Transcript Lecture One - Home - KSU Faculty Member websites

SUBJECT: NURSING & HEALTH
CARE
PREPARED BY
: DR
.SAHAR ABD El HAMEED
ACADEMIC YEAR : 1429- 1430.
SEMESTER
: 1‘ST
SEMESTER.
LEVEL
: 1'ST
LEVEL.
LECTURE' ALLOCATION :
MONDAYFROM: 10-12 AM
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*Health
*Community
*Community Health Nursing
* Primary Health Care
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Health: It is a state of complete physical, mental ,
social and psychological wellbeing .
Healthy person is the person who has complete
physical , mental, social and psychological wellbeing ,
free from all diseases and his body systems working
with complete competency.
Community :It is a group of people who have one or
more personal or environmental characteristics.
Community Health Nursing.
It is the practice of promoting and protecting the health
of population using knowledge of nursing and public
health sciences
Primary health care .
It is the science that aimed for promotion of health ,
prevention of diseases and offering health services to
satisfy that aim .
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Factors affecting the health of individuals
and communities .
1.Intrauterine factors .
a- Malnutretion of the mother .
b- Infectious diseases during pregnancy .
c- Misuse of drugs during pregnancy .
d- Exposure to x rays during pregnancy .
e- Hereditary &chromosomal defects .
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2. Extrauterine factors
a –Malnutrition .
b –Environment .
c –Accidents .
d –Exposure to infectious diseases at early
childhood .
e –Social and cultural factors .
f-Believes and traditions .
g –Economy .
h –Religion
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Community Health Team
-Medical personnel . ( family health physicians
,nurses ,pharmacists)
-Para -medical personnel .( maintenance workers ,
food sanitation , social workers , counseling
personnel ) .
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ELEMENTS OF PRIMARY HEALTH CARE .
1 – HEALTH EDUCATION .
2- VACCINATION AGAINST INFECTIOUS
DISEASES .
3- MATERNAL-CHILD HEALTH .
4- CONTROL OF CHRONIC & ENDEMIC
DISEASES .
5- NUTRITION &FOOD SANITATION .
6 – ENVIRONMENTAL SANITATION .
7- TREATMENT OF COMMON DISEASES &
INJURIES .
8 – PROVISION OF ESSENTIAL DRUGS .
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ROLE OF COMMUNITY HEALTH NURSE .
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As community health nurse is one of important health team
members she has to take an active role in the following :
1.Health education of individuals , families & communities .
2 .Vaccination of children & public against infectious diseases
.*
3.Maternal & child health .
-Premarital care .
-Prenatal ,natal ,post natal care of mothers .
-Care of infants & children .
--Care of elderly people
-Care of children with special needs & handicapped persons .
-Participate in prevention & control of communicable disease.
( vaccination ,isolation & treatment
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Primary Health care
Levels & Elements.
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Primary Health Care
Definition….
Primary Health Care is the science that aimed for
health promotion of individuals & communities
through prevention of diseases, early detection ,
control & treatment of diseases , provision of health
education & health services which aimed to improve
health status & creates healthful living for
individuals & communities
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Levels of prevention
1. Primary prevention.
2. Secondary prevention.
3. Tertiary prevention.
4. Restorative preventiion
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1 .Primary prevention.
Primary prevention deals with promotion of health,
protects against threats to health . It keeps the
problem from occurring. It is implemented before
the problem develops .It deals with well
population
Primary prevention is accomplished by:
-Immunization.
-Sanitary environment.
-Health Education
-Avoidance of exposure to risk factors.
-Chemoprophylaxis & seroprophylaxses
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2 . Secondary Prevention.
Secondary prevention detects & treats the problem at
early stages. It keeps the problem from causing
serious or long term effects or from affecting others It
is implemented after a problem has begun .It's aim is
to cure the patient & to reduce the complications .
Secondary prevention can be accomplished by:
1-Screening of high risk groups .
e . g ) *urine analyses of school age children to detect
DM .
* Mass radiography for detection of TB.
