogon to the south, barangay Pito to the east and Ambuclao to the west. The barangay is 62 kilometers away from Baguio City, 68 kilometers from the Provincial Province Capitol and 9 kilometers from Poblacion.
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B. Land area Boboc-Bisal is the 3rd biggest barangay in the municipality of Bokod in terms of land area. It has as estimated area of Sixty seven Million Six Hundared Eighty Three Thousand Eight Hundred square meters. C. Topography Boboc-Bisal is generally a rough mountainous area. Hilly areas with 18.30% slope plain flat and upland areas randomly spot the area. D. Climate There are two type of soil in the barangay namely: sandy and loam. This types of are suitable for agricultural crops. GENERAL DESCRIPTION OF THE IBALOIS OF BOBOC-BISAL, BOKOD The People For almost 1 month of community immersion in barangay Boboc-Bisal, Bokod, the group may say that the people are shy mango, hospitable and humble. These are the words appropriate to describe the people. Upon arriving on our assigned area, BobocBisal, the people welcomed us with pleasant greetings. From the time we stayed in Boboc for our immersion, the people let us feel we belong to the community family. Though, during our home visits and case findings, we found out that most of the people were shy, in Ibaloi, the so called shy mango to the extent that they dont go out of their houses to talk with us because of shyness.

Source of Living Most of the people are seen to have the passion to work despite the hardships being encountered. They work for the betterment of their family and community and that for survival. The family, just like any other Cordilleran group and/or Filipino groups, is an important aspect in living- extended members of families and close ties among the members. This further strengthens the relationship of the people in the community. Health

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For the people, the aspect of health is a little bit strange since the people know that there are available facilities but some dont seek consultation from these health facilities, maybe due to the distance of their houses from the health center and hospitals and that some maybe influenced by their beliefs for not seeking consultations from these health facilities. Some community folks that we had met already have inadequate knowledge on their health conditions, though they are aware that it is a problem. The Society Boboc-Bisal is comprised of sitios Kawal, Libacong, Bisal, Mangagew. Barangay Boboc-Bisal is located on the southern part of the municipality of Bokod. The barangay shares its boundaries to the north by barangay Poblacion, municipality of Itogon to the south, barangay Pito to the east and Ambuclao to the west. Boboc-Bisal is generally a rough mountainous area. Hilly areas with 18.30% slope plain flat and upland areas randomly spot the area. There are two type of soil in the barangay namely; sandy and loam. This types of are suitable for agricultural crops. Thus, the people are often times found in their gardens or fields since gardening is the major occupation in the community. Hardworking and industrious are some of the appropriate adjectives to describe the people. Moreover, the people live a simple life. Community Organizing Participatory Action Research (COPAR) has five phases namely: Pre-entry Phase, Entry Phase, Organizational Phase, Consolidation, Strengthening and Sustenance Phase and Expansion Phase. ACTIVITIES LINKAGES The community exposure allowed us to mingle with the different people staying in the community-municipal officials, RHU officials, regular residents, key persons and agencies. The municipality of Bokod is headed by Honorable Mauricio T. Macay. Rural health center is lead by Dra. Lilian Velasco, the municipal health officer with public health nurse Mrs. Aurelia Wales. With them are also the barangay midwives of Bokod namely: Francisca Galunza, midwife III of Daclan, Catalina Segundo, midwife II of Boboc-Bisal, Mercedes Calpasi of Karao, Dolores Bumakil of Poblacion, Angelita
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Hilario, midwife II of Pito, Gloria Maxion, midwife II of Ambuclao, Roseal Mendoza, midwife I of Ekip, Beverly Olas, midwife I of Tikey and Marcela Esnara, midwife I of Nawal. With their cooperation, the proposed activities of the group were fulfilled. HEALTH CARE DELIVERY SYSTEM Health care delivery system is the totality of services offered by all health disciplines. Previously, the primary purpose of health care system was to provide care to the ill and injured. However, with the increasing awareness of health promotion, illness prevention and levels of wellness, health care systems are changing as the roles of nurses in these areas. M1: During the community immersion, the group aimed to promote health as what was instructed during the courtesy call with the health team of Bokod, Benguet through home visits, case finding and conducting health teaching such as school teaching on nutrition and hygiene, individual or family health teaching on health concerns such as hypertension, goiter, sanitation, UTI, Pneumonia and others. M2: Activities were rendered by the group during the community exposure to promote health. One of which was the feeding program done to improve nutritional status of children especially those undernourished ones. Immunizations were implemented as a government program and to enhance immune response of infants. The herbarium in the Kawal Elementary School was beautified, unnecessary weeds were removed and the fence was fixed in order to protect the herbal plants as well as to preserve its intangible therapeutic effects. M3: The group was briefed on our first day in the community that the focus of our health care delivery system is health promotion. With that, the group planned activities that are mainly for the purpose of health promotion, such as having health teachings some examples are hypertension, dengue, proper hygiene and nutrition. M4: The community immersion started with a courtesy call with the municipal mayor of Bokod and with the midwife of Bobok. They both approved of our plan to render health care services to the community folks of the different sitios of Bobok, Bokod, Benguet. During the first week, the students along with the clinical instructor conducted an ocular survey of Otbong, Libacong and Kawal. The group was divided into six pairs who home visited the households in each sitio. Problems of families regarding
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health and environment were given health teachings. Community folks were also taken their blood pressures and along with it, health teachings were incorporated regarding maintaining a stable and normal blood pressure. During the second week, sitios Mangagew, Bisal and Central Boboc were ocular surveyed. At the same time, home visits were conducted and family members with health problems were given health teachings. Just the same with the first week, the blood pressures of the community folks were also taken and given appropriate health teachings by the students. HEALTH EDUCATION M1: Throughout our community duty especially on our second week we conducted health teachings on our designated family regarding hypertension, arthritis, goiter, breast feeding, urinary tract infection, sanitation (flies), stroke rehabilitation, range of motion exercises, and pneumonia. On the second day of our second week of duty we conducted school teaching on Otbong Primary School, Bobok-Bisal, Benguet reagarding proper body hygiene and nutrition. M2: Health is a right of every human being. Healthy people are a prerequisite to national development. In order to achieve this prerequisite, it is the nurses goal to promote health. Health teaching is the powerful tool a nurse can use to be able to promote health. To promote awareness in the health aspect of the community, the group disseminated information through health teachings. The following topics were taught to enhance their knowledge: Management of Hypertension, Family Planning, Smoking, Asthma, Management of a child with delayed developmental status, Management of Arthritis, Proper Hand washing, and Dengue. M3: During our community duty, we educated the community folks through health teachings about hypertension, proper hygiene and proper wound healing. On the first week of the community duty, we conducted home visits and taught families about diseases such as hypertension and amoebiasis since these are the most common disease found in that locality at that time. Hence, we taught the folks on the causes, the signs and symptoms and the management of the condition. Proper wound healing and proper hygiene were also taught. On the following weeks of the duty, we were able to teach the elementary pupils about proper hygiene such as toothbrushing, handwashing, shampooing, taking baths; proper nutrition, puberty, and drugs. With these, the
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community folks would apply them in their daily living thus, promoting their health and avoiding illnesses. M4: Aside from the families from the 6 sitios of Bobok who were provided with health teachings by our group, the students of Kawal Elementary School were also visited by the group. The school was composed of 105 students composing of Grades 1 to 6 students. Grades 1 and 2 students were taught about proper nutrition and personal hygiene. Grades 3 and 4 were provided with information about cough and colds and personal hygiene. Moreover, grade 5 students were given lectures about personal hygiene, proper nutrition and diarrhea. Finally, the grade 6 students were taught about personal hygiene, proper nutrition and urinary tract infection. The students participated in the health teachings and were assessed by asking them questions about the lessons given. At the same time, questions from the students were clarified. CAPABILITY BUILDING M3: On July 14, 2010, during our community duty, we conducted a meeting with the barangay health worker and other representatives of the community. Capability building was observed by means of presenting the activities, objective and process of COPAR, how to fill up the family survey form and the initial research team formation with the Barangay Health Worker (BHW). The BHW, as part of the research team, accompanied the students during the family health survey of Sitio Kawal. This increased the capability of data collection for the creation of the community diagnosis. A1: SCHOOLHEALTH TEACHINGS M1 (OTBONG PRIMARY SCHOOL) A. Assessment of the Learner (Grades 1 and 2) The learners are the Grade 1 and 2 elementary pupils that are studying in one classroom. The pupils are aged 6 to 7 years old and speak Ibaloi, Ilokano and Tagalog. B. Nursing Diagnosis Knowledge Deficit: Body Hygiene and Nutrition related to lack of information
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C. Goal To educate the pupils of grades 1 and 2 about Body Hygiene and Nutrition thereby promoting clients wellbeing. D. Teaching Plan Proper NUTRITION: Learning Objective After 20 minutes of discussion, the pupils will be able to: a. Disc Importance of Proper uss Nutrition impo rtanc e of prop er nutri tion.
b. Disc

Content Outline

Resources

Time Allotment

Evaluation

Visual Aids

5 min.

Question and Answer

uss food grou ps and food pyra mid inclu ding enu mera tion of food s

Food Groups Food Pyramid

Visual Aids

15 min.

Games

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unde r the subg roup s thos e state d abov e.

BODY HYGIENE: Learning Objective After 20 minutes of discussion, the pupils will be able to: a. Enumer ate and discuss appropriate hygienic practice on each major parts of the body. Bathing Ear Cleaning Nose Cleaning Brushin g of Teeth Handwa shing Nail Cutting Use of Underw ear Use of Footwea r B Visual Aids o d y E ar s N os e O ra l C a vi ty H a 10 min. Quest ion and Answ er Game s Content Outline Resources Time Allotment Evaluation

18

n ds N ai ls G e ni ta ls F ee t Visual Aids 10 min. Return demonstration

a. Demons

-trate and verbaliz e knowled ge on Body Hygiene .

Steps and inputs about each enumerated hygienic practice.

M3 (KAWAL ELEMENTARY SCHOOL) GRADE 1 AND 2 A. Assessment of the Learner The learners are the Grade 1 and 2 elementary pupils. As the student nurses interact with the elementary pupils when they go out from their staff house, the H.E. room of the school, poor personal hygiene was observed in most of the children as manifested by dirty clothes, hands and feet which are also with unclean nails, unkept hair with pediculosis, and dental carries.
B. Nursing Diagnosis 19

Knowledge Deficit: Hygiene related to lack of information C. Goal To educate the pupils of grades 1 and 2 about hygiene thereby promoting clients wellbeing. D. Teaching Plan Proper Learning Objective After 45 minutes of discussion, the pupils will: a. Enumerate at least 2 importance of handwashin g. b. Demonstrate proper handwashin g technique. c. Verbalize the importance of tooth brushing. d. Demonstrate proper tooth brushing. Learning Content PERSONAL HYGIENE Personal hygiene is an important element in preventing disease and/or preventing cross-infections. Keeping the self clean not only makes one better, but it also keeps one free from diseases or any illnesses. Tips for Kids:
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Content Outline

Resources

Time Allotment

Evaluation

Importance of Discussion handwashing Nurse and clients effort

5 minutes

Question and Answer

Proper handwashing

Demonstration and singing Nurse and clients effort

15 minutes

Return demonstration

Importance of Group discussion tooth brushing Nurse and clients effort

10 minutes

Question and Answer

Proper tooth Demonstration brushing Nurse and clients effort

15 minutes

Return demonstration

1. Bath daily or every other day and change into fresh clothes. 2. Do proper handwashing always before eating and after using the toilet, considering time and scrub element. 3. Brush teeth 2 to 3 times a day after eating. 4. Shampoo hair and comb it often to eliminate lice. 5. Keep nails trimmed at least once a week. GRADE 3 AND 4 A. Assessment of the Learner The learners are the grade 3 and 4 pupils of Kawal Elementary School. The students within the school are hardly distinguished from their respective age and grade. Grade 3 and 4 pupils seem to be grade 1 and 2 pupils because of their height and body builts. Moreover, for most of the students, slight body odor, long and dirty nails, unkept clothes and unkept hair with pediculosis, were observed. During the nutritional assessment, it was found out that there are some pupils needing nutritional counseling, based on their body mass index. B. Nursing Diagnosis Knowledge Deficit: Hygiene and Nutrition related to lack of information C. Goal To educate grade 3 and 4 pupils about proper hygiene and nutritional intake, thus, promoting the clients wellbeing.
D. Teaching Plan Proper

Learning Objective After 1 hour of discussion, the pupils will:

Content Outline

Resources

Time Allotment

Evaluation

a. Identify ways Proper Hygiene on attaining proper hygiene

Role playing 15 Discussion minutes Student nurse and clients effort Discussion with 10

Question and Answer

b. Correctly define hygiene

Hygiene

Question and

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PowerPoint c. Demonstrate proper brushing of hair d. Identify foods in the food pyramid e. Differentiated Go, Grow, and Glow Food. f. Identify at least 3 foods included in each food group that are present in the community. Learning Content: MY PYRAMID Increase recognition of MyPyramid

minutes

Answer

Brushing/combing Demonstration 5 Return of hair minutes demonstration

Food Pyramid

Discussion

5 minutes

Question and Answer Games Question and Answer Drawing Question and Answer

Go, Grow, and Discussion 15 Glow Foods and with visual minutes importance aids Examples of Discussion 10 foods in each food with visual minutes group. aids Singing

Motivate children Make healthy food choices Be physically active daily Be physically active every day Choose healthier foods from each group Eat more from some food groups than others Every color every day Make choices that are right for you Take one step at a time

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NUTRITION FOR SCHOOL AGE CHILDREN Milk, whole - one or more cup Meat, fish, poultry 3 or more servings Dried beans and nuts 1/3 cup or more, cooked Enriched rice and other cereals 4 or more cups, cooked Nutrition for school age children Root cups one or more medium pieces Fat such as butter, oil, margarine 6 teaspoons Green and leafy vegetables 2 medium fruits and 8 tbsp vegetables Eggs 2 to 3 per week Sweets 6 teaspoon

FOOD GROUPS:
Energy Foods (GO)

These are main source of energy for body activities and body heat. These supply energy in concentration form for body activities. These include: rice, corn, cereals, root crops, sugar, butter, lard or oil
Body building Foods (GROW)

These foods build and repair body tissue. Children need them for optimum growth. These foods also help keep the blood red, nerves health, make the bones, teeth and nails hard and strong. These include fish, meat, poultry, dried nuts and beans, eggs, whole milk and other dairy products.
Regulating Foods (GLOW)

These foods protect your eyes and keep illnesses away. They also keep the blood red, the nerves healthy and bones strong. The greener or the deeper the yellow the color of a vegetable, the more vitamin A it has. These include the green leafy and yellow vegetables, Vitamin C rich foods and other fruits and vegetables. HYGIENE
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Hygiene came from the Greek word hygies meaning healthy, sound What is Personal Hygiene? It is a regular routine of Personal Care. Washing and grooming your hair, your face, your skin, your teeth, your ears, your hands, your nails, your feet and hair; Brushing your hair cleans and stimulates hair and scalp; Brush from roots to tips to spread natural oils along the whole length of hair; and shampoo regularly. 1. HAIR How do I choose a shampoo? Is my hair Oily, or is my hair Dry? Do you have lice? What will stop the DANDRUFF??? It is a dry itchy scalp, white flakes on head and shoulders What causes it? Skin cells that grow and die off too fast 1. ACNE Acne is created when oil from the oil glands mix with the dead cells and plug up the hair follicles in the skin it creates a whitehead. A blackhead is when the air touches the plug, the plug turns black. What makes acne worse? Oil-based makeup, hair gels and spray. For girls; menstruation, squeezing or picking at blemishes, hard scrubbing of the skin Who gets acne? Boys and girls during their teen years. Boys may get it worse because they have more skin oil. If your parents had bad acne, chances are you may get it bad too. Acne Myths 1: Does chocolate cause zits? A: NO 2: Does Extra washing help clear zits? A: No, the extra scrubbing irritates skin and could make them worse.
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What is it dandruff?

3: Does acne leave scars? A: Yes, you can reduce the scarring by NOT PICKING and avoid excessive scrubbing. 2. EARS Wash ears daily with a wash cloth dont forget behind the ears. Do not use Qtips in ears it will smash the ear wax deep into the ear canal. Did you know..?? Ear wax is usually removed when you chew food or gum. 3. DENTAL HYGIENE What causes cavities? Sugar and Plaque together creates bacteria that causes tooth decay. Tooth Decay can be transmitted through the mouth from someone who may have tooth decay bacteria. How to avoid tooth decay? Daily dental hygiene routine that consist of brushing for 2-4 minutes and flossing. See a dentist every 6 months. Halitosis or Bad Breath It can be caused by the activity of certain types of oral bacteria. Other causes: Food stuck in teeth, sinus problems, and stomach problems. 4. BODY ODOR What causes body odor? Perspiration and bacteria mixed together, poor hygiene, poor diets or some foods such as onions and garlic. Treatments: The use antiperspirants decreases perspiration and cover odor with a manly smell. Daily baths or showers using soap and scrubbing the entire body with a washcloth Change clothing daily
26

Maintain a healthy diet

1. FINGERNAILS AND TOENAILS File fingernails in one direction Cut toenails straight across never cut into corners Protect against ingrown toenails by avoiding tight shoes, very high heels Prevent Athletes Foot Keep feet and skin clean and dry Change socks daily Avoid walking barefoot in public areas Throw away worn-out shoes and never borrow other peoples shoes

How to prevent Athletes Foot?

Make Hygiene part of your daily routine! GRADE 5 AND 6 A. Assessment of the Learners Kawal Elementary School is located at Kawal, Bokod, Benguet wherein most children study as Grade 5 and Grade 6. Their age ranges from 11 to 16 years old. And since majority of them age 12 years old, they are at pre puberty stage. During the Adolescent period, that is the time wherein children, mostly girls would be confused on the gradual change in their bodies. They are also curious and eager to try new things like drink alcohol or take illegal drugs. The weakness of the learners was that they lack exposure and knowledge to certain things like alcohol and drug intake thus they do not know how to avoid those. They also lack information to the different changes in their bodies. B. Learning Need What is puberty, what are the changes during puberty? What is alcoholism? Why prevent too much alcohol intake? What are illegal drugs? Why avoid illegal drugs? C. Learning Diagnosis Knowledge Deficit: Puberty, Alcoholism, and Illegal drugs related to lack of exposure.
27

D. Goal After the allotted time for discussion and explanation, the students will be able to understand puberty, alcoholism, and illegal drug intake. E. Teaching Plan Learning Objective After 45 minutes of nursing Interventions, the client will be able to: a. Define Puberty correctly What is Puberty? One-onOne discussion 5 minutes languag e that is easier to underst and (Ilocano ) coopera tion of the students time and effort of the student nurses Oral Feed backing: See if the students can define puberty using their own preferred language Content Outline Resources Time Allotment Evaluation

a. Enumerat e at least Changes five experienced by changes experienc boys: ed by

One-onone discussion

10 minutes languag e that is easier

Oral Feed backing: See if the students members can

28

girls and boys during puberty.

Changes experienced by girls:

to underst and (Ilocano ) coopera tion of the students time and effort of the student nurses

enumerate at least five changes experienced by boys and by girls during puberty using their own preferred language

a. Define

What is Alcoholis Alcoholism? m appropria tely

One-onone discussion

5 minutes languag e that is easier to underst and (Ilocano ) coopera tion of the students time and effort of the student nurses

Oral Feed backing: See if the students can define Alcoholism correctly.

a. Enumerat Complications e at least of Alcohol three Consumption: reasons why avoid

One-onone discussion

10 minutes languag e that is easier to underst

Oral Feed backing: See if the students can enumerate three reasons why avoid alcoholism.
29

Alcohol intake

and (Ilocano ) coopera tion of the students time and effort of the student nurses Oral Feed backing: See if the students are able to enumerate reasons why avoid illegal drugs.

a. Enumerat Why to avoid e at least Illegal drugs? five reasons why avoid illegal intake of drugs.

One-onone discussion

15 minutes languag e that is easier to underst and (Ilocano ) coopera tion of the students time and effort of the student nurses

Learning Content Changes during PUBERTY What is Puberty? It is the process of physical changes by which a child's body becomes an adult body, capable of reproduction. Puberty is initiated by hormone signals from the brain to the gonads (the ovaries and testes). Before puberty, body differences between boys and girls are almost entirely restricted to the genitalia. During puberty, major
30

differences of size, shape, composition, and function develop in many body structures and systems. The most obvious of these are referred to as secondary sex characteristics. Mga Pagbabago sa Babae

Ang katawan ay nagkakaroon ng hugis lumalawak.

habang ang buto sa balakang ay

Nadaragdagan ng timbang lalo na sa may balakang. Ito lamang ay nangangahulugan na ikaw ay nagkakaroon na ng malababaeng hugis. Hindi pagdagdag ng timbang- hudyat ng masamang pangangatawan. Patuloy na kumain ng masustansiyang pagkain at regular na mag-ehersisyo. Ang mga kalamnan ay lumalaki at lumakas. Ang bubelya ay nagsisimula ng lumaki. Nagsisimula ng magregla. Nagsisimula na ang paglabas ng tinatawag na white menses.

Mga pagbabago sa Lalaki

Nadaragdagan ang timbang ng mga lalaki. Ang mga balikat ay mas lumalapad. Ang mga kalamnan ay mas lumalaki at mas lumalakas. Ang boses ay mas lumalalim. Ang penis ay mas humahaba at tumataba. Mas lumalaki ang mga testes. Bukod sa pagtubo ng buhok sa katawan, ito rin ay tumutubo sa mukha, tulad ng balbas, bigote o sideburns. Kadalasan ito ay medyo manipis sa una. ALCOHOLISM AND DRUG ABUSE

Ano ang Alkoholismo?

binabanggit ang alkoholismo bilang kahit anong kalagayang nagresulta sa patuloy na pag-inom ng mga inuming alkoholiko sa kabila ng mga problema sa kalusugan at negatibong kahihinatnan nito sa lipunan.

Nilalarawan ng medisina ang alkoholismo bilang isang sakit na nagresulta sa paulit-ulit na pag-inom ng alak at iba pang inuming nakalalasing sa kabila ng mga negatibong kahihinatnan nito.
31

Ano ang mga epekto nito sa ating katawan?

Ang epekto ng sobrang dami ng alkohol sa katawan ay mapanganib sa ating kalusugan. Ang isang alcoholic ay maaaring makakuha ng sakit na kancer sa atay, lalamunan, at esophagus. Maaari ring makakuha ng sakit na pamamaga ng atay (liver cirrhosis), panghihina ng pangangatawan, magkaroon ng masamang epekto sa pag-iisip (brain damage), at lubhang mapanganib para sa mga nagdadalang-tao.

Dagdag pa dito, naitalang malaking bilang ng pagkamatay ay dulot ng aksidente sa mga sasakyan na sanhi ng pagmamaneho habang lasing. Madaming pangyayari din ng suicide o pagpapakamatay at krimen ay gawa ng mga taong nasa impluwensiya ng alak.

Paano masasabing alcoholic ang isang tao?

Craving o sobrang pagnanais- Labis na pangangailangan at pagkahilig sa alak. Pagkawala ng control- Di maiwasang pag-inom ng madami sa anumang okasyon. Physical dependence o pangangailangan ng katawan.-Pagkaranas ng masamang pakiramdam, pagpapawis, panginginig, at pagkabalisa dulot ng biglaang pagtigil matapos ang mahabang panahon ng maramihang pag-inom.

Tolerance- Ang pangangailangan ng mas marami kumpara sa dati bago maabot ang pagiging "high" o ang nais na epekto ng alak.

Solusyon:

Ang lunas o solusyon sa taong alcoholic ay depende sa kunsumo niya ng alcohol. Maaaring gamitin ang detoxification o proseso ng ligtas at maingat na pagtanggal ng alcohol sa katawan o maari din ang pag-inom ng gamot ayon sa reseta ng doktor upang maiwasan ang pagbalik sa dating nakaugalian matapos tumigil sa pag-inom.

Makakatulong din ng malaki ang group counselling upang mas mabilis na makaiwas sa mga karanasang nagtutulak sa kanya upang uminom muli.

Ano naman ang Drug Abuse?

Ito ay ang palagiang pag gamit ng mga ipinagbabawal na gamot. Ito ay nagsisimula sa eksperimentasyon hanggang sa tuluyang pag gamit ng bawal na gamot.

Warning Signs PHYSICAL

32

Bloodshot eyes or pupils that are larger or smaller than usual. Changes in appetite or sleep patterns. Sudden weight loss or weight gain. Deterioration of physical appearance and personal grooming habits. Unusual smells on breath, body, or clothing. Tremors, slurred speech, or impaired coordination. Drop in attendance and performance at work or school. Unexplained need for money or financial problems. May borrow or steal to get it. Engaging in secretive or suspicious behaviors. Sudden change in friends, favorite hangouts, and hobbies. Frequently getting into trouble (fights, accidents, illegal activities). Unexplained change in personality or attitude. Sudden mood swings, irritability, or angry outbursts. Periods of unusual hyperactivity, agitation, or giddiness. Lack of motivation; appears lethargic or spaced out. Appears fearful, anxious, or paranoid, with no reason. Never try. Be busy with educational activities. Always put in mind the effects of drug abuse.

BEHAVIORAL

PSYCHOLOGICAL

How to Prevent Drug Abuse?

PREVENTION IS BETTER THAN CURE! A2: HEALTH ASSESSMENT M1 (OTBONG PRIMARY SCHOOL) During the community duty, the group conducted a school health teaching about nutrition. It was incorporated after the teaching the conduction of health assessment of the pupils of Otbong Primary School. This includes Physical Assessment, Athropometric Measurements and Vital Signs. GRADE I Name Age Gender T RR PR Ht. Significant Finding

33

(y/o) 1. Alejo , Joshua

(C)

(cpm )

(bpm )

(cm) Tenderness on ethmoid sinus Colds with mucoid white nasal discharge Cough

Male

36.1

22

84

107. 1

1. Palas , Elton John 1. Wakl in, Floyd G. 1. Begs eng, Le Ann D.

2. Chan

6 Male 35.8 21 87 106. 5

Male

36.3

20

94

106. 8

Nonproductive cough for 5 days

Female

35.6

26

129

107. 1

ao, Charisse

Female

36

24

89

107. 9

Cough and colds

GRADE II Name Age (y/o) Gender T (C) RR (cpm ) PR (bpm ) Ht. (cm) Significant Finding

1. Begsen g, Mark Lyndon D.

Male

35.4

24

82

121. 3

Scars in upper and lower extremities, and abdomen due to chicken pox Incomplete
34

1. Domin

Male

36.5

25

90

122.

guez, Richar d W.

teeth with cavity Long dirty nails Colds Hyperactive Bowel Sound 22 Teeth +3 Tonsils (+) Lice -

1. Tuali, Jaylord E. 7 Male 35.3 22 115

121. 6

116

1. Hidalg o, Kate F.

Female

37.3

23

91

M3 (KAWAL ELEMENTARY SCHOOL) JULY 14, 2010 One of the primary activities done by the group during the community duty was the conduction of health assessment of the pupils of Kawal Elementary School. This includes Physical Assessment, Nutritional Assessment, Anthropometric Measurements and Vital Signs.

GRADE 1 Name: Eryl - Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails - (-) corneal swelling EYES - (-) dryness - (+) PERRLA NOSE - symmetrical
35

- (+) secretions - moist - (-) cracks at the corner of the mouth THROAT AND MOUTH - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-) Swollen neck - (-) palpable lymph nodes - Alert NEUROLOGIC - Oriented to time, person, and place - (-) Altered mental state - (-)Paresthesia MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 16cm - 15.2 cm - 1.5 cm

Name: Krecel Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails - (-) corneal swelling EYES - (-) dryness - (+) PERRLA NOSE - symmetrical - (+) secretions THROAT AND MOUTH - moist
36

- (-) cracks at the corner of the mouth - (+) lesion on the lower right area of the mouth - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-)Swollen neck - (-) palpable lymph nodes - Alert NEUROLOGIC - Oriented to time, person, and place - (-) Altered mental state - (-)Paresthesia MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 16.2cm - 15.1cm - 1.1 cm

GRADE 3 Name: Maricel Bugtong Age: 9 years old Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails - T - 36.7 C VITAL SIGNS - RR 24cpm - PR 77bpm EYES - (-) corneal swelling

37

- (-) dryness - (+) PERRLA NOSE - symmetrical - (+) secretions - moist - (-) cracks at the corner of the mouth THROAT AND MOUTH - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-)Swollen neck - (-) palpable lymph nodes NEUROLOGIC - Alert - Oriented to time, person, and place - (-) Altered mental state MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 18 cm - 17.3 cm - 2.8 cm

Name: Ruel M. Tolingan Age: 10 years old Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails - T - 36.9 C VITAL SIGNS - RR 24cpm - PR 68bpm EYES - (-) corneal swelling
38

- (-) dryness - (+) PERRLA NOSE - symmetrical - (+) secretions - moist - (-) cracks at the corner of the mouth THROAT AND MOUTH - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-)Swollen neck - (-) palpable lymph nodes - Alert NEUROLOGIC - Oriented to time, person, and place - (-) Altered mental state - (-)Paresthesia MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 18 cm - 16.8 cm - 2.5 cm

Name: Holifield D. Alboros Age: 9 years old Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails VITAL SIGNS - T - 36.6 C - RR 22cpm

39

- PR 74bpm - (-) corneal swelling EYES - (-) dryness - (+) PERRLA NOSE - symmetrical - (-) secretions - moist - (-) cracks at the corner of the mouth THROAT AND MOUTH - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-)Swollen neck - (-) palpable lymph nodes - Alert NEUROLOGIC - Oriented to time, person, and place - (-) Altered mental state - (-)Paresthesia MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 15.5 cm - 15.7 cm - 2.8 cm

Name: Rey Domingo Age: 8 years old Moist skin with good skin turgor SKIN, HAIR, NAILS - Thick, dry hair - (-) Spoon-shaped nails VITAL SIGNS - T - 35.7 C
40

- RR 21cpm - PR 79bpm - (-) corneal swelling EYES - (-) dryness - (+) PERRLA NOSE - symmetrical - (-) secretions - moist - (-) cracks at the corner of the mouth THROAT AND MOUTH - (-) Magenta tongue - (-) Beefy, Red tongue - (-) Bleeding gums - (-)Swollen neck - (-) palpable lymph nodes - Alert NEUROLOGIC - Oriented to time, person, and place - (-) Altered mental state - (-)Paresthesia MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE - 18.3 cm - 17.5 cm - 2.8 cm

GRADE 4 Name: Edmund Manalingod Age: 10 years old SKIN, HAIR, NAILS EYES Head: (-) lesions; (+) lice Skin: dry; (+) scars reactive to light
41

EARS NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS

Ears: (+) serum; (-) tenderness (-) tenderness; (-) lesions Lymph nodes: (-) tenderness 17.8cm 17.8cm 24mm Temp: 36.4 PR: 48 RR: 20

Name: Clint Damurtis Age: 10 years old SKIN, HAIR, NAILS EYES EARS NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS Head:; (+) lice / Skin: dry; (+) scars Eyes: reactive to light Ears: (-) serum; (-) tenderness Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:19.7cm MAM:21cm TRICEPS:20mm Temp: 36.2 PR: 52 RR: 19

Name: Claudine Dominguez Age: 9 years old SKIN, HAIR, NAILS EYES Head: (-) lesions; (+) lice Skin: moist Eyes: reactive to light
42

EARS NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS

Ears: (-) serum; (-) tenderness; (-) lesions Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:21.5cm MAM:23cm TRICEPS:15mm Temp: 35.7 PR: 64 RR:15

Name: Lloyd Manego Age: 9 years old SKIN, HAIR, NAILS EYES EARS NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS Head: (-) lesions; (+) lice Skin: dry; (+) scars Eyes: reactive to light Ears: (-) serum; (-) tenderness Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:18cm MAM:18.5cm TRICEPS:25mm Temp: 36.1 PR: 61 RR: 19

Name: Geroumel Lino Age: 10 years old SKIN, HAIR, NAILS EYES EARS Head: (-) lesions; (+) lice Skin: dry; (+) scars Eyes: reactive to light Ears: (+) serum; (-) tenderness
43

NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS

Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:24cm MAM:25.1cm TRICEPS:30mm Temp: 36.9 PR: 44 RR: 20

Name: Peirre D. Pablo Age: 9 years old SKIN, HAIR, NAILS EYES EARS NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS Head: (-) lesions; (-) lice Skin: dry; (+) scars Eyes: reactive to light Ears: (-) serum; (-) tenderness Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:19.5cm MAM:20cm TRICEPS:27mm Temp: 36.4 PR: 71 RR: 22

Name:Weygan Basatan Age: 10 years old SKIN, HAIR, NAILS EYES EARS Head: (-) lesions; (-) lice Skin: dry; (+) scars Eyes: reactive to light Ears: (+) serum; (-) tenderness
44

NOSE THROAT AND MOUTH MUSCLE CIRCUMFERENCE MIDARM CIRCUMFERENCE TRICEPS CIRCUMFERENCE VITAL SIGNS

Nose: (-) tenderness; (-) lesions Lymph nodes: (-) tenderness MC:19.5cm MAM:21.5cm TRICEPS:13mm Temp:35.6 PR: 59 RR: 23

A3. BLOOD PRESSURE TAKING During home visits and activities conducted in the barangay, blood pressure taking was also rendered to the community people. The results are as follows: M1 (SEPTEMBER 2010) Name 1. Alejo, Melagros 2. Alejo, Velario 3. Arinos, Dominga 4. Bal-eng, Teresita 5. Begse, Myrna 6. Begseng, Tony 7. Beroso, Tessie 8. Bidana, Rosita 9. Bumakil, Dave 10. Bumakil, Devina 11. Bumakil, Lourdes 12. Carbajal, Roseann 13. Chanang, Vilis Age (y/o) 42 75 90 68 26 65 51 59 31 28 48 18 54 Blood Pressure (mmHg) 220/120 140/90 140/70 90/70 90/60 150/100 140/90 220/140 130/80 110/80 120/90 100/80 160/100
45

14. Codod, Luz 15. Colas, Thomasa 16. Comia, Marina 17. Delico,Darwin 18. Dominguez, Xyla 19. Galvan, Ramon 20. Isinon, Moris 21. Kidmano, Liza 22. Leavo, Jane 23. Lucio, Marcelino 24. Manaligod, Ester 25. Mhel, Lindz 26. Owengan, Eleazar 27. Pablo, Christina 28. Pentiano, Landy 29. Siong, Joe 30. Tasyo, Marie 31. Tamiray, Elena 32. Tancio, Rosa 33. Waclin, Eddie 34. Waklin, Glory

30 43 45 37 60+ 31 70 29 55 50 36 55 44 71 64 45 77 34 42 57 45

110/70 150/80 130/90 120/100 100/80 120/80 100/80 130/90 140/100 180/110 140/90 130/90 120/90 180/100 140/120 110/70 110/60 100/70 110/70 140/80 110/60

M2 (AUGUST 2010) 1. 2. 3. 4. 5. 6. 7. Name Gorence Mala Violeta Valdez Thelma Blas Mary Ann Bugtong Ana Incio Benita Antonio Dominga Maylon Age (y/o) 32 47 53 38 37 51 62 Blood Pressure (mmHg) 120/80 110/70 120/80 120/70 110/70 120/70 220/90
46

8. Caroline Mala 9. Panopyo Calsie 10. Virgina Calsie 11. Dexter Diano 12. Luciano Uyap 13. Medardo Meylon 14. Clarita Diano 15. James Moski 16. Marites Moski 17. Marcelia Moski 18. Dario Diano

80 49 47 31 69 40 34 80 57 M3 (JULY 2010)

150/90 120/80 120/90 100/60 110/80 140/80 100/70 120/80 120/70 140/80 130/90

Name 1. Mari Chris Tulingan 2. Dam Ang 3. Jelo Catayao 4. Jefrey Dayagan 5. Mincy Policdas 6. Molteng Alboros 7. Magdalena Pilay 8. Jaqueline Begseng 9. Irene Pacya 10. Benign Atingew 11. Mellita Carap 12. Anita Carap 13. Jeffrey Carap 14. Luisa Damurtis 15. Roy Incio

Age (y/o) 30 94 43 68 45 51 30 29 70 74 55 30 33 28

Blood Pressure (mmHg) 100/60 100/70 120/80 130/80 120/80 160/120 100/80 90/60 100/70 160/100 140/90 160/110 120/80 110/80 120/80

M4 (JUNE 2010) Otbong House # Name Age (y/o) Blood Pressure (mmHg)
47

0133

1. Aquisan, Benjamin 2. Dominguez, Lanro 3. Atilas, Nena 4. Bumakil, Linda 5. Osngaw, Onsing 6. Siong, Lydia 7. Banasen, Rose

52 56 63 57 51 61

150/100 90/70 110/ 70 100/70 130/90 170/100 120/80

Kawal Name 1. Blas, Gretchen 2. Diano, Clarita 3. Pilay, Magdalena 4. Incio, Nanette 5. Becsang, Jaqueline Age (y/o) 25 58 51 29 Blood Pressure (mmHg) 110/70 120/80 110/80 110/80 130/90

Libacong Name 1. Damian, Lourdez Andres 2. Maleari, Recardo Age (y/o) 25 45 Blood Pressure (mmHg) 120/90 130/90

Mangagew Name 1. Illion, Sima 2. Lamsis, Norma 3. Kinsimah, Huwebes Age (y/o) 70 48 78 Blood Pressure (mmHg) 130/80 130/90 130/110
48

4. Lagada, Ayorna 5. Guey, Beeny 6. Agadan, Janet 7. Bangdo, Gibson 8. Agadan, Salvador 9. Bato, Merly 10. Vicente, Umina 11. Sagayo, Simon

46 33 20 22 25 44

130/110 120/80 100/70 140/100 100/80 120/80 110/70 110/ 70

Bisal Name 1. 2. 3. 4. 5. 6. 7. 8. Solano, Moreno Lozano, Berting Bruno, Matias Lozano,Melania Sang-it, Flor Siong, Rosa Begseng, Gloria Sangkel, Cecilia Age (y/o) 52 55 80 56 30 60 54 73 Blood Pressure (mmHg) 150/110 140/110 160/90 170/110 120/80 130/80 100/70 120/70

Name 1. Waat, Masdag 2. Moreno, Tino 3. Quinio, Martha 4. Quinio, Julius 5. Suanding, George 6. Suanding, Dominguez 7. Magtino, Leyte 8. Magtino, Bibo 9. Lacquias, Neil Micheal

Age (y/o) 80 78 54 56 78 74 54 52 15

Blood Pressure (mmHg) 140/80 190/100 170/110 140/110 130/100 120/90 140/110 110/90 130/80
49

10. Cawa, Cariday 11. Aquisa, Candida 12. Calimoso, Betty 13. Calimoso, Ramil 14. Busakan, Lorna 15. Garci, Florentino 16. Jose, Junie 17. Suaking, Ricky 18. Salamo, Roldan 19. Tulingan, Roy 20. Tumilas, Rex 21. Paterno, Hildo 22. Paterno, Rolando 23. Paterno, Lydia 24. Paterno, Butchia 25. Paterno, Eldo 26. Paterno, Saturnino 27. Sigot, Albano 28. Sigot, Gloria 29. Paos, Dagtay 30. Modi, Claudine 31. Pabinal, Cristina 32. Mino, Mary 33. Boyay, Jessica 34. Boyay, Allan 35. Garcia, Ronnie 36. Garcia, Mila

77 58 44 38 25 56 50 19 17 39 19 22 54 43 9 19 48 77 38 65 28 36 61 29 37 28 51

130/70 170/90 120/90 130/90 150/90 160/100 130/90 110/80 150/80 110/70 140/100 140/100 140/80 120/80 110/70 130/90 110/70 140/90 100/70 150/100 110/90 110/80 160/100 100/80 120/80 120/90 120/80
50

37. Gayumba, Rhoda 38. Milo, Lenon 39. Magtino, Grace 40. Caluza, Yolanda 41. Paus, Benjamin 42. Tino, Jocey 43. Carame, Jamie 44. Wakit, Rhelyn 45. Curiman, Sofia 46. Deyosan, Manuel 47. Bumatas, Susana 48. Lorenza, Virginia 49. Matso, Salcedo 50. Matso, Nicholasa 51. Caseo,Adela

28 28 27 24 69 48 47 26 48 59 68 33 57 47 69

110/80 120/80 120/90 110/70 190/150 130/100 120/70 130/90 130/90 110/70 120/70 130/90 120/80 120/80 120/70

A4. CASE FINDING M1 NAME Douglas Palos SIGNIFICANT FINDINGS Post Paralyzed

INTERVENTIONS AND HEALTH TEACHINGS Intervention: Passive ROM exercises Health Teaching:

Unable to move the lower extremities

51

 Constipation Advised client on high fiber diet Advised activity like passive ROM exercises with the wife Advised client to increase fluid intake Dave Bumakil, Sr. Goiter Mr. Dave has a lump on his neck measuring 7.5 in diameter and 5.5 in height He stated that the lump started to grow since he was a teenager but was not able to consult a physician. He claimed that sometimes he felt pain precipitated by swallowing of foods Hypertension (Post-Stroke) Complains of left sided weakness and verbalized that she cannot move her left arm but can move her left leg minimally. Intervention: Assessed status of disease condition Referred to medical assistance Health teaching: Goiter: Description of goiter Types of goiter Causes of goiter Treatment/ Management of goiter Prevention of goiter

Dominga Arenos

Intervention: Assisted Range of Motion Exercises BP Monitoring Health Teaching: Stroke Rehabilitation Definition Risks for another stroke attack Complications Managements Arthritis Definition Signs and Symptoms Managements Range of Motion Exercises Definition
52

Arthritis Condition is manifested by swollen and misaligned joints of both arms with tenderness.

 Dave Bumakil Jr. Newborn Umbilical cord clamp is colored dark greenish brown. No foul smell No redness on surrounding area

Importance Guidelines Steps

Intervention: Performed umbilical cord care Health Teaching: Taught mother how to properly clean the umbilical cord clamp Identified to the mother the different signs of infection. Intervention: Performed umbilical cord care Health Teaching: Taught mother how to properly clean the umbilical cord clamp Identified to the mother the different signs of infection.

It is dry and skin is intact

Dave Bumakil Jr.

Newborn Umbilical cord clamp is colored dark greenish brown. No foul smell No redness on surrounding area

It is dry and skin is intact

M2
53

NAME Dexter Diano

INTERVENTIONS AND HEALTH TEACHINGS Cough Intervention: Presence of non Auscultated lung fields for productive cough crackles or rales No adventitious Encouraged to start quitting (crackles, rales) smoking for own benefit breath sounds heard Health Teaching: over both lung fields Cigarette and smoking RR=20cpm concepts No nasal flaring or Initial steps on how to any signs of difficulty quit smoking of breathing Side effects of smoking Client is a smoker Different nicotine consuming 2 cigarette replacement products packs a day different cigarette substitute Rewards of quitting smoking SIGNIFICANT FINDINGS Delayed Developmental Status Doesnt play interactive games with other child nor with her younger brother No evidence of parallel play Failure to put her clothing on her own (-)imitation of vertical lines (-) verbalization of any words (-)balancing in one foot (-) jumping in place Failure to follow directions (-) response when being talked Intervention: Built rapport to the child as well as to other family members Communicated with the child therapeutically Encouraged the parents to communicate therapeutically with the child most of the time Instructed the parents not to leave the child alone Encouraged the parents to notify their clinic for further assessment on the childs problem Health Teaching: Encouraged the parents to teach the child about self feeding and clothing
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April Jane Moski

 Encouraged them to provide nutritious and adequate food for the child Virginia Calsie Cough With nonproductive cough but with no abnormal breath sound upon auscultation Intervention: Auscultated for lung sounds and assessed breathing pattern Health Teaching: Increase oral fluid intake preferably lukewarm water Wear appropriate clothing (sweater/ jacket, pants) on cold weather Visit the Health Center when cough persist despite the remedies done Intervention: Monitored BP Health Teaching:
Hypertension

Medardo Meylon

Hypertension Blood pressure of 140/30 mmHg

Maria Meylon Rheumatoid Arthritis

Signs and symptoms Activities that prevent hypertension Ways to prevent hypertension

Intervention: Physical assessment specifically on inflamed joints Health Teaching: Identified home remedies for rheumatoid arthritis like application of alternating cold and warm cloth on the area every 5 minutes for pain relief; Adequate exercise and activity; and getting plenty of
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Inflamed joints noted specifically on hands, toes and knees

rest and sleep for a range of 8-10 hours a day. Identified herbal plants that could help in the management of rheumatoid arthritis like drinking powdered ginger to reduce symptom of rheumatoid arthritis and pineapple juice to prevent inflammation. Dario Diano Cough Vital Signs: BP=130/90 mmHg; RR=20cpm; HR=90 bpm Fine crackles auscultated at lower lobes of both lungs Occasional nonproductive cough Presence of Wound Scars prominent at lower extremities Undesirable smell

Intervention:
Auscultated lung fields for

presence of adventitious lung sounds Physical assessment Health Teaching: Proper hygiene Management and prevention of cough Risks of continuous use of cigarette and alcohol drinking Management on wounds and prevention of infection.

M3 NAME Mrs. Colas SIGNIFICANT FINDINGS Cough

INTERVENTIONS AND HEALTH TEACHINGS Intervention: Offered fluids as tolerated by the patient. Elevated the head of the bed of the patient. Opened the windows. Coordinate with the Barangay Health Center and know the services they
56

Wheezes heard on both lung fields upon auscultation With deep respirations, regular in rhythm Lack of ventilation around their house

 Polio

Presence of retained secretions

can provide to the community. Health Teaching:

Immobility

Cough Broaden the knowledge of the family about the nature of cough. Discuss the appropriate interventions of cough. Demonstrate how to use herbal medicines to relieve cough. Intervention: Assessed clients knowledge about proper hygiene. Assessed for skin problems. Assessed cleanliness of nails. Assessed for mouth problems. Health Teaching: Hygiene Discussed what is hygiene Discussed the advantages of proper hand washing. Demonstrated proper hand washing technique. Discussed on what are the interventions done if with skin problem. Described the steps of proper nail care. How to prevent tooth decay.