*Papenculuea smear to detect cancer cervix .
2-Periodic physical Examination.
(e. g) –Measurement of nutritional status of children to
discover mal nutritional diseases.
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3 .Tertiary prevention .
It limits further negative effects of the problem , it 
keeps existing problem from getting worse , it
alleviate the effects of the disease & injury & restore
the individual's optimum level of functioning , it is
implemented after a disease or injury has occurred
Tertiary could be accomplished through: 
-Physiotherapy in cases of poliomyelitis. 
-Training a blind person a useful work to achieve 
income.
-Keep bl.sugar level under control in DM by drugs or
diet.
-Use radiotherapy or chemotherapy in case of 
cancer...

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4 .Restorative Prevention
It aimed to restore optimum level of functioning
after the problem has been occurred.
Restorative prevention could be
accomplished through:
- Follow up care.
- Long term care.
- Rehabilitation.
- Chronic care.
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Elements of Primary Health Care
1-Health Education.
2- Vaccination against infectious diseases.
3- Control & treatment of chronic, endemic &
communicable diseases.
4- Nutrition & Food Sanitation.
5-Environmental Sanitation.
6- Treatment of common diseases & injuries.
7-Maternal child Health.
8- Provision of essential drugs
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First Element
Health Education.
Definition.
Health education is defined as Translation of
health facts & information to correct healthful
behavioral patterns or attitudes on a level of
individual, families & communities.
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Purposes of health education.
-Promote healthful behavior.
-protect health.
-Strengthen community prevention.
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Routes o learning
People learn in three ways:
1. Visually.
2 .Auditory.
3 .Kinesthetically. (By actually performing a
task or handling items)
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Domains of learning.
1 . cognitive.
2. Affective.
Material is presented in a way to affect the
learner's believes, values & attitudes & feeling.
i. e : people must value cleanliness before you can
teach them to wash their hand
3 .psychomotor.
The learner processes the information by doing (by
carrying out the task)
All three domains are important for translation of
learning to desired behaviors.
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How to Prepare an Educational Plan
Teaching plan is apart of the care plan
In order to prepare an educational plan you have
to
follow the following steps:
1. Establish the learner's needs
2 .Prioritize the needs
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3 .State behavioral objectives
4 .Collaborate with other health professionals
involved in the process of learning
5 .Impalement the plan
-Provide quite place
-with few destructions.
-one by one or group teaching
-Keep teaching session short
-Involve the learner in the process
-Incorporate teaching in daily care
-Each on going session should begin with review of
has been learned previously(return
demonstration
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6 .Evaluation
-By obtaining feed back about the learning that
occurred
Skills --------------------- } Retuned demonstration
Information-------------- }Ask questions
- Repeat instruction if the client has not mastered
the skills & information learned.
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Second Element
Vaccination against infectious diseases
1- Definitions
A-Infection
It is the transmission of the microbe or the
causative agent from diseased person or carrier
to a healthy person by direct or indirect method
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b- Source of infection.
It is the reservoir of the microbe which cause the
disease
.
c- Causative agent
It is the microbe which has the ability to cause the
infection or secrets toxins causing the disease.
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d –Carrier
It is a human being or an animal infected
before by the microbe & did not show signs &
symptoms, carry the causative organism in his
body. Carrier could be more dangerous than the
patient him self.
E–Mode of infection
It is the routes by which infection is transmitted.
It could be
-Direct infection (without the presences of host.
-Indirect infection (where there is a host).
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f –Immunity
It is the ability of the alive body to defend the
infection & to destroy any organism fighting it.
g –Cold chain system
It is the process by which the vaccine is kept valid
since it' manufacture till it's usage by the client.
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2- Types of Immunity.
A-Natural Immunity.