Chapiz Family

Improper Hygiene

Mark Tolingaen

Infected Wound

Intervention: Wound Care Health Education:

57

 Educate family on health deficit present which includes its definition, signs and symptoms, possible causes, possible effects if unresolved and management of complication of wound. Reinforce clients family knowledge on the wound care. Encourage the family to consider modifications in lifestyle, practices, etc. to manage the condition more effectively. Encourage the whole family to be more participatory in the management of present health deficit and other health threats. Proper way of cleaning the wounds. Discussed the signs and symptoms. Defined wound infection. Discussed the causes. Ways to manage the problem and ways to change their practices. Susan Tolingaen Meningitis Doctors diagnosed it as meningitis but the family believes that it is cause by witchcraft practices Intervention: Assessed the patients condition. Encouraged the family to help/provide her all her needs. Encouraged the family to provide safety and security. Health Teaching: Trained the patients family to do passive exercise specifically her legs and
58

arms. Encouraged the family not to leave the patient alone to ensure her safety. Encouraged the family to always talk with her to assure the patient that she has her familys support. Intervention: Instructed and assisted the patient to eat onions; and planted onions at their backyard BP monitoring Performed Physical Assessment (Assessed the patients eyes) Referred patient to the Barangay Health Worker Health Teaching: Hypertension Discuss with the family through home visit the possible causes of hypertension to prevent the disease from occurring. Discuss the necessary measures through lecture to prevent hypertension Educated the patient about the appropriate diet regarding his condition.

Molteng Alboros

Hypertension

BP: 160/100 mmHg on Left Arm sitting (+)dizziness (+)nape pain (+)tremors (+)varicosities on both feet (+)Non-pitting edema Cannot sleep at night With presence of headache With mass over right big toe Eyes: with irreversible blindness, (+) cloudiness, (+) redness in both eyes Vital Signs: Temperature : 36.6C RR: 19cpm PR: 67bpm Patient is conscious, oriented to time, place, and person, awake Diet: 4 full cups of Coffee a day Excessive sodium intake Low intake of meat, poultry,

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Milk, fruits, etc. Lifestyle: Sedentary Lifestyle Stays at home Sleep deprivation Anita Carap Hypertension 45 years old Right sided paralysis Irreversible blindness Slurred speech BP: 140/90 Presence of Wound Wound in dorsum of hands and back Poor Hygiene Intervention: Monitored BP Assessed predisposing factors Promoted personal hygiene by trimming nails and wound care Health Teaching: Encouraged to turn side to side every 2 hours Encouraged SO to facilitate turning patient Encouraged to ambulate if tolerated Intervention: Monitored BP Assessed predisposing factors Promoted personal hygiene by trimming nails and wound care Health Teaching: Encouraged to turn side to side every 2 hours Encouraged SO to facilitate turning patient Encouraged to ambulate if tolerated Intervention: Monitored BP during the rotation Assessed possible complications Assessed predisposing factors
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Benigno Atingew

Hypertension BP 180/100 Palpable pulse Impaired hearing Arthritis

Mellita Carap

Hypertension 79 years old BP 160/100 150/90 next taking of BP Eye cataract present Works as a farmer

Health Teaching: Instructed to eat or include garlic in diet Instructed to avoid coffee Instructed to take rests and avoid strenuous activity M4 NAME SIGNIFICANT FINDINGS INTERVENTIONS AND HEALTH TEACHINGS Intervention: BP Monitoring History taking Physical Assessment Health Teaching: Emphasized the importance of adequate rest and sleep of about 8-10 hours Encouraged to increase intake of iron-rich foods such as green leafy vegetables Emphasized importance of having check-ups when frequent dizziness is experienced Encouraged to increase fluid intake especially water and fresh fruit juices Intervention: BP Monitoring History Taking Physical Assessment Health Teaching: Smoking and Alcohol Drinking Discussed and determined the consequences of smoking and drinking alcohol habitually.
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Gloria Begseng Anemia Complained of nape pain and dizziness (symptoms of Anemia) BP of 130/90 mmHg Verbalized that she was diagnosed of anemia for the past years

Cough and colds

Verbalized that she is self medicating

Benjamin Aquisan

Unhealthy lifestyle and personal habits/practices

Smokes Drinks alcohol

Hypertension

BP: 150/90 mmHg

Discussed the different ways on how to quit smoking and drinking alcohol. Discussed the different benefits of quitting cigarette smoking and drinking alcohol. Hypertension Emphasized the importance of low fat and low salt intake. Assisted to identify ways to reduce stress and relaxation techniques. Instructed to keep a diary of blood pressure. Emphasized the importance of lifelong medications and need for follow up treatment.

Umina Vicente

Dry Cough No secretions No abnormal lung sounds auscultated

Intervention: Assessment especially respiratory status Deep Breathing Exercises Health Teaching: Cough Encouraged liberal fluid intake especially water Instructed to avoid smoking and stay away from secondhand smoke Demonstrated deep breathing exercises Advised to implement preventive measures to avoid spreading microorganisms such as covering of mouth while coughing Encouraged steam inhalation

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Jaquelyn Becsang

Hypertension

Intervention: Checked/ Monitored Blood Pressure Health Teaching: Discussed what hypertension is, the cause and possible remedies which includes the use of garlic and other herbal plants Emphasized on the importance of exercise, low fat and sodium diet

Blood pressure of 150/ 100 mmHg Complained for nape pain

Shaira Marie Becsang

Cough and Colds Urinary Tract Infection

Intervention: Physical Assessment History Taking Health Teaching: Cough and Colds Encouraged liberal fluid intake especially water Advised to implement preventive measures to avoid spreading microorganisms such as covering of mouth while coughing Encouraged steam inhalation Discussed what is cough and colds, how it is transmitted and the home remedies. Urinary Tract Infection Discussed UTI/ Urinary Tract Infection and emphasized the importance of increasing fluid intake. Encouraged to urinate whenever needed. Encouraged avoidance of junk foods which are very rich in sodium.
63

Pain upon urination

 Valerie May Becsang Cough and colds Amoebiasis

Encouraged proper hygiene.

Intervention: Physical Assessment History Taking Health Teaching: Encouraged liberal fluid intake especially water Encouraged intake of vitaminrich foods to increase immunity Discussed what is amoebiasis and the source of it. Encouraged proper handwashing before and after handling foods. Instructed to boil water before drinking Advised not to eat raw vegetables unless cooked

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Princess Xyra Cardinas

Incomplete Immunization

Intervention: Physical Assessment History Taking Health Teaching:

Thin Had fever but unrecalled body temperature

Immunization Emphasized the importance of complete immunization Taught on the advantages and the benefits of the different types of immunization Taught on ways to boost up the immune system Encouraged increase in fluid intake to reduce the risk for dehydration. Emphasized the importance of serving nutritious food. Encouraged to provide adequate rest and comfort. Informed about the food groups that will promote nutrition to the child

A5. FEEDING PROGRAM (M2) NAME 1. Sinot, Jay R K. 2. Begseng, Valerie L. 3. Mallare, Kenith M. 4. Incio, Lordan V. 5. Layog, Jansen B. 6. Calado, Angel A. 7. Polkero, Marphyle L. 8. Piok, Rommel S. 9. Saoyao, Jezebel A. 10. Incio, Yves M. A6. WEIGHT MONITORING (M2) NAME BODY MASS INDEX BIRTHDATE (MM-DD-YY)
65

1. Sinot, Jay R K. 2. Begseng, Valerie L. 3. Mallare, Kenith M. 4. Incio, Lordan V. 5. Layog, Jansen B. 6. Calado, Angel A. 7. Polkero, Marphyle L. 8. Piok, Rommel S. 9. Saoyao, Jezebel A. 10. Incio, Yves M. A7. LIST OF FAMILY SURVEYED

17.38 18.37 15.78 18 15.46 16.66 15.94 17.30 15.87 15.78

06-12-05 05-15-06 01-04-06 10-24-04 01-23-06 06-18-05 01-13-06 03-02-06 06-13-05 06-06-06

M3 (KAWAL, BOBOC, BOKOD, BENGUET) 1. Alboros, Berto 2. Alboros, Douglas 3. Alboros, Lorena
4. Alboros, Marcela 5. Alboros, Ponciano 6. Alides, Marcos 7. Alides, Randy

34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52.

Dontogan, Ernesto Dontogan, Juanito Esco, Nardo Incio, Dionesio Incio, Jim Incio, Raymund Incio, Renante Incio, Roland Incio, Rosendo Layog, Bryan Manaligod, Daniel Maniago, Manano Marcelino, Valerio Mendoza, Leon Oyap, Chicnay Pablo, Agosto Pacya, Celestino Pakidao, Ian Pesteloz, Paul
66

8. Amos, Raul Sr. 9. Antonio, Domingo 10. Atingog, Benigno 11. Awas, Amelina 12. Awas, Avelina 13. Basatan, Eliseo 14. Begseng, Brendo 15. Blas, Rufino 16. Botic, Ponciano 17. Bugtong, Filbert 18. Bugtong, Gabriel 19. Bugtong, Orbin

20. Bugtong, Reynaldo 21. Calado, Nestor 22. Carap, Melita 23. Catayao, Lito 24. Catayao, Telog 25. Chapis, Salvador 26. Colas, Ricardo 27. Colas, Thomasa 28. Damortis, Ceasar 29. Delos Santos, Jenethz 30. Diano, Dexter 31. Diano, Jose
32. Dincio, Conen

53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66.

Polkero, Andrew Sabongan, Luid Sabungan, Luzviminda Saoyao, Pepito Sinot, Dexter Sinot, Efler Sinot, Johnny Sinot, Karen Sinot, Pedro Sinot, Willy Sr. Talbase, Evelyn Tolingan, Efipanio Tolingan, Franklyn Waclin, Rafael

33. Dontogan, Arlene

A8. DISCUSSIONS DURING THE NIGHT CLASS (M4) EXPANDED PROGRAM ON IMMUNIZATION (EPI) Minimum Minimum Number st Vaccine Age at 1 Interval of Doses Dose Between Doses BCG Birth or anytime after birth 6 weeks 6 weeks 1 Reason BCG given at earliest possible age protects the possibility of TB meningitis & other TB infections in which infants are prone. 4 weeks 4 weeks An early start with DPT reduces the chance of severe pertussis The extent of protection against polio is increased the earlier the OPV is given Keeps the Philippines polio free Hep B At birth 3 6 weeks An early start of Hep. B reduces
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DPT OPV

3 3

interval from 1st dose to 2nd dose; 8 weeks interval from 2nd dose to 3rd dose

the chance of being infected and becoming a carrier Prevent liver cirrhosis and liver cancer. About 9000 die of complications of HB 10% of the Filipinos have chronic HB infection Eliminate HB before 2012 (a Western Regional Goal)

Measles

9 months

At least 85% of measles can be prevented by immunization at this age Prevents death (2% die), malnutrition, pneumonia, diarrhea (at least 20 %) get these complications from measles, etc. Eliminate measles by 2008

ADMINISTRATION OF VACCINES Vaccine BCG DPT OPV Dose Infants 0.05 ml 0.5 ml 2 drops or depending on manufacturers instructions Route of Administration Intradermal Intramuscular Oral Subcutaneous Intramuscular Site of Administration Right deltoid region of the arm Upper outer portion of the thigh Mouth Outer part of the upper arm Upper outer portion of the thigh

Measles 0.5 ml Hep B 0.5 ml

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SUMMARY OF ACTIVITIES (GHANTT CHART) GROUP M1 (SEPTEMBER 6-7/13-15/20-21, 2010) DATE September 6, 2010 (Monday) OBJECTIVES ACTIVITIES To conduct Courtesy call to the courtesy municipal health center call to the Rechecked tally and municipal interpreted the family health survey center, barangay health center and the municipal mayor To conduct ocular EVALUATION Able to do courtesy call to the municipal health center, and to the daughter of the municipal mayor, mayor wasnt around. Wasnt able to do ocular survey to Otbong because of inadequate time to travel and unpredictable
69

September 7, 2010 (Tuesday)

September 13, 2010 (Monday)

survey at Sitio Otbong To conduct ocular survey and case finding at Sitio Otbong for our Family Nursing Care Plan (FNCP) To conduct home visit to our assigned family

weather

Ocular survey at Sitio

September 14, 2010 (Tuesday)

To conduct school health teachin g in Otbong Primary School

Otbong Case finding Establish rapport Coordinated to the primary teacher of Otbong Elem. School for school teaching Immunization BP Taking Home visit Establish rapport Physical Assessment Identify strengths and weakness of the family Health Teaching BP Taking Preparation of materials for school teaching School Teaching: Grade I Hygiene Handwashing Grade II Nutrition: Food Groups Physical assessment of Students

Able to do ocular survey at Sitio Otbong Able to find cases for FNCP and visited one, a post stoke patient

Conducted Home Visit to our families Conducted health teaching on each family

Conducted school

health teaching in Otbong Primary School about hygiene and nutrition

September 15, 2010 (Wednesday)

To be able to clean the herbariu m of

Cleaning of herbarium Passed a copy of graphs for interpretation to the public health nurse

Able to weed out

the herbariums at Kawal Elem. School

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September 20, 2010 (Monday)

Kawal Elem. School Home Visit Continu e Assess ment with Familie s

in Poblacion and midwife of Bobok Home Visit Community Immersion BP Taking

Not all of the

September 21, 2010 (Tuesday)

Termin ation Phase

Termination Phase Cleaning of Staff house

groups for FNCP were able to conduct home visit because the whole group had a community immersion with the burial of one of a client, Mrs. Arinos who died. Able to terminate properly with our clients Cleaned the staff house

GROUP M2 (AUGUST 9-11/16-17/23-24, 2010) Week 1 Day 1 Date: 09 August 2010 OBJECTIVES: > conduct courtesy call to the Municipal Mayor, Hon. Mauricio T. Macay, to the Rural Health Unit Personnel and do ocular survey. >Departure time: 07:10 am >went directly to Bokod, Municipal Hall to do courtesy call to the Mayor >arrived at the Municipal Health Office (MHO) for a brief orientation on the current health status of the residents of Bokod given by MHO personnel: Ma'am Brigitte Sanone (Medical Technologist) and Ma'am Wales

ACTIVITIES:

71

>went to see Ma'am Irene Pacya (Barangay Health Worker-Sitio Kawal) but was unavailable, thus, names and location of the unsurveyed households were confirmed by Sitio Kawal resident, Mrs. Jenelyn Insio >headed for an ocular survey >went back to the staff house located in Kawal Elementary School EVALUATION: >objectives were met since the group was able to: meet the municipal Mayor, acquire information from the Municipal Health Office and ocular survey was done. Even though Ma'am Irene was unavailable that day, confirmation was still done and accomplished with the help of several residents.

72

Week 1 Day 2 Date: 10 August 2010 OBJECTIVES: > to choose family clients from Libacong, Bobok-Bisal, Bokod and at the same time, assess their living conditions and accomplish Initial Data Base >meet Bobok's barangay officials ACTIVITIES: >by 8:15 am, the group started to hike and arrived at Libacong by 9:00 am >the group was tasked to pair up and look for a family client. Unluckily, many houses were found to be locked which made the client finding difficult for several pairs some pairs who had immediately found their clients were able to accomplish the initial data base right away through observations and interviews >by 11:00 am, C.I. together with the group leader and secretary for that day departed Libacong, passed Nganuan to meet Bobok's Barangay Officials >barangay captain was not present that's why courtesy call was done to Kagawad Julio Dell instead >after visiting families in Libacong, the group worked to tally the census survey that was started by the previous group EVALUATION: >objectives were partially met since not all of the pairs had the chance to have their family client. The barangay chairman and the midwife were unavailable. Week 1 Day 3 Date: 11 August 2010 OBJECTIVES: >meet the Barangay Health Worker of Bobok, Bokod to clarify CBMIS >assist midwife at the Barangay Health Center ACTIVITIES: >departure from Kawal Elementary School at around 8:00 am after attending school's flag ceremony

73

>reached the Health Center, met the midwife (Mrs. Catalina Segundo) and familiarized the center's set up >half of the group assisted with the procedures done at the health center while the other half remained outside to continue the tallying that was not finished the other night. After sometime, the assisting and the tallying group switched places so that everybody is given the chance to perform a skill. >performed BCG, DPT, anti-measles immunizations and OPV administration on infants >assisted in DMPA vaccinations of mothers >performed wound care >met BHW, Mrs. Irene Pacya to verify and confirm data and information on CBMIS EVALUATION: >objectives were met. The group assisted in the Health Center and has interacted with the BHW who verified information on CBMIS Week 2 Day 1 Date: 16 August 2010 OBJECTIVES: >to conduct home visit to each subgroup's family client >perform a thorough physical assessment on our clients >continue accomplishing the Initial Data Base and start with the first level assessment ACTIVITIES: >Departure time: 7:15 am >by 11:00 am, the group started to hike towards Libacong and arrived at around 11:30 am >met our family client and started conducting physical assessment and interview >did BP taking >returned to the staff house in Kawal EVALUATION: >objectives were met since all subgroups were able to assess their

74

client and establish rapport, thereby, accomplishing initial data base (for some) and starting the first level assessment Week 2 Day 2 Date: 17 August 2010 OBJECTIVES: ACTIVITIES: >to fence and fix the herbarium in Kawal Elementary School >attended the flag ceremony in Kawal Elementary School >removed and cleaned unnecessary weeds in the herbarium >started to fence the herbarium at around 8:45 am by using the woods and logs prepared by the grade six Students >made "sampayan" beside the Home Economics room >departed Kawal by 2:00 pm EVALUATION: >objective partially met since the other herbarium was not yet fenced Week 3 Day 1 Date: 23 August 2010 OBJECTIVES: >to perform feeding program in Kawal Day Care Center >to do physical assessment on the Day Care pupils >to do comprehensive physical assessment of every subgroup's family client ACTIVITIES: >the group attended the morning flag ceremony >by 8:30 am, the group went to the Day Care Center and started the program with a prayer >the group facilitated the game "bring me" and others such as coloring activity >we did physical assessment on the Day Care pupils: age, height, weight, arm circumference, temperature, PERRLA, triceps skinfold thickness >we ended the program by feeding the children with the food that
75

the group has prepared >by 11: 30 am, the group hiked for Libacong to meet our family clients and did Physical Assessment EVALUATION: >we were able to accomplish the feeding program and physical assessment of the pupils. Objectives were fully met.

Week 3 Day 2 Date: 24 August 2010 OBJECTIVE: ACTIVITIES: >to be able to paint the fence of the herbarium >the planned activity for the day, which is painting the fence of the school herbarium was not done because there was no available paint >the group decides to return to Libacong for the last time and the four pairs who had gone back encounteredtheir family clients. BP taking, additional health teachings were done >some members, together with CI, went to meet the Kagawad for health and BHW but were not around that time >a pair went to search for their family client's residence and returned by 2:00 pm >departed Kawal Elementary School EVALUATION: >objective was not met, but many worthy activities were done and accomplished in lieu of painting the fence of the herbarium

GROUP M3 (JULY 12-14/19-20/36-37, 2010) Date: June 12, 2010 Objectives:

76

To conduct courtesy calls Ocular survey Spot mapping Suppose to have courtesy call with the barangay captain of Bobok-Bisal but was not around Went to Kawal Elementary school and spoke to Mr. Johnny Bugnay, school principal, if we can stay at the school (serve as our quarters), they allowed us and together with Mrs. Daisy Sinot (Grade 6 teacher), we fixed the HE room.

Activities:

Went to Bokod Poblacion, courtesy call at the rural health unit and municipal hall. Important people met: Hon. Mauricio Macay (mayor), Dr. Lilian Velasco (MHO), Maam Francisca Galunza (midwife at Dadan) and Mrs. Catalina Segundo (midwife at Bobok-Bisal) Maam Brigitte Sanone (medical technologist) and Maam Ignacio Fabiola (rural sanitary inspector)

Coordinated with maam Segundo regarding CBMIS and other concerns and information we need for the updates of CBMIS. Went back to Bobok-Bisal and had ocular survey as well as update the spot map. Objectives were partially met; some important personnel (Brgy. Captain and BHW) were not met this day and spot map was not yet finalized. Date: July 13, 2010

Evaluation:

Objectives:

Case/family finding Blood Pressure taking Health teaching Coordinate with Mrs. Catalina Segundo regarding CBMIS Coordinate with maam Magdalene Pilay regarding health teaching to the kindergarten class To have courtesy call with Brgy. Captain of Bobok-Bisal, Herbarium make-over

Activities:
77

Attended flag ceremony at around 8:00 am in Kawal Elementary School 8 students went for case finding, BP taking and Health Teaching Four students accompanied Mr. Jaylord Indalos, coordinated with Maam Catalina Segundo regarding CBMIS. They also coordinated with Maam Magdalene Pilay regarding health teaching to Kindergarten class. They were supposed to have a courtesy call with Brgy. Captain but he was not around.

In the afternoon, students were divided into 2 groups to improve the 2 herbariums Objectives were partially met. Brgy. Captain was not around for courtesy call. 4 students did not have their family clients yet. Date: July 14, 2010

Evaluation:

Objectives: Health teaching to kindergarten students Case finding for the 4 students Case finding: the four students went to find their own family. There were four families that the brgy. Health worker, maam Irene Pacya recommended. They want to find the four families the BHW recommended. Nutritional assessment was done to grades 1 and 2 The objectives were partially met since the group did not have the chance to do the health teaching to the kindergarten students due to the unexpected rainy weather but still thought of another activity which was nutritional assessment to grades 1 and 2. The four students did not have their family yet since the families recommended were either not around or not willing. Date: July 19, 2010 Objectives: Census at Sitio Kawal Case finding for the four children Evaluation:

Activities:

Activities:
78

Departure time: 7:00 am Arrived at Sitio Kawal at 10:00 am Maam Irene Pacya accompanied the group around Kawal while doing the survey. The group interviewed at least one member of each household regarding the questions in the survey form which includes the number of person living in that particular house, their age and birthdate and if they are family planning acceptor

Went back to Maam Irene Pacyas house to update and finalize the forms There were 8 houses that were not yet surveyed so 10 of the students find these houses to be updated

Evaluation: Objectives were partially met since the census was done but the four students do not have their family yet. Date: July 20, 2010 Objectives:

Health teaching on grades 3 and 4 about hygiene Health teaching on grades 5 and 6 about changes during puberty and alcoholism and vices Nutritional assessment on grades 3 to 6 Home visit Family finding for the four students The group was divided into two: group for grades 3 and 4 then the other group for grades 5 and 6. The group for grades 3 and 4 performed nutritional assessment first. The other group started with the health teaching for grades 5 and 6. After 1 hour and 30 minutes, the groups changed activities. The group of grades 5 and 6 proceeded to nutritional assessment while the other group went for health teaching.

Activities:

After the activities in Kawal Elementary School, the group went to visit their families. They gathered information and identified family problems. The four students searched for their families

Evaluation:
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Objectives were met. Health teaching and nutritional assessment were done from grades 3 to 6. The group was able to visit their own family and finally, the four students found their families. Date: July 26, 2010

Objectives: Census 20 houses left Health teaching to the families Group ARAS Departure time: 7:00 am We went to maam Irene Pacyas house to ask the location of the 20 houses but she was not around because she was confined Since we cannot proceed to the census we just visited our families and conducted health teaching Since we were able to finish early, we just went back and fixed the herbarium Conducted group ARAS after dinner Objectives were partially met since the census was not done but the health teachings and ARAS went on smoothly. Date: July 27, 2010 Objectives: Plant more herbal medicine in the herbarium Final touch in the herbarium General cleaning of the HE room Plated herbal medicines in the herbarium and relocated some plants Painted some parts of the herbarium Conducted general cleaning of the HE room then prepared for departure

Activities:

Evaluation:

Activities:

Evaluation:

80

Objectives were partially met since we finished the beautification of the herbarium and we conducted general cleaning in the HE room.

GROUP M4 (JUNE 14-15/21-23/28-29, 2010) 1st WEEK DATE June 14, 2010 OBJECTIVES Courtesy call to the Municipal Mayor, Sangunian officers and to the Municipal Health Officer/ PHN. Courtesy call to Barangay Officials and to the Midwife. Preparation of the staff house and delegation of task during the whole rotation of group M4. To conduct ocular survey, home visit, operation BP, family case finding, family initial database gathering and health teachings at sitio Otbong. Journal sharing. To conduct ocular survey, home visit, operation BP, family case finding, family initial database gathering and health teachings at sitio Kawal and Libacong. To coordinate with the Principal of Kawal Elementary School about health status of students and activities to be conducted such as Health teaching on Cough and Colds, Diarrhea, Proper Hygiene, Proper Nutrition and Urinary Tract Infection (UTI).

June 15, 2010

2nd WEEK DATE June 21, 2010 OBJECTIVES

To conduct ocular survey, home visit, operation BP, family

case finding, family initial database gathering and health teachings at sitio Mangagew. To coordinate to the Teacher- in- charge about the health status of students and activities to be conducted such as Health Teaching on Proper Hygiene, giving of medicines like Paracetamol and to conduct Operation Timbang on students. June 22, 2010
To conduct ocular survey, home visit, operation BP, family

case finding, family initial database gathering and health teachings at sitio Bisal.
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 Courtesy call to the Barangay Captain of Bisal. To coordinate with the Principal of Bisal Elementary School about health status of students and activities to be conducted such as Health Teaching on Proper Hygiene and Proper Nutrition. June 23, 2010
To conduct ocular survey, home visit, operation BP, family

case finding, family initial database gathering and health teachings at sitio Central Boboc ARAS. Revised accomplishment report.

3rd WEEK DATE June 28, 2010 OBJECTIVES To attend oath taking of newly elected officials at Bokod Municipal Hall. Render a group performance for the community folks through the singing of the Ibaloi song Eskoyda which means Education. To conduct ocular survey, home visit, operation BP, family case finding, family initial database gathering and health teachings at sitio Cobabeng. To coordinate with Kawal Elementary Schools principal regarding the planned school health teaching. To conduct a school health teaching at Kawal Elementary School and discuss about proper nutrition, personal hygiene, cough and colds, diarrhea and UTI. General cleaning of the staff house.

June 29, 2010

ACCOMPLISMENT REPORT By Group M4 1ST WEEK

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DATE June 14, 2010

ACTIVITIES Courtesy call to Mrs. Catalina Segundo (Bobok District II Midwife) and Kagawad Josepha Located and cleaned the Staff house Conducted Ocular Survey, Spot mapping, Home visitation, Operation BP, Case finding, Gathering of Family Initial Database and Individualized Health Teaching at Otbong, Bobok. Courtesy call to the Municipal Mayor (Mr. Mauricio T. Macay), to the RHU personnel: Dr. Lilian C. Velasco (Municipal Health Officer), Brigitte M. Senone (Medical Technologist), Aurelia L. Wales (Municipal Health Nurse), Fabiola C. Ignacio (Rural Sanitary Inspector), Francisca S. Galunga (Midwife III- Daclan), Barbara B. Catino (Midwife III- Bila, Catalina S. Segundo (Midwife II- Bobok- Bisal) and to the Police Leaders Continued Ocular Survey, Home visitations, Operation BP, Family Case Finding and Family Initial Database Gathering at Kawal and Libacong. Visited Kawal Elementary school and had courtesy call to the Principal Mr. Johnny Bugnay, and the principal requested to conduct Health Teaching on Proper Hygiene, Proper Nutrition and Sex Education which will we conducted with the students parents.

June 15, 2010

2ND WEEK DATE June 21, 2010 ACTIVITIES Conducted Ocular survey, Home visitations, Operation BP, Family Initial database gathering and individualized Health teaching at Mangagew. Coordinated with the School Head Teacher of Bolo Elementary School, Mrs. Carolina Colas to conduct a health teaching regarding Cough and Colds, Diarrhea, Proper Hygiene, Proper Nutrition and Urinary Tract Infection (UTI) upon the availability of time and if not possible, to be endorsed to the incoming group. Continued home visits, operation BP, family initial data base
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gathering, and individual health teaching at Boboc Proper Conducted Group ARAS June 22, 2010
Conducted Ocular survey, Home visitations, Operation BP,

Family Initial database gathering and individualized Health teaching at Bisal. Visited the family of the Barangay Captain of Bisal. Conducted courtesy call to the Barangay Captains wife since the Barangay Captain is in Baguio for some reasons. June 23, 2010
Continued home visits, operation BP, family initial data base

gathering and individualized health teaching in Boboc Proper

3RD WEEK DATE June 28, 2010 ACTIVITIES Attended and participated at the Oath Taking and Turn Over Ceremony of the Municipal Mayor and Sangunian Officers in the Municipal Hall of Bokod Coordinated with the Municipal Health Officer, Dr. Lilian Velasco. Coordinated with the Principal of Kawal Elementary School, Mr. Johnny Bugnay for the conduct of Health Teaching. Reiterated on their request on the seminar. Coordinated with Cobabeng Elementary Schools Teacher-inCharge, Mrs. Tamilan regarding schools health needs such as health teaching on Cough and Colds, Diarrhea, Proper Hygiene, Proper Nutrition and Urinary Tract Infection (UTI). Gave the Token of Appreciation to Maam Catalina Segundo (Bobok District II Midwife)
Conducted Health Teaching at Kawal Elementary School.

June 29, 2010

Grades 1 to 3 with the topics Cough and Colds, Proper Hygiene and Proper Nutrition taught by Karen Dangpason, Mary Ann Molina, Diana Olangcay, Divine Tiangson, Nikki Tuazon and Laverne Tuban. Grades 4 and 6 with the topics Diarrhea, Proper Hygiene and Urinary tract Infection/ UTI taught by Loida Dulay, Isabelina Lingayo, Noreen Pineda and Jenny Greece Sidayen. And Grade 5 with the same topics taught by Eunice Basali and Jill Canuto. Conducted General Cleaning of the Staff House

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Community Immersion M1 Otbong, Bobok, Bokod Activities 1. Formulation of Goals, objectives, and plans. 2. Courtesy Calls Barangay Halls, Barangay Health Center 3. Ocular Survey 4. Home Visits 5. Interview/Data gathering 6. Case Finding 7.Implementation of FNCP 8. Other Activities A. School Health Teaching B. Herbarium Cleaning C. Social Integration D. Health Teaching 9. Termination Phase
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Sept. 6

Sept. 7

Sept. 13

Sept. 14

Sept. 15

Sept. 20

Sept. 21

Community Immersion M2 Libacong, Bobok, Bokod Activities 1. Formulation of Goals, objectives, and plans. 2. Courtesy Calls Barangay Halls, Barangay Health Center 3. Ocular Survey 4. Home Visits 5. Interview/Data gathering 6. Case Finding 7. Implementation of FNCP 8. Other Activities A. Coordinate regarding CBMIS B. Feeding program C. Herbarium D. Coordinating regarding CBMIS 9. Termination Phase Aug. 9 Aug. 10 Aug. 11 Aug. 16 Aug. 17 Aug. 23 Aug. 24

Community Immersion M3 Kawal, Bobok, Bokod Activities July 12 July 13 July 14 July 19 July 20 July 26 July 27

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1. Formulation of Goals, objectives, and plans. 2. Courtesy Calls Barangay Halls, Barangay Health Center 3. Ocular Survey 4. Home Visits 5. Interview/ Data gathering 6. Case Finding 7.Implementation of FNCP 8. Other Activities A. Health teaching B. Herbarium C. Spot Mapping D. BP taking E. Census F. Nutritional Assessment G. ARAS 9. Termination Phase

Community Immersion M4 Bobok, Bokod

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Activities 1. Formulation of Goals, objectives, and plans. 2. Courtesy Calls Barangay Halls, Barangay Health Center 3. Ocular Survey 4. Home Visits 5. Interview/Data gathering 6. Case Finding 7. Implementation of FNCP 8. Other Activities A. School B. Operation Bp

June June 14 15

June 21

June 22

June 23

June 28

June 29

C. Health Teaching D. ARAS E. Coordination with: officials and school administrators 9. Termination Phase

LEGEND: Objectives: Fully Met

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Objectives: Partially Met Objectives: Not Met

DOH UPDATE ESSENTIAL NEWBORN CARE (The DOH/WHO Protocol) What Immediate Newborn Care Practices will save lives? Four Core Steps of Essential Newborn Care:
1. Immediate and thorough drying

2. Early skin-to-skin contact 3. Properly timed cord clamping 4. Non-separation of the newborn and mother for early initiation of breastfeeding TIME BAND: AT PERINEAL BULGING PREPARE FOR THE DELIVERY Check temperature of the delivery room

25 - 28C

Free of air drafts Free of air drafts Notify appropriate staff

Arrange needed supplies in linear fashion 89

 Check resuscitation equipment

Wash hands with clean water and soap

Double glove just before delivery TIME BAND: WITHIN 1ST 30 SECONDS IMMEDIATE AND THOROUGH DRYING Call out the time of birth Dry the newborn thoroughly for at least 30 seconds Wipe the eyes, face, head, front and back, arms and legs Remove the wet cloth Do a quick check of breathing while drying
Note:

Do not ventilate unless the baby is floppy/limp and not breathing Do not suction unless the mouth/nose are blocked with secretions or other material TIME BAND: 0 TO 3 MINUTES: IMMEDIATE AND THOROUGH DRYING Do not wipe off vernix
Do not bathe the newborn

Do not bathe the newborn

Do not do foot printing

No slapping No hanging upside down No squeezing of chest TIME BAND: AFTER 30 SECONDS OF DRYING EARLY SKIN-TO-SKIN CONTACT If newborn is breathing or crying: Position the newborn prone on the mothers abdomen or chest abdomen or chest Cover the newborns back with a dry blanket Cover the newborns head with a bonnet
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 Note:

Avoid any manipulation, e.g. routine suctioning that may cause trauma or infection suctioning that may cause trauma or infection Place identification band on ankle (not wrist) Skin to skin contact is doable even for cesarean section newborns

TIME BAND: 1 TO 3 MINUTES PROPERLY - TIMED CORD CLAMPING Remove the first set of gloves
After the umbilical pulsations have stopped, clamp the cord using a sterile stopped,

clamp the cord using a sterile plastic clamp or tie at 2 cm from the umbilical base
Clamp again at 5 cm from the base

Cut the cord close to the plastic clamp

Note:

Do not milk the cord towards the baby After the 1st clamp, you may strip the cord After the 1st clamp, you may strip the cord of blood before applying the 2nd clamp Cut the cord close to the plastic clamp so that there is no need for a 2nd trim Do not apply any substance onto the cord TIME BAND: WITHIN 90 MINUTES NON-SEPARATION OF NEWBORN FROM MOTHER FOR EARLY BREASTFEEDING Leave the newborn in skin-to-skin contact Observe for feeding cues, including tonguing, Observe for feeding cues, including tonguing, licking, rooting

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 Point these out to the mother and encourage her to nudge the newborn towards the

breast: Counsel on positioning

Newborns neck is not flexed nor twisted Newborn is facing the breast Newborns body is close to mothers body

Newborns whole body is supported Counsel on attachment and suckling Mouth wide open
Lower lip turned outwards

Babys chin touching breast Suckling is slow, deep with some pauses
Note:

Minimize handling by health workers

Do not give sugar water, formula or other prelacteals Do not give bottles or pacifiers

Do not throw away colostrums

Weighing, bathing, eye care, examinations, injections (hepatitis B, BCG) should be

done injections (hepatitis B, BCG) should be done after the first full breastfeed is completed Postpone washing until at least 6 hours THE EVIDENCE IS SOLID! THE FOLLOWING NEWBORN CARE PRACTICES WILL SAVE LIVES:
1. Immediate and Thorough Drying 2. Early Skin-to-Skin Contact 3. Properly Timed Cord Clamping 4. Non-separation of Newborn from Mother for Early Breastfeeding

REFERENCE: http://www.scribd.com/doc/34524396/Essential-Newborn-Care

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ORGANIZATIONAL CHART

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PRESENTATION OF TABLES & INTERPRETATION During the community duty on June 2010 Group M3 conducted a survey to update the information gathered last January 2007 regarding the health condition of each family in Sitiio Kawal using the CBMIS Questionnaire. After the survey Group M2 tallied the results and the results were interpreted by Group M1. The tables, figures, and their corresponding interpretation are as follows:

AGE (y/o) Under 1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90 N/A

FAMILY SURVEY (KAWAL, BOBOC, BOKOD, BENGUET) MALE FEMALE 1 17 20 10 17 18 15 11 11 9 12 1 10 4 3 0 1 2 0 1 2

TOTAL

3 4 18 35 16 36 18 36 12 29 14 32 12 27 15 26 8 19 2 11 3 15 6 7 9 19 2 6 1 4 2 2 3 4 2 4 1 1 1 2 2 4 TOTAL 325 Table 1. POPULATION BY AGE AND GENDER OF SITIO KAWAL

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Figure 1. POPULATION BY AGE AND GENDER OF SITIO KAWAL

Table 1 represents the population by age and gender of Sitio Kawal. The highest value in the population belongs to the bracket age of 5-9 and 10-14 which is 36. In the age group of 5-9, 20 are male and 16 are female while in the age group of 10- 14, 10 are male and 18 are female. The lowest value in the population belongs to the age group of 85- 89 years old composed of one member who is a female. The graph represents a beehive shaped population. This means that the population is considered to be young. A big part of the population is made up of ages 0-19 years old which considered to be young but the irony is that the working population is as twice as big as the young population. Despite of the fact that the working population is of huge number, the number one income generating job in the community is through farming. Farming is not a stable work. The income from this work is affected by different factors such as the weather, pests, transportation problem and kind of soil. The population according to gender is indicative that males are more than females. There are an increasing number of bachelors in the community. Despite that they have their own land and houses, they remained single and avoid starting a family due to the fear of not sustaining their own family. This is one of the many factors that contribute to the imbalance between male and female in this community. CIVIL STATUS Married Single Children Widowed Separated TOTAL TOTAL 104 74 132 15 0 325

Table 2. CIVIL STATUS OF SITIO KAWAL

Figure 2. CIVIL STATUS OF SITIO KAWAL

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Table 2 shows the Civil Status of the people living in Sitio Kawal. In the 325 population of the sitio, 132 are children which are considered as the highest. Second is married which is composed of 104 members. Third, single composed of 74 members. Next are the widowed composed of 15 and lastly is separated with a zero value. The largest portion of the population belongs to the civil status of children. There are many children in the community since many families in the place are not using any family planning method and also many of them prefer to use a natural family planning method. Many in the population are also married, producing more children. Next largest portion belongs to the married civil status. Despite the fear of some of not sustaining their family, many still pursue a married life. Thirdly is the single group which is composed of 74 people. Many of their population also prefer to be single due to poverty or low income; they fear that they will not be able to provide the needs of their family. The widowed group is composed of 15 members of the community. Nobody in the community is separated, thus showing that the community gives a high respect in the blessedness and sanctity of the matrimonial sacrament.

EDUCATIONAL ATTAINMENT No formal education Elementary (undergraduate) Elementary (graduate) High school (undergraduate) High school (graduate) College (undergraduate) College (graduate) TOTAL

TOTAL 80 70 74 15 54 13 18 325

Table 3. EDUCATIONAL ATTAINMENT

Figure 3. EDUCATIONAL ATTAINMENT

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Table 3 illustrates the educational attainment of Sitio Kawal. The highest value belongs to the group of those who do not have formal education which is composed of 80 members. The lowest value belongs to the group of those who reached college but undergraduate which is composed of 13 members. The biggest portion of the population is literate which prove that education is still valued by the community. The other portion of the population did not receive a formal education. Parts of this are children under school age, and others are those who did not attend classes which may be caused by the distance between their homes and the school. Only few finished College level which may be due to poor economic conditions since source of income in the community is limited.

TYPE OF TOILET Flush type Water sealed Dig pit TOTAL

TOTAL 13 30 17 60

Table 4. TYPE OF TOILET FACILITY PER HOUSEHOLD

Figure 4. TYPE OF TOILET FACILITY PER HOUSEHOLD

Table 4 showing the type of Toilet Facility reveals that the most used type is water sealed with a total number of 30 (50%) out of 60, next is dig pit with a total number of 17 (28.33 %) and the least utilized is flush type with a total number of 13 (21.67%). Most of the community folks use the Water sealed toilet facility which is the most common type that is utilized by households. This is a good point because in the water sealed type, the water in the bowl prevents the flies from breeding on the waste which is important in preventing transmission of diseases from vectors of diseases like flies. Although there are still community folks that use the conventional types of toiletry which
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are the flush type and the dig pit. The dig pit utilization would signify that some of households do not still have a comfort room. Also, flush type toilet facilities are used but at least only by least proportion of the households. Factors that would possibly affect the utilization of the dig pit method or flush type on some of the households include poverty, lack of interest and for the dig pit alone, and the distance of the houses since the distances between neighborhoods are quite far. Dig pit or flush type methods would not have a significant effect on the health or in the daily lives of the community folks. They may get various diseases from the vectors breeding from humans wastes. Although, the fact that there is a proportion of households still utilize the dig pit method is alarming and should be addressed by the government.

GARBAGE DISPOSAL Burning Pit private Open dumping/Communal TOTAL

TOTAL 48 10 2 60

Table 5. GARBAGE DISPOSAL PER HOUSEHOLD Figure 5. GARBAGE DISPOSAL PER HOUSEHOLD

Garbage disposal methods of the community folks show that burning is the most utilized method with 48 (80%) out of 60, next is the pit privy with 10 (16.67%) and the least utilized is open dumping or communal with a total number of 2 (3.33%). A very big proportion of the population still follows the burning method of handling garbage. Although the government discourages this method, the community folks are still unaware of its hazards because of the lack of information dissemination regarding the anti-burning program of the government. Only a small number utilizes pit privy which is the one recommended by the government in the far-flung areas. Also, in which communal dumping is not common. This makes a very small proportion uses open dumping/communal. Factors that would affect these include lack of interest in doing their
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own pit privy or they find burning method the easiest to get rid of their waste but they dont know the harmful effects that they may suffer from the smoke emitted by their trash like respiratory diseases. Information dissemination about the harmful effects that they may get from the burning method is needed and also the participation and willingness of the community not to use the burning method.

LEVEL OF WATER SUPPLY Level 1 Level 2 Level 3 TOTAL

TOTAL 4 26 30 60

Table 6. LEVEL OF WATER SUPPLY

Figure 6. LEVEL OF WATER SUPPLY Table 6 represents Level of Water Supply facilities in all households. It shows that the most utilized is Level 3 (Waterworks System or Individual House Connections) with total number of 30 out of 60 (50%). Next, with a minimal difference from the highest, is level 2 (Communal Faucet System or Stand Post) with the total number of 26 (43.33%) and the least utilized is level 1 (Point Source) with the total of 4 (6.67%). The community mostly uses piped systems of water supply which include Level 2 (communal faucet system or stand post) and Level 3 (waterworks system or individual house connections). This would indicate that water supply is sufficient and not a major concern in the community since only a very small number uses the point source system (level 1). This would also indicate that water systems in the far-flung areas are already fixed especially that they are rich with water supply from the mountains.

FAMILY PLANNING ACCEPTORS

TOTAL

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YES NO TOTAL

18 14 32

Table 7. FAMILY PLANNING ACCEPTORS

Figure 7. FAMILY PLANNING ACCEPTORS Table 7 shows the number of family planning acceptors. The table reveals that a higher number of community people answered yes with a total number of 18 (56.25%) out of 32 while 14 (45.75%) answered no. A greater number of couples use family planning methods. The numbers between who accepts family planning and those who dont are not that far with only a difference of 4.This may be a good finding, but still, many couples still are not into family planning. Population control is very important in the community. This suggests that in this community, maybe, some are not that exposed to appropriate information about family planning. They still lived with traditions and practices like believing that the measurement of wealth is not measured by material things but by having a lot of offspring. But at least many are now opened to the idea of family planning considering that in this modern time, it is difficult to earn for a living and for your own family. Overpopulation is not a foreseen problem because of the large land area, but having an undesirably large number of children would be a burden because of the limited source of income which would further cause poverty. The health workers in the community should then implement more health teachings regarding family planning methods to the reproductive population. FAMILY METHOD USED Pills DMPA Condom IUD BTL TOTAL 0 5 0 0 4
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Vasectomy Abstinence/Calendar LAM Withdrawal TOTAL Table 8. FAMILY METHOD USED Figure 8. FAMILY METHOD USED

0 2 2 8 21

Table 8 comprises methods of family planning used. It shows that most of the population uses withdrawal method with a total number of 8 (38.10%) out of 21. Abstinence or Calendar and LAM have the least number of only 2 each (9.52%). The community uses both natural and artificial family planning methods. The most commonly used methods are those which require motivation, yet are free. Withdrawal which is the most commonly used, has a failure rate of 18% (Pillitteri, A. Maternal and Child Health Nursing 4th ed.) which makes it not a very safe method of family planning. Other natural family planning methods used have a high success rates from 98-100%.Also, it is noticeable that there is a significant number utilizing the natural method like the withdrawal, abstinence/calendar and LAM methods compared to the artificial method of family planning. Although the DOH is promoting the artificial methods, they still prefer the natural way. This may be affected by their traditional practices utilizing what was used to or maybe some are not yet open or exposed with the use of artificial methods. However, there are mothers utilizing DMPA and also had BTL. This signifies that some had already accepted the artificial method especially that the Barangay health center is convincing the community to try the artificial method in family planning. There is still the need to convince mothers to try the artificial method with the proper and careful health teaching about this because some mothers are hesitant to try because of hearsays about of the negative side effects of these artificial methods.

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Artificial family planning methods are available at the health center which includes DMPA, Pills and condoms.

SUMMARY OF STRENGTHS, LIMITATIONS, PROBLEMS ENCOUNTERED AND LEARNING INSIGHTS DERIVED A. Attitudes In general, the group found Community Health Nursing full of surprises both in a positive and in a negative way. There are things that the group did not expect to happen. In the positive side, the group found community health nursing entertaining and at the same time a good opportunity to learn new things. It is entertaining since the group got the chance to meet other people with different cultures and personalities. The community people especially the officials welcomed the group warm-heartedly. The Barangay Health Worker was also there to guide the student nurses as they have their first visit to their assigned families. Community Health Nursing gave the group the opportunity to apply nursing theories, intervention and skills in true-to-life setting. They rendered their care efficiently and effectively. Community Health Nursing also gave way in identifying their strengths and weaknesses in dealing with the community as a whole. It also motivates them to read more about the different cases that they had encountered in the community to update themselves from new information and for them to improve the kind of service they will render. On the other hand, they constructed a well-built relationship resulting to teamwork and cooperation from everyone. The group got the chance to know each other
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more and built a special friendship among them. The group learned to adjust with each other and understand each others personalities. In the negative side, the group found community health nursing exhausting, timeconsuming, and financially straining. They have to walk for several hours to reach their area and have their home visits. There are lots of works to accomplish in Community Health Nursing. They thought this as a negative side because they are still on the process of adjusting. In addition, time span of community health nursing (7 days) is not enough to deliver care to the majority of community folks.