-Natural Passive which transmitted from the mother
to fetus through placenta (e.g. .measles)
-Natural active which follow an exposure to some
diseases (e.g. .measles
b- Acquired Immunity
-Acquired Passive which by giving a
serum
-Acquired active which could be attained by giving
vaccine
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3. Diseases that could be prevented by
vaccination.
a- Tuberculoses.
b- Hepatitis (B)
c – Poliomyelitis
d- Diphtheria
e- Pertusses
f- Tetanus
g – Measles
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4 .Main Vaccines
a- BCG Vaccine
:
-It is administered to protect the child from tuberculoses
-It is available as a freeze dried vaccine & reconstituted just before
usage
-It is sensitive to heat & light
-The reconstituted BCG vaccine is very un stable , so it should be
used properly during one session (5-6 hours) .The residual vaccine
should be discarded at the end of the session .
-It is stored at the refrigerator of the health center at temp. of 0 -8
degree .c.
On the meddle shelf of the refrigerator
-It should be given at the day of birth & because not all children are
born in the hospital, it should be given within the first month of
life.
-Its dose is (O.1 ml) given intra dermally in the left upper arm.
-Reaction: within two weeks a small red soft tender swelling is
formed, after 2-3 weeks the swelling become abscess, ulcerates.
The ulcer heals by scaring; this scar is a sign of
vaccination
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B-Triple vaccine (DPT).
-It contains: -Diphtheria toxiod
-Pertusses killed vaccine
-Tetanus toxiod
-DPT is damaged by freezing.
-It is stored on the second shelf of the refrigerator (48degrees)
-Diphtheria &tetanus vaccines are stable vaccines
where pertusses vaccine is damaged by the sun light.
-Dose: 3 doses at the age of 2, 4, & 6 months of age.
With a booster dose at the age of 18-24 months.
-Each dose is (0.5) ml to be injected intramuscularly in
the meddle or lateral aspect of the thigh.
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C-Polio-mylitis Vaccine.
There are 2 types of polio vaccine
•Injectable (Salk)
•Oral (sabin)
-Oral vaccine is mostly used as it is more effective,stimulates
natural immunity & induces both circulatory & intestinal
resistance
-It is least heat stable vaccine
- It is kept at 0-8 degree in the health center on the top shelf of the
refrigerator
-Freezing does not damage oral polio vaccine
-Dose: For primary vaccination of infants it is given in 3 doses at the
age of 2, 4, & 6 months .Each dose is one drop ⁄ mouth
-Booster dose is given at the age of 8-24 months
-There are no contra indications for polio vaccine; however the dose
must repeated if the child spits out the drops.
- When the child has diarrhea the dose is given but not counted in
the primary 3 doses &an extra dose 4-8 weeks later is given.
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D – Hepatitis B vaccine
Two hepatitis B vaccines are available; one
is prepared from plasma of HB positive
carrier & the other which is mostly used
in many countries prepared by
recombinant DNA technology.
-Both vaccines are safe &highly protective
against hepatitis B infection.
-Hepatitis B vaccine should be protected
from being frozen.
-It is kept at 2-8 degree in the second shelf
of refrigerator.
-Dose: o.5ml given by intramuscular injection at
-
lateral aspect of the thigh.
-There are no contraindications for the vaccine
- Side effects are : Soreness & erryethema
at the site of injection .
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E – Measles Vaccine
It is a live attenuated vaccine with high efficacy, with
induction of active immunity in more than 95 % of
susceptible individual's m possibly for life.
-It is available as freeze dried vaccine, to be reconstituted
just before usage
- The reconstituted vaccine is quickly loses its potency. i.e. .
If the vaccine is stored at the room temperature foe one
hour , it loses 50% of it's potency
-Freezing does not damage the vaccine
-It is kept at 4-8 degree on the first shelf of the refrigerator
of the health center.
-Reconstituted vaccine, unused within 8 hours should be
discarded.
- Dose: 0.5ml. Subcutaneously in the Rt arm. At the age of 9
months.
-In some countries the vaccine is integrated in MMR vaccine
(Measles, mumps & rubella vaccine), it is given in one
dose at the age of 9-12 months.
-Side effects:
• Fever &rash lasting 1-2 days.
•Febrile convulsions are rarely occurring.
-
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