B. Knowledge and Skills Through CHN, the groups comprehension about nursing and the different aspects related to it became broad. Knowledge about different kinds of diseases and its nature came out. All the stock knowledge, starting from the time they entered the profession were applied. Knowledge about different interventions were also applied and enhanced through their health teachings. Community Health Nursing motivates them to read more about the different cases that they had encountered in the community to update themselves from new information for them to improve the kind of service they will render. Skills of vital signs taking, nursing process (assessing, diagnosing, planning, intervening, evaluation), and conduction of health teachings were applied and enhanced. The group performed the skills frequently while they were in the area. Some of the group members enhanced their communication skills but some lacks this skill and see this as a barrier for rendering efficient and effective care. Skills on physical assessment and physical examination were done but not comprehensively. They have to improve and practice more about physical assessment. C. Problems Encountered The following problems were encountered during the span of time in the community: Environment

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The environment is not well established since there are open canals and most of the trails are steep, rough with sharp rocks, not cemented, and very muddy during rainy days both of which poses a risk for injury. It is energy consuming going up and down the steep stairs taking almost an hour to climb. The stairs are usually made up of sharp stones and moss which are slippery especially on rainy days. Some of its trails are narrow and can be hardly passed by. Lots of animals wastes are scattered everywhere especially cows manure making it a threat for peoples health. Loitering cows around the area in herds make it difficult to pass by to go to houses. There are also lots of mosquitoes because of plenty of grasses, plants, and trees which serve as their breeding ground. The community is aware of this and warned us to be careful on the mosquito that causes dengue. Also, clustered houses were rarely observed. Most of the households were distant from each other. Animal Group of wandering cows was observed. Some are very wild when taunted and are ready to attack passers-by. They have no den and so they are free to roam around. This was a problem for everyone in the group because some are afraid of stray cows and dogs. People Though almost all the people in the community welcomed the group warmheartedly, there were also some of them who did not care and did not participate. Some entertained but had hesitations to give information about their own family. In general, it is a common notion that Ibalois are shy mango where the block expected closed doors, however it didnt seem that way since people there were accommodating and were willing to be family clients. Communication Almost all the people in the community are Ibaloi. This communication barrier was one of the major problems of the group since most of us cannot understand and speak the dialect. But this problem did not affect the interaction too much since some of the student nurses and community folks used alternative medium to communicate each other - through using Ilokano dialect. Transportation

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The group observed that the community lacks in medium for transportation. The people usually walk for several hours to reach their destination. Jeepneys, buses and other public vehicles arrive and pass in varied times and sometimes find difficulty in passing through narrow rocky trails. Eventually people have no choice but to walk several kilometers. Weather During the community duty, the weather was unpredictable. Sometimes, the climate is warm, and then becomes rainy. Warm climate means more energy needed. The group easily gets tired and thirsty. During rainy weather, the group stays in the staff house and did their indoor activities including their paper works. SUGGESTIONS TO IMPROVE AND ENHANCE CHN EXPOSURE NEXT SEMESTER The group should be ready all the time. They have to prepare ahead of time the things that are needed to avoid waste of time and effort. They also have to learn to manage their time well in order for them to accomplish everything they have to finish. The group should plan their activities to have a guide and to have systematic and organized accomplishments. Each member of the group should have assigned tasks to do The group should also read and study cases they encountered during the exposure to have adequate knowledge about certain conditions and concerns of the community The group should have adequate economic funds to be used during the immersion The group should have CHN Bag complete with its instruments and materials Suggested activities: Feeding program addressing malnourished children Accurate BMI taking of children Conduct survey in Libakong and Otbong, Bobok, Benguet using CBMIS Questionnaire

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SUMMARY OF LEARNING INSIGHTS Our Community Experience at Bokod was an enriching experience. Although we had limited time to stay with the community folks, we are very fulfilled for at least we have given the best service that we can give them. A lot of things were learned and it was a very good start of a community immersion experience since it was our first time to have a community immersion. Health problems of the people were identified but the thing that caught our attention was their high blood pressure which they do not address as different. Most of the people of Bokod have unusually high blood pressure but they perceive it as normal. They dont see it as a problem so this is where our health teachings took place. We had our client teachings regarding their condition, as we have seen, they are eager to learn, but we are not there to monitor them all the time so we just hope that they continue to follow the correct health managements for their condition. Another unforgettable experience is when we went to the community folks to express our deepest sympathy for they have just lost a member. There, we have witness how they do the bayanihan, the rituals and beliefs that they follow when someone died. We have tried eating with them and established a deeper nurse-client relationship. Our Clinical Instructors were the ones who guided us throughout this enriching experience; we can say that if they werent there to guide us, our first community immersion will not be as memorable as it is. We are very thankful for them because for the three days that we were out of our houses, they took care of us, guided every step that we take and made our own parents feel that we are safe. As for our different groups, this immersion established a deeper relationship among all of us within a group. We have known each other better. Our community immersion tested our teamwork and time management. We learned how to manage and fulfil any task given to us together. And with the tighter bond that we have had, we can already say that we are really a group, and we are here to help and strengthen each other. Promote healthy community and to be the torch bearers of good health, that is the aim goal for every community. The people should know that health give a big impact to ones life. With good communication and helping each other hand-in-hand, this dream may be achieved. Health is a continuum it means that if you are ill for today it doesnt
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mean that you will be forever ill and weak. Community exposure I think is the holistic view of nursing since you wont know the cases that would go in front of you.

APPENDICES LETTERS July 12, 2010 Saint Louis University School of Nursing Hon. Mauricio T. Macay Municipal Mayor Bokod, Benguet Sir, Salutations!!! We, section M3, third year students of Saint Louis University, School of Nursing, would like to inform your office that we are going to conduct our community exposure in one of your barangays, Barangay Boboc-Bisal. We therefore ask for your kind consideration to permit the group to continue the exposure for 7 days (July12-14, 19-20, 26-27) in the said barangay. Our group is planning to have health assessments and health teachings to the community folks of the barangay. Your permission will greatly help our efforts to promote quality health services in our area. Thank you and God bless. Respectfully Yours,
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Sibaen, Yuki Group Representative Jaylord Indalos Clinical Instructor July 12, 2010 Saint Louis University School of Nursing Dra. Lilian Velasco Municipal Health Officer Bokod, Benguet Maam, Salutations!!! We, section M3, third year students of Saint Louis University, School of Nursing, would like to inform your office that we are going to conduct our community exposure in one of your barangays, Barangay Boboc-Bisal. We therefore ask for your kind consideration to permit the group to continue the exposure for 7 days (July12-14, 19-20, 26-27) in the said barangay. Our group is planning to have health assessments and health teachings to the community folks of the barangay. Your permission will greatly help our efforts to promote quality health services in our area. Thank you and God bless.

Respectfully Yours,

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Pisilen, Jasmen Group Representative Jaylord Indalos Clinical Instructor July 12, 2010 Saint Louis University School of Nursing Ms. Aurelia Wales Public Health Nurse Bokod, Benguet Maam, Salutations!!! We, section M3, third year students of Saint Louis University, School of Nursing, would like to inform your office that we are going to conduct our community exposure in one of your barangays, Barangay Boboc-Bisal. We therefore ask for your kind consideration to permit the group to continue the exposure for 7 days (July12-14, 19-20, 26-27) in the said barangay. Our group is planning to have health assessments and health teachings to the community folks of the barangay. Your permission will greatly help our efforts to promote quality health services in our area. Thank you and God bless.

Respectfully Yours, Sicco, Maria Josephine

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Group Representative Jaylord Indalos Clinical Instructor July 12, 2010 Saint Louis University School of Nursing Ms. Catalina Segundo Midwife- Boboc-Bisal Bokod, Benguet Maam, Salutations!!! We, section M3, third year students of Saint Louis University, School of Nursing, would like to inform your office that we are going to conduct our community exposure in one of your barangays, Barangay Boboc-Bisal. We therefore ask for your kind consideration to permit the group to continue the exposure for 7 days (July12-14, 19-20, 26-27) in the said barangay. Our group is planning to have health assessments and health teachings to the community folks of the barangay. Your permission will greatly help our efforts to promote quality health services in our area. Thank you and God bless.

Respectfully Yours, Brao, Marynel Dixie Group Representative

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Jaylord Indalos Clinical Instructor July 12, 2010 Saint Louis University School of Nursing Mr. Johnny Bugnay The Principal Kawal Elementary School Sir, Salutations!!! We, section M3, third year students of Saint Louis University, School of Nursing, would like to inform your office that we are going to conduct our community exposure in barangay Boboc-Bisal. We would like to ask for your permission for the group to utilize the schools Home Economics room to be our staff house for the seven-day exposure in the community. Moreover, we also like to ask for permission in conducting health teachings in the students of your school regarding health promotion. Your permission will greatly help our efforts to promote quality health services in our area. Thank you and God bless.

Respectfully Yours, Eguilos, Janine Mae Group Representative

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Jaylord Indalos Clinical Instructor

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COMPILED TEACHING PLANS OF M1, M2, M3, M4 TEACHING PLAN ON SANITARY HOUSKEEPING DESCRIPTION OF THE LEARNER: The family Palos, who resides at # 0192 Otbong, Bobok Bisal, Bokod, Benguet, has been seen some health threats in their surroundings and inside their house. Because of piled garbage in their kitchen which attracts flies, rodents and other pests which will be dangerous to the health of the family since it is a place where we store, cook and eat food. Since the family is used to having flies on their surroundings, they are not doing any intervention to remove it. LEARNING NEED: How to implement in maintaining a sanitary environment NURSING DIAGNOSIS: Inability to make decisions with respect to taking appropriate health action due to: low salience of the problem condition S: > Normal lang dayta ngilaw nga adatta ta gamin diyay basura ket madik pay nga naibelleng as verbalized by Mrs. Palos O: > Abundant flies noted at the kitchen specifically to the peeled potato > Unkempt or indisposed piled garbage GOAL: The familys health threat will diminish to prevent the transmission of microorganism especially when landing on foods of the family

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LEARNING OBJECTIVES Upon completion of the topic about environmental sanitation, the family will be able to: 1. Define Sanitary Housekeeping 2. Discuss the ways on how to keep flies away

LEARNING CONTENT

TIME ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

Definition of Sanitary Housekeeping Ways on how to keep the flies away

1 minute Handout in the definition of sanitary housekeeping 5 minutes Handout on ways on how to keep flies away 5 minutes Handout on the possible effects of the presence of flies on their health

3. Explain all the possible effects of the presence of flies on their health

Causes of presence of flies

Instant oral feedback. The family will correctly define the sanitary housekeeping Instant oral feedback. The family will correctly discuss ways on how to keep flies away Instant oral feedback. The family will explain all the possible causes of presence of flies

LEARNING CONTENT Define Sanitary Housekeeping: Sanitary housekeeping would be defined as cleaning like tubs, floors, toilets, etc with bleach/disinfectants or any sort of normal cleaner. This way, you are living in a relatively clean place so the chances of getting an infection or to intake of bacteria (at least in the home) is reduced. Other things such as taking shoes off before entering home could be another example of sanitary housekeeping as shoes bring in dirt, feces, mud, etc. Basically just maintaining clean living environment and practicing clean living.
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For example, if you handle raw meat, you have to wash hands before touching anything else before of the transfer of bacteria. Having a place for everything in its place. In other words no clutter, then cleansing is easier. Dust furniture, clean spider webs, baseboards, vacuum, mop floors, clean bathrooms, wipe down and disinfect bathroom and kitchen. Ways on How to Keep Flies Away: Prevention Flies can be controlled by management practices such as manure composting, which will generate enough heat to control fly department. The use of dry cups in the house and automated feeders will keep the litter dry and free or freed. Use of pits and lagoons in cage layer houses will keep feces from building up in the house. Slats under feeders and waterers will keep the house litter dry and will also allow for easier treatment of the feces with chemicals. Treatment and control flies: Pyrethrum fly sprays can be fogged in the house or on ranges to obtain quick kill of mosquitoes in an outbreak, but control will not last more than a few hours. Residual sprays of carbaryl, malathion, propoxur or stirofos can be applied to exterior surfaces of building or outdoors to vegetation from which poultry are excluded. If needed, breeding areas can be treated with larvicides or a biological control agent. Commercial baits formulated as granules and should be placed in pans or in protected areas. Baits can be placed in fly traps. To increase the effectiveness of dry Bait, such as methomyl, one part field-grade molasses may be diluted with three parts in a 5-gallon (20 litre) can and covered with aremovable window screen lid on which the dry bait is placed. Some commercial baits a fly attractant. Control of fly larvae in manure is done with a larvicide, which can be applied as aliquid, dry or in the birds feed. Larvicide treatment should only be done on a spot treatment, where large numbers of larvae are seen, as larviciding manure disturbs the natural balance of predators and

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parasite to the larvae. One exception to this rule is the larvicide cyromazine, which is toxic to fly larvae, but not to their predators or parasites. Keep garbage in a covered container and if possible segregate waste Keep Flies Away outdoor In summer, flies and other insects can ruin a picnic, an outdoor BBQ or anything that has food or drinks. Sometimes sidewalk cafes, outdoor bars or even your patio or yard at home can attract more than the normal share of flies. It is sometimes hard to know how to deal with them, since they are flying insects. But here is one way to all but eliminate them from your gathering area. You may have to reapply this couple of times during your stay outdoors, but it is quite effective, not only on flies but mosquitoes, also. Since it basically has no smell, no one will know you sprayed anything around, and if you have a business that serves drinks or food outside this can be a real blessing so it doesn't disturb the people who are eating or drinking. Instructions:
1. Purchase a really good spray bottle that has a sturdy sprayer head on it. Smaller, reused sprayer bottles don't work quite as well

as the sprayer nozzle tends to quit working very easily, so don't scrimp. You can buy these at just about any home improvement store. 2. Purchase a good brand of hydrogen peroxide so it will be fresh. Fill the bottle to about 1/4-1/3 with the peroxide and fill the rest of the bottle with plain tap water. 3. Spray the entire area with this solution, especially around areas that will hold food or sticky drinks. You don't have to soak it, just mist the surfaces and the outer perimeter of the area fairly well.

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4. Respraying may be necessary every so often as hydrogen peroxide. Hydrogen breaks down into other elements fairly quickly, but going around the edges of the area should help. 5. Keep your bottle handy, as it is also good for other insects as well Homemade Fly Control Traps You need a clean, empty one gallon milk container. Be sure to keep the cap. Cut four or five small holes all around about two inches down from where it starts to slope towards the cap (about where the center of the handle is.) Mix 1/4-cup syrup and 1/4 cup apple cider vinegar and pour into container. Fill to halfway with water and put on cap. Place a couple of these flytraps where the flies are thick. You will probably have to empty it out every other day or so. Get Rid of Outdoor Flies Flies can be huge annoyance, especially during the hot summer months. They can ruin a beautiful day outdoors, and can get into your home no matter how hard you try to keep them out. If you want to stop flies, the best way get rid of them is to eliminate the outdoor flies so they cant move into your house. Learn how to get rid of perky outdoor flies so you can enjoy the inside and outside of your home without worrying about troublesome bugs. Instructions: 1. Clean out any outdoor trash cans that may be attracting flies. See where flies are appearing and get rid of the food or other items that may be attracting them. Keep lids on your trash cans so the flies dont return.

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2.

Fill a Ziploc bag or any plastic bag half full of water and hang it in an area you are having problems with flies. A common theory claims that the reflection from the water may bounce the sound of their wings vibrating back to them, causing them to leave. Whatever the reason, it can help keep flies away.

3.
4.

Hang flypaper in the area if you have something to attach it to, like the side of a building or a tree limb. Make sure its out of the way so someone doesnt walk into it. Purchase a bug zapper and hang it in the area. Flies and other bugs will fly into it and be killed. Hang it well out of reach of children and pets. Light bug repellent candles containing citronella oil when you are outdoors. The smell of candles will keep flies and other pest away.

5.

Possible effects of Presence of Flies Vacation season may be winding down but fly season is still in its prime, putting millions at risk for the exposure to the diseases that flies spread to both human and animals. With heightened and wide-spread public awareness about precautions needed to prevent infection from west Nile virus by mosquitoes, there is increasing evidence that flies also carry deadly diseases that affect both human and animals, including E. coli, influenza and salmonella. Summer outbreaks of vesicular stomatitis (VS)a painful blistering disease that affects livestock, including horses resulted in quarantines in multiple locations in Texas, new Mexico, and Colorado, according to recent update issued by the Texas animal health commission (TAHC). The viral infection, thought to be spread by flies, can cause horses, cattle and other livestock to develop blister- like lesions that can take several weeks to heal. The commissions recommendation for preventing VS transmission is CONTROL BITING FLIES.

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Flies: underestimated disease carriers While the challenge of managing flies is not new to stable and farm owners, there is new awareness and concern about the diseases they spread. Flies have been underestimated as vectors of disease, said Dennis D. French, DVM, professor, Veterinary clinical sciences at Louisiana State University and a specialist in equine parasite research. There is good evidence that flies can spread disease, and many of these pathogens can also infect humans. Flies and mosquitoes are worldwide problem for all species of poultry of all ages. Mosquitoes are common in areas near still or stagnant water or in damp climates. Adults flies and mosquitoes are ideal vectors of disease. Can be so numerous as to create a health and public relations concern. Adult flies have wings, are active during the daytime and lay eggs in poultry manure, in moist soil, spilled feed or on the carcases of dead birds. Adult flies, larvae (maggots) and pupae will all be seen in and around the poultry house. Although flies do not commonly cause direct health concerns, they transmit disease agent. Adult flies, larvae (maggots) and pupae will all be seen in and the poultry house. Diagnosis in made by visual identification of adult flies and mosquitoes or their larvae.

REFERENCE:
How

to

Keep

Flies

Away

Outdoors

eHow.com

http://www.ehow.com/how_5237500_keep-flies-away-

outdoors.html#ixzz0zJ35tBbV

TEACHING PLAN FOR STROKE REHABILITATION, ARTHRITIS AND ROM EXERCISES

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DESCRIPTION OF THE LEARNER: Dominga Arenos, 90 years old, from Otbong, Boboc, Bokod, Benguet. She is recovering from stoke and is currently staying with one of her daughters. She complains of left sided weakness and verbalized that she cannot move her left arm but can move her left leg minimally. Her daughter states that the client also has arthritis. This condition is manifested by swollen and misaligned joints of both arms with tenderness. The client is currently taking medications after admission to a health institution early this month; some of the which are Amlodipine and Cefalexine. The client verbalized that she wants to walk and stand alone again and have independence in doing her activities of daily living. The client understands Ilocano and Ibaloi, because of her age and current condition she has minimal difficulty in hearing that may affect communication and reading which will prevent her from using visual aids. LEARNING NEED: There is significant need for adequate knowledge on stroke rehabilitation, arthritis, and range of motion exercises so that the client and the family would be able to manage effectively and efficiently the clients health condition. Specifically, their learning needs seek to address the LEARNING DIAGNOSIS: Knowledge deficit: Adequate knowledge on stroke rehabilitation, arthritis, and range of motion exercises related to unfamiliarity to information resources. GOAL: The client and the family will be able to have adequate knowledge on stroke rehabilitation, arthritis, and range of motion exercises. STROKE REHABILITATION

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LEARNING OBJECTIVES

LEARNING CONTENT

TEACHING STRATEGY

TIME ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

After 20 minutes of discussion on the topic on stroke rehabilitation, the client and the family will be able to: Define what is Definition of Stroke: A stroke is a stroke type of brain injury. Symptoms depend on the part of the brain that is affected. People who survive a stroke often have weakness on one side of the body or trouble with moving, talking, or thinking. Strokes are more common in older people. Enumerate risks Risks for another stroke attack: for another stroke People who have had a stroke attack older age, high blood pressure (hypertension), high cholesterol, having had a transient ischemic attack (TIA), and heart disease

One-on-one discussion

2 minutes Instant oral feedback: Pamphlet After 2 minutes of oneon-one discussion the client and the family will be able to properly define what is stroke in their own words. 2-3 minutes Pamphlet Instant oral feedback: After 2-3 minutes of oneon-one discussion the client and the family will be able to identify at least 3-5 risks for another stroke attack.

One-on-one discussion

Enumerate Complications of Stroke: One-on-one complications Weakness or paralysis on one discussion brought about by side or whole of the body

5 minutes Instant oral feedback: Pamphlet After 5 minutes of oneon-one discussion the
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stroke

Problems with balance or coordination Problems using language 7-10 minutes Pamphlet

Discuss and Managements of Post-stroke attack: One-on-one enumerate the Range of Motion Exercises discussion different Log Rolling/position changes managements for Using supportive devices like post-stroke attack cane for ambulation Warm Compress Diet Compliance medication therapy Family Support

client and the family will be able to enumerate at least 5-10 complications brought about by stroke. Instant oral feedback: After 7-10 minutes of one-on-one discussion the client and the family will be able to discuss and enumerate at least 3-7 different managements for post-stroke attack.

ARTHRITIS LEARNING CONTENT LEARNING TEACHING TIME ALLOTMENT/ METHOD OF EVALUATION

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OBJECTIVES After 18 minutes of discussion on stroke rehabilitation, the client and the family will be able to: Define what is Definition of Arthritis: arthritis Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints. Enumerate signs Signs and Symptoms of Arthritis: and symptoms of Pain arthritis Limited function of joints (limited movement) Inflammation of the joints from arthritis

STRATEGY

RESOURCES NEEDED

One-on-one discussion

2-3 minutes Pamphlet

Instant oral feedback: After 2-3 minutes of oneon-one discussion the client and the family will be able to properly define what is arthritis in their own words. Instant oral feedback: After 5 minutes of one-onone discussion the client and the family will be able to identify at least 2-3 signs and symptoms of arthritis. Instant oral feedback: After 7-10 minutes of oneon-one discussion the client and the family will be able to discuss and
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One-on-one discussion

5 minutes Pamphlet

Enumerate and Management of Arthritis: discuss the Range of Motion Exercises different Warm Compress managements of Diet arthritis Family Support

One-on-one discussion

7-10 minutes Pamphlet

enumerate at least 2-4 different managements for arthritis. RANGE OF MOTION (ROM) EXERCISES TIME ALLOTMENT/ TEACHING RESOURCES STRATEGY NEEDED

LEARNING OBJECTIVES After 36 minutes of discussion on stroke rehabilitation, the client and the family will be able to: Define what is Range of Motion (ROM) Exercises

LEARNING CONTENT

METHOD OF EVALUATION

Definition of ROM Exercises: Range of motion exercises are gentle stretching exercises that move each joint as far as possible in all directions. Normal daily activities do not take joints through their full range of motion. Range of motion exercises are recommend to help keep joints mobile, prevent stiffness and reduce deformities. Enumerate Importance of ROM Exercises: importance of Prevent joint stiffness

One-on-one discussion

2-3 minutes Pamphlet

Instant oral feedback: After 2-3 minutes of one-on-one discussion the client and the family will be able to properly define what is Range of Motion (ROM) Exercises in their own words.

One-on-one discussion

2-3 minutes

Instant oral feedback: After 2-3 minutes of one-on-one discussion

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ROM Exercises:

Enumerate guidelines in ROM Exercises:

Discuss and demonstrate the steps of ROM Exercises:

and deformities Prevent muscle shrinkage Prevent lost of bone minerals Promote blood circulation Guidelines in ROM Exercises: One-on-one Check for discussion contraindications like swollen joints Encourage patient participation (promote independence) Good body alignment, etc. Steps of ROM Exercises One Head and Neck exercises on Shoulder and Elbow one exercises discus Ankle and Foot exercises sion Retur n Demo nstration

Pamphlet

the client and the family will be able to enumerate at least 2-3 importance of ROM Exercises.

7-10 minutes Pamphlet

Instant oral feedback: After 7-10 minutes of one-on-one discussion the client and the family will be able to enumerate at least 5-10 guidelines in ROM Exercises.

15-20 minutes Pamphlet

Instant oral feedback and return demonstration: After 15-20 minutes of one-on-one discussion and return demonstration the client and the family will be able to discuss and demonstrate the steps of ROM Exercises.

LEARNING CONTENT STROKE REHABILITATION

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Definition of Stroke: A stroke is a type of brain injury. Symptoms depend on the part of the brain that is affected. People who survive a stroke often have weakness on one side of the body or trouble with moving, talking, or thinking. Strokes are more common in older people. Almost three-fourths of all strokes occur in people 65 years of age or over. However, a person of any age can have a stroke. Risks for another stroke attack: People who have had a stroke have an increased risk of another stroke, especially during the first year after the original stroke. The risk of another stroke goes up with older age, high blood pressure (hypertension), high cholesterol, having had a transient ischemic attack (TIA), and heart disease. Warning: Patients and families should also learn the warning signs of a TIA (such as weakness on one side of the body and slurred speech) and see a doctor immediately if these happen. Complications of Stroke: Each stroke is different depending on the part of the brain injured, how bad the injury is, and the person's general health. Some of the effects of stroke are: Weakness or paralysis on one side or whole of the body Problems with balance or coordination Problems using language Being unaware of or ignoring things on one side of the body (bodily neglect or inattention). Pain, numbness, or odd sensations Problems with memory, thinking, attention, or learning Depression Trouble swallowing
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Trouble swallowing Problems with bowel or bladder control Getting tired very quickly Sudden bursts of emotion

(cognitive problems) Managements of Post-stroke attack: Range of Motion Exercises Log Rolling/position changes Change position every two hours Use pillows to prevent pain, discomfort or complications brought by prolonged pressure

Using supportive devices like cane for ambulation Warm Compress Diet The main preventive measure is adopting a healthy eating lifestyle. Always go for a healthy diet with emphasis on vegetables, clean protein foods, fruits and grains. This diet preparation ensures that the blood vessels are in good state and that the body will receive an abundant and rich supply of important minerals, vitamins and antioxidants from plants.

Compliance medication therapy Family Support ARTHRITIS

Definition of Arthritis: Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints. Signs and Symptoms of Arthritis: Pain Limited function of joints (limited movement)
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Inflammation of the joints from arthritis is characterized: joint stiffness, swelling, redness, and warmth; tenderness of the inflamed joint can be present

Management of Arthritis: Range of Motion Exercises Warm Compress Diet Unfortunately there is conflicting advice regarding diet for arthritis. However there are some guidelines that may help.

Vitamin C Vitamin E Unsalted nuts Ginger anti-inflammatory foods Fruits and vegetables Some report that vegetables from the solanum (or nightshade) family cause problems potatoes, capsicums, eggplant, and tomatoes. Foods high in saturated fat such as full-fat dairy, fatty meat, baked foods. Dairy products

Foods that may Aggravate

Family Support
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RANGE OF MOTION EXERCISES Definition of ROM Exercises: Range of motion exercises are gentle stretching exercises that move each joint as far as possible in all directions. Normal daily activities do not take joints through their full range of motion. Range of motion exercises are recommend to help keep joints mobile, prevent stiffness and reduce deformities. Importance of ROM Exercises: Prevent joint stiffness and deformities Prevent muscle shrinkage Prevent lost of bone minerals Promote blood circulation Check for contraindications like swollen joints Encourage patient participation (promote independence) Good body alignment Body and bed is flat, may be with one pillow under the head High fowlers position if tolerated Cover and keep the patient warm to relax muscle Follow logical sequence (shoulder to toe) Be gentle, move joints slowly and smoothly Never bend or extend the joints to the point of pain

Guidelines in ROM Exercises:

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Stop if painful Minimum of 3-10 repetitions of ROM with each joint

Steps of ROM Exercises: 1. Ensure that the client understands the reason for doing ROM exercises. 2. Start exercises at the person's head and work down toward his toes.
3. Head and Neck exercises: Lay the person on his back with his head as flat (no pillow) as possible. Support the back of the

person's head with one of your hands. Support the chin with your other hand. Chin-to-chest. Raise the back of the person's head up from the bed. Gently tip his chin toward his chest. Try to rest the person's chin on his chest if possible. Head turns. Put one hand on each side of the person's face. Turn the person's head toward the right as if he were looking over his right shoulder. Then slowly turn the person's head so he is looking over his left shoulder. Turn the head only far enough so that the person's nose is lined up above their shoulder. Head tilts. Put one of your hands on each side of the person's face. Tilt the head to the side, bringing the right ear toward the right shoulder. Then slowly tilt the person's head to bring the left ear toward the left shoulder.
4. Shoulder and Elbow exercises: Put one hand under the person's elbow and hold his wrist with your other hand. Keep the person's

elbow straight, or bend the elbow slightly if necessary.

Shoulder movement, up and down. Turn the person's palm in toward the body. Bring the right arm forward and upward over the person's head until the inner arm touches his ear. Bring the arm back down to his side. Shoulder movement, side to side. Raise the right arm out to the side to shoulder level. Raise it upward over the person's head as far as possible. Bring the arm back down to his side and then swing across the body toward the left shoulder. Swing the arm back down to his side.

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Shoulder rotation. Bring the right arm out to the person's side. Bend the elbow so the thumb and fingers are pointing up. Rotate (turn) the arm so the thumb and fingers point down toward the person's toes. Elbow bends, up and down. With the person's right arm at his side, turn the palm of his hand face up. Bend the arm at the elbow so that the fingers are pointing toward the ceiling. If possible, continue bending the elbow and touch the hand (fingertips) to the front of the right shoulder. Move the hand back down to the person's side.

Elbow bends, side to side. Hold the right arm out at shoulder level with the palm facing up. Bend the elbow. Try to make the person's fingertips touch the top of his right shoulder. Repeat the above exercises with the left arm.

5. Hip and Knee exercises: If the person has had a hip injury or surgery, only do hip exercises with instructions from a caregiver.

Place the person's right leg flat on the bed. Put one hand under the ankle and your other hand under the knee. Straighten the leg and return it to a flat position on the bed after each exercise.

Hip and knee bends. Slowly bend the hip and knee up toward the chest as much as possible. Slide your hand out from under the knee and toward the upper thigh (leg). Do this to help the knee bend completely. Leg movement, side to side. Move the right leg out to the right side as far as possible. Then return the leg to the middle and cross it over the left leg. Leg rotation, in and out. With the leg flat on the bed, roll the leg toward the middle so the big toe touches the bed. Roll the leg outward so the little toe touches the bed. Knee rotation, in and out. Bend the person's knee so the bottom of the right foot is flat on the bed. Roll the leg inward as far as possible. Try to touch the bed with the big toe. Roll the leg outward as far as possible. Try to touch the bed with the small toe. Repeat the above exercises with the left leg.

6. Ankle and Foot exercises: Hold the right ankle with one hand. Put your other hand on the bottom of the foot.

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Ankle bends. Push the person's foot so his toes point up toward the ceiling. Then put your hand on top of the foot and push the foot down again. Ankle rotation. Hold the ankle with one hand. Hold the person's upper foot with your other hand. Gently turn the foot and ankle in circles. Toe bends. With your palm on top of the person's foot, curl the toes down toward the sole (bottom) of the foot. Then straighten and stretch the toes. Toe spreads. Use your fingers then bring them together. Repeat with the left ankle and foot.

REFERENCES: Stroke Rehabilitation:

http://www.strokecenter.org/patients/ras.pdf http://www.free-ed.net/sweethaven/MedTech/NurseFund/default.asp?iNum=2&fraNum=040202

Arthritis:
http://www.everydiet.org/diet/arthritis-diet http://www.medicinenet.com/arthritis/article.htm

Range of Motion (ROM) Exercises:

Clinical Companion for Fundamentals of Nursing (Potter and Perry), 6th Edition by Ronnie Peterson http://www.youtube.com/watch?v=eoxUqNj5uZ4&feature=related http://www.drugs.com/cg/passive-range-of-motion-exercises.html http://arthritis.about.com/od/exercise/g/rangeofmotion.htm

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TEACHING PLAN ON GOITER DESCRIPTION OF THE LEARNER Mr. Dave Bumakil Sr., a resident of Otbong, Bobok-Bisal, Bokod, Benguet, is a father of 5 children. Upon assessment, he was observed to have a goiter as manifested by a lump on his neck measuring 7.5 cm in diameter and 5.5 cm in height. He stated that this swelling started to grow since he was a teenager. No clinical consultation is done from the time the condition begun. He confessed that he lacks enough knowledge about the disease and expressed willingness to learn more regarding goiter. The client understands Tagalog, Ilocano and Ibaloi which may serve as medium of communication. Also, there is no other present condition that may hinder the learning process.

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LEARNING NEED Information about goiter, its different types, causes, treatments, and preventions. LEARNING DIAGNOSIS Knowledge deficit: Goiter related to lack on information as manifested by clients verbalization of desire to know about goiter. GOAL The client will be able to acquire knowledge about goiter and apply it for the promotion, maintenance, and restoration of health.

LEARNING OBJECTIVES Upon completion of the topic about goiter, the client will be able to: 1. Describe goiter 1. Differentiate types of goiter

LEARNING CONTENT

TIME ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

Description of goiter Types of goiter

1 minute Pamphlet 3 minutes Pamphlet

Instant oral feedback. The client will correctly describe goiter. Instant oral feedback. The client will correctly differentiate the types of goiter
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3. Enumerate the causes of goiter 4. Identify treatments of goiter

Causes of goiter Treatments of goiter

2 minutes Pamphlet 3 minutes Pamphlet 3 minutes Pamphlet

5. Identify ways to prevent goiter

Ways on how to prevent goiter

Instant oral feedback. The client will completely enumerate causes of goiter Instant oral feedback. The client will correctly identify the treatments for goiter. Instant oral feedback. The client will correctly identify ways to prevent goiter.

LEARNING CONTENT GOITER

Disease of the thyroid gland, characterized by an enlargement of the gland, visible externally as a swelling on the front of the neck. In simple goiter the basal metabolic rate is somewhat lowered, and in toxic goiter it is elevated.

TYPES AND ITS CAUSES AND CORRESPONDING TREATMENTS:

Simple goiter is characterized by an enlargement of the entire thyroid gland or one of its two lobes. It is associated with hypothyroidism, a condition caused by insufficient production of thyroid hormone. Because the body needs iodine to produce thyroid hormone, inadequate amounts of iodine in the diet may result in simple goiters. Simple goiters may be classified as either endemic or nontoxic.
Endemic goiters are caused by a deficiency of iodine in the diet and usually occur in populations living in areas with iodine-

depleted soil.
The cause of most nontoxic goiters is unknown, but researchers suspect that environmental factors and heredity play a role. In

some areas of the world, certain chemical compounds in food or water may block the bodys production of thyroid hormones
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and lead to nontoxic goiter formation. These compounds, known as goitrogens, also include certain drugs, such as aminoglutethimide and lithium.

Toxic goiter also called exophthalmic goiter, hyperthyroidism, thyrotoxicosis, or Graves' disease Caused by an excess of thyroxine secretion. The cause of the excessive secretion is obscure. In some cases it may result from excessive stimulation by the pituitary gland. The symptoms of toxic goiter may include a rapid heartbeat, tremor, increased sweating, increased appetite, weight loss, weakness, and fatigue. Some patients have eye problems, such as staring or protrusion. Commonly treated with radioactive iodine, which is taken up by the gland and destroys the cells by irradiation. Drugs also can be used to suppress hormone production, or most of the toxic goiter can be removed surgically.

REFERENCE: Microsoft Encarta 2009. 1993-2008 Microsoft Corporation. TEACHING PLAN FAMILY PLANNING DESCRIPTION OF THE LEARNER The learners are Roderick Confisal, 24 years old, and Aima Confisal, (age not recalled by Roderick). They live in Libacong Bobok-Bisal, Bokod Benguet. They have two children, namely Mharjun, 3 years old, and Erika Mae 1 year 1 month old. Roderick and Aima works as farmers in the field they are renting, they also work as gardeners. Roderick is a high school graduate while Aima entered college for a year. Roderick is a native of Ilocos Norte while Aima is a native of Benguet. Roderick, who has worked in various places, is fluent in both Ilocano and Tagalog which made him prefer either of the two languages as a medium of communication. He told that the family planning they are currently accepting is Oral Contraceptive Pills and he said that they are using it because they need to be practical.

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LEARNING NEED The learners need to be aware of other Family Planning methods that they can utilize and also they need to know what the benefits of using family planning method are. They should also know the disadvantages to facilitate their decision on what to use. LEARNING DIAGNOSIS Knowledge Deficit: Family Planning Methods related to lack of knowledge as manifested by: S: > Rodericks verbalization about knowing nothing about family planning method and being unaware of its benefits. GOAL The client would be able to know about family planning methods and its advantages and disadvantages.

LEARNING OBJECTIVES

LEARNING CONTENT

TEACHING STRATEGY

TIME ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

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After 30 minutes of discussion, the client would be able to: 1. Define family planning methods 2. Enumerate 6 out of 11 family planning methods

Definition of Family Planning Method

Discussi on

2 minutes Handout

Instant oral feedback: client will be able to define family planning method

Types of Family planning Natural Family Planning Methods Lactating Amenorrhea Method (LAM) Mucus/Billin gs/Ovu-lation Basal Body Temperature Symptothermal method Two Day Method Standard Days Method

Discussi on

20 minutes Handout

Instant oral feedback: client will be able to enumerate 6 out of 11 family planning methods

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LEARNING CONTENT TYPE 1. Lactating Amenorhea Method (LAM) DESCRIPTION / USES ADVANTAGES A. NATURAL FAMILY PLANNING METHOD Temporary Universally available to introductory all postpartum postpartum method of breastfeeding woman postponing pregnancy Protection from an based on physiological unplanned pregnancy infertility experienced begins immediately by Breast Feeding after giving birth women No other FP Perfect use: 99.5% commodities are Typical use: 98% required Contributes to improve maternal and child health and nutrition Abstaining from sexual Can be used by any intercourse during woman of reproductive fertile (wet) days age as long as she is not prevents pregnancy suffering from an Perfect use: 97% unusual disease or Typical use: 80% condition that results in extraordinary vaginal discharge that makes DISADVANTAGES Effective only for a maximum of 6 months postpartum Effectiveness may decrease if a mother and child are separated for extended periods of time Full or nearly full BF may be difficult to maintain for up to 6 months due to a variety of social circumstances Cannot be used by women with medical conditions that would make pregnancy especially dangerous

1. Mucus / Billings/ Ovulation

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1. Basal Body

Temperature

1. Sypto-thermal method

1. Two Day Method

BBT method is identifying the fertile and infertile period of a womans cycle by daily taking and recording of the rise in body temperature during and after ovulation Perfect use: 99% Typical use: 80% STH method is identifying the fertile and infertile days of the menstrual cycle as determined through a combination of observations made on the cervical mucus, basal body temperature, and other signs of ovulation Perfect use: 90% Typical use: 80% Is a simple fertility awareness based method of FP that

observation difficult Very effective

Requires to take BBT everyday and time to record temperature Couples may practice abstinence during fertile periods

Can be used by women with any cycle length No health related side

Needs the cooperation of the husband Can become unreliable

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involves: cervical secretions as an indicator of fertility, women checking the presence of secretions everyday Perfect use: 96.5% Typical use: 86%

effects associated Incurs very little or no cost Immediately reversible Promoted male partner involvement in FP Enhances self discipline mutual respect cooperation communication, and shared responsibility of the couple for the FP Provides opportunities for enhancing the couples sexual life Can be integrated in health and FP services Acceptable to couples regardless of culture, religion, socioeconomic status, and education Not dependent on medically qualified personnel; the technology can be transferred by a trained autonomous user Once learned, may

for women who have conditions that cause abnormal cervical secretions Doesnt protect the client from HIV/AIDS

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1. Standard days Method

1. Female Sterilization

require no further help from health care providers All users with No health related side menstrual cycles effects associated with between 26 and 32 its use days are counseled to Increases self abstain from sexual awareness and intercourse on days 8knowledge of human 19 to avoid pregnancy reproduction and can The couples use color lead to a diagnosis of coded cycle beads to some gynecological mark the fertile and problems infertile days of No need for counting or menstrual cycle charting Perfect use: 95% Can be used either to Typical use: 88% avoid or achieve pregnancy Very little cost and promotes partner involvement Enhances self discipline, mutual respect A. ARTIFICIAL FAMILY PLANNING METHOD Safe and simple Permanent method of surgical procedure contraception which provides Nothing to remember,

Cannot be used by women who usually have menstrual cycle between 26 and 32 days long

Permanent-reversal surgery is difficult

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1. Male Sterilization

1. Pill

1. Male condom

permanent contraception for women who do not want more children Perfect use: 99.5% Permanent method wherin the vas deferens (passage of sperm) is tied and cut or blocked through a small opening on the scrotal skin Perfect use: 99.9% Typical use: 99.8% Contains hormones estrogen and progesterone taken daily to prevent contraception Perfect use: 99.7% Typical use: 92% Thin sheath of latex rubber made to fit on a mans erect penis to prevent the passage of sperm cells and sexually transmitted

no supplies needed, and no repeated clinic visits required

Very effective 3 months after the procedure Permanent, safe, simple, and easy to perform

May be uncomfortable due to slight pain and swelling 2-3 days after the procedure Reversibility is difficult and expensive

Safe as proven through extensive studies Convenient and easy to use

Often not used correctly and consistently, lowering its effectiveness

Safe and has no hormonal effect Protects against microorganisms causing STIs/HIV

May cause allergy for people who are sensitive to latex or lubricant Interrupts the sexual act

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1. Injectibles

disease organisms into the vagina Perfect use: 98% Typical use: 85% Contain synthetic hormone, progestin which suppresses ovulation, thickens cervical mucus, making it difficult for sperm to pass through and changes uterine lining Perfect use: 99.7% Typical use: 97% Reversible No need for daily intake Does not interfere with sexual intercourse Perceived as culturally acceptable by some women Private since it is not coitally dependent

REFERENCE:

Public Health Nursing in the Philippines 10th edition

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TEACHING PLAN ON EFFECTS OF SMOKING DESCRIPTION OF THE LEARNER The learner is Dario Diano, 57 years old who is a smoker. He usually puffs a minimum of 14 sticks per day. Upon initial assessment, there is occasional coughing noted and with fine crackles heard upon auscultation. The client has no family history of any cardiovascular diseases but with history of heredo-familial diseases like asthma (his last child). Also upon assessment, client has no idea of what smoking might lead to and was willing to learn about what it may cause; thus, teaching plan regarding smoking was prepared. EDUCATIONAL DIAGNOSIS Health seeking behaviors related to lack of knowledge about the effects of smoking. PURPOSE To provide patient with inputs and essential information regarding the effects of smoking. GOAL The patient will be able to gain essential information regarding the effects of smoking

LEARNING

TEACHING

TIME

METHOD OF
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LEARNING OBJECTIVES CONTENT

ALLOTMENT STRATEGY / RESOURCES NEEDED EVALUATION What is in the cigarette? Tobacco Nicotine In your body To others One on one discussion One on one discussion 5 minutes 5 minutes

LEARNING OBJECTIVES

Within 20 minutes of teaching session, the learner will be able to: Know general information regarding cigarette. Know the effects of nicotine

Pamphlet Internet Fundame ntals of Nursing, Kozier Merck Manual of Medical Informati Instant oral feedback: The client can describe the cigarette. Instant oral feedback: The client can enumerate 5 out of 11 effects of nicotine in our body and to the people around us Instant oral feedback: The client can enumerate 3 out of 6 ways to prevent one from smoking.

Know the probable ways to prevent one from smoking.

Suggested Methods on how to Stop/Divert urge from smoking.

One on one discussion

10 minutes

on

Withdrawal symptoms
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LEARNING CONTENT The Cigarette A Cigarette is a small roll of finely cut tobacco leaves wrapped in a cylinder of thin paper for smoking. The cigarette is ignited at one end and allowed to smolder; its smoke is inhaled from the other end, which is held in or to the mouth and in some cases a cigarette holder may be used as well. Most modern manufactured cigarettes are filtered and include reconstituted tobacco and other additives. Commercially manufactured cigarettes are seemingly simple objects consisting mainly of a tobacco blend, paper, PVA glue to bond the outer layer of paper together, and often also a cellulose acetatebased filter. A key ingredient that makes cigarettes more addictive is the inclusion of reconstituted tobacco, which has additives to make nicotine more volatile as the cigarette burns. 1. Filter made of 95% cellulose acetate. 2. Tipping paper to cover the filter. 3. Rolling paper to cover the tobacco. 4. Tobacco/Carcinogen blend. The paper for holding the tobacco blend may vary in porosity to allow ventilation of the burning ember or contain materials that control the burning rate of the cigarette and stability of the produced ash. Papers used in tipping the cigarette and surrounding the filter stabilize the mouthpiece from saliva and moderate the burning of the cigarette as well as the delivery of smoke with the presence of one or two rows of small laserdrilled air holes.

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The Nicotine Nicotine, the primary psychoactive chemical in cigarettes, is addictive. On average, each cigarette smoked shortens lifespan by 11 minutes and half of smokers die early of tobacco-related disease and lose, on average, 14 years of life. In low concentrations (an average cigarette yields about 1 mg of absorbed nicotine), the substance acts as a stimulant in mammals and is the main factor responsible for the dependence-forming properties of tobacco smoking. According to the American Heart Association, nicotine addiction has historically been one of the hardest addictions to break, while the pharmacological and behavioral characteristics that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. Nicotine: What does it do?

In the Body To others Secondhand smokers person who does not actually smoke but the smoke gets as or more effect as the primary smoker. inhales much or the

Do you want To Stop? You just need some resolve, motivation, strong and

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reinforcement of the benefits of doing so. Below are some significant tips and strategies that may help you get on your way to the path of a smoke-free lifestyle. `* Set a quit date, ideally within the next 2 weeks. * Tell your family, friends, and coworkers that you are going to quit, and ask them for their understanding and support. * Anticipate challenges that you may face as you attempt to quit smoking. You may want to keep a diary to include what you are doing when you smoke, your mood, and the place, time, and intensity of cravings when you smoke. Develop a plan for these challenges that may include what you can do when: - You have an urge to smoke - You are around others who are smoking - You are having nicotine withdrawal symptoms (such as nervousness or irritability). Withdrawal Symptoms Lack of nicotine use in a 24-hour period can result in: Aggression, Hostility, Anger, Inappropriate social interaction REFERENCES:
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=833010 Fundamentals of Nursing, Kozier et. Al, 7th ed. Merck Manual of Medical Information, 2nd home edition

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TEACHING PLAN ON ASTHMA DESCRIPTION OF THE LEARNER The learners are Roderick and Aima Confisal, the parents of Mharjun and Erica. Both children have asthma and is believed to be inherited from the father who is experiencing asthma attacks as well. The family Confisal lives in Libacong, Boboc-Bisal, Benguet. Roderick and Aima are both farmers but currently, the latter is in Aurora Province. Roderick is a high school graduate while Aima entered college for a year. Roderick is a native of Ilocos Norte while Aima is a native of Benguet. Roderick, who has worked in various places, is fluent in both Ilocano and Tagalog which made him prefer either of the two languages as a medium of communication. He verbalizes concern on the presence of asthma among his children. LEARNING NEED: Ways on how to prevent asthma attacks LEARNING DIAGNOSIS: Knowledge deficit: Ways on how to prevent and manage asthma attacks related to Rodericks verbalization of concern towards the existence of asthma among Mharjun and Erica GOAL: The client/s will be able to prevent and/or manage asthma attacks

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TIME LEARNING OBJECTIVES Following a 30 minute teaching session, the client will be able to: Define asthma Definition of asthma Lecture 2 minutes Booklet Instant oral feedback: Client/s will be able to answer questions regarding asthma Enumerate 5 signs and symptoms of asthma 5 signs and symptoms of asthma Lecture 3 minutes Booklet Instant oral feedback: Client/s will be able to enumerate the 5 signs and symptoms of asthma Enumerate causes and risk factors of asthma Causes and risk factors of asthma 3 host factors 5 environmental factors Lecture 5 minutes Booklet Instant oral feedback: Client/s will be able to enumerate 3 host factors and 5 environmental factors of asthma LEARNING CONTENT TEACHING STRATEGY ALLOTMENT/ RESOURCES NEEDED METHOD OF EVALUATION

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Enumerate 5 food asthma triggers

5 food asthma triggers

Lecture

5 minutes Booklet

Instant oral feedback: Client/s will be able to enumerate 5 food asthma triggers

Enumerate 4 ways on how to prevent asthma attacks

4 ways on how to prevent asthma attacks

Lecture

5 minutes Booklet

Instant oral feedback: Client/s will be able to enumerate 4 ways on how to prevent asthma attacks

Enumerate 4 home remedies for asthma 4 home remedies for asthma

Lecture

5 minutes Booklet

Instant oral feedback: Client/s will be able to enumerate 4 home remedies for asthma

LEARNING CONTENT

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Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air. This can cause the following Signs and symptoms: wheezing, coughing, chest tightness, nasal flaring, and trouble breathing, especially early in the morning or at night. When your asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that your vital organs do not get enough oxygen. People can die from severe asthma attacks. Severity of Asthma Attack Sign/Symptom Alertness May agitation Breathlessness Talks in Wheeze Respiratory rate (/min) Pulse rate (/min) Causes and Risk Factors
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Mild

Moderate show Agitated

Severe Agitated

Imminent Respiratory Arrest Confused/Drowsy

On walking Sentences Moderate Increased 100

On talking Phrases Loud Increased 100-120

Even at rest Words Loud Often >30 >120 <60 (Bradycardia) Absent

 Asthma development has both a genetic and environmental component. Host factors: predispose individuals to or protect them from developing asthma Genetic predisposition Allergy Airway hyper responsiveness Gender Race / Ethnicity Environmental factors: influence susceptibility to development of asthma in predisposed individuals, precipitate asthma aggravation and/or cause symptoms to persist Indoor allergens Outdoor allergens Occupational factors Tobacco smoke Air pollution Respiratory infections Parasitic infections Socioeconomic factors Family Size Diet and Drugs

Asthma Triggers
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 Triggers are risk factors for asthma attacks. These cannot cause asthma to develop initially, but can worsen established asthma. They induce inflammation and/or provoke acute bronchoconstriction. It involves further exposure to causal factors (allergens and occupational agents) that have already sensitized the airways of the person with asthma. Irritant gases and smoke House dust mite found in pillows, mattresses, carpets Respiratory infection Weather changes Food and Food Additives Trigger Asthma While its not common for food allergies to cause asthma, food allergies can cause a severe life-threatening reaction. The most common foods associated with allergic symptoms are: Eggs and Chicken Cow's milk Peanuts Soy Wheat Fish Shrimp and other shellfish Salads & some fresh fruits Food Preservatives Exercise Certain drugs Strong emotions

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Can Asthma Be Prevented? Currently, there isn't a way to prevent asthma from starting in the first place. However, you can take steps to control the disease and prevent its symptoms. Learn about your asthma and how to control it. Use medicines as your doctor directs. Avoid Asthma triggers Keep track of your asthma symptoms and level of control. Medicines Your doctor will consider many things when deciding which asthma medicines are best for you. Doctors usually use a stepwise approach to prescribing medicines. Your doctor will check to see how well a medicine works for you; he or she will make changes in the dose or medicine, as needed. Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler or nebulizers. Asthma inhalers are the most common and effective way to deliver asthma drugs to the lungs. There are some combination asthma inhalers, which contain two different medications: an inhaled steroid and a long-acting bronchodilator. These combination asthma inhalers are popular due to their convenience, and the medications last for at least 12 hours. If youre having difficulty using small inhalers, your doctor may prescribe an asthma nebulizer, also known as a breathing machine. The asthma nebulizer with a mask is typically used for infants, small children, elderly adults, or anyone who has difficulty Get regular checkups for your asthma. Clean the house at least once a week Avoid pets with fur or feathers Wash the bedding (sheets, pillow cases, mattress pads) weekly in hot water

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using inhalers with spacers. The nebulizer changes asthma medications from a liquid to a mist, so that they can be more easily inhaled into the lungs. This takes a few more minutes of time when compared to inhalers. Home remedies for asthma: Steam bath - relieve congested lungs Steaming ginger tea with garlic cloves every morning and evening Garlic cloves boiled in milk 1 teaspoon honey in a glass of warm water daily Drink warm water before sleeping and right after waking up (avoid cold fluid) REFERENCES: Promoting Healthy Lifestyles An Integrated Community based Approach to Prevention and Control of Non-communicable Diseases Booklet 2 by Josefina A. Tuazon, RN, DrPH, Luz Barbara P. Dones, RN, MPH, and Sheila R. Bonito, RN, MAN pp. 25-27
http://www.nlm.nih.gov/medlineplus/asthma.html http://en.wikipedia.org/wiki/Asthma#Signs_and_symptoms http://www.cw.bc.ca/library/pdf/pamphlets/BCCH1108asmtha.pdf http://almglobal.net/blog1/wp-content/uploads/2008/07/asthma.jpg http://www.webmd.com/asthma/guide/asthma-triggers?page=2 http://www.herbalremediesinfo.com/Asthma.html http://www.natural-homeremedies.com/homeremedies_asthma.htm

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TEACHING PLAN FOR MANAGEMENT ON DELAYED DEVELOPMENTAL STATUS DESCRIPTION OF THE LEARNER A 34 year old mother claimed that her daughter doesnt able to act normally as her age of 2 year old. She verbalized that her daughter had acquired the illness (what she described to us) when her daughter was 1 month old and taking medications such as antibiotics for upper respiratory tract infection. She also added that her child possibly had drug overdose. The mother wanted to know how would they deal into their child and what are the managements for this. Client is able to speak and understand Ilokano and prefer it as a medium of discussion. Furthermore, the client has no hearing problems that may affect her learning. LEARNING NEED How to manage delayed developmental status of a child LEANING DIAGNOSIS Knowledge deficit: management for delayed developmental status of a child related to lack of information as manifested by the verbalization of the client anya ngay ngata ti mabalin nga aramidin GOAL After one-on-one discussion, the mother will be able to manage or deal on her daughters delayed developmental status.

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TIME LEARNING OBJECTIVES Upon completion he topic on management for delayed developmental status, the client will be able to: 1. Described what is delayed developmental status as what her understanding is >Description of developmental delay >one-on-one discussion >7 min >Instant oral feedback: the mother will correctly answer question about what is delayed developmental status LEARNING CONTENT TEACHING ALLOTMENT/ STRATEGY RESOURCES NEEDED METHOD OF EVALUATION

2. Discussed what

are the assessments for

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a child with delayed developmental status >Assessments > one-on-one discussion >10 min >Instant oral feedback: the mother discusses assessments for a child with delayed developmental status

3. Discussed the causes of the developmental delay 4. Discussed the possible symptoms >What are the causes of developmental delay? 5. Identify ways on how to manage child with developmental delay >What are the > one-on-one
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> one-on-one discussion

>Instant oral feedback: the mother discusses >5 min the causes of developmental delay

>Instant oral feedback: the mother will discussed what are possible symptoms

symptoms

discussion

>5 min

>management (parents concern)

>one-on-one discussions >15 min

>Instant oral feedback: the mother will identify ways on how to manage or how to cope up with her daughter with developmental delay

LEARNING CONTENT Description Developmental delay refers to when a child's development lags behind established normal ranges for his or her age. Sometimes the term is used for mental retardation, which is not a delay in development but rather a permanent limitation. If most children crawl by eight months of age and walk by the middle of the second year, then a child five or six months behind schedule in reaching these milestones may be classified as developmentally delayed regarding mobility. At least 8 percent of all children from birth to six years have developmental problems and delays in one or more areas of development. Some have global delays, which means they lag in all developmental areas. Doctors try to locate the source of the delay and then design a treatment plan. When the cause of a child's delay is identified, the pediatrician and family know better what to expect, and the child can begin to receive
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appropriate treatment and support. If the problem is a genetic disorder, then parents may seek genetic counseling regarding their decision on having additional children. Assessments

Developmental assessment: The physician's review of a child's current competencies (including knowledge, skills, and personality), and consideration of the best ways to help the child develop further. Family assessment: Interpretation of a child's development from family members, as well as their ideas about priorities and concerns about the child's future development. Multidisciplinary assessment: The assessment by a group of professionals who work with the child and family, directly or indirectly. The assessment interprets different phases of a child's development and types of behavior and skills. Play-based assessment: This assessment involves observation of the child playing alone, with peers, or with parents or other familiar caregivers, in free play or in special games. Play provides a diagnostic framework within which children show abilities, feelings, learning style, and social skills in groups.

What are the causes? Chronic illness ,Autism ,Cerebral palsy, Premature birth ,Williams syndrome ,Fragile X syndrome ,Meningitis Velocardiofacial syndrome ,Aflatoxicosis - developmental delay in children ,Birth asphyxiation ,Brain structure abnormalities ,Brain trauma ,Child abuse and neglect ,Chromosomal abnormalities ,Downs syndrome ,Encephalitis ,Fetal exposure to toxins ,Genetic causes ,Head injury ,Hypothyroidism ,Intrauterine infection ,Malnutrition ,Meningitis ,Metabolic disorders,Neurocutaneous syndromes ,Nonchromosomal dysmorphic disorders ,Normal variant ,Perinatal complications ,Prader-Willi syndrome ,Premature birth What are the symptoms?
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Between the ages of 12 and 30 months, a child begins to strike out independently from a secure base of trust set up with the primary caregiver during the first year. As toddlers learn to walk, there is access to new territory. Boundless energy and insatiable curiosity drives the child to explore the environment and master new skills. Increased motor skills, immaturity, and lack of experience also place the toddler at risk for accidental injury. Children with developmental delays may tend to be more reserved and less adventuresome. They may tend not to explore their environment or take risks in it. The healthy toddler years are characterized by the struggle for autonomy as the child develops a sense of personhood separate from the parent. Toddlers' egocentric and demanding behavior, often marked by temper tantrums and negativism, has given this period a negative reputation. However, toddlers who do not evince this challenging behavior may be delayed. Dramatic growth of language and cognitive skills during the second year enables the healthy toddler to think and solve problems for the first time. For the child who is not progressing in language skills, developmental delays are readily identifiable That depends on whether the problem is physical or cognitive (in other words, one that affects your child's ability to learn). A physical delay can be a symptom of a larger disability, such as spina bifida or autism -- but it can also simply mean your child needs a few more weeks or months to catch up to his peers, or may need physiotherapy for muscle weakness. Some children will have delays in a particular area, such as walking, while the rest of their skills continue developing on or ahead of schedule. If that's the case for your child, it may just mean he's concentrating so hard on talking or understanding that his brain has pushed walking to a back burner for the moment. Learning to walk late can also run in families or it may be a reflection of your child's personality: some children are more independent than others, and this has a bearing on how soon they learn various skills. You may also find your child takes no interest in walking for months and then makes a sudden leap forwards (literally!). However, if you are concerned about any aspect of your child's development, it is important to bring it up with your child's health visitor or GP.

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Also, keep a close eye on your child's language development. Speech delays can result from a hearing problem, a problem with the central nervous system or brain, a problem with the larynx, throat, mouth or nose, difficulty understanding the meaning of words and sentences (receptive language abilities), difficulty expressing ideas in words and sentences (expressive language abilities) or simply from a lack of communication with parents and other adults. As with walking, learning to talk late may simply be a family trait. Twins who develop a special language between themselves may also be late talkers. Again, if you are at all concerned about your child, speak to your health visitor or GP. Current research indicates that early intervention and treatment can go a long way in correcting language development problems. It may help to remind yourself that the timetable for normal language development is broad, and any child can run into small roadblocks along the way. You may find your pre-schooler repeating a word several times in the middle of a sentence as a way of holding your attention as he formulates the rest of his thought (this is not the same thing as stuttering). As long as your child can speak clearly by the time he's ready for reception, he's on track. In the meantime, keep observing him and try not to worry. Also, encourage his language development wherever you can -- point to objects in books and ask him to name them and sing rhyming songs with him when you're in the car or on a walk. Talk to him as much as you can in a normal, evenly paced tone -- the most important help you can give is to model correct speech. Managements: Cornerstone for any developmental delay is the therapeutic school Early identification means early intervention
Gross motor delay and fine motor delay needs physical therapy

Speech and language therapy: the parents must communicate with the child more frequently and attempt to socialized with others Counseling and behavioral modification approach
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 Multidisciplinary approach Developmental screening should be implemented as a part of health maintenance visits REFERENCE:
http://www.healthline.com/galecontent/developmental-delay-1/2

TEACHING PLAN FOR HANDWASHING DESCRIPTION OF THE LEARNER Chris Tanoyo, 12 years of age, male, living with his parents Mr. Boy and Mrs. Virginia Tanoyo together with his siblings Clinton and Mylene at Libacong Boboc, Bokod. He is studying at Kawal Elementary School on his 6th grade. He goes to school having his pack lunch and eat with his friends and siblings in school. During the interview, they were not around since theyre in school but according to his father, it is important that his children could learn from us. LEARNING NEED Hand Washing LEARNING DIAGNOSIS Knowledge deficit: Proper hand washing related to lack of exposure. GOAL After learning-teaching process, the clients will be able to develop the necessary attitude and skill on proper hand washing and when to hand wash.

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TIME LEARNING OBJECTIVES LEARNING CONTENT TEACHING STRATEGY ALLOTMENT/ RESOURCES NEEDED METHOD OF EVALUATION

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After 20 minutes of health teaching, the client will be able to:

Give the reason for hand washing Purpose of hand washing Discussion 3 minutes Pamphlet Instant oral feedback: the client will be able to state the reason of hand washing

Enumerate the necessities in hand washing Necessities in hand washing Activity in naming materials 3 minutes Soap, running water, towel

Instant oral feedback: the client will be able to name the materials provided

Show the steps on hand washing Steps in hand washing Demonstration and Supervised Return 10 minutes Pamphlet on doing

Hands on: Proper hand washing should be demonstrated with minimal supervision
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LEARNING CONTENT

What is Hand Washing? Hand washing is the simplest and most cost effective way of preventing the transmission of infection and thus reducing the incidence of health-care associated infections. It is the process of rubbing hands creating friction using the running water and soap. Necessities in Hand Washing 1. Soap 2. Running water
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3. Hand towel Benefits of Hand Washing 1. Prevents contamination 2. Prevents occurrence of sickness 3. Clean hand Steps in Hand Washing 1. Prepare for hand washing Remove jewelry (rings, bracelets) and watches before washing hands, Ensure that the nails are clipped short Roll the sleeves up to the elbow. 2. Wet hands and wrist 3. Lather soap and scrub hands well, palm to palm. 4. Scrub in between and around finger. 5. Scrub back of each hand with palm of other hand. 6. Scrub fingertips of each hand in opposite palm. 7. Scrub each thumb clasped in opposite hand. 8. Scrub each wrist clasped in opposite hand. 9. Rinse thoroughly under running water. 10. Pat hands dry with paper towel/ hand towel. 11. Turn off water using same paper towel/ hand towel.

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When to hand Wash 1. Before and after eating or handling food 2. Before playing with a group media 3. After blowing nose, coughing, sneezing, or putting hands in the mouth 4. After using the toilet 5. After handling garbage 6. After handling uncooked food 7. After playing outdoors or in sand 8. After playing with pets or animals 9. Whenever they look or smell dirty 10. After visiting relatives/ friends who are sick

TEACHING PLAN FOR COUGH AND COLDS DESCRIPTION OF THE LEARNER June 15, 2010, we do ocular survey to Kawal and June 23, 2010 when we coordinated at the principal of Kawal Elementary School. The school principal verbalized need for health teaching about cough and colds to the students ages 7-12 years old. LEARNING NEED How to prevent occurrences of cough and colds.

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LEARNING DIAGNOSIS Knowledge Deficit: occurrences of cough and colds management relayed to lack of knowledge manifested by verbal responses. GOAL After the teaching-learning process, the clients will be able to develop the necessary attitude & knowledge on how to prevent cough and colds.

TIME LEARNING OBJECTIVES Upon completion of health teaching, clients will be able to:
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LEARNING CONTENT

TEACHING STRATEGY

ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

1. Define on their own words what is cough and colds. 2. Briefly discuss the causes of cough and colds. 3. Enumerate possible ways on how to prevent cough and colds. 4. Demonstrate proper hand washing.

Definition of cough and colds.

Lecture

2 minutes

Instant oral feedback: The clients define cough and colds in their own words.

Causes of cough and colds.

Lecture

5 minutes

Instant oral feedback: The clients discuss causes of cough and colds.

Ways to prevent cough and colds.

Lecture

5 minutes

Instant oral feedback: The clients enumerated ways to prevent cough and colds.

Steps of proper hand washing. a. Wet hands with water b. Apply soap c. Scrub backs of hand, wrists, between

Lecture and demonstration

10 minutes

Instant oral feedback and demonstration: The clients demonstrated proper hand washing.

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fingers, and under fingers. Scrub for 20 seconds. d. Rinse with water e. Towel dry 5. Identify nonpharmacologic management of cough and colds. 6. Briefly discuss how colds if already acquired. Management of cough Lecture 2 minutes Instant oral feedback: The client discuss how to manage cough and colds if already acquired. to manage cough and and colds. Non- pharmacologic management of cough and colds. Lecture 2 minutes Instant oral feedback: The clients identify non-pharmacologic management of cough and colds.

LEARNING CONTENT Definition of cough and colds.

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The common cold is a viral infection, characterized by nasal congestion, a clear, runny nose, sneezing, scratchy throat and general malaise. Cough is a forceful release of air from the lungs that can be heard. Coughing protects the respiratory system by clearing it of irritants and secretions.

Causes of cough and colds. Changes in temperature, humidity and rainfall patterns influence the growth of viruses and fungi. This increases the risk of the spread of infectious diseases such as cough and colds. Cough and colds are commonly spread through bacteria- or virus-infected droplets coughed or sneezed into the air. Practice good hand washing techniques. Wash in warm or hot running water. Use soap. Keep away from crowded places during cough and cold epidemics. Frequent hand washing can reduce your chances of getting a cough or colds. Ways to prevent cough and colds.

Steps of proper hand washing. a. Wet hands with water b. Apply soap c. Scrub backs of hand, wrists, between fingers, and under fingers. Scrub for 20 seconds. d. Rinse with water e. Towel dry Non- pharmacologic management of cough and colds. Drinking lots of liquids can help you recover from a cold. Fluids help keep mucus more liquid and help prevent ear infections, bronchitis and other complications. Management of cough and colds.

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It's better to blow your nose with a tissue than a handkerchief, as long as you use the tissue only once. Coughing on a tissue is preferred likewise. Water therapy.

TEACHING PLAN FOR DIARRHEA DESCRIPTION OF THE LEARNER The clients are the Grade 4 pupils of Kawal Elementary School Bokod,Benguet. They claim that they want to know information about Diarrhea regarding its symptoms, causes and prevention. The clients are able to speak and understand Ibaloi and Ilokano. None of them has a hearing and visual problem. They prefer one- one lecture discussion. LEARNING NEED Information about the symptoms, causes and prevention of Diarrhea LEARNING DIAGNOSIS Knowledge Deficit regarding the symptoms, causes and prevention of diarrhea GOAL
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The clients will be able to know the Symptoms, causes and prevention diarrhea

LEARNING OBJECTIVES Upon discussion of the topic about Diarrhea the clients will be able to: 1. Define and

LEARNING CONTENT

TEACHING STRATEGY

TIME ALLOTMENT/ RESOURCES NEEDED

METHOD OF EVALUATION

Definition and causes of Diarrhea

One- one lecture discussion. Provide hand outs

2-3 minutes discussion about diarrhea ant its causes

Instant Oral feedback: The clients will state correctly the definition
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state at least 3 causes of

diarrhea.

of diarrhea and its causes

2.

symptoms of Symptoms of diarrhea

One- one lecture discussion. Provide hand outs

3 minutes discussion about the symptoms of diarrhea

Recitation: The client will state at least 3 symptoms of Diarrhea

diarrhea

3.

State the

Complications of diarrhea

One- one lecture discussion. Provide hand outs

3-4 minutes about the complications of diarrhea

Recitation: The clients will give the possible complication of diarrhea.

possible complications of diarrhea

4.

State ways

Ways to prevent Diarrhea

One- one lecture discussion. Provide hand outs

5 minutes discussion about the ways on how to prevent diarrhea.

Recitation: The clients will state the ways on how to prevent diarrhea

on how to prevent diarrhea

LEARNING CONTENT
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What is diarrhea? Diarrhea is loose, watery stools. A person with diarrhea typically passes stool more than three times a day. People with diarrhea may pass more than a quart of stool a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own without special treatment. Prolonged diarrhea persisting for more than 2 days may be a sign of a more serious problem and poses the risk of dehydration. Chronic diarrhea may be a feature of a chronic disease. Causes of Diarrhea Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease. A few of the more common causes of diarrhea include the following:
Bacterial infections - Several types of bacteria consumed through contaminated food or water can cause diarrhea Food intolerances -Some people are unable to digest food components such as artificial sweeteners and lactosethe sugar

found in milk.
Parasites - Parasites can enter the body through food or water and settle in the digestive system. Intestinal diseases- Inflammatory bowel disease, colitis, Crohns disease, and celiac disease often lead to diarrhea.

Symptoms of Diarrhea Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

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Complications of Diarrhea
Dehydration occurs when there is excessive loss of fluids and minerals from the body due to diarrhea, with or without

vomiting. Electrolytes (minerals) also are lost with water when diarrhea is prolonged or severe, and mineral or electrolyte deficiencies may occur. Ways to prevent Diarrhea

Practice good hand-washing hygiene, especially when you are around a group of children, or after using public bathrooms or shopping. Wash your hands after you have a bowel movement, or after wiping up your children after theirbowel movements. It's possible to spread bacteria.

Wash fruits and vegetables thoroughly before eating. Cook food thoroughly, especially meat. Avoid foods that have a tendency to loosen bowels, like the sorbitol found in many diet Practice good stress management if your diarrhea is caused by anxiety. Read your medication labels carefully. If one of the side effects is diarrhea, check with your physician about changing medications

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TEACHING PLAN ON URINARY TRACT INFECTION DESCRIPTION OF THE LEARNER UTI is a common illness experienced by the higher years of the Elementary School of Kawal, particularly Grades 4, 5 and 6, according to Mr. Johnny Bugnay, the school principal. He noted he wanted the students to be taught about UTI to make them aware and to prevent the occurrence of such illness since they are not familiar to it, especially to those who did not experience it yet. The students can understand, speak and read Ibaloi and Ilocano, and for some, English. They and the student nurses, themselves, chose Ilocano as a medium of instruction since it is the common dialect understood. Moreover, there are no problems that may affect learning of the topic. The students, as well as the student nurses, favored lecture discussion as a teaching strategy to better understand the topic and to gain active participation from the students. LEARNING NEED The Preventive measures for Urinary Tract Infection LEARNING DIAGNOSIS Knowledge Deficit: Preventive Measures for Urinary Tract Infection related to lack of exposure GOAL The pupils will gain necessary attitude, knowledge and skills on the prevention of Urinary Tract Infection.

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TIME LEARNING OBJECTIVES Upon completion of the topic on the Urinary Tract Infection, the client will be able to: LEARNING CONTENT TEACHING STRATEGY ALLOTMENT/ RESOURCES NEEDED METHOD OF EVALUATION

Describe Urinary Tract Infection

Urinary Tract Infection

Lecture discussion to the whole class with visual aids

3 minutes Visual aids

Instant oral feedback: The client will correctly describe what Urinary Tract Infection is.

Enumerate at least 3

Risk Factors of

Lecture

3 minutes

Instant oral feedback:

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causes of Urinary Tract Infection

Urinary Tract Infection

discussion to the whole class with visual aids Lecture discussion to the whole class with visual aids

Visual Aids on pictures showing the habits/ causes 2 minutes

The client will enumerate at least 3 causes of Urinary Tract Infection. Instant oral feedback: The client will enumerate the signs and symptoms of Urinary Tract Infection.

Enumerate Signs and Symptoms of Urinary Tract Infection

Signs and Symptoms of Urinary Tract Infection

Visual Aids

Preventive Measures for Urinary Tract Infection

Lecture discussion to the whole class with visual aids

5 minutes Visual Aids on pictures showing preventive measures

Instant oral feedback: The client will enumerate the preventive measures for Urinary Tract Infection

Enumerate the preventive measures for UTI.

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LEARNING CONTENT Urinary Tract Infection

A urinary tract infection (UTI) is an infection involving the kidneys, ureters, bladder, or urethra. These are the structures that urine passes through before being eliminated from the body. Urinary tract infections are much more common in adults than in children, but about 1%-2% of children do get urinary tract infections. Urinary tract infections in children are more likely to be serious than those in adults and should not be ignored. Urinary tract infection is the most common urinary tract problem in children besides bedwetting. Urinary tract infection is second only to respiratory infection as the most common type of infection. These infections are much more common in girls and women than in boys and men younger than 50 years of age. The reason for this is not well understood, but anatomic differences between the genders (a shorter urethra in women) might be partially responsible.

Causes: The urine is normally sterile. An infection occurs when bacteria get into the urine and begin to grow. The infection usually starts at the opening of the urethra where the urine leaves the body and moves upward into the urinary tract.

The culprit in at least 90% of uncomplicated infections is a type of bacteria called Escherichia coli, better know as E. coli. These bacteria normally live in the bowel (colon) and around theanus.
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People with conditions that block (obstruct) the urinary tract, such as kidney stones People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury or bladder decompensation after menopause) People with suppressed immune systems: Examples of situations in which the immune system is suppressed are AIDS and diabetes. People who takeimmunosuppressant medications also are at increased risk. Young children: Young children have trouble wiping themselves and washing their hands well after a bowel movement. Poor hygiene has been linked to an increased frequency of urinary tract infections. Children of all ages: urinary tract infection in children can be (but is not always) a sign of an abnormality in the urinary tract, usually a partial blockage. An example is a condition in which urine moves backward from the bladder up the ureters (vesicoureteral reflux).

Urinary Tract Infection Symptoms: Lower urinary tract infection (cystitis): The lining of the urethra and bladder becomes inflamed and irritated.

Dysuria: pain or burning during urination Frequency: more frequent urination (or waking up at night to urinate); often with only a small amount of urine Urgency: the sensation of not being able to hold urine Hesitancy: the sensation of not being able to urinate easily or completely (or feeling that you have to urinate but only a few drops of urine come out)

Cloudy, bad-smelling, or bloody urine Lower abdominal pain

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Mild fever (less than 101 F), chills, and "just not feeling well" (malaise) Upper urinary tract infection (pyelonephritis): Symptoms develop rapidly and may or may not include the symptoms for a

lower urinary tract infection.

Fairly high fever (higher than 101 F) Shaking chills Nausea Vomiting Flank pain: pain in your back or side, usually on only one side at about waist level In newborns, infants, children, and elderly people, the classic symptoms of a urinary tract infection may not be present. Other

symptoms may indicate a urinary tract infection.

Newborns: fever or hypothermia (low temperature), poor feeding, jaundice Infants: vomiting, diarrhea, fever, poor feeding, not thriving Children: irritability, eating poorly, unexplained fever that doesn't go away, loss of bowel control, loose bowels, change in urination pattern

Urinary Tract Infection Prevention: Women and girls should wipe from front to back (not back to front) after going to the bathroom. This helps prevent bacteria from the anus entering the urethra. Empty your bladder regularly and completely, especially after sexual intercourse.
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Drink plenty of fluids. Cranberry juice, especially, has been shown to help prevent urinary tract infections. There is evidence that cranberries reduce the risk of the bacteria's adhesion to bladder cells. Reduce intake of sodium- rich foods. Wear cotton undergarments, which allow air circulation and discourage the warm, moist environment needed for bacteria growth. Nylon pantyhose should have a cotton crotch

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TEACHING PLAN FOR HYPERTENSION DESCRIPTION OF THE LEARNER Mellita Carap, 74F, the caretaker of Anita Carap, resides in 0175 Kawal, Bobok-Bisal, Bokod with her daughters Anita and Jenette; sons Gil and Geoffrey; and granddaughter Regyne, daughter of Jenette. Mellita is a farmer and a caretaker at the same time. Upon assessment, Mellitas blood pressures were high ranging about 160-180 as the systole and 80 as the diastole. Mellita has also blurred vision but claims not to feel headache or dizziness. During the blood pressure taking, Mellita told shes really hypertensive and that she goes to the barangay health station sometimes because the barangay health worker might be lazy in going to their place because of the distance from barangay health station. She, however, explained that she is eating garlic to reduce her BP, with no maintenance medications being taken in. Moreover, Anita, 55, her daughter, is blind and right-body paralyzed. When trying to light her eyes, her eyes were not reactive to light. She has stiff extremities. She is also hypertensive with last BP taken of 140/90 mmHg. When getting the blood pressure of Anita, she usually withdraws her arms due to pain experienced when the BP cuff is inflated. On further assessment of Anita, she can do things on her own such as walking towards the kitchen and urinating alone in her own chamber. She answers questions but not that clear. She has poor hygiene due to her situation. She has long fingernails and toenails. She has also halitosis. There are also portions of her skin that are near to break, such as those located in her hands and in her back (like bedsores). LEARNING NEED: How to prevent hypertension LEARNING DIAGNOSIS Knowledge Deficit: Hypertension related to treatment regimen and control of disease process GOAL After 2 hours (1 hour per day for two days) of nursing interventions patient Mellita will be able to understand of the condition. LEARNING TIME ALLOTMENT/ METHOD OF

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LEARNING OBJECTIVES Upon completion of the nursing interventions, the learner will be to: 1. Maintain blood pressure at less than 140/90 mmHg with lifestyle modifications Lifestyle modificati ons CONTENT

TEACHING STRATEGY RESOURCES NEEDED EVALUATION

One on one lecture Discussion Story telling

30 minutes- interest and willingness, time and effort of both the nurse and learner. Handouts, PHN book

Goal partially met: The patient was not able to maintain blood pressure at less than 140/90 mmHg even with lifestyle modifications.

Needs to be monitored still

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1. Adhere to the dietary regimen: reduce calorie, sodium, and fat intake; increase fruit and vegetable intake. 1. Abstain from coffee intake

Dietary manageme nt on hypertensi on

One on one lecture Discussion Examples

30 minutes- interest and willingness, time and effort of both the nurse and learner.

Goal met: The patient adhered to the dietary regimen. She reduced the intake of salt and fat.

Complicat ions of coffee intake

One on one lecture Discussion Story telling

15minutes- interest and willingness, time and effort of both the nurse and learner.

Goal met: The patient abstained from coffee intake.

1. Maintain pulse rate and respiratory rate within normal ranges.

Complicat ions of hypertensi on

One on one lecture Discussion

15 minutes- interest and willingness, time and effort of both the nurse and learner.

Goal partially met: The patient didnt maintain pulse rate and respiratory rate within normal ranges. She needs to be monitored.

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1. Exhibit no complications

Complicat ions of hypertensi on

One on one lecture Discussion Question and answer

30 minutes- interest and willingness, time and effort of both the nurse and learner, handout, pictures

Goal partially met: The patient has no dizziness and headache but has high BP.

LEARNING CONTENT Hypertension or High Blood Pressure is a medical condition in which constricted arterial blood vessels increase the resistance to blood flow, causing an increase in blood pressure against vessel walls. The heart must work harder to pump blood through the narrowed arteries. If the condition persists, damage to the heart and blood vessels is likely, increasing the risk for stroke, heart attack, and kidney or heart failure. Often called the silent killer, hypertension usually causes no symptoms until it reaches a life-threatening stage. Blood pressure is classified in four categories: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Normal blood pressure in an adult is less than 120/80 mm Hg, in which 120 describes systolic pressure and 80 describes diastolic pressure.
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Prehypertension is defined as a systolic pressure of 120 to 139 mm Hg or a diastolic pressure of 80 to 89 mm Hg. People with prehypertension are likely to develop hypertension at some point during their life. Stage 1 hypertension is defined as a systolic pressure of 140 to 159 mm Hg or a diastolic pressure of 90 to 99 mm Hg. Stage 2 hypertension is defined as 160/100 mm Hg or higher. Development of Hypertension: Two factors determine blood pressure: the amount of blood the heart pumps and the diameter of the arteries receiving blood from the heart. When the arteries narrow, they increase the resistance to blood flow. The heart works harder to pump more blood to make sure the same amount of blood circulates to all the body tissues. The more blood the heart pumps and the smaller the arteries, the higher the blood pressure. The kidneys play a major role in the regulation of blood pressure. Kidneys secrete the hormone renin, which causes arteries to contract, thereby raising blood pressure. The kidneys also control the fluid volume of blood, either by retaining salt or excreting salt into urine. When kidneys retain salt in the bloodstream, the salt attracts water, increasing the fluid volume of blood. As a higher volume of blood passes through arteries, it increases blood pressure. Risk factors that may contribute to elevated blood pressure in some people include a diet high in salt, physical inactivity, obesity, and heavy alcohol consumption. Included also are family history, advancing age, and race. Complications: Increased pressure on the inner walls of blood vessels makes the vessels less flexible over time and more vulnerable to the buildup of fatty deposits in a process known as atherosclerosis. Weakened portions of the blood vessel wall may balloon, forming an

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aneurysm. If an aneurysm ruptures, internal hemorrhaging (bleeding) results. Both atherosclerosis and a ruptured aneurysm in the brain can lead to a stroke. Hypertension forces the heart to work harder to pump adequate blood throughout the body. This extra work causes the muscles of the heart to enlarge, and eventually the enlarged heart becomes inefficient in pumping blood. An enlarged heart may lead to heart failure, in which the heart can not pump enough blood to meet the bodys needs. Increased blood pressure may damage the small blood vessels within the kidney. The kidney then becomes unable to filter blood efficiently, and waste products may build up in the blood in a condition known as uremia. Without medical treatment, kidney failure will result. Treatment: Physicians recommend that people with prehypertension undergo diet and lifestyle changes, such as losing weight and quitting smoking, in order to prevent a rise in blood pressure. Some patients can lower their blood pressure by limiting salt in their diet. Increasing physical activity and reducing alcohol consumption to less than two drinks per day for men and one drink per day for women may also lower blood pressure. For those with stage 1 and stage 2 hypertension, a physician may prescribe diet and lifestyle changes, as well as one or more drugs known as antihypertensives. Diuretics are antihypertensives that promote excess salt and water excretion, reducing the amount of fluid in the bloodstream and relieving pressure on blood vessel walls. Beta blockers reduce heart rate and the amount of blood the heart pumps. ACE inhibitors prevent the narrowing of blood vessel walls to control blood pressure. Calcium channel blockers slow heart rate and relax blood vessels. Studies show that two drugs are more effective than one drug at lowering blood pressure to less than 140/90 mm Hg.

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DASH DIET The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan designed to prevent and treat hypertension. Funded by the United States government, this diet was developed and tested at several major medical centers. The effectiveness of the diet in reducing hypertension was reported in the April 17, 1997, issue of the New England Journal of Medicine. The DASH diet is rich in fruits, vegetables, and dairy products that are low in total and saturated fat. DASH also includes portions of meat, poultry, and fish, providing ample protein. In addition DASH provides large amounts of fiber, potassium, calcium, and magnesium. Based on their experience prescribing the diet, the scientists who developed the DASH diet offer these tips:

Start small. Make gradual changes in your eating habits. Center your meal around carbohydrates, such as pasta, rice, beans, or vegetables. Treat meat as one part of your whole meal, instead of as the main course. Use fruits or low-fat, low-calorie foods such as sugar-free gelatin for desserts and snacks. The DASH experts add: Remember! If you use the DASH diet to help prevent or control high blood pressure, make it part of a lifestyle that includes choosing foods lower in salt and sodium, keeping a healthy weight, being physically active, and, if you drink alcohol, doing so in moderation.

CAFFEINE Caffeine, an alkaloid (C8H10O2N4H2O) found in coffee, tea, cacao, and some other plants. It is also present in most cola beverages. Caffeine was discovered in coffee in 1820. In 1838 it was established that theine, discovered in tea in 1827, is identical to caffeine. The drug increases the blood pressure, stimulates the central nervous system, promotes urine formation, and stimulates the action of the heart and lungs. Caffeine is used in treating migraine because it constricts the dilated blood vessels and thereby reduces

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the pain. It also increases the potency of analgesics such as aspirin, and it can somewhat relieve asthma attacks by widening the bronchial airways. Caffeine is produced commercially chiefly as a byproduct in making caffeine-free coffee. Caffeine has been suggested as a possible cause of cancer and of birth defects. No studies, however, have yet confirmed any of these charges.

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TEACHING PLAN FOR HYGIENE DESCRIPTION OF THE LEARNER The learners are the children of Mr. and Mrs Pepito Saoyao, they are currently residing at Lower Kawal, Bokod, Benguet. Some of them are elementary students but some are out of school. They are physically fit with no known deformities. Their musculoskeletal abilities are good and no known sensory deficits. They can speak and understand Ibaloi and Ilocano. The mother verbalized that they are difficult to discipline regarding hygiene and added that she would appreciate if we talk to them regarding the said matter. LEARNING NEED Understanding of the child, of the importance and ways of maintaining good personal hygiene. LEARNING DIAGNOSIS Knowledge Deficit: importance and ways of maintaining good personal hygiene GOAL The client will apply in their activities of daily living the ways to maintain good hygiene

LEARNING

TIME

METHOD OF
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LEARNING OBJECTIVES After the lecture and demonstration of the topic on personal hygiene, the client will be able to: 1. Define in own word what is hygiene. Definition and importance of hygiene in simple words using Ilocano CONTENT

TEACHING STRATEGY

ALLOTMENT/ RESOURCES NEEDED EVALUATION

One-on-one lecture

2 minutes - Booklet prepared which includes definition in Ilocano -time, effort and cooperation of the student nurse and the learners -Knowledge of the student nurse

Instant oral feedback: the learners will accurately answer the questions about the importance of hygiene

2. Enumerate ways to maintain good

Discussion of enumerated ways

One-on one lecture with illustrations

15 minutes

Instant oral feedback: the learners will be able to

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hygiene and how to do it

of maintaining good hygiene

and demonstrations

enumerate ways of maintaining good hygiene Return demonstration: the learners will demonstrate to the student nurse the proper hand washing.

LEARNING CONTENT Good Personal Hygiene Iti good hygiene ket importante tapno maiwasan iti sakit, aytoy ket naglaon ti pagmintenar iti nalinis nga bagi. 1. Pag-alaga iti Buok

Washing: Digusin iti buok kada , makalipas ti maysa nga aldaw, tapno maikkat iti rugit nga dumket ken maiwasan iti pinagdadael iti buok. Cutting: Nu atiddog unayen iti buok, mayat nga ipapukis tapno haan ng araken iti kuto wenno isupay nga makaalaan iti rugit.

1. Pag-alaga iti ngipin Brushing: pinirmi ng narugit iti ngewat isu nga pinirmi nga agsipilyo maminduwa wenno mamin tallo ti maysa nga aldaw tapno haan ng madadael iti ngipin. 1. Pag-alaga iti pisikal ng bagi
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Bathing: Agdigos maminsan kada aldaw tapno malinisan iti rugit nga naala ti pinagayayam. Nu nalinis iti bagi, awan ti gagatel nga haan ng agpaturog wenno makaalaan iti sugat. Trimming Nails: Ti kuko ket narugit la unay, tila maigiggaman nu agayayam ti ubing. Pinirmi da met nga isubo iti ima da isu nga kailangan mapututan iti kuko da, tapno haan nga sumeksek iti rugit. Hand washing: narugit iti ima isu nga dapat pinirmi nga aggugas tapno makaiwas iti sakit kasla, diarrhea o sakit iti tiyan.

REFERENCE: http://www.hygiene.com/article/good personal hygiene/tips

Shryock, Shryock, Modern Medical Guide,Pacific Press Publishing association, 1999

TEACHING PLAN FOR PROPER SANITATION DESCRIPTION OF THE LEARNER

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The Palos Family is a nuclear type of family which is composed of Mr. Douglas, 48 years old, Mrs. Cornelia, 45 years old and their son Elton John, 7 years old. The family resides in a small community of Otbong Boboc Bisal Bokod Benguet. They owned a wooden house with 3 rooms but only one room is used for sleeping purposes. The entrance to their house is a narrow stairs without rails. While Mrs. Cornelia was cooking, the student nurse observed that the peelings of the potatoes were left inside the plastic which is open and was surrounded with flies. According to the client they usually eat vegetables which they gather in their farm. The water they used for household purposes and for drinking comes from the spring through the faucet. The mother wants to learn more about keeping the familys health by providing proper sanitation. They speak Ilocano, Ibaloi and Tagalog. LEARNING NEED To improve knowledge on maintaining the health of the family through proper sanitation LEARNING DIAGNOSIS Knowledge deficit: Proper Environmental Health and Sanitation related to lack of information on proper interventions. GOAL The client will have a healthy sanitation habit and limit the cause of possible diseases

LEARNING OBJECTIVE

LEARNING CONTENT

LEARNING STRATEGIES/

TIME ALLOTMENT AND RESOURCES

EVALUATION

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ACTIVITIES After 15 minutes of teaching session, the clients would be able to: 1. Explain the importance of environmental health and sanitation. Implementation (PD 856, 1978) Sanitation related diseases Pneumonia Tuberculosis Intestinal parasitism Schistosomiasis Malaria Infectious hepatitis Filariasis Dengue Hemorrhagic Fever One-on-one lecture discussion

NEEDED

2 minutes Hand-out

Instant oral feedback: explain the importance of environmental health and sanitation in own words.

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2. Enumerate and explain the 4 rights in food safety 3. Verbalize the importance of water supply sanitation

Importance of Food sanitation program. The Four Rights in Food safety: Right source Right Preparation Right cooking Right storage

One-on-one lecture discussion

5 minutes Hand-out

Instant oral feedback: the client will enumerate and explain the 4 rights in food safety.

Importance of water Correct water boiling time.

One-on-one lecture discussion

5 minutes Hand-out

Instant oral feedback: the client will verbalize the importance of water supply sanitation.

4. Demonstrate ways to prevent potential injury on the presence of accident hazard.

Possible health risk on the presence of health hazard. Ways to prevent the risk.

One-on-one lecture discussion

3 minutes Hand-out

Observation, Oral feedback and question and answer

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LEARNING CONTENT The Department of Health, through the EOHO, has authority to act on all issues and concerns in environment and health including the very comprehensive Sanitation Code of the Philippines (PD 856, 1978). Environmental health and Sanitation is still a health problem in the country. Diarrheal diseases ranked the first in the leading causes of morbidity among the general population. Other sanitation diseases are pneumonia, tuberculosis, intestinal parasitism, schistosomiasis, malaria, infectious hepatitis, filariasis and dengue hemorrhagic diseases which are controlled and/are eradicated by health programs and environmental sanitation components but still afflicting a great number of people. Food Sanitation Four Rights in Food Safety: 1. Right Source Always buy fresh meat, fish, fruits and vegetables. Avoid buying canned foods with dents, bulges, deformation, broken seals and improper seams. 1. Right Preparation Avoid contact between cooked foods and raw foods. Wash vegetables well if to be eaten raw. Always wash hands and kitchen utensils before and after preparing foods. Sweep kitchen floors to remove food droppings to prevent the harbor of rats and insects. 1. Right Cooking Eat cooked food immediately. Wash hands thoroughly before and after eating.
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1. Right Storage Store cooked foods carefully. Be sure to use tightly sealed containers for storing food. Reheat stored food before eating. Rule in Food safety: When in Doubt, throw it out! Water Sanitation Importance of water Think about the different ways you use water. You drink water when you are thirsty. You take a bath and wash your clothes with water. You water the grass or other plants. You swim in water. Water pouring over huge dams may even make the electricity that lights up your home. About three-quarters of Earths surface is water. Living things are mostly made up of water. Without water, there would be no life on Earth. Correct water boiling time According to Wilderness Medical Society, water temperatures above 160 F (70 C) kill all pathogens within 30 minutes and above 185 F (85 C) within a few minutes. So in the time it takes for the water to reach the boiling point 100 C from 70 C, all pathogens will be killed, even at high altitude. REFERENCES: Public Health Nursing in the Philippines
http://www.survivaltopics.com/survival/how-long-do-you-need-to-boil-water/

Microsoft Encarta 2009. 1993-2008 Microsoft Corporation. All rights reserved.

DOCUMENTATION
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GROUP M1

M1 on their way to Sitio Otbong and passing thru the hanging bridge

Blood Pressure Taking

Wound cleaning of a 5 year-old child, Ellaine Joy Aquisan hit by a bicycle

204

Assessment of Client with Goiter School Health Teaching on Hygiene and Nutrition at Otbong Primary School

205

Student Nurses Improved and Cleaned Kawal Elementary Schools Herbarium

Community Immersion during the Burial of Mrs. Dominga Arinos Mr. Indalos delivering his Eulogy

206

Meeting Old Community Folks Attending the Ceremony

Witnessing the Ibaloi Way of Culture in Butchering Pigs

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GROUP M2 Home Visit: Diano Family Physical Assessment

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Home Visit: Confisal Family

Beautification of Kawal Elementary School

209

Herbarium Removing the weeds and, Replanting and regrouping the plants

210

Placing the Foundation of the Fence

Fencing of the Herbarium

211

Putting up the sign and Aftercare

GROUP M3

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Courtesy call with Hon. Mauricio Macay, Mayor-Elect of Bokod at Bokod Municipal Hall

Courtesy call with the Municipal Health Officers (sitting is MHO Dra. Lilian Velasco)

Courtesy Call and Retrieving Data from Bisal-

Boboc Midwife Catalina Segundo

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Blood pressure monitoring on community folks

Ocular Survey with Clinical Instructor Mr. Jaylord Indalos

Working on with Kawal Elementarys Herbarium

214

Promoting Hygiene of Unable Client

Conduction of Family Survey with Barangay Health Worker Irene Pacya

School Health Teaching

215

M3 at Kawal Elementary School GROUP M4 Sitio Bisal

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Home Visit

Hanging Bridge Experience

Courtesy Call to Bobok Bisal c/o Kapitans wife Sitio Mangagew

217

Hiking to Mangagew

Bolo Elementary School Sitio Kawal

Coordinating with Teachers at Kawal Elementary School Sitio Otbong

218

Sitio Libacong

Oath taking and Turn over Ceremony

219

School Health Teaching on Proper Hygiene

220

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SPOTMAP

222

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